Clinical managements of implant periapical lesions: a report of three cases with five to twelve years of follow-up

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.

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Outcome of orthograde endodontic retreatment - a two-year follow-up

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1604174n ◽

2016 ◽

Vol 144 (3-4) ◽

pp. 174-180 ◽

Cited By ~ 2

Author(s):

Jelena Neskovic ◽

Slavoljub Zivkovic ◽

Milica Medojevic ◽

Milos Maksimovic

Keyword(s):

Clinical Signs ◽

Complete Healing ◽

Periapical Lesion ◽

Periapical Lesions ◽

Group I ◽

Group Ii ◽

Periapical Inflammation ◽

Endodontic Retreatment ◽

Observation Period

Introduction. Endodontic retreatment is a complex intervention that requires detailed analysis of possible reasons for failure, and flawless practical execution of the procedure. Objective. The aim of the study was to assess the outcome of endodontic retreatment based on clinical and radiographic criteria after a two-year observation period. Methods. Clinical study included 49 teeth indicated for endodontic retreatment based on periapical index (PAI). All teeth were divided into two groups. Group I comprised teeth without any periapical lesion (PAI score of 1 and 2) while Group II consisted of teeth with visible periapical radiolucency (PAI score of 3, 4, and 5). Endodontic retreatment was completed in two visits with inter-appointment medication of 2% chlorhexidine and calcium hydroxide for two weeks. Outcome of endodontic retreatment was evaluated 12-24 months after final obturation. Results. Endodontic retreatment was successful in 93.3% in Group I after 24 months. In Group II, successful treatment and complete healing was found in 52.9% of teeth, whereas 14.7% of teeth showed only partial healing. However, clinical symptomatology was not present in any of the cases. Considering the absence of clinical signs and subjective symptoms, retreatment was successful in 67.6% of cases where chronic periapical inflammation was present. Conclusion. Endodontic retreatment was successful in high percentage in teeth with and without periapical lesions.

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Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion

Brazilian Dental Journal ◽

10.1590/0103-6440201701449 ◽

2017 ◽

Vol 28 (6) ◽

pp. 688-693 ◽

Cited By ~ 2

Author(s):

Lucas Senhorinho Esteves ◽

Águida Cristina Gomes Henriques ◽

Carolina Ávila Varginha de Moraes e Silva ◽

Maria Cristina Teixeira Cangussu ◽

Eduardo Antônio Gonçalves Ramos ◽

...

Keyword(s):

Differential Diagnosis ◽

Periodic Acid ◽

Lesion Size ◽

Periapical Lesion ◽

Periodic Acid Schiff ◽

Bacterial Colony ◽

Periapical Lesions ◽

Criteria For Diagnosis ◽

Hematoxylin Eosin

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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Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

International Journal of Dentistry ◽

10.1155/2021/8816628 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Kawther Bel Haj Salah ◽

Sabra Jaâfoura ◽

Mahdi tlili ◽

Marwa Ben Ameur ◽

Saida Sahtout

Keyword(s):

Treatment Group ◽

Root Canal ◽

Apical Periodontitis ◽

Root Canal Treatment ◽

Inclusion Criteria ◽

Root Canal Filling ◽

Radiographic Findings ◽

Periapical Lesions ◽

Single Cone

Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results. Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion. The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.

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Apical third enlargement of the root canal and its relationship with the repair of periapical lesions

European Journal of Dentistry ◽

10.1055/s-0039-1698976 ◽

2012 ◽

Vol 06 (04) ◽

pp. 385-388 ◽

Cited By ~ 9

Author(s):

Ronaldo Araújo Souza ◽

João Costa Pinto Dantas ◽

Paula Maciel Brandão ◽

Suely Colombo ◽

Maurício Lago ◽

...

Keyword(s):

