Non-surgical Management of Large Periapical Lesions with the Agreement Evaluation of the Methods

Aim: The aim of this study is to evaluate the agreement between three routinely used non-surgical management techniques for large periapical lesions namely the treatments with Calcium hydroxide, Mineralo-Trioxide Aggregate and Bio-dentine. Methods: Data was collected from 60 patients at the Department of Restorative Dentistry, Faculty of Dental Sciences, University of Peradeniya. The variables age, gender and area of the infected region before and after the treatment and the treatment type were considered. Two homoscedastic and heteroscedastic Mixed-effects models were fitted and the agreement between three treatments were assessed using Concordance Correlation Coefficient (CCC) and Total Deviation Index (TDI). Results: CCC value calculated for treatment types 1 & 2, 1 & 3 and 2 & 3 are (0.905, 0.909, 0.874) for homoscedastic model and (0.989, 0.990, 0.975) for heteroscedastic model. Further, corresponding TDI values for homoscedastic and heteroscedastic models are (3.148, 4.390, 1.647) and (2.963, 4.388, 1.457) respectively. Conclusions: Since all the CCC values are close to 1 and TDI values are low, there is a strong agreement between all three treatments and hence they be used interchangeably. Moreover, the agreement between Treatments with Calcium hydroxide and Bio-dentine is higher compared to the agreements between the other treatments. (i.e., Calcium hydroxide with Mineralo-Trioxide Aggregate and Biodentine with Mineralo-Trioxide Aggregate).

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Non Surgical Management of Large Periapical Lesions Using Calcium Hydroxide - A Report of Two Cases

The Journal of Dentists ◽

10.12974/2311-8695.2016.04.01.4 ◽

2016 ◽

Vol 4 (1) ◽

pp. 24-29

Author(s):

Nidambur Ballal ◽

◽

Isha Jain

Keyword(s):

Calcium Hydroxide ◽

Surgical Management ◽

Periapical Lesions

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Abordagem endodôntica não cirúrgica em extensa lesão periapical: relato de caso

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i6.4816 ◽

2020 ◽

Vol 9 (6) ◽

pp. 513-516

Author(s):

Mailon Cury Carneiro ◽

Fernanda Angelio Da Costa ◽

Paula Gabriela Vieira Chicora ◽

Marcos Sergio Endo ◽

Vanessa Cristina Veltrini

Keyword(s):

