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Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.

Sood N, Maheshwari N, Gothi R, Sood N - Int J Clin Pediatr Dent (2015)

Bottom Line: How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N.Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.Int J Clin Pediatr Dent 2015;8(2):133-137.

View Article: PubMed Central - PubMed

Affiliation: Reader, Department of Conservative Dentistry and Endodontics Vananchal Dental College, Garhwa, Jharkhand, India.

ABSTRACT
Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137.

No MeSH data available.


Related in: MedlinePlus

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Figure 7: Postoperative photograph

Mentions: A 20 years old female patient reported to the dental clinic with the chief complaint of a large palatal swelling. The patient gave a history of trauma to her anterior teeth when she was 17 years old. At that time, she did not seek any treatment for the same. On examination, a palatal swelling was seen behind the canine (Fig. 1). Lymph nodes were nonpalpable. Vitality testing was done w.r.t. 13, 12 in which 13 was nonvital and 12 gave delayed response. Hot and cold tests were done in which again no response was elicited w.r.t. 13 and delayed response w.r.t. 12. The swelling was 2 × 2 cm in size. The tooth (13) was slightly discolored. On radiographic examination, a large well circumscribed radiolucency was seen involving the roots of canine and lateral incisor (Fig. 2). Slight displacement of roots was also seen. Patient was given antibiotics at the beginning of the treatment and then the abscess was punctured after 1 week. When the root canal was opened i.r.t. 13, suppurative fluid mixed with blood (Fig. 3) followed which was aspirated and sent for culture and examination (Fig. 4). Positive aspiration was done in subsequent visits and intermediate open dressings were given for 2 weeks i.r.t. 13. Once the canal was completely dried and no pus discharge was seen, Ca(OH)2 (metapex) dressing was given (Fig. 5) and changed regularly for the next 8 weeks. Vigorous warm saline irrigation was done initially and later the canal was irrigated with 2.5% hypochlorite. Simultaneously, root canal treatment i.r.t. 12 was also started and no pus discharge was seen. Obturation for both the teeth was done after 6 months (Fig. 6). The patient was followed for next 18 months and good healing was observed clinically and radiographically (Figs 7 and 8).


Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.

Sood N, Maheshwari N, Gothi R, Sood N - Int J Clin Pediatr Dent (2015)

Postoperative photograph
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562047&req=5

Figure 7: Postoperative photograph
Mentions: A 20 years old female patient reported to the dental clinic with the chief complaint of a large palatal swelling. The patient gave a history of trauma to her anterior teeth when she was 17 years old. At that time, she did not seek any treatment for the same. On examination, a palatal swelling was seen behind the canine (Fig. 1). Lymph nodes were nonpalpable. Vitality testing was done w.r.t. 13, 12 in which 13 was nonvital and 12 gave delayed response. Hot and cold tests were done in which again no response was elicited w.r.t. 13 and delayed response w.r.t. 12. The swelling was 2 × 2 cm in size. The tooth (13) was slightly discolored. On radiographic examination, a large well circumscribed radiolucency was seen involving the roots of canine and lateral incisor (Fig. 2). Slight displacement of roots was also seen. Patient was given antibiotics at the beginning of the treatment and then the abscess was punctured after 1 week. When the root canal was opened i.r.t. 13, suppurative fluid mixed with blood (Fig. 3) followed which was aspirated and sent for culture and examination (Fig. 4). Positive aspiration was done in subsequent visits and intermediate open dressings were given for 2 weeks i.r.t. 13. Once the canal was completely dried and no pus discharge was seen, Ca(OH)2 (metapex) dressing was given (Fig. 5) and changed regularly for the next 8 weeks. Vigorous warm saline irrigation was done initially and later the canal was irrigated with 2.5% hypochlorite. Simultaneously, root canal treatment i.r.t. 12 was also started and no pus discharge was seen. Obturation for both the teeth was done after 6 months (Fig. 6). The patient was followed for next 18 months and good healing was observed clinically and radiographically (Figs 7 and 8).

Bottom Line: How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N.Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.Int J Clin Pediatr Dent 2015;8(2):133-137.

View Article: PubMed Central - PubMed

Affiliation: Reader, Department of Conservative Dentistry and Endodontics Vananchal Dental College, Garhwa, Jharkhand, India.

ABSTRACT
Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137.

No MeSH data available.


Related in: MedlinePlus