Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Vital tooth with periapical lesion: spontaneous healing after conservative treatment

생활치에서 나타나는 치근단 병소: 보존적 치료 후 자연치유

  • Kim, Hyun-Joo (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Lee, Seung-Jong (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Jung, Il-Young (Department of Conservative Dentistry, Yonsei University College of Dentistry) ;
  • Park, Sung-Ho (Department of Conservative Dentistry, Yonsei University College of Dentistry)
  • 김현주 (연세대학교 치과대학 보존학교실) ;
  • 이승종 (연세대학교 치과대학 보존학교실) ;
  • 정일영 (연세대학교 치과대학 보존학교실) ;
  • 박성호 (연세대학교 치과대학 보존학교실)
  • Received : 2011.12.27
  • Accepted : 2012.04.06
  • Published : 2012.06.01
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Abstract

It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

기계적 또는 세균 부산물에 의한 만성자극이 치아에 지속적으로 가해질 경우 치근단 부위로 치수 신경 섬유의 sprouting이 증가하고 neuropeptide, cytokine의 분비가 촉진되어 파골세포의 활성도가 증가하게 된다. 이로 인해 생활치에서 치근단 병소가 발생가능하며, 이러한 기전을 이해하고 자극원을 제거해주는 보존적 치료만으로도 자연치유를 기대할 수 있을 것이다.

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References

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