GENİŞ PERİAPİKAL LEZYONLU DİŞLERİN CERRAHİ OLMAYAN ENDODONTİK TEDAVİSİ: OLGU SUNUMU

Year 2021, Volume: 31 Issue: 1, 100 - 103, 15.01.2021

Seda Elmas Mesut Enes Odabaş

https://doi.org/10.17567/ataunidfd.751974

Abstract

Total pulpa nekrozuna kadar ilerleyen pulpa enfeksiyonları çürük, dental işlemler ve travma sonucu ortaya çıkmaktadırlar. İnflamasyon periradiküler dokulara yayılana kadar diş asemptomatik kalabilmekte; yayılmaya başladığında ise spontan ağrı ve perküsyon görülebilmektedir. Radyografik olarak; periodontal aralığın genişlemesinden, periapikal lezyona kadar değişebilen görüntüler izlenebilmektedir. Büyük periapikal lezyonlar için tedavi seçenekleri, cerrahi olmayan kök kanal tedavisi ve apikal cerrahiden diş çekimine kadar uzanmaktadır. Bu olgu sunumunda, alt ön bölgedeki üç dişi içine alan geniş kist benzeri periapikal lezyonun cerrahi olmayan endodontik tedavisi anlatılmaktadır. Bir yıl boyunca yapılan üç aylık klinik ve radyografik kontrollerde lezyonun iyileştiği görülmüştür. Tomografik incelemede ise lezyonun kemik benzeri dokuyla dolduğu gözlemlenmiştir. İdeal koşullarda yapılan uygun tedavi planlaması ile lezyon ne kadar büyük olursa olsun, cerrahi müdahaleye gerek olmadan iyileşme sağlanabilmektedir.
Anahtar kelimeler: Alt kesici dişler, cerrahi olmayan endodontik tedavi, geniş periapikal lezyon
Nonsurgical Endodontic Treatment of Teeth Associated with a Large Periapical Lesion: A Case Report
Abstract
Pulp infections leading to total pulp necrosis occur as a result of caries, dental procedures and trauma. The tooth may remain asymptomatic until inflammation spreads to the periradicular tissues; spontaneous pain and percussion can be seen when spread. Radiographic changes may occur, ranging from a thickening of the periodontal ligament space to the appearance of a periapical radiolucent lesion. Treatment options for large periapical lesions range from non-surgical root canal treatment and apical surgery to tooth extraction. This case report describes a nonsurgical management of a large mandibular cyst-like periapical lesion involving mandibular incisors. The patient returned for clinical and radiographic controls every 3 months during the first year, radiographic evidence of lesion healing was observed at the 12-months follow-up. Tomography showed that the lesion was filled with bone like tissue. With appropriate treatment planning under ideal conditions, no matter how large the lesion is, improvement can be achieved without the need of surgical intervention.
Keywords: Large periapical lesion; mandibular incisors; nonsurgical endodontic treatment

Keywords

Alt kesici dişler, cerrahi olmayan endodontik tedavi, nonsurgical endodontic treatment

References

• 1. Stashenko P. Interrelationship of Dental Pulp and Apical Periodontitis. Seltzer and Bender's Dental Pulp, Hargreaves KM, Goodis HE (Editors). China. Quintessence Publish 2002:389-409.
• 2. Berman LH., Rotstein I. Diagnosis. Cohen's Pathways of the Pulp, Hargreaves K M., Berman LH (Editors). Missouri. Elsevier 2016:2-32.
• 3. Kim S and Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006; 32: 601-23.
• 4. Lin LM, Ricucci D, Lin J, Rosenberg PA. Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts. J Endod 2009; 35: 607-15.
• 5. Ghorbanzadeh S, Ashraf H, Hosseinpour S, and Ghorbanzadeh F. Nonsurgical management of a large periapical lesion: A case report. Iranian Endod J 2017; 12: 253-6.
• 6. Moshari A, Vatanpour M, EsnaAshari E, Zakershahrak M, and Ara, AJ. Nonsurgical management of an extensive endodontic periapical lesion: A case report. Iranian Endod J 2017; 12: 116-9.
• 7. Karunakaran JV, Abraham CS, Karthik AK and Jayaprakash N. Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach. J Pharmacy & Bioallied Sci 2017; 9 (Supp:1) : 246-251.
• 8. Oztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J 2002; 35: 73-8.
• 9. Caliskan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J 2004; 37: 408-416.
• 10. Arslan H, Topçuoğlu HS, Barutçıgil Ç, Karataş E, Aladağ H, Köseoğlu M, Ezmeci B. Geniş periapikal lezyonlu dişlerin cerrahi girişimsiz kök kanal tedavileri. Atatürk Üniv Diş Hek Fak Dergi 2012; 22: 61-5.
• 11. Sood N, Maheshwari N, Gothi R, Sood N. Treatment of large periapical cyst like lesion: A noninvasive approach: A report of two cases. International J Clin Pediatr Dent 2015; 8: 133-7.
• 12. Kunhappan S, Kunhappan N, Saraf KK, Kridutt V. Nonsurgical endodontic treatment of teeth associated with large periapical lesion using triple antibiotic paste and mineral trioxide aggregate apical plug: A case series. J Conservative Dent 2017; 20: 141-5.
• 13. Bayram M, Bayram E, Eren H. Endodontik tedavisi yapılmış geniş periapikal lezyonlu dişlerin uzun dönem radyografik takibi: 2 olgu sunumu. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 2015; 25(Supp:11): 39-43.