• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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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%).

• 대한소아치과학회지
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• 제34권2호
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• pp.329-334
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• 2007

유치의 치수감염은 주로 치아우식증이나 외상에 의해 발생한다. 유치의 치수 감염을 적절히 치료하지 않으면, 계승영구치의 법랑질 형성 부전이나 매복, 치배의 위치 변화, 치근 만곡 등의 합병증을 초래한다. 유치의 치근단 병소에 의한 계승영구치는 여러 방향으로 변위가 가능하다. 변위된 계승영구치의 치료법으로는 유치 발거 후 주기적 관찰, 외과적인 노출, 교정적 견인, 치아이식, 영구치의 발거 등이 있다. 본 증례들에서는 초진시 임상적 및 방사선학적 검사 결과, 유전치의 치근단 병소에 의해 변위된 영구치 치배가 관찰되었다. 변위 정도와 치근 발육 정도, 맹출 방향 등을 고려하여 유치 발거 후 변위된 영구치의 자발적 맹출 유도를 기대하였다. 두 증례에서 유치의 발거 후 주기적 관찰만으로 변위된 영구치의 자발적 맹출의 결과를 얻을 수 있었다.

• 치과방사선
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• 제25권1호
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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.

• 대한소아치과학회지
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• 제38권1호
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• pp.82-87
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• 2011

유치의 치수 감염에 대한 적절한 치료가 이루어지지 않거나 치료가 실패한 경우 치근단 병소를 야기할 수 있다. 이는 발육중인 계승 영구치에도 영향을 주어 법랑질 형성 부전, 치배의 위치 및 맹출 경로 변화, 치근 만곡, 치아 매복 등의 합병증을 유발할 수 있다. 계승 영구치의 맹출 방향에 이상을 일으키는 장애 요인으로는 유치의 만기 잔존, 유구치의 불균형적인 치근 흡수, 유치의 치근단 병소 등의 맹출 전 장애 요인과 외상이나 구강 악습관과 같은 맹출 후 장애 요인이 있다. 맹출 경로의 이상을 보이는 계승 영구치의 치료 방법으로는 주기적인 관찰, 외과적 노출, 교정적 견인, 치아 이식, 발치 등이 있으며 치료 방법 선택시 치아의 위치, 상태, 치근 형성 정도 및 만곡 여부, 맹출 방향, 인접 구조물과의 관계 등을 고려하여야 한다. 본 증례들은 유치의 치근단 병소에 의해 비정상적인 맹출 경로를 보이는 소구치를 가진 환자들에서 감염된 유치의 발거와 공간 유지만으로 이환된 소구치의 양호한 자발적 맹출을 보였기에 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제48권3호
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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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• 제8권1호
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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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• 제35권4호
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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.

• 대한치과의사협회지
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• 제51권1호
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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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• 제20권1호
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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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• 제42권4호
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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.