Treatment of periapical lesions by endodontic treatment and oral surgery on the bases of literature- case report

Esetismertetés

Abstract

More than 90% of the periapical lesions of necrotized teeth are granuloma, cyst and abscess. Granuloma is the most common histologically detected periapical lesion with endodontic origin. Radicular cyst has two forms: true cyst and pock-
et/bay cyst. Pocket cyst may heal well after endodontic treatment but true cyst needs apical surgery. It is impossible to
make a differential diagnosis among these periapical lesions radiologically. Depending on the case following treatments
can be useful: endodontic treatment or endodontic treatment combined with oral surgery. Our case report is based on the treatment of large periapical lesions on lower molar teeth. The 46 and 47 teeth had previous root canal treatment but these were radiologically insuffi cient. The periapical lesion of 46 tooth was extremly large therefore oral surgery was
planned after revision. During the fi rst oral surgery treatment cystostomia was made with resection of 46 tooth and length-
ening of clinical crown of 47 tooth to be suited for revision and fi nally for restauration. After healing we revised the root
canal fi lling of 47 tooth and long-term temporary fi lling was placed into the tooth. During the second oral surgery treat-
ment cystectomia and retrograd fi lling of 46 was made with MTA than we waited for radiological healing. Controll x-ray
was made in half and one year. The healing of periapical lesions was complete in 1,5 year radiologically.