Repair of large periapical radiolucent lesions of endodontic origin without surgical treatment

Abstract

The aim of this paper is to present two case reports of pulp necrosis and radiolucent periapical lesions, which were treated without surgical treatment. The first was a mandibular molar with periapical lesion of endodontic origin extending towards the furcation in a 20-year-old woman, and the second affected a maxillary right lateral incisor with a large periapical lesion in a 22-year-old woman. The endodontic treatments were carried out in two sessions, with crown-down instrumentation, irrigation with 2.5% sodium hypochlorite and intracanal medication with calcium hydroxide paste. After 30 days, the root canals were filled with gutta-percha and Sealapex sealer by the lateral condensation technique. The clinical and radiographic examination after 1 year revealed complete repair. The appropriate diagnosis of lesions of endodontic origin and the treatment and obturation of the infected canals allowed complete repair of these large radiolucent periapical lesions without surgical treatment.

Treatment of extraoral submental sinus tract associated with large periapical lesion of traumatized lower central incisors teeth by periapical surgery and demineralized freeze-dried bone allograft

“…[15] Some authors declared that a period of more than 2 years is able to determine the final treatment result of these lesions. [16] In the present case, the recession of the periapical lesion by periapical surgery with DFDBA was evident after 1 year.…”

Tratamento com MTA Repair HP de extensa perfuração radicular após iatrogenia: relato de caso

“…O tratamento de lesões perirradiculares é complexo, no entanto é consenso que a redução ou eliminação do conteúdo bacteriano no sistema de canais radiculares traz resultados eficazes, e mesmo grandes lesões podem responder positivamente ao tratamento endodôntico não cirúrgico 22,23 .…”

Healing of a large periapical lesion using triple antibiotic paste and intracanal aspiration in nonsurgical endodontic retreatment

“…[ 16 ] Of late, it has been proved that if the lesion is effectively evacuated of the inflammatory exudates and the microbial load is reduced with an effective intracanal medicament, it is possible to stimulate the immunological system to induce repair, even in cystic lesions. [ 17 ] Considering all this, nonsurgical root canal treatment should always be the first choice in cases of non-vital teeth with infected root canals. Elimination of bacteria from the root canal is the most important factor for the successful treatment of periapical lesions, and the lack of regression of such lesions is generally assigned to the persistence of bacteria inside the root canal.…”