Pulp Tester Research Articles

How should we anaesthetise painful mandibular premolars?

Design Randomised clinical trialStudy population The present study evaluated patients of different genders aged between 18-65 years old. The study design and the language of the consent form were approved by the Ethics Committee at Tehran University of Medical Sciences (TUMS) (approval code: IR.TUMS.REC.1394.1906). The study was registered in the Iranian Registry of Clinical Trials.Data Analysis The evaluation was performed using the Heft-Parker Visual Analog Scale (HP VAS) and complemented with the electrical pulp test accuracy to determine the success of anaesthesia Results In this study, the success rate was 93.8% (95% CI 79.19-99.23) for mental/incisive nerve block (MINB), and 81.2% (95% CI 63.56-92.79) for inferior alveolar nerve block (IANB). The difference was not significant (p = 0.26). An interesting result was the combination of both techniques was 100% successful in the failed cases (2 in MINB group; 6 in IANB group).Conclusions In conclusion, MINB using 4% Articaine showed a similar success rate as IANB using 4% Articaine in local anaesthesia for mandibular premolars with irreversible pulpitis. The beginning of anaesthesia was faster for MINB, and the injection was painless. The post-injection pain for MINB was higher than for IANB. Both techniques showed similar efficacy.

Periapical lymphoma: Review of reported cases in the literature

Oral lymphoma can resemble clinically to other pathologic entities such as periapical radiolucencies, or dental abscess. The aim of this study was to review the literature related to misdiagnosed periapical lymphomas and discuss their characteristics. In this review study, authenticated search engines and databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were surfed to find articles related to the topic by using related keywords. Out of more than 100 articles approximately, 50 were closely relevant to the title, and ultimately 43 well-documented English articles were chosen. Out of 45 reported cases, 63% were male and 37% were female with mean age of 41.22 years. The majority of such lesions have been detected in the mandible (61%) with a mandibular to maxillary involvement ratio of 1.58:1. The most frequent type of lymphoma was diffuse large B cell lymphoma (DLBCL) (53%). Noteworthy, 49% of periapical lymphoma has been misdiagnosed as pulpal pathology and treated through root canal therapy. The mean time lapse before making the correct diagnosis was 4.3 months. Although rare, periapical lymphoma should be ranked in the differential diagnosis of a periapical lesion especially when vitality pulp tests are positive.

Diagnostic accuracy of dental pulse oximeter with customized sensor holder, thermal test and electric pulp test for the evaluation of pulp vitality: an in vivo study

Background: the efficiency of the diagnostic aids plays an important role in the treatment plan. This study aims to assess the diagnostic accuracy of dental pulse oximeter with a customized sensor holder, thermal test and electric pulp tester in assessing the actual pulp status and to evaluate the oxygen saturation level in control healthy teeth, non-vital and teeth with irreversible pulpitis. Material and methods: thirty-seven single canal teeth requiring endodontic therapy were included in the study. The selected teeth were tested with dental pulse oximeter, electric pulp test, cold spray, and heated gutta percha stick. Between each test a time lag of 2 minutes was allowed for the central sensitization to occur. Three blinded operators were involved in the study. The actual status of the pulp was evaluated after the initiation of endodontic treatment. To assess the actual pulp status direct visual examination of access cavity as performed. The data was statistically analysed using (ANOVA) Analysis of Variance and Post-hoc Tukey test. Results: sensitivity of pulse oximeter, heat test, cold and electric pulp test, was 100, 25, 50, and 12, respectively. The specificity of these tests was 100, 72 81, and 77, respectively. The ANOVA showed that there was statistical difference between all the groups (p=0.0005). Post-Hoc Tukey revealed that there was statistical difference among all the groups, nonvital group (p=0.0005), control group (p=0.01) and for irreversible pulpitis (p=0.01). The overall diagnostic accuracy of pulse oximeter was 100% followed by cold test 66%, heat test to be 49% and electric pulp test to be 45%. Conclusion: the custom-made holder used in the present study aided in providing accurate response for pulp vitality testing. In this study the diagnostic accuracy was high with dental pulse oximeter followed by cold, heat and the least was electric pulp tester in different pulpal conditions.KEYWORDS Cold test; Heat test; Oxygen saturation; Pulse oximeter; Vitality tests.

