Fogorvosi szemle, 2014 (107. évfolyam, 1-4. szám)

2014-06-01 / 2. szám

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FOGORVOSI SZEMLE ■ 107. évf. 2. sz. 2014.

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Pozsgay S, Marton R, Bartha K, Nyárasdy I

Treatment of periapical lesions by endodontic treatment and oral surgery on the bases

of literature- case report

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 pocket/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 insufficient. The periapical lesion of 46 tooth was extremly large therefore oral surgery was planned after revision. During the first oral surgery treatment cystostomia was made with resection of 46 tooth and lengthening of clinical crown of 47 tooth to be suited for revision and finally for restauration. After healing we revised the root canal filling of 47 tooth and long-term temporary filling was placed into the tooth. During the second oral surgery treatment cystectomia and retrograd filling of 46 was made with MTA than we waited for radiological healing. Contrail x-ray was made in half and one year. The healing of periapical lesions was complete in 1,5 year radiologically.

Key words: endodontic treatment, radicular cyst, true cyst, pocket cyst, oral surgery

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