Management Of Large Periapical Lesion Research Articles

Conservative approach in the management of large periapical lesion in a long standing trauma case: A case report

Pulpal and periradicular pathology is the common sequel following trauma to the teeth severe enough to cause displacement of tooth resulting in necrosis of pulp as a result of severing of neurovascular supply near apical constriction. This case report evidenced a conservative non-surgical endodontic management of a large periapical lesion in a 19-year-old young male induced due to traumatic injury to the face.

Evaluation of knowledge, attitude and practice of endodontic postgraduates towards preference of surgical vs non-surgical management of large periapical lesion - A survey

Evaluation of knowledge, attitude and practice of endodontic postgraduates towards preference of surgical vs non-surgical management of large periapical lesion - A survey

Management of large periapical lesion with the combination of second generation platelet extract and xenograft: A report of two cases

Periapical inflammatory lesion is the local response of bone around the apex of tooth that develops after the necrosis of the pulp tissue or substantial periodontal disease. Periapical surgery aims to remove periapical pathology to achieve wound healing and regeneration of bone and periodontal tissue. The purpose of this case report is to through a light on use of platelet-rich fibrin and bone graft in the treatment of large periapical lesion. Platelet rich fibrin (PRF) is a magnificent tissue engineering product and has gained substantial popularity due to its promising results in wound healing bone induction. Bone graft used in both cases in the present case report was xenograft which is similar to human cancellous bone and is known to have osteoinductive as well as osteoconductive properties. Keywords: Periapical inflammatory lesion, Platelet rich fibrin xenograft, Regeneration, Wound healing, Periapical surgery.

The Use of Calcium Hydroxide as an Intracanal Medicament in the Treatment of Large Periapical Lesions. A Review

Abstract Calcium hydroxide is a slow-acting antiseptic substance used in several forms for the last century in various fields of dentistry. Its applications in endodontics are by far the most meaningful including the treatment of root resorptions and perforations, inducing the apexification process, and most importantly as intracanal medicaments representing a crucial step in the nonsurgical management of large periapical lesions. The aim of this article is to conduct a review of the properties, antimicrobial effect, combination with adjuvant substances, biocompatibility, cytotoxicity, and adverse effects of calcium hydroxide-based dressings as an additional manoeuvre in the conservative treatment of chronic apical periodontitis and to draw attention on the importance of this extra step.

Non-surgical Management of Large Periapical Lesions with the Agreement Evaluation of the Methods

Aim: The aim of this study is to evaluate the agreement between three routinely used non-surgical management techniques for large periapical lesions namely the treatments with Calcium hydroxide, Mineralo-Trioxide Aggregate and Bio-dentine.
 Methods: Data was collected from 60 patients at the Department of Restorative Dentistry, Faculty of Dental Sciences, University of Peradeniya. The variables age, gender and area of the infected region before and after the treatment and the treatment type were considered. Two homoscedastic and heteroscedastic Mixed-effects models were fitted and the agreement between three treatments were assessed using Concordance Correlation Coefficient (CCC) and Total Deviation Index (TDI).
 Results: CCC value calculated for treatment types 1 & 2, 1 & 3 and 2 & 3 are (0.905, 0.909, 0.874) for homoscedastic model and (0.989, 0.990, 0.975) for heteroscedastic model. Further, corresponding TDI values for homoscedastic and heteroscedastic models are (3.148, 4.390, 1.647) and (2.963, 4.388, 1.457) respectively.
 Conclusions: Since all the CCC values are close to 1 and TDI values are low, there is a strong agreement between all three treatments and hence they be used interchangeably. Moreover, the agreement between Treatments with Calcium hydroxide and Bio-dentine is higher compared to the agreements between the other treatments. (i.e., Calcium hydroxide with Mineralo-Trioxide Aggregate and Biodentine with Mineralo-Trioxide Aggregate).

Review on Platelet Rich Fibrin and Case Report on Management of Large Periapical Lesion

Review on Platelet Rich Fibrin and Case Report on Management of Large Periapical Lesion

Management of large periapical lesion due to trauma using triple antibiotic paste

Introduction: Mechanical instrumentation and chemical irrigation alone is not considered enough to eliminate microorganisms in the deeper layer of root canal system. Therefore, antibacterial medicaments are required for complete disinfection of root canal dentin. Case Presentation: Triple antibiotic paste application (metronidazole, ciprofloxacin and minocycline) have demonstrated good clinical and radiographical results for treatment of presented traumatized teeth with periapical lesion. Conclusion: It confirms that conservative treatment should be first option for treatment of periapical lesion. Triple antibiotic paste has benefical effects for traumatized teeth with periapical lesion.

Non Surgical Management of Large Periapical Lesions Using Calcium Hydroxide - A Report of Two Cases

Nonsurgical management of periapical lesions has shown to have a high success rate. In the present case series, two large periapical lesions were treated with conservative therapy by the use of calcium hydroxide as an interim root canal dressing. The lesions resulted in successful resolution and healed completely. Long term follow-up of these cases is required to assess the success rate achievable by this mode of treatment.