Comparison of Pulp Sensibility Tests Responses in Type 2 Diabetes Patients and Healthy Individuals

IntroductionDiabetes is a common disease that may have some influence on sensory nerves. The aim of this study was to evaluate dental pulp responses to 2 pulp sensibility tests (ie, cold and electric) in patients with type 2 diabetes compared with healthy individuals. MethodsThree hundred twenty-two premolar teeth in 51 patients who had type 2 diabetes and 347 premolar teeth in 53 individuals with no medical conditions were investigated. The patients with type 2 diabetes were unified and had fasting plasma glucose <300, hemoglobin A1C <10, less than a 10-year history of diabetes mellitus, and no history of hypertension. Electric and cold pulp sensibility tests were performed for all teeth. The cold test results were recorded by the Heft-Parker visual analog scale, and the electric pulp test results were recorded based on the pulp tester's grade that evoked a response. ResultsThere was no statistically significant difference between upper and lower premolar teeth in healthy individuals compared with the patients with diabetes in response to the cold and electric pulp tests (P > .05). In the patients with diabetes, the response of their upper premolars to the cold test was significantly reduced in diabetic patients >45 years of age (β = −1.15, P = .013). However, there was no significant correlation between the cold test and age in the lower premolars of both diabetic and nondiabetic participants (P > .05). There was also no significant correlation between the need for a higher number of the electric pulp test current to evoke a response in maxillary and mandibular premolars of the patients with diabetes and nondiabetic participants with age (P > .05). ConclusionsThere was a significant correlation between the reduction of maxillary premolar teeth responses to the cold test in diabetes patients >45 years of age.

Efficiency of new custom-made pulse oximeter sensor holder in assessment of actual pulp status.

Aim:This study aims to assess the diagnostic accuracy of new custom-made pulse oximeter sensor holder in assessment of actual pulp status with three pulp sensibility tests.Materials and Methods:Seventy-nine single canal teeth requiring endodontic therapy was included in the study. The tooth that was requiring root canal treatment was tested with heat test, cold test, electric pulp test, and pulse oximeter. Between each test, a time period of 2 min was allowed. The response from three pulp sensibility tests and the reading from pulse oximeter were recorded. Following which root canal treatment was performed. The result obtained from four pulp tests were correlated with the clinical finding after access cavity preparation. The data obtained was statistically assessed. Receiver operator characteristic (ROC) curve analysis was performed to assess the efficacy of the pulp tests. In the above statistical tools, the probability value. 05 is considered as significant level.Results:The overall diagnostic accuracy was found to be significantly higher with pulse oximeter when compared with other three pulp sensibility tests. The ROC curve demonstrates the results obtained from pulse oximeter was found to be more reliable than other pulp tests.Conclusion:Within the limitation of the study, diagnostic accuracy of pulse oximeter with custom made sensor holder was reliable and accurate in assessment of actual pulp status.

The Validity of Pulp Tests on Crowned Teeth: A Clinical Study.

Objective:The aim of this study was to evaluate the sensitivity and specificity of electric pulp testing (EPT) using the bridging technique in comparison to a cold test on crowned teeth.Methods:Thirty teeth were included in this study. Only one crowned tooth from each subject was included. The adjacent teeth served as controls. The crowned teeth were tested for pulp vitality using a bridging EPT technique and cold test. Vitality was confirmed upon access based on bleeding or lack of bleeding from detected root canal systems. The data was statistically analyzed using the McNamara test (P<0.05).Results:The sensitivities of the cold test and bridging EPT were 87% and 66% respectively. Accuracy for cold and bridging EPT were 87% and 67% respectively. The cold test demonstrated a statistically significant higher accuracy and sensitivity than the bridging EPT. However, no significant difference was detected in the specificity between the two tests.Conclusion:Both EPT and cold test should be considered as an adjunctive diagnostic tool when determining pulp status in a crowned tooth. Pulp sensitivity tests are essential but the results should be interpreted in combination with other clinical signs/symptoms.

Impact of maxillary teeth morphology on the failure rate of local anesthesia.

