In human periodontal disease there is an increase in the number of mast cells that may be participating either in the destructive events or in the defense mechanism of periodontal disease via secretion of cytokines. ^[1]

Biopsy were taken of 96 periapical lesions and after appropriate immunohistochemical and staining procedures, mast cells were found in 68 (70.8%) lesions. The presence of mast cells was greater in cysts than in granulomas (P < 0.0028). These findings suggest mast cells play a role in regulation of cellular immune mechanisms in periapical lesions in inflamed periapical tissue. ^[2] 

In animal models for gingivitis and of periodontitis, there too is an increase in the number of mast cells. ^[3][4]

Mast cell hyperactivity and degranulation can be inhibited by palmitoylethanolamide. ^[5] 

In the light of such evidence it has been suggested that cannabinomimetic compounds, including palmitoylethanolamide and its congeners, could represent possible candidates for treating several chronic inflammatory diseases.^{[6] [7]}

In dentistry palmitoylethanolamide might become a new treatment option for various chronic inflammatory states, such as peridontitis and gingivitis. Furthermore, due to its analgesic effects, chronic pain might be reduced by this novel drug.  

Jan M. Keppel Hesselink, MD, PhD, January 2011 

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