5-lipoxygenase presents a functional role in apical periodontitis development through the regulation of canonic receptor activator of nuclear factor kappa-B–receptor activator of nuclear factor kappa-B ligand–osteoprotegerin osteoclastogenesis signaling.

Early on, osteoclastogenesis signaling is down-regulated by the inhibition of 5-LO, but long-term inhibition fails to prevent expression of bone catabolic mediators.

Ultimately, inhibition of 5-lipoxygenase did not prevent osteoclast formation and periapical bone resorption probably because of detrimental regulation of cytokines, chemokines, and osteopontin in early versus late apical periodontitis course.