Objective:To investigate the effect of maxillary single and multiple rooted teeth on the success rate of buccal infiltration anesthesia.Subjects and Methods:This clinical study was performed by dividing the participants into three groups. Group one included 30 patients with upper anterior teeth, group two 23 patients with upper premolars teeth and group three 39 patients with upper molars for extraction. Onset time of anesthtic action was evaluted by using electronic pulp tester. Pulp testing assessments were carried out immediately before the injection and at the intervals of 2 mins following the injection until the anesthetic success obtains.Results:Seventy-nine patients in this study secured anesthetic success within study duration time (10 min). However, there were 13 patients with dental anesthesia failures (3 patients with single rooted teeth and 10 patients with multiple rooted teeth). There were no significant differences in the mean onset time of pulpal anesthesia between the anterior, middle and posterior teeth (P value = 0.449). Clinically, patients with single rooted teeth reported faster dental anesthesia and earlier teeth extraction than patients with multiple rooted teeth.Conclusion:This study showed that the single rooted teeth have faster pulpal anesthesia and early extraction than teeth with multiple roots but not statistically significant. Administration of extra local anesthetic cartridge or using intraseptal injection technique can be a solution to overcome the failure of anesthesia in the maxillary posterior teeth.

Evaluating Vitality and Periodontal Sensitivity of Teeth Adjacent to the Site of Open Sinus Lift Surgery before and after Treatment: A Case Series Study.

The aim of this study was to evaluate the effect of open sinus lift surgery on dental vitality and periodontal sensitivity of teeth adjacent to a surgery area. Forty-one patients undergoing open sinus lift surgery were evaluated for dental vitality and periodontal sensitivity of adjacent teeth. Dental vitality was evaluated using an electric pulp tester and cold spray. Periodontal sensitivity of teeth in the surgery area of open sinus lift was evaluated by interview and visual analogue scale before surgery and one, three, and six weeks after surgery. In order to increase the validity of the study, one healthy tooth was considered as a control. In the experimental group, differences in periodontal sensitivity were significant between the four measured times (P < 0.001). Pretreatment compared with three weeks posttreatment, pretreatment compared with one week posttreatment, six weeks posttreatment compared with one week posttreatment, and three weeks posttreatment compared with one week posttreatment showed significant differences (P = 0.001). In the control group, the periodontal sensitivity between the four measured times did not differ significantly (P = 0.421). In the experimental group, pulpal sensitivity was significant between the four measured times (P = 0.019). It was found that the test and control groups showed significant differences in pretreatment versus six weeks posttreatment and one week posttreatment versus three weeks posttreatment (P < 0.001). Pulse sensitivity significantly changed after open sinus lift surgery, making it clear that the surgery may lead to necrosis of adjacent teeth. However, further research is needed. Also, teeth in area of the surgery may be periodontally affected, but will undergo recovery.

Efficacy of Pulpal Anesthesia Using a Needle-less Syringe.

The purpose of this study was to investigate the manufacturer's claims regarding a novel needleless intraligamentary local anesthesia injection device (Numbee, BioDent) to provide effective single tooth anesthesia. Investigators compared the Numbee with a traditional inferior alveolar nerve block (IANB) during a restorative procedure on mandibular teeth. A randomized, split-mouth design was conducted with 15 adult subjects receiving an IANB on one side and a Numbee injection on the same tooth type on the contralateral side. Subjects recorded injection pain using the Visual Analog Scale (VAS) and their preferred injection technique. Anesthesia was considered profound with 2 consecutive electric pulp tester readings of 80. If subjects became symptomatic during the restorative procedure, rescue anesthesia was administered. The difference in VAS scores for injection pain between the Numbee and the IANB was not significant (p = .078). For the IANB, the incidence of profound anesthesia was 46%, and required rescue anesthesia was 20%. For the Numbee, the incidence of profound anesthesia was 0%, and required rescue anesthesia was 60%. Subject preference was evenly split (50/50%) between the 2 techniques. The IANB outperformed the Numbee device for achieving profound anesthesia and requiring less rescue anesthesia.

Nonsurgical Retreatment Using Regenerative Endodontic Protocols: A Case Report

The aim of this case report was to describe regenerative endodontic procedures (REPs) of the previously treated mature teeth with long-term results. Regenerative endodontic procedures are aimed to treat apical periodontitis and regenerate the pulp-dentin complex in necrotic teeth. However, there is no consensus in using REPs in the previously treated mature teeth. The aim of this case report was to describe REPs of the previously treated mature teeth with long-term results. A 25-year-old woman presented pain on chewing on 15 and swelling (WHO numbering system). The tooth had been endodontically treated and restored 4 years ago. After removing the old root canal filing, the roots were irrigated with 2.5% sodium hypochlorite and 17% EDTA using sonic activation. Calcium hydroxide (CH) was used as medicament for 3 weeks. At the second visit, CH was removed, and canals were irrigated as like as the first visit. Apical bleeding was induced, and concentrated growth factors (CGFs) were placed inside the root canal. The tooth has been followed up to 3 years. The tooth was functional and asymptomatic at the recall visits. Since the first-year follow-up, the tooth responded to the electric pulp test and the thermal test. Radiological examinations revealed healing of apical lesion and hard tissue deposition. Regenerative endodontic procedures can offer an advantage over traditional endodontic procedures in terms of tertiary healing, with a predictable, user-friendly procedure also for retreatment cases.

