• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.232-237
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• 2001

The purpose of this study was to find the clinical features of periapical lesions. A total of 130 periapical lesions which were obtained from biopsy and diagnosed histopathologically as periapical cyst, periapical abscess, and periapical granuloma at the Department of Dentistry in Hanyang University Hospital were throughly analysed according to the distribution and incidence of age, sex, location, and so on. The following results were obtained : 1. Out of 130 periapical lesions, 88 cases(67.7%) were periapical cysts, 30 cases(23.1%) were periapical abscesses, and 12 cases(9.2%) were periapical granulomas. 2. The periapical lesions occurred most frequently in the third decade, and followed by the fourth, fifth, sixth, and second decade. The periapical cysts occurred most frequently in the third decade(26.1%), the periapical granulomas in the fourth decade(33.3%) the periapical abscesses in the sixth decade(26.7%). 3. The periapical lesions were more frequent in men than in women with the ratio of men to women of 1.4 : 1. The radio of men to women of periapical cysts was 1.6 : 1, that of periapical granulomas was 0.5 : 1, and that of periapical abscesses was 1.3 : 1. 4. The periapical lesions were more frequent in maxilla than in mandible with the ratio of 1.2 : 1. The ratio of maxilla to mandible of periapical cysts was 1.5 : 1, that of periapical granulomas was 0.5 : 1, that of periapical abscesses was 1 : 1. 5. The most commonly involved location of the periapical lesions was maxillary anterior teeth(40.8%), and followed by mandibular molars, mandibular premolars, and mandibular anterior teeth and maxillary molars. The most frequent location of the periapical cysts was maxillary anterior teeth(48.9%), that of periapical granulomas was mandibular molars(50.0%), that of periapical abscesses was mandibular molars(40.0%).

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.329-334
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• 2007

The infection of primary teeth occurs by caries or trauma. But, if it is not treated on time, the complication may occur such as enamel hypoplasia, discoloration, impaction, displacement and dilaceration of permanent successors. The periapical lesion on primary tooth could displace the permanent successors in any direction. Treatment options of displaced tooth are observation after extracting the primary teeth, surgical exposure orthodontic traction, transplantation and extraction. In these cases, displacement of permanent central incisor caused by the periapical lesion of primary teeth was observed. The spontaneous eruption after extraction of primary teeth was expected considering degree of displacement, development of root and direction of eruption. This case report shows spontaneous eruption of displaced permanent tooth germ was achieved with periodic examination after extraction of primary teeth.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.39-49
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• 1995

This study was performed to determine the each location of lesions in the maxillary sinus and to evaluate the relationship between the floor of the antrum and the apical regions of teeth by the comparison of the panoramic view and panoramic sinus view. For this study, experimentally with two dry skulls, jelly balls of 8mm and 15mm in diameter containing a short wire for the radiopacity similar to the cyst and clinically 5 patients having mucosal cyst in the antrum and 10 patients having periapical lesion of molar were used. The experimental cystic lesions were simulated with jelly ball being attached in turn to each wall of the antrum. The radiolucent periapical lesions of upper molars were formed by using round bur and the radiopaque periapical lesions were simulated by filling the former lesions with lead foil. Each panoramic view and each panoramic sinus view of the experimental lesions and patients were obtained by using panoramic machine and analyzed. The obtained results were as follows : 1. On the panoramic sinus view, the innominate line was approximately coincided with the most lateral portion of the antrum and the posterior wall appeared as the narrow area at the mesial side of the innominate line. The anterior wall occupied totally the mesial side of the innominate line, and the medial wall occupied the mesial half of the antrum. 2. In all cases of experimental cystic lesion attached to each wall of the antrum, the location of each lesion was able to be determined by applying Tube shift technic. 3. The palatal root and mesiobuccal root of the molar appeared as being transposed each other mesiolaterally on the panoramic and panoramic sinus views. 4. The panoramic sinus view was superior to the panoramic view in revealing the relationship between the floor of the antrum and the periapical lesion.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.82-87
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• 2011

The pulp infection of primary tooth is often caused by dental caries or trauma. But, if it is not managed properly, it can be produce the periapical lesion. The periapical lesion can cause some complications such as enamel hypoplasia, displacement, root dilaceration and impaction. Treatment options of displaced permanent successor are clinical and radiological follow-up after extraction of primary teeth, surgical opening, orthodontic traction, transplantation and extraction. In these cases, the premolars with abnormal eruption path caused by periapical lesion of the primary tooth have shown successful spontaneous eruption just as a result of extraction of infected primary tooth and space maintenance.

