Influence of periapical lesion size on healing outcome following regenerative endodontic procedures: a clinical investigation

Abstract Periapical actinomycosis caused by a gram-positive anaerobic pathogen characterizes a typical extra-radicular infection. This study determined the frequency and correlated the content of bacteria colonies with the of periapical actinomycosis size. The study comprised a total of 218 periapical lesions (PL) (cysts, granulomas or abscess). The specimens embedded in paraffin were sliced into 4-µm sections and stained with hematoxylin-eosin, Gram, Periodic Acid-Schiff (PAS) and Grocott’s stain. The presence of bacterial colonies composed of filamentous structures labeled with the histochemical stains were described as Actinomyces, and for each case, the bacterial colonies were counted and measured. The correlation between the number and size of bacterial colonies and the size of PL was tested using Pearson’s adjusted correlation coefficient. From 218 PL, bacterial colonies were identified in 64 biopsies. Seven cases (0.3%) fulfill the criteria for diagnosis of periapical actinomycosis. All of cases were therapy-resistant and did not showed periapical repair after 12 months of follow-up. Periapical surgery or dental extraction was performed. The correlation test indicated no correlation between the number of bacterial colonies and the lesion size (p=0.752, r=-0.148). However, a larger bacterial colony size generally resulted in a larger periapical lesion (P=0.000, r=0.657). The frequency of periapical actinomycosis was low, and this lesion should be included in the differential diagnosis of PL. The size of the Actinomyces colonies seemed to contribute to increase the size of the periapical lesion.

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Quantitative radiographic evaluation of periapical bone resorption in dog's teeth contaminated with bacterial endotoxin (LPS) associated or not with calcium hydroxide

Brazilian Dental Journal ◽

10.1590/s0103-64402008000400002 ◽

2008 ◽

Vol 19 (4) ◽

pp. 296-300 ◽

Cited By ~ 7

Author(s):

Léa Assed Bezerra da Silva ◽

Raquel Assed Bezerra da Silva ◽

Luis Guilherme Siqueira Branco ◽

Valéria Pontelli Navarro ◽

Paulo Nelson-Filho

Keyword(s):

Bone Resorption ◽

Calcium Hydroxide ◽

Saline Group ◽

Lesion Size ◽

Bacterial Endotoxin ◽

Radiographic Evaluation ◽

Periapical Lesion ◽

Pulp Tissue ◽

Group 4 ◽

Group 2

The aim of this study was to quantify radiographically the periapical bone resorption in dogs' teeth contaminated with bacterial endotoxin (LPS), associated or not with calcium hydroxide. After pulp tissue removal, 60 premolars were randomly assigned to 4 groups and were either filled with LPS (group 1), filled with LPS plus calcium hydroxide (group 2) or filled with saline (group 3) for a period of 30 days. In group 4, periapical lesion formation was induced with no canal treatment. Standardized radiographs were taken at the beginning of the treatment and after 30 days and the Image J Program was used for measurement of periapical lesion size. Periapical lesions were observed in groups 1 (average of 8.44 mm2) and 4 (average of 3.02 mm2). The lamina dura was intact and there were no areas of periapical bone resorption in groups 2 and 3. It may be concluded that calcium hydroxide was effective in inactivating LPS, as demonstrated by the absence of apical periodontitis in the roots that were filled with bacterial endotoxin plus calcium hydroxide.

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A comparative clinical study of bioceramic and calcium hydroxide based root canal sealer in the treatment of non-vital permanent tooth with periapical lesion

Update Dental College Journal ◽

10.3329/updcj.v11i2.56092 ◽

2021 ◽

Vol 11 (2) ◽

pp. 26-31

Author(s):

Farzana Hoque Tanmi ◽

Md Abdul Hannan Sheikh ◽

Mozammal Hossain ◽

SM Abdul Quader ◽

Salahuddin Ahmed ◽

...

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Standard Procedure ◽

Lesion Size ◽

Permanent Tooth ◽

Permanent Teeth ◽

Periapical Lesion ◽

Root Canal Sealer ◽

Anterior Teeth ◽

Short Period

Introduction: The use of Bioceramic sealer in the obduration of the root canal system has been expected by many of the previous studies. However, the clinical outcome has not yet been established. Objective: To compare the effectiveness of bioceramic and calcium hydroxide based root canal sealer in treatment of non-vital permanent teeth with periapical lesion (Periapical periodontitis). Materials and Methods: A total 100 mature permanent anterior teeth were selected after clinical and radiological examination which had non-vital pulp with periapical lesion. Clinically pulp vitality test, palpation and percussion test was performed maintaining standard procedure. Following cavity preparation and biomechanical preparation, each canal was obturated either with bioceramic (Endosequence BC) or calcium hydroxide based sealer (Sealapex, Kerr). All participants were evaluated immediately after obturation, at 3 and 6 months for the assessment of change in size of periapical lesion, condition of periodontal ligament space, lamina dura and incidence of post-operative pain, swelling. Statistical analysis was performed using Chi- square(X2) test and t-test. A value of p<0.05 was considered as statistically significant. Results: Bioceramic was more effective in reducing the lesion size than that of calcium hydroxide. At 6 months, the mean lesion size was reduced from 3.52±0.7 to 1.30±0.462 mm in Bioceramics and from 3.48±1.07 to 1.58± 0.498 mm in sealapex treated teeth.. Furthermore, 98% of bioceramic treated teeth and 94% of sealapex treated teeth showed absence of swelling. The differences between two groups were statistically significant (p<0.05). Conclusion: In this short period of study, Bioceramics based sealer seems to be more effective than calcium hydroxide based sealer in repair of periapical lesions of the nonvital teeth. Update Dent. Coll. j: 2021; 11(2): 26-31

