Healing of a Large Periapical Lesion and Adjacent Cortical Bone: Cone-Beam CT Aided Diagnosis and Treatment
DOI:
https://doi.org/10.12974/2311-8695.2018.06.5Keywords:
Cone beam CT, healing, nonsurgical endodontic treatment, periapical lesion.Abstract
The primary aim of root canal treatment is the resolution of clinical symptoms and radiographic signs. Periapical lesion is a crucial problem resulting in the loss of teeth. The major reason of periapical lesion associated with infected pulpal tissue are caused by pulpal inflammation and/or degeneration through deep caries, trauma, or by a combination of these parameters. Periapical lesion in teeth with root canal treatment should be initially treated with nonsurgical retreatment procedures. Small volume Cone Beam CT can be a powerful tool in endodontic diagnosis, treatment planning and follow-up. This case report presents a complete clinical and radiological healing of a large periapical lesion and adjacent cortical bone of a hopeless tooth after retreatment procedures.
References
Chugal N, Mallya SM, Kahler B and Lin LM. Endodontic treatment outcomes. Dent Clin North Am 2017; 61(1): 59-80. https://doi.org/10.1016/j.cden.2016.08.009
Pak JG and White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod 2011; 37(4): 429-38. https://doi.org/10.1016/j.joen.2010.12.016
Nair PN. New perspectives on radicular cysts: do they heal? Int Endod J 1998; 31(3): 155-60. https://doi.org/10.1046/j.1365-2591.1998.00146.x
Nair PN, Sjögren U, Figdor D and Sundqvist G. Persistent periapical radiolucencies of root-filled human teeth, failed endodontic treatments, and periapical scars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87(5): 617-27. https://doi.org/10.1016/S1079-2104(99)70145-9
Hommez GM, Coppens CR and De Moor RJ. Periapical health related to the quality of coronal restorations and root fillings. Int Endod J 2002; 35(8): 680-89. https://doi.org/10.1046/j.1365-2591.2002.00546.x
Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and metaanalysis. J Endod 2011; 37(7): 895-902. https://doi.org/10.1016/j.joen.2011.04.002
Maalouf EM and Gutmann JL. Biological perspectives on the non-surgical endodontic management of periradicular pathosis. Int Endod J 1994; 27(3): 154-62. https://doi.org/10.1111/j.1365-2591.1994.tb00246.x
Nardi C, Calistri L, Pradella S, Desideri I, Lorini C and Colagrande S. Accuracy of orthopantomography for apical periodontitis without endodontic treatment. J Endod 2017; 43(10): 1640-46. https://doi.org/10.1016/j.joen.2017.06.020
Lin LM, Huang GT and Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. J Endod 2007; 33(8): 908-16. https://doi.org/10.1016/j.joen.2007.02.006
Tahmasbi M, Jalali P, Nair MK, Barghan S and Nair UP. Prevalence of middle mesial canals and isthmi in the mesial root of mandibular molars: an in vivo cone-beam computed tomographic study. J Endod 2017; 43(7): 1080-83. https://doi.org/10.1016/j.joen.2017.02.008
Karabucak B, Bunes A, Chehoud C, Kohli MR and Setzer F. Prevalence of apical periodontitis in endodontically treated premolars and molars with untreated canal: A cone-beam computed tomography study. J Endod 2016; 42(4): 538-41. https://doi.org/10.1016/j.joen.2015.12.026
Scarfe WC, Li Z, Aboelmaaty W, Scott SA and Farman AG. Maxillofacial cone beam computed tomography: essence, elements and steps to interpretation. Aust Dent J 2012; 57 Suppl 1: 46-60. https://doi.org/10.1111/j.1834-7819.2011.01657.x
Scarfe WC, Levin MD, Gane D and Farman AG. Use of cone beam computed tomography in endodontics. Int J Dent 2009; 2009: 634567. https://doi.org/10.1155/2009/634567
Patel S, Durack C, Abella F, Shemesh H, Roig M and Lemberg K. Cone beam computed tomography in endodontics – a review. Int Endod J 2015; 48(1): 3-15. https://doi.org/10.1111/iej.12270
Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, et al. SEDENTEXCT Project Consortium. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 2012; 81(2): 267-71. https://doi.org/10.1016/j.ejrad.2010.11.028
Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of cone beam computed tomography in endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120(4): 508-12.
Al-Salehi SK and Horner K. Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study. J Dent 2016; 53: 57-63. https://doi.org/10.1016/j.jdent.2016.07.012
Leonardo MR, Hernandez ME, Silva LA and Tanomaru-Filho M. Effect of a calcium hydroxide-based root canal dressing on periapical repair in dogs: A histological study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102(5): 680-85. https://doi.org/10.1016/j.tripleo.2006.03.021
Tanomaru Filho M, Leonardo MR and da Silva LA. Effect of irrigating solution and calcium hydroxide root canal dressing on the repair of apical and periapical tissues of teeth with periapical lesion. J Endod 2002; 28(4): 295-99. https://doi.org/10.1097/00004770-200204000-00009
Lakhani AA, Sekhar KS, Gupta P, Tejolatha B, Gupta A, Kashyap S, et al. Efficacy of triple antibiotic paste, moxifloxacin, calcium hydroxide and 2% chlorhexidine gel in elimination of E. faecalis: An in vitro study. J Clin Diagn Res 2017; 11(1): ZC06-ZC09. https://doi.org/10.7860/JCDR/2017/22394.9132