Abstract
Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA) obturation using cone beam computed tomography (CBCT). The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA) radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.
Highlights
Periapical lesion of endodontic origin is one of the most frequently occurring pathologic conditions found in the alveolar bone
Periapical lesions may progress from the inflammation of the periodontal ligament around the root apex into a variety of pathologic conditions, like apical abscess, periapical granuloma, and radicular cyst
When endodontic treatment is done properly, healing of the periapical lesion occurs with hard tissue regeneration, which is characterized by gradual resolution of the periapical radiolucency [1]
Summary
Periapical lesion of endodontic origin is one of the most frequently occurring pathologic conditions found in the alveolar bone. Besides the possible clinical signs and symptoms associated with the periapical lesions, there are changes in the mineralization and structure of the periradicular bone which results in resorption This can be visualized by various radiographic techniques as periapical radiolucencies. Despite its outstanding tissue biocompatibility, MTA has few disadvantages, which include delayed setting time, poor handling characteristics, unpredictable antibacterial effects, and high cost [1] It has long been debated whether bone healing after endodontic treatment is ongoing or whether the treatment effort has been futile. The following case report describes evaluation of healing of a large periapical lesion in an asymptomatic non-vital left maxillary lateral incisor with an open apex treated with MTA obturation using CBCT and IOPA radiographs over a period of two years
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