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Endodontic treatment of upper incisors with periapical lesions: case report

Year: 2024

Type: article

Abstract: This case report shows the healing of teeth with large periapical lesions following endodontic treatment without apical surgery. A 17-year-old female patient with trauma history was admitted to our clinic with the complaint of persistent intraoral-fistula and recurrent swelling in the upper-anterior region. Clinical examination revealed hypersensitivity to percussion, palpation and first-degree mobility. After opening access cavity, rubber-dam was applied. Working lengths were determined with an apex-locator and confirmed by radiography. The teeth were prepared to #140 and #130. Irrigation with 2.5%NaOCl was performed after each file and 17%EDTA, distilled water and 2.5%NaOCl were used as final irrigation. Calcium hydroxide was used as an intra-canal medicament. After one week, at the second session, root canal filling was decided since both teeth were asymptomatic. The canals were obturated using cold lateral condensation technique. At the 9-month follow-up, the teeth were asymptomatic and the lesions were healed radiographically. Traditional endodontic treatment should be the first choice in the treatment of periapical lesions because of healing potential. Calcium hydroxide is commonly used material in endodontics due to its bacterial effects. It has been known that the use of calcium hydroxide as an intracanal medicament for one week eliminates bacteria in root canals and facilitates healing. In these cases, calcium hydroxide was used; nine-month follow-up radiographs after root canal filling confirmed healing of the lesions, with trabecular formation and density change and asymptomatic teeth. Using the right materials with right indication during treatment will affect prognosis, while protecting the clinician and the patient from both financial and moral losses. Periodic follow-ups allow transparent evaluation of the treatment results.

Source: International Dental Journal

DOI: 10.1016/j.identj.2024.07.349

Authors: Nuri Yeniev, Hatice SAĞLAM, Güzide Pelin Sezgin

Institution: Biruni University

Language: English

Topic: Endodontics and Root Canal Treatments

Subfield: Oral Surgery

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,550