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Healing of periapical lesion with mineral trioxide aggregate apexification

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v11i2.36448 ◽

2018 ◽

Vol 11 (2) ◽

pp. 122

Author(s):

Sultana Parveen ◽

Mozammal Hossain ◽

Md. Abdul Hannan Sheikh ◽

Md. Joynal Abdin

Keyword(s):

Clinical Outcome ◽

Clinical Success ◽

Mineral Trioxide Aggregate ◽

Lesion Size ◽

Periapical Lesion ◽

Anterior Teeth ◽

Mean Size ◽

The Mean ◽

Radiological Examinations ◽

Observation Period

<p class="Abstract">In the present study, the ability of mineral trioxide aggregate in the formation of apical plug for healing of large periapical lesion with open apex was assessed and evaluated the clinical outcome. Fifteen participants with periapical lesion at the upper anterior teeth with open apex were treated with mineral trioxide aggregate. The effect on healing of apical size was evaluated at 3, 6, and 12 months by radiological examinations in the form of periapical index criteria, diameter of the lesion size and the presence or absence of apical tissue barrier. The results found that neither pain nor any sinus was detected at 12 months. The mean size of the apical lesion was gradually reduced from 5.1 × 3.8 to 1.5 × 0.9 mm and mean PAI was reduced from 3.3 to 1.7 mm. The differences between mean size of periapical lesion at preoperative and 12 months observation period was also statistically significant (p<0.05). The clinical success shown significant success rate of 93.3% analyzed with Z-test. In conclusion, tooth with open apex can be successfully treated with mineral trioxide aggregate apexification technique followed by root canal obturation.</p>

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Toll-like Receptor 2 Knockout Mice Showed Increased Periapical Lesion Size and Osteoclast Number

Journal of Endodontics ◽

10.1016/j.joen.2012.03.017 ◽

2012 ◽

Vol 38 (6) ◽

pp. 803-813 ◽

Cited By ~ 30

Author(s):

Raquel Assed Bezerra da Silva ◽

Paula Dariana Fernandes Ferreira ◽

Andiara De Rossi ◽

Paulo Nelson-Filho ◽

Lea Assed Bezerra Silva

Keyword(s):

Knockout Mice ◽

Lesion Size ◽

Toll Like Receptor ◽

Periapical Lesion ◽

Osteoclast Number ◽

Toll Like Receptor 2

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Factors Affecting the Outcome of Periapical Surgery; a Prospective Longitudinal Clinical Study

Applied Sciences ◽

10.3390/app112411768 ◽

2021 ◽

Vol 11 (24) ◽

pp. 11768

Author(s):

Muhammad Adeel Ahmed ◽

Nouman Mughal ◽

Syed Hani Abidi ◽

Muhammad Furqan Bari ◽

Mohammed Mustafa ◽

...

Keyword(s):

Smoking Status ◽

Lesion Size ◽

Endodontic Treatment ◽

Periapical Lesion ◽

Preoperative Pain ◽

Patient Age ◽

Anterior Teeth ◽

Patient Âgé ◽

Periapical Healing ◽

Prospective Longitudinal

Wound healing following periapical surgery is influenced by age, gender, smoking, periapical lesion size, type of root-end filling, method of root-end cavity preparation and the use of microsurgical or conventional technique. This study aimed to evaluate the influence of various preoperative factors such as age, gender, smoking, preoperative pain, and preoperative periapical lesion size on the outcome of surgical endodontic treatment. A thorough history, examination, and investigation were performed to establish patient age, gender, smoking status, periapical lesion size, and the presence of preoperative pain. Forty patients aged between 15–57 years presented with persistent chronic apical periodontitis of single-rooted anterior teeth after conventional re-root canal treatment were enrolled for periapical surgery. Following periapical surgery, all patients were recalled for evaluation of periapical healing after 12 months based on clinical and periapical X-ray examination due to inaccessibility of an advanced imaging system (CBCT). Chi-squared and Fisher’s exact test were applied, which revealed a statistically significant association of periapical healing with age (p = 0.025), smoking (p = 0.029), and lesion size (p < 0.001). Although, the success of periapical healing was higher in males 78.6% (22/28) compared to females 58.3% (7/12) however, no statistically significant relationship was found between gender and healing (p = 0.254). Patient age, smoking status, and size of the preoperative lesion had a strong influence on periapical healing after surgical endodontic treatment.

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