11/135. Central giant cell granuloma: a troublesome lesion. This case reports a central giant cell granuloma, an uncommon but potentially troublesome idiopathic benign lesion. Its radiographic similarity to a routine inflammatory periradicular lesion led to not only delay in diagnosis, but also further delay in successful treatment. ( info) |
12/135. hemangioma of the mandible presenting as a periapical radiolucency. A case of an hemangioma of the mandible in a 53-yr-old female patient is presented. The lesion was removed, and no atypia or mitotic cells were found. The excision was curative, and the overall prognosis was excellent. A differential diagnosis of radiolucent periapical lesions of the mandibular symphysis is presented. ( info) |
13/135. The implant periapical lesion: four case reports and review of the literature. postoperative complications have been identified with implant failure in conjunction with the increased use of root-type implant restorations. The failure of osseointegrated dental implants primarily occurs as a result of peri-implantitis and occlusal overload. Less frequently reported failures, however, have been attributed to implant periapical lesions. The etiology and treatment modalities for such lesions have been speculated throughout the literature. This article discusses possible etiologies of and treatment for implant periapical lesions based on the existing literature and four case reports. ( info) |
14/135. Treatment of a human transosseous mandibular defect by guided bone regeneration. The treatment of through-and-through human periapical lesions by barrier membrane techniques has not been reported in the periodontal literature. However, periodontists frequently perform this treatment. The authors present a case that demonstrates radiopacity after regeneration surgery of a human periapical transosseous mandibular defect, suggesting local bone regeneration. The surgical technique performed in this case was based on the principles of guided bone regeneration using a demineralized freeze-dried bone membrane (DFDBM). The bone membrane acted as an efficient barrier that excluded the nonosteogenic tissue. Radiographic findings demonstrated bone fill after 8 months. ( info) |
15/135. 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. ( info) |
16/135. When all else fails.... Endodontic surgery may be indicated if orthograde endodontic treatment cannot be carried out or is unsuccessful. Advances in instruments, materials and techniques have made surgical endodontics a more predictable procedure. A complex case that required surgical intervention is presented to illustrate this point. ( info) |
17/135. Central (intraosseous) adenoid cystic carcinoma of the mandible: report of a case with periapical involvement. Primary intraosseous salivary gland tumors are rare, with mucopidermoid carcinoma being the most frequent histotype. The authors present a case of adenoid cystic carcinoma, located in the mandibular incisor region, associated with pain. Endodontic treatment resulted in increased pain and progressive mandibular expansion. An apicoectomy was conducted, and an intraosseous adenoid cystic carcinoma was diagnosed at histological examination. The patient was treated by wide surgical resection, and is alive and well without recurrences or distant metastases 14 yr after the original diagnosis. The case presented herein calls attention to the preoperative clinical diagnosis of periapical lesions. Radiologically, focal sclerosing osteitis, cementoblastoma, cementifying and ossifying fibroma, periapical cemental dysplasia, complex odontoma, and calcifying epithelial odontogenic tumor should be considered in the differential diagnosis. In addition the unusual occurrence of salivary gland tumors in intraosseous location stresses the importance of systematic histological examination of any tissue sample obtained after endodontic procedures. ( info) |
18/135. Stafne's bone cavity in the anterior mandible: a possible diagnostic challenge. Stafne was the first to report the presence of "bone cavities" in the angle of 35 mandibles. Such cavities generally appear in the area between the mandibular first molar and the mandibular angle, and are not considered rare. One of their primary radiological diagnostic features is the characteristic location below the mandibular canal. Stafne's bone cavity is relatively rare in the anterior mandible. The mandibular canal is not present in the anterior mandible. As a result, diagnosis in the anterior mandible may be missed. Needless treatment modalities such as endodontic treatment, bone trephining, and bone exploration may be conducted. The purpose of the present report is to describe a new case of Stafne's bone cavity in the anterior mandible and discuss the differential diagnosis process. The dental computerized tomography scan is suggested as the most suitable noninvasive diagnostic and follow-up modality for this bony configuration in the anterior mandible. ( info) |
19/135. Treatment of a mandibular molar with perforating internal resorption. A case is presented in which a previous partial root canal treatment on a mandibular molar developed internal resorption of the distal canal. The case was followed at the University of oklahoma student clinic and endodontic treatment completed in the mesial canals, with calcium hydroxide placed in the distal canal for 10 months due to a pre-existing perforating defect of the root surface. endodontics was then completed. A 17-month follow-up film showed osseous repair apically and also adjacent to the distal root surface where a slight overextension of filling material was evident. ( info) |
20/135. A new bacterial species associated with failed endodontic treatment: identification and description of actinomyces radicidentis. OBJECTIVE: This report describes 2 endodontic patients who had persistent signs and symptoms after conventional root canal treatment. The aim of this study was to determine what microorganisms were present in the root canals of the teeth with failed endodontic therapy. STUDY DESIGN: After removal of the root fillings, the canals were sampled by advanced microbiological techniques and the isolates were characterized by various tests. RESULTS: bacteria, which grew in pure cultures, were isolated in each case. The bacteria were similar to each other and were classified as actinomyces on the basis of phylogenic and phenotypic evidence. The bacteria were different from others within the genus, thus warranting designation as a new species, actinomyces radicidentis. CONCLUSIONS: The 2 cases of endodontic failure were infected with A radicidentis, a new actinomyces species. This bacterium joins a restricted group of other microorganisms that have been associated with failure of root canal treatment. ( info) |