B Cells at the Core: Immune Mechanisms and Therapeutic Potentials in Periapical Lesions.

INTRODUCTION: Periapical lesions (PLs) are common inflammatory diseases primarily caused by microbial infections within root canals. These infections trigger complex immune responses in periapical tissues, with B lymphocytes playing dual roles: defending against pathogens while also contributing to tissue damage. This highlights the crucial role of B cells in the immunological processes of PLs. METHODS: A comprehensive review of the literature on B cells in PLs was conducted using PubMed, Web of Science, Scopus, and ScienceDirect databases. RESULTS: The review included 120 studies that examined the distribution and subtypes of B cells, their dual functions in PLs, and the potential applications of B-cell-related therapies in treating apical periodontitis. CONCLUSIONS: This review enhances our understanding of the complex immune mechanisms in PLs and aids in the development of new therapeutic approaches from a B-cell perspective.