A Novel Approach for Apexification: A 2-year Follow-up

ABSTRACT Aim To present a novel approach for nonsurgical management of large periapical lesion with open apex by using White Portland Cement to create an apical plug leads to substantial periapical healing. Summary Radiographic examination in this case indicated previous root canal treated, immature tooth with a wide-open apex and a periapical radiolucency. After cleaning and shaping Triple antibiotic paste was placed for 3 weeks. Hydroxyapatite was mixed with sterile saline & placed beyond the canal apex until with the aim of creating a periapical barrier. WPC powder was then mixed with sterile water, carried inside the canal to create apical plug (4mm) and obturation. The remainder of the canal was filled with thermoplastic gutta-percha. This was followed by post &core and PFM crown. Clinical follow-up of 2 years revealed absence of clinical symptoms and substantial periapical healing. How to cite this article Deshpande SS, Bansode PV. A Novel Approach for Apexification: A 2-year Follow-up Case Report. Int J Prosthodont Restor Dent 2016;6(1)17-20.

Non surgical management of large periapical lesion using mta: report of 2 cases

In the past, cases with open apices were often treated over several appointments, using calcium hydroxide, with the hope of creating a ‘‘calcific’’ barrier against which gutta percha could eventually be placed. The treatment could be as long and the prognosis is questionable. These roots were often thinner and, therefore, more brittle; extending treatment over a long period of time without providing a permanent restoration increased the chances of losing these teeth due to fracture. With the favorable histologic response of MTA, this material is the best current choice for this procedure. Completion of these cases in an effective and efficient way allows for permanent restorations to be done in a timelier manner, prolonging the longevity of these teeth. The following case report demonstrates the use of MTA as an obturating material to promote periapical healing with an open apex.

Non Surgical Management of Large Periapical Lesions of Endodontic Origin: A Case Series

ABSTRACT The success of root canal treatment is based on total elimination of root canal content, thorough cleaning, shaping and obturation of root canal system. Calcium hydroxide is recommended as intra-canal medicament because of its antibacterial properties, tissue dissolving ability, inhibition of tooth resorption and indication of tissue repair by hard tissue formation. The present case series highlights the use of calcium hydroxide as an inter appointment endodontic dressing for management of large periapical radiolucency and periodically reviewed. Thus the non surgical healing of large periapical lesions provided favourable clinical and radiographic response.

Non Surgical Management of Large Periapical Lesions-A Report of Two Cases

Diseases of dental pulp, if not managed within appropriate time, cause periapical infection which may result in the formation of periapical lesions. It is a general belief that large periapical lesions will not heal by nonsurgical endodontic treatment and needs surgical intervention. But there is no direct evidence that all large periapical lesions need surgical intervention. When endodontic treatment is performed to accepted clinical standards, a success rate of around 90% can be expected. This article highlights the healing potential of non surgical endodontic treatment in the management of large periapical lesions.

Conservative Endodontic Management Of Teeth Associated With Extensive Periapical Pathology: Report Of Two Cases

Traditionally, long-term calcium hydroxide dressings have been recommended for the conservative management of large periapical lesions. However, calcium hydroxide therapy has some disadvantages such as variability of treatment time, difficulties with patient follow-up and prolonged treatment periods that increase the risk of root canal contamination via microleakage and crown fractures. This paper reports the healing of large periapical lesions following conservative non-surgical treatment with calcium hydroxide dressings.

Comparative study of surgical fenestration and conventional surgical and non-surgical techniques in the management of large periapical lesions

Surgical Fenestration - a procedure of opening into a patholgical lesion for diagnostic and therapeutic purpose, was compared with conventional apicectomy and conservative endodontic treatment using calcium hydroxide, to assess the efficacy of surgical fenestration in terms of quality and rate of post-surgical healing and total treatment time. 44 cases having peri-apical lesions >2 cm in diameter on radiograph were included in the study. The age of the patient ranged from 15-45 years. The cases were randomly divided into the three study groups : Group I was treated with conservative endodontic treatment using intra-canal calcium hydroxide. Group II was treated by conventional root-canal treatment and apicectomy. Group III cases were treated by root-canal treatment and surgical fenestration. It was found that all the three modalities of treatment were effective in the management of large peri-apical lesions. However, treatment time in group II and III was much shorter (one week - in either single visit or in two visits) compared to group I (2-8 months) requiring multiple visits. Also, it was seen that surgical fenestration was simpler to perform, required less surgical time, was least traumatic with minimal post-surgical complications compared with conventional apicectomy procedure. Quality of post-operative healing was comparable in both the Group II and III cases. Rate of healing in Group III cases at 3 months follow-up was found to be greater in comparison to group II cases, however, at 6 months follow-up, healing in both, group II and III cases was comparable. Another interesting observation of the study was, that all but one of the tissue specimens from group II and group III cases (n-25) were found to be apical cyst (92.3%)