• Title/Summary/Keyword: Periapical lesion

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TREATMENT FOR BILATERAL PERIAPICAL PATHOLOGIC INVOLVEMENT IN PREMOLARS DUE TO DENS EVAGINATUS (소구치(小臼齒) 개재결절(介在結節)로 인(因)한 양측성(兩側性) 치근단병소(齒根端病巢)의 처치예(處置例))

  • Kwon, Hyuk-Choon;Han, Soo-Boo;Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.7 no.1
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    • pp.41-45
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    • 1981
  • A 19-year-old Korean woman presented with left mandibular dental pain and swelling. Periapical radiolucencies were associated with the mandibular left first molar, second molar and the mandibular right second molar. The mandibular right second molar root developed incompletely and has the open apex. Clinical examination revealed worn accessory occlusal cusps of premolars. A diagnosis of dens evaginatus with associated periapical lesion secondary to pulpal necrosis was made. The root canal of the lower right second premolar was sealed with Calcium hydroxide paste for apexification. About two months later Calcium hydroxide paste was removed and the canal was resealed with new Calcium hydroxide paste. After four months the canal was sealed permanently with guttapercha and zinc oxide-eugenol sealer. The root canals of the lower left premolars were irrigated every week with 3.5% NaOCl solution for and half month. And the canals were sealed with gutta-percha and ZOE sealer. Preventive endodontic treatment for the lower right first premolar was undertaken.

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Bioblock technique to treat severe internal resorption with subsequent periapical pathology: a case report

  • Mark Frater;Tekla Sary;Sufyan Garoushi
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.43.1-43.9
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    • 2020
  • A variety of therapeutic modalities can be used for the endodontic treatment of a traumatized tooth with internal root resorption (IRR). The authors present a case report of the successful restoration of a traumatized upper central incisor that was weakened due to severe IRR and subsequent periapical lesion formation. A 20-year-old female patient was referred to our clinic with severe internal resorption and subsequent periapical pathosis destroying the buccal bone wall. Root canal treatment had been initiated previously at another dental practice, but at that time, the patient's condition could not be managed even with several treatments. After cone-beam computed tomography imaging and proper chemomechanical cleaning, the tooth was managed with a mineral trioxide aggregate plug followed by root canal filling using short fiber-reinforced composite, known as the Bioblock technique. This report is the first documentation of the use of the Bioblock technique in the restoration of a traumatized tooth. The Bioblock technique appears to be ideal for restoring wide irregular root canals, as in cases of severe internal resorption, because it can uniquely fill out the hollow irregularities of the canal. However, further long-term clinical investigations are required to provide additional information about this new technique.

Ga-G7 SCINTIGRAPHIC AND RADIOGRAPHIC EVALUATION OF THE ACTIVITY OF EXPERIMENTALLY INDUCED MANDIBULAR INFLAMMATORY LESION (Ga-67 골주사와 X선사진을 이용한 실험적 하악골 염증성 병변의 활성도 평가)

  • Kim Yung-Gul;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.19-29
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    • 1991
  • The purpose of this study was to evaluate the usefulness of Ga-67 scintigram in predicting the disappearance of inflammatory activity in mandibular lesions of dogs. Inflammatory bony lesions were produced artificially by the injection of sclerosing solution and bacterial suspension through the distal root canals of the lower 4th premolars in 10 dogs. The serial Ga-67 scintigrams and periapical radiograms were obtained. After 3 to 6 weeks duration of antibiotic therapy, the experimental animals were killed, and the mandibles were dissected. Bacteriologic culture and antibiotic sensitivity test were done. 1. The following results were obtained. The negative Ga-67 scan has 100% predictive value, and is a strong evidence of the resolution of inflammatory activity. In 2 animals of positive Ga-67 scan, I animal had negative culture. In 14 cases of positive Ga-67 scan, radiographically there was increase in the size of lesion in 9 cases, no change in 5 cases. In 8 cases of negative Ga-67 scan, radiographically there was increase in the size of lesion in I case, no change in 6 cases and decrease in 1 case.

