Favorable response of an extensive periapical lesion to root canal treatment

Evaluation of the Factors and Treatment Options of Separated Endodontic Files Among Dentists and Undergraduate Students in Riyadh Area

“…Leaving a fractured instrument inside the root canal with incomplete obturation or ineffective coronal seal may lead to micro-organisms penetration inside the canal developing periapical lesion and so treatment failure [18,19].…”

Periapical healing by non-surgical intervention : A case report

“…Since these ions are continuously resorbed by periapical fluids, regular renewal of the dressing is required to enhance the periapical healing process. 1 Hence in the present case report calcium hydroxide dressing was renewed on weekly basis.…”

“…Subsequently, immunopathological process lead to periapical infections. 1 These infections are generally diagnosed either during routine dental radiographic examination or following severe toothache. And as a conservative approach, all periapical infections should be initially treated with non-surgical means.…”

Management of Separated Instruments from the root canal- A Review

“…Many clinicians associate "broken instruments" with separated files, but the term could also apply to a sectioned silver point, a segment of lentulo, a gates glidden drill, lateral or finger spreaders, and paste fillers and they can be made from nickel-titanium,stainless steel or carbon steel (2).With the advent of rotary NiTi files, there has been an unfortunate increase in the occurrence of broken instruments (3).Today separated instruments can usually be removed due to technological advancements, ultrasonic instrumentation, and microtube delivery methods (4)(5).Specifically,the dental operating microscope allows clinicians to visualize most broken instruments (6).The ability to non-surgically access and remove a broken instrument will be influenced by the diameter,length and position of the obstruction within a canal and the type of the metallic object (2,7) Instruments located in the straight portion of the canal can usually be removed (8). If the entire segment of the broken instrument is apical to the curvature and safe access with visualization is not possible,then nonsurgical removal usually cannot be accomplished (8).Leaving a fractured instrument inside the root canal coupled with incomplete obturation or ineffective coronal seal may lead micro-organisms to penetrate inside the canal and develops periapical lesion.Oztan and Soares et al have confirmed that large periapical lesions can respond favorably to nonsurgical treatment using calcium hydroxide paste (9,10).…”