Abstract
Endodontic perforations are defined as a iatrogenic mechanical communication between the root canal and supporting periodontal tissues. Dental imaging techniques are essential for satisfactory detection of these conditions. The purpose of this study was to describe the clinical case of a patient diagnosed with endo-periodontal cystic lesion by endodontic perforation by cone beam computed tomography (CBCT). A 67-year-old female patient who required oral rehabilitation treatment with an implant-supported denture in the posterior mandible was seen at the Dental Clinic of the State University of Rio Grande do Norte (UERN). Based on the data collected during clinical examination, complementary tests were requested for assessment of his overall dental condition. Periapical radiography revealed the presence of a lesion in the apex of tooth 22, which was associated with an endodontic lesion. CBCT showed a lateral lesion caused by root perforation suffered during prior endodontic treatment. After histopathological analysis, the diagnosis was a radicular cyst. This study highlights the importance of CBCT imaging for establishment of the correct diagnosis, treatment planning, and prevention of complications.
Highlights
Dentistry’s principle is the maintenance of the tooth in order to preserve the balance of the stomatognathic apparatus
The present study demonstrated the importance of the correct indication of periapical radiography and CBTC to establish the correct diagnosis since, in the case of a misdiagnosis, the treatment of choice for the patient would be unsatisfactory
The American Academy of Oral and Maxillofacial Radiology (AAOMR) and the American Association of Endodontists (AAE) issued a declaration that emphasizes the rational indication of cone beam computed tomography (CBCT), which should be used only after complete clinical examination, and that the diagnostic benefits of scanning should outweigh the risks of radiation exposure (Scarfe, Levin, Gane & Farman, 2009)
Summary
Dentistry’s principle is the maintenance of the tooth in order to preserve the balance of the stomatognathic apparatus. Despite the advances in imaging resources, the diagnosis of some root alterations, such as vertical root fracture, external root resorption and root perforation, can be extremely challenging, especially when specific clinical signs and symptoms are absent (Bernardes et al, 2009; Moudi et al, 2014). In this case, a more accurate method is necessary. Within this context, imaging science has witnessed advances in medical imaging over the past decades that were applied, with varying degrees of success, to different areas of Dentistry These advanced imaging techniques are important by permitting imaging in different planes (Bueno et al, 2007), as well as the visualization of anatomical structures and pathologies in three dimensions with better resolution. The patient signed the Free and Informed Consent Term, in which the research objectives were clarified and privacy, confidentiality and anonymity are ensured
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