• Restorative Dentistry and Endodontics
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• v.48 no.3
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• pp.23.1-23.8
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• 2023

Objectives: The formation of new bone by periosteum due to an insult is called periosteal bone reaction (PBR). This study assessed the cone beam computed tomography (CBCT) patterns of periosteal bone reactions associated with periapical inflammatory lesion (apical periodontitis/periapical rarefying osteitis). Materials and Methods: Twenty-two small field of view CBCT images of patients with PBR were selected from a database of a private practice limited to endodontics. The volume of the periapical inflammatory lesion, the presence of cortical fenestration, the distance of the root apices to the affected cortex, and the location, pattern, and longest diameter of the periosteal reaction were recorded. Statistical analysis was performed using Wilcoxon Ranksum, Fischer's exact, Spearman Correlation Coefficient, and paired t-test. Results: In all cases, periosteal bone reaction manifested as either parallel (90.9%) or irregular (9.1%). No correlation was found between periapical inflammatory lesion volume and the periosteal reaction's longest diameter (p > 0.05). Cortical fenestration was noted in 72.7% of the cases. In addition, the findings showed that periosteal reactions were located mostly on the buccal and were present 53.8% and 100% of the time in the mandible and maxilla, respectively. Conclusions: The periosteal reactions of endodontic origin had a nonaggressive form (i.e., parallel or irregular), and none of the lesions resulted in a periosteal reaction with an ominous Codman's triangle or spicule pattern.

• Restorative Dentistry and Endodontics
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• v.8 no.1
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• pp.19-30
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• 1982

This study was performed to elucidate the histopathologic distribution of immunoglobulins, particularly IgA, IgG and IgM in the periapical lesions, including 22 periapical granulomas and 18 periapical cysts. The immunoperoxidase staining method using reagents manufactured and supplied by Danish DAKO company was employed in this study. In comparison with the immunohistochemical methods, this method was proved to be reliable and convinient one to detect immunoglobulins in the tissue. The following results were obtained: 1. In the 22 periapical granulomas, IgG was found in 20 cases (90.9%), IgA in 16 cases (72.7%) and IgM in 19 cases (86.3%). 2. In the 18 periapical cysts, IgG was found in 16 cases (88.8%), IgA in 13 cases (72.2%) and IgM in 15 cases (83.3%). 3. The distribution of immunoglobulins both in periapical granulomas and periapical cysts was in great diversity according to the lesion and area. 4. More immunoglobulins were found in the exudative area with moderate or severe infiltrations of plasma cells and lymphocytes and less concentration of immunoglobulins were seen in the area with leukocytes infiltration and tissue destruction. 5. The area with collagenolysis and reparative activity contained more abundant IgG and IgM than IgA in periapical granulomas. 6. IgG was dominant in the granulomatous connective tissue and immunoglobulins were not easily found in the fibrous capsule in periapical cysts.

• Imaging Science in Dentistry
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• v.35 no.4
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• pp.221-223
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• 2005

A case of osteoporotic bone marrow defect, which appeared as a well-defined multilocular radiolucency overlapping the roots of mandibular right second molar, was reported. On periapical radiograph, a daughter cyst-like radiolucency was seen at the anterior margin of the lesion making it difficult to rule out odontogenic keratocyst.

• The Journal of the Korean dental association
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• v.51 no.1
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• pp.33-38
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• 2013

Traumatic bone cyst is known as a symptomless, radiolucent bony les ion incidentally found during routine radiographic examinations. The main characters of traumatic bone cyst are asymptomatic and unicystic radiolucent bony lesion with vital tooth. This case is a confusing case of a traumatic bone cyst with sudden gingival swelling and appearance like a periapical abscess. After surgical exploration and drainage, clinical and radiographic examination showed bony healing with pulpal vitality preserved after 7 months postoperatively.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.55-70
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• 1995

Periapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce he31ing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nonspecific inflammation, fibrosis and periapical Cyst were evaluated for the distribution of immunoglobulin containing cells. The influence of the state of root canal treatment on the distribution of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with Vitapex(calcium hydroxide). The distribution of immunoglobulin-containing cells according to the presence of pain and fistula was also evaluated. The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<0.05) The number of immunoglobulin-containing cells in fibrosis was remarkably lower than that of periapical abscess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig-containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distribution of immunoglobulin containing cells in periapical lesions.(t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.265-270
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• 2012

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.