Non-surgical treatment of large periapical lesions

Humberto Ramah Menezes de Matos, Luanni Belmino Mastroianni, Aldo Angelim Dias, Fabio de Almeida Gomes

Objective: To report two cases in which conventional end- odontic therapy resulted in clinical success without the need for further corrective surgery. Case report: The first case reports a 21-year-old patient who sought dental care for orth- odontic reasons. Panoramic radiograph revealed a large radio- lucent area in the periapical region of teeth #12 , 11 , 21 , 22 and 23. Treatment was limited to endodontic therapy which consisted of pulpectomy , emptying the septic content, bio- mechanical preparation and dressing. In the second session , the root canal system of all 5 teeth were filled. Radiographic control after two and five years showed complete repair of the radiolucent area and areas of bone formation. The sec- ond case reports a 84-year-old, diabetic patient who sought dental care for prosthodontic reasons . Intraoral examination revealed expansion of cortical bone in the lower anterior re- gion. Panoramic radiograph revealed extensive radiolucent area in teeth #32 , 31 , 41 , 42 and 43 . Treatment consisted of conservative endodontic treatment , without the further need for surgery similar to the first case. Radiographic control after one year showed decreased radiolucency and bone healing. Conclusion: Surgery is not always recommended for cases of large periapical lesions and the clinical and radiographic follow-ups are of paramount importance for treatment.

Keywords: Periapical periodontitis. Periapical diseases. Root canal preparation.

How to cite: Matos HRM, Mastroianni LB, Dias AA, Gomes FA. Non-surgical treatment of large periapical lesions. Dental Press Endod. 2014 May- Aug;4(2):88-93. DOI: http://dx.doi.org/10.14436/2178-3713.4.2.088-093.oar

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