The effect of different conductive substances on the response of electric pulp test

The effect of different conductive substances on the response of electric pulp test

Efficacy of the osteocentric method of intraseptal anesthesia in mandibular molars treatment with dental caries and irreversible pulpitis

In the literature, various methods for the mandibular molars anesthesia are known, including periodontal pains as an adjunct to nerve block. However, these methods do not provide for amendments in the case of partial destruction of the vertices of the cortical substance of the bone tissue of the mandible. Aim: to perform a clinical and functional research of the possibility of using the osteocentric method of intraseptal anesthesia in mandibular molars treatment with dental caries and irreversible pulpitis. Materials and methods. In total, 324 patients aged 32—65 years (mean age 48.5 years). In all cases was used 4% solution of articaine with epinephrine 1: 200,000 (Septanest, 40 mg + 5 μg of epinephrine per 1 ml, Septodont) and short 30G Septaject Evolution dental needles (0.30×9 mm) with a scalpel-like cut. To assess the effectiveness of the anesthesia was performed pulp electrical stimulation before the study, after 2, 5 and 10 minutes after injection with the IVN-01 “Pulptest-Pro” electronic pulp test device (“Cascade-FTO”, Russia). Results. The treatment of the tooth decay (213 cases) was started at 3 minutes after the injection. Of 127 teeth treated with endodontic methods, for 104 (81.9%) teeth the duration of anesthesia was sufficient for amputation and extirpation of the pulp. With the removal of 23 (18.1%) teeth for acute pulpitis, the final stage of pulp extirpation was painful. Conclusion. This method of anesthesia can be especially recommended for people with somatic pathology because of a minimal amount of local anesthetic (0.36 ml for a two-canal tooth) with epinephrine 1:200,000.

Regenerative Endodontics: A Paradigm Shift in Clinical Endodontics.

ABSTRACTPreserving the natural dentition in its normal form and function is one of the major goals of endodontic treatment. Re-establishing the lost vitality and development of root maturation in immature permanent teeth with pulp necrosis/apical periodontitis is quiet challenging clinically. The very basis of regenerative endodontics relies on the concept of tissue engineering using stem cells, biomimetic scaffold, and bioactive growth factors to regenerate the pulp tissue damaged by microbial infection, injury, or developmental defects. In clinical endodontics, this approach is referred to as a “paradigm shift.” Even though repair instead of true regeneration is achieved with current protocols, it is hoped that further research in the area of stem-cell-based tissue engineering will allow for true regeneration and improved treatment outcomes. The aim of this review is to discuss about the various aspects of regenerative endodontics, current clinical protocols, and the future of pulp regeneration techniques.

Effects of Diode Low-Level Laser Therapy of 810 Nm on Pulpal Anesthesia of Maxillary Premolars: A Double-Blind Randomized Clinical Trial.

Objective:The purpose of this study was to investigate the pulpal effect of diode low-level laser therapy (LLLT) of 810 nm on the alleviation of pain in patients requiring dental procedures.Methods:The current study was a double-blind randomized clinical trial carried out on twenty participants. The electric pulp testing (EPT) was recorded at baseline. Patients were randomly divided into sham laser and laser group respectively receiving low-level laser with placebo and active probes. Low-level laser at 810 nm, 200 MW constant power, 30s irradiation time and energy dose of 6 J was used. The electric pulp testing (EPT) method was again adopted to assess the rate of induced anesthesia. Laser and sham laser treatments were carried out in two different sessions with a one-week interval to ensure avoiding the potential false placebo results. Data were analyzed in SSPS-24 using Chi-square test and t-test. The p-value was set at 0.05.Results:A low-level laser at 810 nm significantly alleviate EPT-induced pain compared to the pain before laser irradiation (P≤0.001). While the difference of EPT-induced pain before and after sham laser irradiation was not significant in control group (P>0.05). There was no correlation between the anesthetic effects of a laser application at 810 nm and other variables including age and gender (P>0.05).Conclusion:An 810 nm low-level laser is a powerful device for induced anesthesia applications in patients requiring dental procedures. It also lessens the patients’ fear of dental procedures.