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CASE REPORT : THE DISPLACEMENT OF PERMANENT TOOTH BUDS BY PERIAPICAL LESIONS OF ANTERIOR PRIMARY TEETH (유전치 치근단 병소에 의한 계승 영구치배의 변위)

  • Choi, Sun-Ah;Lee, Nan-Young;Lee, Sang-Ho;Lee, Chang-Seop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.224-228
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    • 2005
  • The effect of primary tooth infection on permanent teeth was reported by many previous study. It is seen histologic change in the enamel forming organ and in the surrounding sac, thus produce the defect as either hypoplasia or hypocalcification and alter the eruption of the permanent teeth. The periapical inflammation cause permanent tooth displacement in various direction and can be classified into the three categories : rotation, deflection inversion. This study reported case which displacement of succedaneous teeth may be caused by periapical infection of primary dentition and concluded that treatment procedure of infected primary tooth is selected and performed by importance to retain the tooth for space maintain, possibility to successfully restored, evidence of abnormal development of the succedaneous tooth.

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Species of therapy-resistant flora from infected root canals: their survival and resistant mechanisms to $Ca(OH)_2$

  • Lee, Woo-Cheol
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.607-607
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    • 2003
  • The purpose of this presentation is to investigate whether the certain therapy resistant bacteria can impair the immune defense system in the pariapical tissue. Recent studies have reported that the facultative or obligatory anaerobic bacteria such as Fusobacterium nucleatum, Enterococcus faecalis and Actinomyces species and Gram positive facultative bacteria Enterococcus faecalis have been shown to dominate in persistent periapical lesion and usually recovered from failed root canal treated cases. Moreover, E. faecalis has been reported to withstand the antimicrobial agent and endure potential starvation and resist the antibacterial effect of calcium hydroxide intracanal medication.(omitted)

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Recurrent symptomatic cemento-osseous dysplasia: A case report

  • Min, Chang-Ki;Koh, Kwang-Joon;Kim, Kyoung-A
    • Imaging Science in Dentistry
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    • v.48 no.2
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    • pp.131-137
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    • 2018
  • Cemento-osseous dysplasia (COD) is a benign fibro-osseous lesion of bone, in which normal bone is replaced by fibrous tissue, followed by calcification with osseous and cementum-like tissue. COD is classified into 3 categories according to its location: periapical, focal, and florid COD (FCOD). On radiography, FCOD appears radiolucent in its early stages. As it matures, radiopacities appear within the lesion, causing them to show a mixed appearance of radiolucency and radiopacity. Because FCOD is usually asymptomatic and grows in a self-limited manner, it does not require treatment. Secondary infection is the most frequent cause of symptomatic cases. We report a case of FCOD with symptoms that appeared after a dental restoration procedure and persisted after repeated operations. The purpose of this report is to emphasize the importance of thorough radiological evaluations of patients with FCOD before treatment.

Surgical management of an accessory canal in a maxillary premolar: a case report

  • Kim, Hee-Jin;Yu, Mi-Kyung;Lee, Kwang-Won;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.44 no.3
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    • pp.30.1-30.6
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    • 2019
  • We report the surgical endodontic treatment of a maxillary first premolar with a lateral lesion that originated from an accessory canal. Although lesions originating from accessory canals frequently heal with simple conventional endodontic therapy, some lesions may need additional and different treatment. In the present case, conventional root canal retreatment led to incomplete healing with the need for further treatment (i.e., surgery). Surgical endodontic management with a fast-setting calcium silicate cement was performed on the accessory canal using a dental operating microscope. At the patient's 9-month recall visit, the lesion was resolved upon radiography.

LEVELS OF TNF-α,-β, IL-1β, TGF-β1 AND THEIR RELATIONSHIP WITH THE PRESENCE OF SPECIFIC BLACK PIGMENTED BACTERIA IN PERIAPICAL AND PULPAL DISEASES (치근단 및 치수병변 환자에서의 TNF-α와 β, IL-1β 및 TGF-β1의 수준과 근관내 특정 black pigmented bacteria와의 연관성에 관한 연구)