Case Report ◽

Calcium Hydroxide ◽

Surgical Management ◽

Root Canal ◽

Endodontic Treatment ◽

Root Canal Treatment ◽

Periapical Lesion ◽

Periapical Lesions ◽

Periapical Cyst

O objetivo deste trabalho é relatar um caso clínico de uma extensa lesão periapical em maxila, tratada somente por uma abordagem endodôntica não cirúrgica, com expressivo reparo periapical. Paciente do sexo feminino, 52 anos, compareceu à clínica odontológica, com a queixa principal de “cisto crescendo na boca”. Os dentes 13, 14 e 15 apresentavam-se sem vitalidade pulpar. Os exames radiográficos mostraram duas áreas radiolúcidas, uniloculares, envolvendo os ápices dos dentes 13 e 15, ambos sem sinais de intervenção endodôntica. As áreas eram sugestivas de granuloma periapical e cisto periapical inflamatório, respectivamente. Realizou-se tratamento endodôntico dos dentes 13, 14 e 15. Após 11 meses, notou-se regressão significativa da rarefação óssea periapical, não sendo necessária qualquer intervenção cirúrgica. A paciente continuará em proservação até a remissão completa da lesão. O preparo químico-mecânico, associado ao emprego de medicação intracanal, pode ser suficiente para o reparo de lesões periapicais extensas. Sugere-se que o tratamento conservador seja sempre a primeira opção em casos semelhantes, de forma a se evitar cirurgias parendodônticas invasivas desnecessárias. Descritores: Endodontia; Cisto Radicular; Tratamento Conservador. Referências Hammouti J, Chhoul H, Ramdi H. Non-surgical management of large periapical cyst like lesion: case report and litterature review. J Oral Heal Dent Sci. 2019;3(1):1–7. Mitra A, Adhikari C. Management of large periapical lesions by non surgical endodontic approach - two case reports. 2017;2(5):97–104. Al Khasawnah Q, Hassan F, Malhan D, Engelhardt M, Daghma DES, Obidat D, et al. Nonsurgical clinical management of periapical lesions using calcium hydroxide-iodoform-silicon-oil paste. Biomed Res Int. 2018;2018:1-8. Schulz M, von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. 2009;35(5):634-42. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(1):93-102. Gutmann JL, Baumgartner JC, Gluskin AH, Hartwell GR, Walton RE. Identify and define all diagnostic terms for periapical/periradicular health and disease states. JOE. 2009;35(12):1658-74. Antoh M, Hasegawa H, Kawakami T, Kage T, Chino T, Eda S. Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case. J Cranio-Maxillo-Facial Surg. 1983;21(5):210-13. Natkin E, Oswald RJ, Carries LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg. 1984;57(1):82-94. Rathod DM, Mulay SA. Non-surgical treatment of large periapical lesion using various formulations of calcium hydroxide & nd: yag laser. Int J Curr Res. 2017;9(8):56668-72. Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, et al. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3):423-28. Sant’ana Filho M, Rados PV. Lesões apicais. In: Silveira JOL, Beltrão GC. Exodontia. 1Porto Alegre: Missau; 1998. cap. 22, p. 275-85. Sood N, Maheshwari N, Gothi R, Sood N. Treatment of large periapical cyst like lesion: a noninvasive approach: a report of two cases. Int J Clin Pediatr Dent. 2015;8(2):133-37. Singh U, Nagpal R, Sinha D, Tuhin, Tyagi N. Iodoform based calcium hydroxide paste (metapex):an aid for the healing of chronic periapical lesion. J Adv Res Biol Sci. 2013;6(1):63-7. Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary UK. Nonsurgical management of a periapical cyst: a case report. J Int Oral Health. 2013;5(3):79-84. Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J. 2004;37(6):408-16. Kanmaz F, Altunbaş D, Zan R, Akpınar KE. Nonsurgical endodontic treatment of a large periradicular lesion. Turk Endod J. 2017;2(1):21–4. Öztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J. 2002;35(1):73–8. Barroso JAY, Uchimura JYT, Endo MS, Pavan NNO, Queiroz AF. Avaliação in vitro da influência da lima patência na manutenção do comprimento de trabalho. Rev Odontol UNESP. 2017;46(2):72-6. Madhusudhana K, Surada R, Kumar CS, Lavanya A. Non-surgical management of a large periapical lesion: a case report. Ann Essences Dent. 2017;9(2):22-5. Soares J, Santos S, Silveira F, Nunes E. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin. Int Endod J. 2006;39(7):566-75. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J. 2013;48(3):133-40. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endod J. 2001;34(5):341-45. Soares JA, Brito-Júnior M, Silveira FF, Nunes E, Santos SMC. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci. 2008;50(1):107-11.

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Surgical management of damaged inferior alveolar nerve caused by endodontic overfilling of calcium hydroxide paste

International Endodontic Journal ◽

10.1111/iej.12560 ◽

2015 ◽

Vol 49 (11) ◽

pp. 1020-1029 ◽

Cited By ~ 12

Author(s):

S.-H. Byun ◽

S.-S. Kim ◽

H.-J. Chung ◽

H.-K. Lim ◽

W.-H. Hei ◽

...

Keyword(s):

Calcium Hydroxide ◽

Surgical Management ◽

Inferior Alveolar Nerve

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Effect of triple antibiotic paste and calcium hydroxide on the rate of healing of periapical lesions: A systematic review

Journal of Conservative Dentistry ◽

10.4103/jcd.jcd_637_20 ◽

2021 ◽

Vol 24 (4) ◽

pp. 307

Author(s):

NKiran Kumar ◽

Biji Brigit ◽

BS Annapoorna ◽

SavithaB Naik ◽

Seema Merwade ◽

...

Keyword(s):

Systematic Review ◽

Calcium Hydroxide ◽

Periapical Lesions ◽

Triple Antibiotic Paste

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Trends in Surgical Management and Mortality of Intracerebral Hemorrhage in the United States Before and After the STICH Trial

Neurocritical Care ◽

10.1007/s12028-010-9351-4 ◽

2010 ◽

Vol 13 (1) ◽

pp. 82-86 ◽

Cited By ~ 21

Author(s):

Opeolu Adeoye ◽

Andrew Ringer ◽

Richard Hornung ◽

Pooja Khatri ◽

Mario Zuccarello ◽

...

