The tooth has pulp vitality and has a periapical lesion: Criteria for diagnosis and treatment.

Alberto Consolaro, Antônio Cesar Oliveira de Azevedo, Walter João Genovese, Ingrid Araújo Oliveira, Dario Augusto Oliveira Miranda

Many clinicians get confused when finding a tooth with periapical lesion and unchanged pulp vitality. Several lesions resemble chronic inflammatory periapical lesions when revealed by imaging examination, and teeth remain with pulp vitality. We always have to bear in mind that: 1) teeth with pulp vitality should not be accessed without previous diagnosis of lesions; and endodontic treatment should not be carried out as diagnostic tool or therapeutic test for periapical lesions in teeth with pulp vitality. 2) Carrying out endodontic treatment in teeth with pulp vitality and lesions that resemble periapical periodontitis might extend time dedicated to an appropriate approach and, thus, considerably worsen lesion prognosis. 3) In teeth with pulp vitality and periapical lesions of undetermined origin, it is key to establish a relationship among clinical, imaging and microscopic specialties, so as to allow for an exchange of experience and knowledge with a view to reaching safe diagnosis and carrying out effective treatment. 4) Lesions mentioned herein should be born in mind or noted down in order to allow for further application in the event of having teeth with periapical lesions and pulp vitality!

Keywords: Periapical periodontitis. Periapical lesions. Pulp vitality.

How to cite: Consolaro A, Azevedo ACO, Genovese WJ, Oliveira IA, Miranda DAO. The tooth has pulp vitality and has a periapical lesion: Criteria for diagnosis and treatment. Dental Press Endod. 2018 Jan-Apr;8(1):8-16. DOI: https://doi.org/10.14436/2358-2545.8.1.008-016.end

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