Calcium Hydroxide ◽

Undergraduate Students ◽

Root Canal ◽

Endodontic Treatment ◽

Exact Test ◽

Periapical Lesions ◽

Group I ◽

Group Ii ◽

Determinant Factor

ABSTRACTObjective: The purpose of this study was to evaluate if the apical third enlargement of root canal is the determinant factor for the repair of periapical lesions in endodontic treatment.Methods: Eighty upper and lower incisors, canines and premolars with periapical lesions were randomly divided in 2 groups and were treated by undergraduate students. Canals were instrumented with up to 3 files in group I (n = 40) and up to 4 files in group II (n = 40) 1 mm short of the apex and were filled with a calcium hydroxide dressing. After removing calcium hydroxide 14 days later, both groups were filled using the lateral condensation technique. In the 2-year follow-up, a few patients did not return, and some cases did not present conditions for accurate comparisons. Therefore, only 43 patients (24 in group I and 19 in group II) presented conditions for radiographic comparisons. Data were statistically analyzed using Fisher's exact test.Results: Comparison of the initial and follow-up radiographs showed that 22 out of 24 (91.67%) patients in group I and 17 out of 19 patients (89.47%) in group II showed repair. Statistical analysis revealed no significant differences between the groups (P>.05).Conclusion: The results of this study show that the apical third enlargement did not alter the outcome of endodontic treatment of teeth with periapical lesion performed by undergraduate students. (Eur J Dent 2012;6:385-388)

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Retrospective Evaluation of Healing of Periapical Lesions after Unintentional Extrusion of Mineral Trioxide Aggregate

Journal of Applied Biomaterials & Functional Materials ◽

10.5301/jabfm.5000359 ◽

2017 ◽

Vol 15 (4) ◽

pp. e382-e386 ◽

Cited By ~ 1

Author(s):

Levent Demiriz ◽

Ebru Hazar Bodrumlu

Keyword(s):

Mineral Trioxide Aggregate ◽

Complete Healing ◽

Retrospective Evaluation ◽

Periapical Lesions ◽

Periapical Healing ◽

Open Apices ◽

Group 2 ◽

Group 1

Background During the apexification procedure for teeth with open apices, mineral trioxide aggregate (MTA) may be unintentionally extruded. The aim of the present study was the retrospective evaluation of the healing of periapical lesions in permanent incisor teeth with open apices after the unintentional extrusion of MTA. Methods The clinical and radiographic records of 55 maxillary permanent central teeth treated by MTA apexification were evaluated. Filled teeth with unintentionally extruded MTA were selected as group 1 (n = 21), whereas the teeth with no MTA extrusion were selected as group 2 (n = 34). For each tooth, the clinical and radiographic records from a 3-year follow-up were investigated. Results Complete healing (CH) was observed in 19 teeth (90.4%) in group 1, whereas the same type of healing was observed in all 34 teeth (100%) in group 2 (p>0.05). At the 6-month follow-up appointment, 25 teeth (73.5%) showed CH in group 2, whereas 15 teeth (71.4%) showed CH at the 1-year follow-up in group 1 (p<0.001). At the end of the 3-year follow-up period, the amount of MTA extrusion was reduced in 17 teeth (85%) (p<0.05), whereas it was almost absent in 2 teeth (10%). Conclusions The unintentional extrusion of MTA does not prevent the healing of periapical lesions, but may be a delaying factor for periapical healing.

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Endodontic treatment of traumatized teeth with chronic periapical lesions using antibiotic paste and mineral trioxide aggregate obturation - a preliminary study

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180301018c ◽

2019 ◽

Vol 147 (5-6) ◽

pp. 270-275

Author(s):

Bojana Cetenovic ◽

Dejan Markovic ◽

James Gutmann ◽

Tamara Peric ◽

Vukoman Jokanovic

Keyword(s):

Root Canal ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Complete Regression ◽

San Jose ◽

Periapical Lesions ◽

Significant Difference ◽

Preliminary Study ◽

Healing Assessment

Introduction/Objective. The purpose of this study was to assess effectiveness of endodontic root canal procedures in traumatized permanent teeth with necrotic pulps and chronic periapical lesions after definitive obturation with mineral trioxide aggregate (MTA) products. Adobe Photoshop CS (San Jose, CA, USA) image-analysis software was used for healing assessment. Methods. Twenty-seven traumatized single-rooted permanent teeth diagnosed with necrotic pulps and chronic periapical lesions were treated with non-surgical procedure using a tri-antibiotic paste and calcium hydroxide as intra-canal medication. Definitive obturation was performed with ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or MTA+ Cerkamed (Cerkamed, Stalowa Wola, Poland). Control follow-ups were done three, six, 12, and 24 months following the completion of treatment. Results. The positive clinical outcome was recorded in 24 (88.9%) cases, while radiographic success was present in 26 (96.3%) cases. A statistically significant decrease in the sizes of periapical lesions was consistently observed at follow-up periods (p < 0.001). There was no statistically significant difference between the two tested MTA materials (p > 0.05). Conclusion. The MTA products were effective for the root canal obturation and appeared to contribute to the significant reduction or complete regression of periapical lesions in teeth treated. The presented procedure may be proposed for everyday clinical practice.

