• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.233-248
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• 1987

The author studied the effect of periapical bone loss on radiographic interpretation by using a dry adult human mandible. Artificial bony lesions were created at the apices of two mandibular second molars and four mandibular bicuspids. The jaw was stabilized and various artificial lesions were radiographed under ideal circumstances. Radiographic pictures were recorded and compared with the size of the actual lesions. The obtained results were as follows: 1. The size of actual lesions were always larger than their radiographic pictures. 2. The size of actual lesion had a greater discrepancy in the molar area where the cortical plates were havier, but the lesions in the bicuspid areas were only slightely larger than their radiographic pictures, and in these areas the cortical plates were quite thin. 3 Periapical lesions located in cancellous bone did not appear on a radiograph, regardless of the size of the created lesion, but when the junctional bone was involved or the cortical plate was perforated, the definite bone destructive change was observed on the roentenogram. 4. Removal of the entire buccal or lingual plate did not affect the trabecular pattern of bone on the roentgenogram. 5. When the cancellous bone and junctional bone were removed simultaneously, altered trabecular patterns were observed on the roentgenogram.

• Restorative Dentistry and Endodontics
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• v.38 no.2
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• pp.90-92
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• 2013

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.

• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.160-166
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• 2013

This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.

• Journal of Veterinary Clinics
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• v.19 no.2
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• pp.253-255
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• 2002

A 10-year-old, female mixed breed dog and a 3-year-old, female chihuahua which had swelling below lower eyelid were refered to Veterinary Medical Teaching Hospital, Seoul National University. The plain maxillary oblique view revealed radiolucency at periapical area in maxillary fourth premolar. The 2 cases were diagnosed as periapical abscess by clinical sign and radiographs, and apicoectomies were performed for resetting the lesions and preserving the teeth. Under general anesthesia with isoflurane, periapical abscess was resected by burs and the defect was filled with zinc phosphate cement. Radiograph was perfomed at 1 week and 1 year after apicoectomy and there was no evidence of recurrence.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.316-327
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• 1998

This study was designed to examine the tissue levels of interleukin-$1{\alpha}$(IL-$1{\alpha}$), interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) in inflamed human dental pulps and periapical lesions, and to determine the relationship between each cytokine and pulpal and periapical pathosis. The pulps used in this experiment, were obtained in routine endodontic treatment and the periapical lesions in periapical surgery after clinical diagnoses were performed. These specimens were divided into four groups as normal pulp group(control group, n=9), acute pulpitis group(n=g), chronic pulpitis group(n= 10) and periapical lesion group(n= 18) and stored in liquid N2. For extract preparation, tissues were finely minced with a scalpel, and the fragments were incubated in $0.5m\ell$ homogenizing buffer (0.1 mol/L potassium chloride, 0.02 mol/L TRIS; pH=7.6) for two hours and grinded with glass homogenizer. Debris was removed by centrifugation and supernatants were immediately tested with enzymelinked immunosorbent assay (ELISA, R&D Co., Minneapolis, USA). Following results were obtained; 1. The concentrations of IL-$1{\alpha}$ in all experimental groups were significantly higher than in control group(p<0.05). And the concentrations of IL-$1{\alpha}$ in periapical lesion group were somewhat higher than in two pulpitis groups, but the differences among those groups were not stastically significant (p>0.05). 2. The concentrations of IL-$1{\beta}$ in all experimental groups were significantly higher than in control group (p<0.05), and all the experimental groups expressed similar concentrations. 3. The concentrations of TNF-${\alpha}$ in all experimental groups were higher than in control group but only the differences between chronic pulpitis group and control group were statistically significant(p<0.05). And the concentrations of TNF-${\alpha}$ in acute and chronic pulpit is groups were higher than in periapical lesion group but only the differences between chronic pulpitis group and periapical lesion group were statistically significant (p<0.05). 4. There was significant correlation only between IL-$1{\alpha}$ and IL-$1{\beta}$ in periapical lesion group (p<0.05).

• The Journal of the Korean dental association
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• v.19 no.8 s.147
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• pp.673-678
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• 1981

• The Journal of the Korean dental association
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• v.40 no.5 s.396
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• pp.388-397
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• 2002

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.12.1-12.11
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• 2022

Objectives: This pilot study aimed to establish the interrelationship between collagen and mast cells in periapical granulomas and periapical cysts. Materials and Methods: An observational cross-sectional study was conducted on the paraffin-embedded tissue sections of 68 specimens (34 periapical granulomas and 34 periapical cysts). The specimens were stained with picrosirius to observe collagen fiber birefringence and anti-tryptase antibody to evaluate the mast cell count immunohistochemically. The mean number and birefringence of collagen fibers, as well as the mean number of mast cells (total, granulated, and degranulated), and the mean inflammatory cell density were calculated. The data obtained were analyzed using the Kruskal Wallis test, Mann Whitney U test, and Spearman correlation test (p < 0.05). Results: The mean number of thick collagen fibers was higher in periapical cysts, while that of thin fibers was higher in granulomas (p = 0.00). Cysts emitted orange-yellow to red birefringence, whereas periapical granulomas had predominantly green fibers (p = 0.00). The mean inflammatory cell density was comparable in all groups (p = 0.129). The number of total, degranulated, and granulated mast cells exhibited significant results (p = 0.00) in both groups. Thick cyst fibers showed significant inverse correlations with inflammation and degranulated mast cells (p = 0.041, 0.04 respectively). Conclusions: Mast cells and inflammatory cells influenced the nature of collagen fiber formation and its birefringence. This finding may assist in the prediction of the nature, pathogenesis, and biological behavior of periapical lesions.

• 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.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.16 no.1
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• pp.113-126
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• 1986

This study was undertaken to document and better define this condition to help clarify this clinical and radiographic appearances by the analysis of clinical and radiographic features of cementoma. A study was made of a series of 104 cases with cementoma. This investigation of cementoma revealed the following features: 1. The female occurred in 73% of periapical cemental dysplasia and benign cementoblastoma, and 80% of cementifying fibroma. 2. 40% of periapical cemental dysplasia occurred in the fifth decades, and 73% of benign cementoblastoma during the second and third decades, while there was no age predilection in the cementifying fibroma. 3. 63% of periapical cemental dysplasia occurred in the mandibular anterior region. 91% of benign cementoblastoma and 80% of cementifying fibroma occurred in the mandibular premolar and/or molar region. 4. There were no cases complaining the associated clinical signs and subjective symptoms in the periapical cemental dysplasia, however the patient complained the pain in 36% of benign cementoblastoma and 40% of cementifying fibroma. 5. There were no cases expanding the cortical plates in the periapical cemental dysplasia, however 73% of benign cementoblastoma and all of 5 cases of cementifying fibroma showed the expansion of cortical plates. 6. Several radiographic features of the periapical cemental dysplasia were shown: a. 29% of the cases had multiple lesions. b. 53% of the cases were in the mature stage. c. During the osteolytic stage, the alveolar lamina dura was lost in 89% of the cases.