Management of Cyst-like Periapical Lesions by Orthograde Decompression and Long-term Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series

Soares, Suelleng Maria Cunha Santos; Brito-Júnior, Manoel; Souza, Flávia Kelly de; Zastrow, Eduardo Von; Cunha, Carla Oliveira da; Silveira, Frank Ferreira; Nunes, Eduardo; César, Carlos Augusto Santos; Glória, José Cristiano Ramos; Soares, Janir Alves

doi:10.1016/j.joen.2016.04.021

Cited by 17 publications

(17 citation statements)

References 44 publications

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“…[ 2 ] Large periapical lesions and apical true cysts are of inflammatory origin and should be treated initially with a nonsurgical approach. [ 3 ] When intra- or extra-radicular infections are persistent, and periapical pathology fails to resolve after nonsurgical endodontic management protocols, only then a surgical option should be considered. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach

et al. 2017

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Periapical lesions of endodontic origin are common pathological conditions affecting periradicular tissues. Microbial infection of pulpal tissues is primarily responsible for initiation and progression of apical periodontitis. The primary objective of endodontic therapy should be to restore involved teeth to a state of normalcy nonsurgically. Different nonsurgical management techniques, namely, conservative root canal therapy, decompression technique, method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and tissue repair therapy, active nonsurgical decompression technique, and the apexum procedure have been advocated. New techniques which use drug-loaded injectable scaffolds, simvastatin, and epigallocatechin-3-gallate have been tried. Surgical option should be considered when intra- or extra-radicular infections are persistent. Incidence of nonendodontic periapical lesions has also been reported. An accurate diagnosis of the periapical lesion whether it is of endodontic or nonendodontic origin has to be made. Surgical methods have many disadvantages, and hence should be considered as an option only in the case of failure of nonsurgical techniques. Assessment of healing of periapical lesions has to be done periodically which necessitates a long-term follow-up. Even large periapical lesions and retreatment cases where the lesion is of endodontic origin have been successfully managed nonsurgically with orthograde endodontic therapy.

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Section: Introductionmentioning

confidence: 99%

Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach

et al. 2017

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“…13 Meskipun cairan kistik mengandung kristal kolesterol, pergantian medikamen di dalam saluran akar yang dilakukan setiap dua sampai tiga minggu, serta diikuti oleh pengisian telah menyebabkan penyembuhan lesi secara lengkap dalam waktu 12 sampai 15 bulan. [14][15][16] Siquierra [16][17][18][19] menyatakan bahwa waktu yang diperlukan kalsium hidroksida untuk meningkatkan pH menjadi 9 di dalam saluran akar dan jaringan periapeks adalah minimal 14 hari dan mencapai pH 12 dalam 1-3 bulan. Pada kasus ini lesi mengalami pengecilan ukuran dan hilangnya pembengkakan terjadi pada bulan kedelapan, dan dibutuhkan observasi serta kontrol untuk penyembuhan lengkap pada 3 bulan, 6 bulan, serta 1 tahun setelah pengisian.…”

Section: Pembahasanunclassified

Perawatan endodontik non bedah pada gigi molar pertama rahang bawah kiri nekrosis pulpa dengan lesi periapikal

