1/53. diagnosis and treatment of cutaneous facial sinus tracts of dental origin.BACKGROUND: Cutaneous draining sinus tracts of dental origin often are a diagnostic challenge. A delay in correctly diagnosing these types of lesions can result in ineffective and inappropriate treatment. CASE DESCRIPTION: The authors present five cases of facial lesions that were initially misdiagnosed as lesions of nonodontogenic origin. The correct diagnosis in each case was cutaneous sinus tract secondary to pulpal necrosis and suppurative apical periodontitis. All facial sinus tracts resolved after the patients received nonsurgical root canal therapy. CLINICAL IMPLICATIONS: As patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, possible dental etiology may be overlooked. Early correct diagnosis and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment.- - - - - - - - - - ranking = 1keywords = periodontitis (Clic here for more details about this article) |
2/53. Focal cemento-osseous dysplasia in the maxilla mimicking periapical granuloma.A case of focal cemento-osseous dysplasia of the maxilla in a 19-year-old man is reported. Clinically, the lesion resembled periapical pathosis of odontogenic origin. The clinical and histopathologic features of cemento-osseous dysplasia are reviewed.- - - - - - - - - - ranking = 4.4938099880803keywords = periapical (Clic here for more details about this article) |
3/53. Successful treatment of pulpal-periodontal combined lesion in a birooted maxillary lateral incisor with concomitant palato-radicular groove. A case report.Palato-radicular groove (PRG) is a common developmental anomaly of maxillary incisors, whereas PRG associated with a birooted maxillary incisor is relatively infrequent. The clinical significance of PRG is related to the incidence of localized periodontitis with or without pulpal pathosis, depending on the depth, extent, and complexity of the groove. Successful treatments of PRG in single-rooted incisors have been reported in the literature. However, treatment of PRG in birooted incisors has often been ineffective. This case report describes a pulpal-periodontal combined lesion occurring on a birooted maxillary left lateral incisor with concomitant PRG in a 13-year-old boy which was successfully treated by conventional endodontic therapy in combination with periodontal treatment including accessory root resection, radiculoplasty and bone grafting. Seven-year follow-up is included in this report. The basis of a successful result is accurate diagnosis and elimination of inflammatory irritants and contributory factors. awareness of the existence of this abnormality by the clinician is important.- - - - - - - - - - ranking = 1keywords = periodontitis (Clic here for more details about this article) |
4/53. Delayed apical healing after apexification treatment of non-vital immature tooth: a case report.We report the endodontic treatment of a non-vital permanent immature tooth in which unexpected complications such as exacerbation of apical periodontitis followed by external root resorption occurred after that the initial stages of the healing process were clinically and radiographically evident. After continued treatment stable repair was obtained.- - - - - - - - - - ranking = 1keywords = periodontitis (Clic here for more details about this article) |
5/53. Periapical cemental dysplasia: case report.The authors present a case of periapical cemental dysplasia affecting the mandibular left canine, with vital pulp, in a 43-year-old black female patient, an occurrence that follows the classical cases found in the literature. The need of a careful history, clinical and radiographic exams and vitality tests are emphasized in order to reach the correct diagnosis of this disease.- - - - - - - - - - ranking = 0.89876199761607keywords = periapical (Clic here for more details about this article) |
6/53. Reversible and irreversible painful pulpitides: diagnosis and treatment.The foregoing clinical evidence indicates that when pain is severe, or when mild to moderate pain is present with a previous history of pain in the aching tooth, with or without periapical radiolucency, the tooth is in the IRPP category. Treatment dictates endodontic therapy or extraction. On the other hand, when clinical evidence indicates that the pain is mild or moderate with no previous history of pain, normal pulp vitality, and there is no positive percussion sign, the pulp is in the RPP category. Treatment dictates indirect or direct pulp capping in teeth with or without periapical radiolucency. The success rate favours teeth with no periapical radiolucency, 98%; in teeth with periapical radiolucency the success rate is less favorable, 43%. Efforts should be made to maintain pulp vitality. Endodontic therapy can always be done, if in time the pulp develops necrosis.- - - - - - - - - - ranking = 3.5950479904643keywords = periapical (Clic here for more details about this article) |
7/53. Charcot-Leyden crystals within a periapical lesion.Transmission electron microscopy revealed the presence of Charcot-Leyden crystals within a periapical lesion, which was assessed histopathologically as consistent with a periapical granuloma that failed to resolve after conventional endodontic treatment. This paper presents the clinical, radiographic, histological, and ultrastructural findings of this case and discusses their potential clinical significance.- - - - - - - - - - ranking = 5.3925719856964keywords = periapical (Clic here for more details about this article) |
8/53. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract.A necrotic immature mandibular second premolar with periapical involvement in a 13-year-old patient was treated. Instead of the standard root canal treatment protocol and apexification, antimicrobial agents were used in the canal, after which the canal was left empty. Radiographic examination showed the start of apical closure 5 months after the completion of the antimicrobial protocol. Thickening of the canal wall and complete apical closure was confirmed 30 months after the treatment, indicating the revascularization potential of a young permanent tooth pulp into a bacteria-free root canal space.- - - - - - - - - - ranking = 4.8987619976161keywords = periodontitis, periapical (Clic here for more details about this article) |
9/53. Endodontic infection caused by localized aggressive periodontitis: a case report and bacteriologic evaluation.A rare case of a periodontally induced endodontic lesion in a systemically healthy subject of 28 years is described. The patient, having presented with severe attachment loss on the palatal and distal aspects of his maxillary right second premolar, was diagnosed with localized aggressive periodontitis. He had never received periodontal treatment. The tooth was nonvital and showed all signs of symptomatic apical periodontitis. It was also free of any restoration. All clinical findings clearly suggested that the endodontic problem was caused by the aggressive periodontal disease. Bacteriologic screening of the pocket and the root canal, by using "checkerboard" dna-dna hybridization analysis, revealed diverse flora in the periodontal lesion. The sample obtained from the root canal exhibited dna from a limited number of species, including black-pigmented anaerobic rods. No bacterial dna was found in the root canal that was not also recovered from the periodontal pocket.- - - - - - - - - - ranking = 6keywords = periodontitis (Clic here for more details about this article) |
10/53. Effect of occlusal trauma on healing of periapical pathoses: report of two cases.AIM: To present two clinical cases and demonstrate that occlusal trauma may affect healing of periapical pathoses. SUMMARY: Two teeth with periradicular disease did not respond successfully to conventional root canal treatment or endodontic surgery. occlusal adjustment was finally performed on both cases. After occlusal adjustment, uncomplicated healing and periapical repair occurred in both cases. The findings in these two cases suggest that occlusal trauma may play a role in the healing of periapical pathoses. KEY learning POINTS: Occlusal trauma is positively correlated with changes in periodontal tissues. Although experiments in animals have shown that application of forces to teeth will not induce further periodontal destruction, we believe that some failures of root canal treatment may be due to the presence of occlusal trauma modulating the responses of inflamed periapical tissues or apical pathoses with persistent infection.- - - - - - - - - - ranking = 7.1900959809286keywords = periapical (Clic here for more details about this article) |
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