Non-surgical endodontic treatment of large periapical lesions
22/07/2024
Fellow
Warning: Undefined variable $post in /var/www/vhosts/styleitaliano-endodontics.org/endodontics.styleitaliano.org/wp-content/plugins/oxygen/component-framework/components/classes/code-block.class.php(133) : eval()'d code on line 2
Warning: Attempt to read property "ID" on null in /var/www/vhosts/styleitaliano-endodontics.org/endodontics.styleitaliano.org/wp-content/plugins/oxygen/component-framework/components/classes/code-block.class.php(133) : eval()'d code on line 2
This article showing the method of using non-setting calcium hydroxide in case with large periapical lesion .
Fig. 1
A 43 years old female her chief complaint was to change an old amalgam restoration of lower left four also associated with slight numbness in the area adjacent to it, x- ray showed a large periapical lesion related to the tooth.
Preoperative x- ray showed a large periapical lesion related to the tooth.
Fig. 2
Panoramic view Of CBCT
CBCT was asked to recognize size of lesion .
AAE …
CBCT should be only used when answer of question for which imaging is required cannot assumed adequately by lower dose conventional radiograph.
Fig. 3
Axial and Sagittal view
Fig. 4
Shows 3D view
Fig. 5
Cavity test and WL determination
Fig. 6
Final irrigation protocol
Fig. 7
After BMP and MTA plug
Fig. 8
After 6 months, adjacent canine showed a negative response to cold sensibility test then cavity test was done and found non-vital so root canal treatment was done for it as will.
Fig. 9
Follow up Coronal view
Fig. 10
Follow up Axial view
Fig. 11
Follow up Sagittal view for lower 4.
Fig. 12
Follow up sagittal view for lower canine
Fig. 13
Follow up 3D view
Fig. 14
Ali Ayad Gargom. -Graduated in 2012-2013 from Benghazi University, Faculty of Dentistry. -General practitioner, but most dental work limited to Endodontics especially large lesions related to root apices, perforations, and separated instruments. -Demonstrator in Conservative & Endodontic department, Benghazi University, Dental Faculty since 2016. -Master Degree student in Endodontics. -Former teaching staff in Arab diploma from 2019 to 2021. -Endodontic courses instructor: Basic and advanced ones. -Fellow at Style Italiano Endodontics.
Conclusions
Teeth with large periapical lesion due to failed endodontic therapies or necrotic pulp can be good candidates for non-surgical root canal treatment …
thorough cleaning and shaping of canal along with disinfection using irrigation protocol and appropriate obturation technique are the key factors in initiating the healing process.
Bibliography
1)Fernandes M, de Ataide I. Nonsurgical management of periapical lesions. J Conserv Dent. 2010 Oct;13(4):240-5. doi: 10.4103/0972-0707.73384. PMID: 21217952; PMCID: PMC3010029.
2)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 May-Aug;8(2):133-7. doi: 10.5005/jp-journals-10005-1299. Epub 2015 Aug 11. PMID: 26379382; PMCID: PMC4562047.
3)Zehnder M: Root canal irrigants, J Endod 32:389, 2006.
4) Cehreli ZC, Sara S, Uysal S, Turgut MD. MTA apical plugs in the treatment of traumatized immature teeth with large periapical lesions. Dent Traumatol.
