Endodontic pathogens present in teeth diagnosed with pulp necrosis and AP have been associated with the expression of mediators related to soft tissue and bone destruction in AP, such as matrix metalloproteinases (MMPs)-2 and -9, receptor activator of NFκB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). This evidence concerns the gene TNFSF11 and alkaline phosphatase measurement.