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Surgical management of mandibular central incisors with dumbbell shaped periapical lesion: a case report.

Garlapati R, Venigalla BS, Patil JD, Jayaprakash T, Chaitanya CH, Kalluru RS - Case Rep Dent (2014)

Bottom Line: A twenty-four-year-old male patient presented with pain in the mandibular central incisors.Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion.After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh 508254, India.

ABSTRACT
Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

No MeSH data available.


Related in: MedlinePlus

Postoperative radiograph after one year showing healing.
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fig4: Postoperative radiograph after one year showing healing.

Mentions: Under local anaesthesia, a full thickness mucoperiosteal flap was elevated. A large soft lesion was seen involving the root apices of 31, 41. The lesion was circumferentially separated from the bony crypt and the teeth. Using gracey curettes, the granulation tissue in the apical and lateral root surfaces of the mandibular central incisors was curetted. For the histopathological examination, the granulation tissue was fixed in 10% buffered formalin. The surgical site was washed with sterile saline solution after the complete removal of the lesion. Apical 3 mm of the roots was resected for 31, 41 and the retrograde filling was done with mineral trioxide aggregate (MTA). As the extension of the defect was large, bone graft (Perioglas) was placed. The mucoperiosteal flap was sutured in place and the periapical radiograph was taken for the confirmation of accuracy of retrograde filling for 31, 41. The granulation tissue was sent for histopathological examination, the findings were suggestive of cystic capsule. The patient was periodically reviewed after 3 months, 6 months, and one year. Patient was asymptomatic during one-year follow-up. At one-year follow-up, a radiograph was taken in relation to mandibular central incisors, which confirmed the satisfactory healing of periapical lesion (Figure 4).


Surgical management of mandibular central incisors with dumbbell shaped periapical lesion: a case report.

Garlapati R, Venigalla BS, Patil JD, Jayaprakash T, Chaitanya CH, Kalluru RS - Case Rep Dent (2014)

Postoperative radiograph after one year showing healing.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109420&req=5

fig4: Postoperative radiograph after one year showing healing.
Mentions: Under local anaesthesia, a full thickness mucoperiosteal flap was elevated. A large soft lesion was seen involving the root apices of 31, 41. The lesion was circumferentially separated from the bony crypt and the teeth. Using gracey curettes, the granulation tissue in the apical and lateral root surfaces of the mandibular central incisors was curetted. For the histopathological examination, the granulation tissue was fixed in 10% buffered formalin. The surgical site was washed with sterile saline solution after the complete removal of the lesion. Apical 3 mm of the roots was resected for 31, 41 and the retrograde filling was done with mineral trioxide aggregate (MTA). As the extension of the defect was large, bone graft (Perioglas) was placed. The mucoperiosteal flap was sutured in place and the periapical radiograph was taken for the confirmation of accuracy of retrograde filling for 31, 41. The granulation tissue was sent for histopathological examination, the findings were suggestive of cystic capsule. The patient was periodically reviewed after 3 months, 6 months, and one year. Patient was asymptomatic during one-year follow-up. At one-year follow-up, a radiograph was taken in relation to mandibular central incisors, which confirmed the satisfactory healing of periapical lesion (Figure 4).

Bottom Line: A twenty-four-year-old male patient presented with pain in the mandibular central incisors.Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion.After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh 508254, India.

ABSTRACT
Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

No MeSH data available.


Related in: MedlinePlus