Widy¹,

Muryani

2020

J Ked Gi Unpad

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Perjalanan infeksi penyakit pulpa bisa menjalar terus ke saluran akar dan jaringan periapikal sehingga membuat lesi periapikal. Lesi periapikal terutama pada gigi molar menjadi tantangan bagi dokter gigi karena lebih disarankan perawatan endodontik bedah dibandingkan dengan non bedah. Tujuan laporan kasus ini membahas keberhasilan perawatan endodontik non bedah pada gigi nekrosis pulpa dengan lesi periapikal. Laporan kasus: Kasus ini merupakan gigi molar pertama rahang bawah kiri dengan lesi periapikal pada pasien laki-laki berusia 25 tahun. Saluran akar dipreparasi saluran akar dan diirigasi dengan NaOCL 5,25% dan EDTA 18% disertai agitasi dan menghasilkan saluran akar yang bersih, Saluran akar setelah bersih dan kering diberi medikamen kalsium hidroksida. Evaluasi klinis dilakukan setiap 2 minggu sampai tidak adanya keluhan dari pasien. Pengisian saluran akar dilakukan secara hermetis. Pemeriksaan klinis dan radiografi setelah 1 bulan memperlihatkan perbaikan dari lesi periapikal. Tahapan preparasi biomekanis pada perawatan endodontik non bedah pada gigi yang mengalami nekrosis pulpa dengan lesi periapikal apabila dilakukan dengan optimal dapat membantu medikamen kalsium hidroksida berpenetrasi baik pada jaringan periapikal dan membuat proses perbaikan pada lesi periapikal. Pengisian yang hermetis membantu sterilisasi saluran akar tetap terjaga dengan penutupan yang rapat. Radiografi merupakan metode yang paling banyak digunakan untuk mendeteksi lesi periapikal. Gambaran radiografi seperti perubahan densitas sekitar lesi, pembentukan kembali trabekula dan lamina dura menandakan adanya penyembuhan, terutama ketika dikaitkan dengan hasil klinis bahwa gigi tersebut tidak memiliki gejala dengan jaringan lunak yang sehat. Simpulan: Perawatan endodontik non bedah pada gigi molar pertama rahang bawah kiri nekrosis pulpa dengan lesi periapikal menunjukan keberhasilan dengan terjadinya penyembuhan jaringan keras Kata kunci: Perawatan endodontik non bedah, lesi periapikal, molar pertama, nekrosis pulpa Non-surgical endodontic treatment of left mandibular first molar pulp necrosis with periapical lesions ABSTRACT Introduction: The pulp disease infection course can spread to the root canals and periapical tissues, which creates periapical lesions. Periapical lesions, especially molar teeth, are a challenge for dentists because surgical endodontic treatment is more recommended than non-surgical treatment. This case report was aimed to discuss the successful non-surgical endodontic treatment of pulp necrotic teeth with periapical lesions. Case report: This case was discussing the left mandibular first molar with a periapical lesion in a 25-years-old male patient. Root canals was prepared and irrigated with 5.25% NaOCL and 18% EDTA, followed by agitation, which resulted in clean root canals. After being cleaned and dried, the calcium hydroxide medicament was given. Clinical evaluation was carried out every two weeks until there were no complaints from the patient. Root canal filling was performed hermetically. After one month...

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“…In addition the use of intracanal medication after chemomechanical preparation provides better chance of periapical repair, since the mechanical preparation by itself does not reach all the lateral root canals or dental tubules (44).…”

Section: Orthograde Root Canal Treatmentmentioning

confidence: 99%

Conservative management of periapical lesions of endodontic origin - a review of the different techniques

Borisova-Papancheva

Svetlozarova

2018

Scripta Scientifica Medicinae Dentalis

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INTRODUCTION: Periapical lesions of endodontic origin are common pathological conditions affecting the periradicular tissues. Mainly responsible for the initiation and progression of apical periodontitis is the microbial infection of pulpal tissues. There are different conservative techniques that can be applied in order to establish a healing process of periapical lesions of endodontic origin. MATERIALS AND METHODS: We have conducted a research that covers related articles and publications, in order to review the different conservative management treatment techniques for lesions affecting the periradicular tissues. RESULTS: Different non-surgical management techniques have been described, namely: conservative root canal therapy, decompression technique, a method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and repair therapy, active non-surgical decompression technique, and the apexum procedure. CONCLUSION: All of the described management techniques present with advantages, disadvantages and specific indications that should be taken into consideration when managing the treatment plan of every specific clinical case.

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Management of Cyst-like Periapical Lesions by Orthograde Decompression and Long-term Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series

Cited by 17 publications

References 44 publications

Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach

Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach

Perawatan endodontik non bedah pada gigi molar pertama rahang bawah kiri nekrosis pulpa dengan lesi periapikal

Conservative management of periapical lesions of endodontic origin - a review of the different techniques

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