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Odontogenic cutaneous sinus tract - misdiagnosis and follow-up in a seven-year-old boy

IIUM Journal of Orofacial and Health Sciences ◽

10.31436/ijohs.v1i2.28 ◽

2020 ◽

Vol 1 (2) ◽

pp. 84-90

Author(s):

Deng Qianyi ◽

Mustapha Rammal ◽

Zhang Huini ◽

He Hongwen ◽

Huang Fang

Keyword(s):

Cutaneous Lesion ◽

Sinus Tract ◽

Submandibular Region ◽

Periapical Lesions ◽

Dental Examination ◽

Dental Origin ◽

Suppurative Lymphadenitis ◽

Systemic Antibiotics ◽

Cutaneous Sinus

Cutaneous sinus tracts of dental origin are relatively rare, but frequently misdiagnosed. In this case report, we present a seven-year-old patient with a cutaneous lesion in the left submandibular region misdiagnosed by a physician as an abscess secondary to suppurative lymphadenitis, and thus incorrectly treated with surgery and systemic antibiotics. Following a detailed dental examination, the patient was correctly diagnosed with an odontogenic sinus tract from a periapical abscess of tooth 36. Treatment of the immature tooth was initiated with apexification combined with nonsurgical endodontic treatment. The cutaneous and the periapical lesions were all resolved after the treatment and there has been no recurrence during an eight-year follow-up.

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Concentrated Growth Factors as an Ingenious Biomaterial in Regeneration of Bony Defects after Periapical Surgery: A Report of Two Cases

Case Reports in Dentistry ◽

10.1155/2019/7046203 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Nivedhitha Malli Sureshbabu ◽

Kathiravan Selvarasu ◽

Jayanth Kumar V ◽

Mahalakshmi Nandakumar ◽

Deepak Selvam

Keyword(s):

Growth Factors ◽

Bone Regeneration ◽

Healing Time ◽

Platelet Concentrates ◽

Periapical Lesions ◽

New Family ◽

Retrograde Filling ◽

Concentrated Growth Factors ◽

Autologous Platelet

The overall success of a periapical surgery is assessed in terms of regeneration of functional periradicular tissues. The regenerative potential of platelets has been well documented. This article describes the use of concentrated growth factors (CGF), a new family of autologous platelet concentrates, as a sole material for bone regeneration after periapical surgery. 32- and 35-year-old female patients diagnosed with Ellis Class IV, an open apex in 11 with apical periodontitis in 11 and 12 and previously root canal-treated 31 and 41 with a chronic apical abscess, respectively, were managed with endodontic surgery. Subsequent to apicectomy and retrograde filling, the CGF fibrin block and membrane were used before suturing. There was uneventful healing during the immediate post-op and the subsequent follow-up periods. CGF is produced by a differential centrifugation process that results in the formation of a denser fibrin matrix richer in growth factors than those observed in PRF. Reasonable osseous healing was seen as early as 6-month follow-up, thereby recommending the use of CGF as an alternative to bone grafts and membranes in extensive periapical lesions to enhance bone regeneration and to decrease the healing time.

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Regenerative Endodontic Therapy with Platelet Rich Fibrin: Case Series

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-44.1.3 ◽

2020 ◽

Vol 44 (1) ◽

pp. 15-19 ◽

Cited By ~ 1

Author(s):

G Kandemir Demirci ◽

P Güneri ◽

MK Çalışkan

Keyword(s):

Case Series ◽

Cone Beam ◽

Permanent Teeth ◽

Platelet Rich Fibrin ◽

Periapical Lesions ◽

Root Canals ◽

Immature Teeth ◽

Triple Antibiotic Paste ◽

Cone Beam Computerized Tomography

Regenerative endodontic therapy (RET) provides a novel treatment modality for the immature teeth with pulp necrosis. The aim of this case series was to evaluate RET of immature permanent teeth using platelet rich fibrin (PRF) at 36-month follow-up periods. In the present case series, three immature maxillary incisors diagnosed with pulp necrosis and apical periodontitis were treated with RET. The root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and medicated with triple antibiotic paste(TAP). At the second visit, TAP was removed and root canals were conditioned with 17% EDTA. PRF was used as a scaffold. MTA was placed over PRF and the teeth were restored with composite resin. Periapical radiographs and cone beam computerized tomography(CBCT) were used to evaluate the healing. At the end of the 36-month follow-up periods, there was no response to pulp sensibility tests with cold and electric pulp tester, but all teeth showed decreased periapical lesions or evidence of healing.

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