Keyword(s):

United States ◽

Intracerebral Hemorrhage ◽

Surgical Management ◽

The United States ◽

Before And After ◽

Stich Trial

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Management of Large Periapical Cystic Lesion by Aspiration and Nonsurgical Endodontic Therapy using Calcium Hydroxide Paste

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1249 ◽

2012 ◽

Vol 13 (6) ◽

pp. 897-901 ◽

Cited By ~ 6

Author(s):

Kunjamma Thomas ◽

T Prasanth Dhanapal ◽

Elsy P Simon

Keyword(s):

Calcium Hydroxide ◽

Cystic Lesion ◽

Additional Treatment ◽

Radiographic Evaluation ◽

Treatment Protocols ◽

Maxillary Central Incisor ◽

Periapical Lesions ◽

Nonsurgical Management ◽

Complications Of Surgery ◽

Periapical Cyst

ABSTRACT Aim To report a case of conservative nonsurgical management of periapical lesions. Background Small periapical lesions of endodontic origin usually heal by conventional endodontic therapy alone. Larger periapical lesions presumed to be cystic may require additional treatment protocols to aid in regression. Conservative nonsurgical management of such lesions eliminates the possible complications of surgery and has wider patient compliance and acceptance. Case description A periapical cystic lesion associated with maxillary central incisor and lateral incisor was treated conservatively using buccal aspiration decompression followed by conventional endodontic therapy employing calcium hydroxide iodoform paste as intracanal medicament is reported. Clinical significance The treatment was successful as evidenced by relief of symptoms and radiographic evaluation. Conclusion Large periapical cyst-like lesions can resolve by nonsurgical endodontic therapy employing calcium hydroxide intracanal interappointment medicament. How to cite this article Thomas K, Dhanapal PT, Simon EP. Management of Large Periapical Cystic Lesion by Aspiration and Nonsurgical Endodontic Therapy using Calcium Hydroxide Paste. J Contemp Dent Pract 2012;13(6):897-901.

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Towards qualification of FDG PET as biomarker of response to neo-adjuvant therapy: A meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e22128 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e22128-e22128

Author(s):

Andrew D. Vincent ◽

Saiyada N. F. Rizivi ◽

Harm van Tinteren ◽

Ingrid Riphagen ◽

Otto S. Hoekstra

Keyword(s):

Publication Bias ◽

Fdg Pet ◽

Meta Analysis ◽

Model Development ◽

Histopathological Response ◽

Treatment Type ◽

Neoadjuvant Systemic Therapy ◽

Before And After ◽

Maximal Sensitivity ◽

Meta Regression

e22128 Background: For FDG PET to qualify as a biomarker of response to cancer therapy beyond proof of principle, the evidence should be aggregated. Methods: A systematic literature search (Jan 1995-May 2011) for studies in solid extracerebral tumors with distinct cohorts of n≥10 patients, PET before and after cytotoxic neoadjuvant systemic therapy (with or without radiotherapy), dichotomized histopathological (PA) response. For model development we selected studies reporting individual or dichotomous aggregated level data, and performed bivariate SROC meta-regression. Results: 52 studies were identified, comprising data from 1,710 patients: rectal (32%), esophageal (21%), sarcoma (20%), breast (13%) and other cancers (14%). Most PET measures were SUVmax (65%) and other SUV measures (32%). Treatment type ChT (38%) and ChRT (62%); 46% were PA responders. The meta-regression indicated a weak increase in specificity for chemotherapy studies over chemoradiotherapy studies (p=0.08), however this disappeared after adjusting for publication bias. High baseline uptake rates improved diagnostic sensitivity (p=0.01). The SROC-AUC after adjusting for publication bias was 0.77. Maximal sensitivity and specificity was achieved with a PET reduction of 60%. Conclusions: There is a moderate association between FDG-PET change and histopathological response. This relation appears to be a function of baseline uptake, which may (at least in part) relate to repeatability issues.

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