  • Byun, Ho-Young;Lim, Sung-Sam;Park, Dong-Sung
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.1-12
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    • 1999
  • Bacterial infection of the pulp results in the development of a periapical lesion with the concomitant resorption of periapical bone. The cytokines are believed to play an important role in this matter. The purpose of this study was to find the relationship among the presence of black pigmented bacteria, the levels of cytokines(TNF-${\alpha}$, -${\beta}$, IL-$1{\beta}$, and TGF-${\beta}1$), and the amount of bone resorption in periapical and pulpal diseases. For the purpose, the patients were grouped into chronic apical pathosis, acute apical pathosis, acute pulpitis, and a healthy control group. Root canal samples were taken from periapical tissue exudates during routine endodontic treatment, and the venous blood was taken from each patients. The samples were processed to measure local and systemic levels of the cytokines using enzyme linked immunosorbent assay(ELISA). Bacterial content of Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella nigrescens were measured by indirect immunofluorescence method and the size of the periapical lesions were measured from the radiographs. The following results were obtained: 1. The levels of bone resorptive cytokines(TNF-${\alpha}$, TNF-${\beta}$, and IL-$1{\beta}$) in exudates from acute and chronic apical pathoses were significantly higher than those from acute pulpitis and the normal pulps(p<0.05). 2. IL-$1{\beta}$ were the highest among the bone resorptive cytokines in apical pathoses. However, no statistical difference between acute and chronic lesions were found(p>0.05). 3. The levels of TGF-${\beta}1$ in exudates from acute pulpitis and chronic apical pathoses were significantly higher than those from acute apical pathoses and the normal pulps(p<0.05). However, there were no significant correlations among the levels of bone resorptive cytokines. 4. The levels of TNF-${\beta}$ in serum were significantly higher than those from the exudates while serum TGF-${\beta}1$ concentrations were significantly lower(p<0.05). 5. Exudates from the canals in which the P. nigrescens were detected showed significantly higher levels of IL-$1{\beta}$ than those from the canals without the microorganism(p<0.05). 6. There were no significant correlations among the levels of the cytokines, the amount of bone destruction, and the presence of acute and chronic symptoms(p>0.05).

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The Therapeutic Effects of a Pulsed Nd:YAG Laser on Oral Lesions (구강병소에 대한 펄스형 Nd: YAG 레이저의 치료효과)

  • 신금백
    • Journal of Oral Medicine and Pain
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    • v.22 no.2
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    • pp.309-325
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    • 1997
  • In order to set the lasing variables and evaluate, clinically, the therapeutic effects of a pulsed Nd:YAG laser on oral lesion, the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, Pulse duration 120$\mu$sec, fiber diameter 200$\mu$m/320$\mu$m) to 22 cases of oral soft tissue lesions and 6 cases of oral hard tissue lesions. The obtained results were as follows : 1. The effective excision with contact mode and the effective hemostasis of accompanied bleeding with noncontact mode were occurred by lasing on oral soft tissue lesions with fiber diameter of 320$\mu$m under the variables of 2.0~4.0W and 20~50Hz which were controlled into high power/low pulses for excision, low power/high pulses for hemostasis, low power in granulation tissue and high power in fibrous tissue according to therapeutic goals and tissue conditions. 2. About 50% of decreasing effect on hypersensitivity was occurred by lasing with non-contact and contact mode on cervical abrasion which caused dentinal hypersensitivity with fiber diameter of 320$\mu$m under the variables of 0.7 - 1.0W and 10Hz which were applied 2~3 times with 1 week interval. 3. The effective sterilization of infected root canal and lesion of periapical abscess was occurred by lasing with contact and spiral modes on wall of root canal and periapical abscess with fiber diameter of 200$\mu$m of which the tip was placed about 1mm shorter than root canal length under the variables of 1.OW and 10Hz.

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A CASE REPORT ON INTENTIONAL REPLANTATION OF MAXILLARY FIRST BICUSPID (Intentional Replantation에 의한 상악 제 1 소구치 치료의 증례보고)

  • Chung, Woo-Jin;Kim, Jong-Bum;Lee, Sang-Hoon;Hahn, Sae-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.556-561
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    • 1997
  • Intentional replantation of the posterior teeth has been performed as a last resort except extraction when it is impossible to perform the conventional endodontic or surgical endodontic treatment. Many studies have done with the prognosis, and root resorption, of which the responsibility might have been injury of periodontal ligament and remaining periodontal lesion, proved to be major cause of failure. Intentional replantation, however, can exclude anatomic difficulty, risk of nerve injury, and maxillary sinus trauma that surgical access can raise, especially in posterior teeth, and it is reported that success rate is not less than surgical endodontics, independent of replantation of traumatically avulsed teeth. The success of intentional replantation can be evaluated with, clinically, reduction of pocket depth, pain and mobility(physical mobility), and, radiographically, hard tissue formation, reduction of periapical radiolucency. In this case report, for the maxillary left first bicuspid with dens evaginatus that had periapical lesion, painfulness, mobility and showed no reduction of mobility after even extirpation and a number of irrigation, extraction followed by extraoral root filling with calcium hydroxide and replantation was performed. Based on many studies, it is concluded that hard tissue formation capacity of calcium hydroxide, preceded extirpation before extraction, and careful extraction without injuring periodontal ligament affected successful results of this case.

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