Pulpal-anesthesia of a mandibular first molar with irreversible pulpitis by inferior alveolar nerve block plus buccal infiltration using articaine or lignocaine.

Introduction:This study aims to compare the efficacy of a combination of an inferior alveolar nerve block (IANB) plus buccal infiltration using 4% articaine versus 2% lignocaine in achieving anesthesia of lower first molar teeth with irreversible pulpitis.Materials and Methods:Seventy adult patients were selected. A random sequence list was employed to administer IANB plus buccal infiltration. After the onset of lip numbness, cold test and electric pulp testing were performed. Five patients, four missed blocks and one no bleeding, were excluded. Heft Parker Visual Analog Scale scores during pulp extirpation were recorded. The data of sixty-five patients were statistically analyzed using Chi-square and Mann–Whitney U-test.Results:The success rate after lip-numbness for articaine is 91.42% and for lignocaine is 94.28%. The difference is statistically, not significant (P = 0.6425). During access, the success rate for lignocaine is 96.87%, whereas 96.96% for articaine. This difference is also not significant (P = 0.982366).Conclusion:IANB plus buccal infiltration using articaine or lignocaine is equally effective in anesthetizing mandibular first molar with irreversible pulpitis.

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis.

ObjectivesThis systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth.Materials and MethodsThe MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of “oximetry” AND “dental pulp test” were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale.ResultsOf the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%–85.04%) for the central incisors, 89.29% (95% CI, 89.22%–89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%–89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment.ConclusionsAlthough most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.Trial RegistrationInternational Prospective Register of Systematic Reviews Identifier: CRD42018085598

Clinical evaluation of efficacy of transcortical anesthesia for the extraction of impacted mandibular third molars: a randomized controlled trial.

BackgroundThis study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery.MethodsThis prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer.ResultsThirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013).ConclusionThe IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain.

BackgroundIntraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required.MethodsThis study aims to investigate the efficacy of IO using the Anesto® device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (Ultracain® D-S, Sanofi-Aventis, Frankfurt, Germany) IO.ResultsThe electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant.ConclusionIO with the Anesto® device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

FREQUENCY OF REVERSIBLE AND IRREVERSIBLE PULPITIS IN PATIENTS VISITING DENTAL OPD OF SMDC COLLEGE OF DENTISTRY

Objective: The main objective of study was to determine the incidence of reversible and irreversible pulpitis in patients coming for dental check-up in out-door patient department of College of Dentistry, SMDC. &#x0D; Materials and Methods: About 443 patients were examined in dental OPD and data was collected on basis of especially designed questionnaire. All clinical findings, radiographical interpretations and objective pulpal testing were included within the patient assessment. The data was coded and entered into SPSS 20 for data analysis. &#x0D; Results: Among 443 patients 304 patients were assessed for pulpal disease. (females 149, males 155). Total teeth examined were 1055 both clinically and radiographically for pulpitis and seen to be more common in males as compared to females with mandibular posteriors affected more. Irreversible pulpitis seen to be more common in females and caries being the number one cause of the disease. Pulpitis was seen to be significantly related with age p = 0.029. &#x0D; Conclusion: Early diagnosis and treatment can reversal the condition and improve the oral health status preventing premature extractions and root canals and prosthesis applications.&#x0D;

MANAGEMENT OF LATERAL PERIODONTAL CYST EMBEDDED IN BONE

Lateral periodontal cysts (LPCs) are odontogenic cysts with rare occurrence and developmental origin. A 46-year old female patient, chronic smoker with non-contributory medical history presented with dull pain/pressure in the left mandibular premolar region and the associated teeth were vital on pulp testing. Periapical radiograph revealed a well- circumscribed, radiolucent region measuring <1cm in diameter with loss of lamina dura in teeth, which were in contact with the lesion, and interproximal buccal bone loss. The clinical and radiographic features were suggestive of LPC and the patient was advised to undergo conservative surgical management of the cystic lesion. The full-thickness mucoperiosteal flap was elevated, complete debridement was done, and enucleation was performed using a surgical curette. The flaps were approximated and then sutured. Histological examination was performed on the tissue sample obtained during surgery and the findings confirmed the diagnosis of LPC. The post-operative follow-up was uneventful with no biological complications such as pain, swelling, or bleeding at the surgical site and periodontal healing was satisfactory.