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Non-Surgical Treatment of Teeth with Large Periapical Lesions

Yıl 2012, Cilt: 5 Sayı: 4, 1034 - 1041, 01.01.2012

Öz

Periapical lesions generally ocur as a result of an inflammatory response against the non-vital pulp. Treatment options include non-surgical root canal treatment, apical surgery and extraction. Recently, investigators consider that inflammatory periapical lesions must be treated with non-surgical root canal treatment by using Ca OH 2 as an intracanal medicament primarily with a long-term success. At the same time, surgical intervention can be more traumatic for children and has risk of damage to healthy tissue.The aim of the present case series is to show that the orthograde root canal treatment with using Ca OH 2between the session is effective treatment method for the teeth with large periapical lesion, especially in adolescence. The teeth with large periapical lesion teeth can be successfuly treated with traditional root canal treatment by using Ca OH 2 as an intracanal medicament. Despite taking a longer time the presented technique eliminates the need for surgical intervention

Kaynakça

  • Yıldırım T., Gençoğlu N. Use of mineral trioxide aggregate in the treatment of large periapical le- sions: reports of three cases. Eur. J. Dent. 4:468- 474, 2010.
  • Venugopal P., Kumar A., Jyothi KN. Successful Healing Of Periapical Lesions with Non-Surgical Endodontic Approach. J. Dent. Sci. Res. 2:1-6, 2011.
  • Nair PNR. Review: New perspectives on radicu- lar cysts: do they heal? Int. Endod. J. 31:155– 160, 1998.
  • Siqueira JF Jr. Strategies to treat infected root ca- nals. J. Calif. Dent. Assoc. 29:825-837, 2001.
  • Calıskan MK. Prognosis of large cyst-like peria- pical lesions following nonsurgical root canal tre- atment: a clinical review. Int. Endod. J. 37:408– 416, 2004.
  • Simon JHS. Incidence of periapical cysts in re- lation to the root canal. J. Endod. 6:845–848, 1980.
  • Lin S., Guttmacher Z., Steif M., Braun R. Apical root end resection (Apicoectomy) as treatment op- tion in cases of dental trauma in young patient. Refuat Hapeh Vehashinayim. Apr;28:30-34, 73, 2011.
  • Lieblich, SE. Endodontic surgery. Dent. Clin. North Am. 56:121-132, 2012.
  • Lin LM., Huang GTJ., Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. J. Endod. 33:908–916, 2007.
  • Broon NJ., Bortoluzzi EA., Bramante CM. Repair of large periapical radiolucent lesions of endo- dontic origin without surgical treatment. Aust. En- dod. J. 33:36–41, 2007.
  • Riccitiello F., Stabile P., Amato M., Rengo S., D’ambrosio C. The treatment of the large peri- radicular endodontic injury. Minerva Stomatol. 60:417-426, 2011.
  • Tolasaria S., Das UK. Surgical and nonsurgical management of bilateral periapical lesions in the maxillary anterior region. J. Surg. Tech. Case Rep. 3:44-48, 2011.
  • Wang X., Li YG., Pan XY. Clinical evaluation of large periapical lesions following apical surgery. Hua Xi Kou Qiang Yi Xue Za Zhi. 28:641-645, 2010.
  • Von Arx T., Alsaees M., Salvi GE. Five-year chan- ges in periodontal parameters after apical sur- gery. J. Endod. 37: 910-918, 2011.
  • Ricucci D., Russo J., Rutberg M., Burleson JA., Spangberg LSW. A prospective cohort study of endodontic treatments of 1,369 root canals: re- sults after 5 years. Oral Surg. Oral Med. Oral Pat- hol. Oral Radiol. Endod. 112:825-842, 2011.
  • Öztan MD. Endodontic treatment of teeth associ- ated with a large periapical lesion. Int. Endod. J. 35:73-78, 2002.
  • Kalaskar R., Tiku A., Damle SG. Periapical re- pair and apical closure of a pulpless tooth using calcium hydroxide--a case report. J. Indian Soc. Pedod. Prev. Dent. 22:158-161, 2004.
  • Saatchi M. Healing of large periapical lesion: A non-surgical endodontic treatment approach. Aust. Endod. J. 33;136–140, 2007.
  • Shuping GB., Ørstavik D., Sigurdsson A., Trope M. Reduction of intracanal bacteria using nickel- titanium rotary ınstrumentation and various medi- cations. J. Endod. 26:751-755, 2000.
  • Waltimo T., Trope M., Haapasalo M., Ørstavik D. Clinical efficacy of treatment procedures in endodontic infection control and one year follow- up of periapical healing. J. Endod. 31:863-866, 2005.
  • Ørstavik D. Intracanal Medication: Pitt Ford TR. Harty’s Endodontics in Clinical Practice. Elsevier Science Limited, Fifth Edition, 2004, 95-112.
  • Johnson WT., Noblett WC. Cleaning and sha- ping: Torabinejad M., Walton RE. Endodontics Principles And Practice. Saunders Elsevier, Fourth Edition, 2009, 258-286.
  • Siqueira JF Jr., Lopes HP. Mechanisms of antimic- robial activity of calcium hydroxide: a critical re- view. Int. Endod. J. 32:361-369, 1999.
  • Leonardo MR., Almeida WA., Ito IY., Silva LAB. Radiographic and microbiologic evaluation of posttreatment apical and periapical repair of root canals of dogs’ teeth with experimentally in- duced chronic lesion. Oral Surg. Oral Med. Oral Pathol. 78:232–238, 1994.
  • Gomes IC., Almeida NS., Salles MR., Gomes GC. Diffusion of calcium through dentin. J. En- dod. 22:590-595, 1996.
  • Nerwich A., Figdor D., Messer HH. pH changes in root dentin over a 4-week period following root canal dressing with calcium hydroxide. J. Endod. 19:302-306, 1993.
  • Bystrom A., Claesson R., Sundqvist G. The an- tibacterial effect of camphorated paramonoch- lorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod. Dent. Traumatol. 1:170-175, 1985.
  • Leonardo MR., Silveira FF., Silva LAB., Filho MT., Utrilla LS. Calcium Hydroxide Root Canal Dres- sing. Histopathological Evaluation of Periapical Repair at Different Time Periods. Braz. Dent. J. 13:17-22, 2002.
  • Andreasen JO., Farik B., Munksgaard EC. Long- term calcium hydroxide as a rootcanal dressing may increase risk of root fracture. Dent. Trauma- tol. 18:134-137, 2002.
  • Peters CI., Koka RS., Highsmith S., Peters OA. Calcium hydroxide dressings using different pre- paration and application modes: density and dis- solution by simulated tissue pressure. Int. Endod. J. 38:889–895, 2005.
  • Gibson R., Howlett P., Cole BOI. Efficacy of spirally filled versus injected non-setting calcium hydroxide dressings. Dent. Traumatol. 24:356– 359, 2008.
  • Staehle HJ., Thoma C., Miiller HP. Comparative in vitro investigation of different methods for tem- porary root canal filling with aqueous suspensi- ons of calcium hydroxide. Endod. Dent. Trauma- tol. 13:106-112, 1997.
  • Sigurdsson A., Stancill R., Madison S. Intracanal placement of Ca(OH)2: A comparison of techni- ques. J. Endod. 18;367-370, 1992.

Geniş Periapikal Lezyonlu Dişlerin Cerrahi Olmayan Yöntemle Tedavisi

Yıl 2012, Cilt: 5 Sayı: 4, 1034 - 1041, 01.01.2012

Öz

Endodontik kaynaklı periapikal lezyonlar, devital pulpaya karşı verilen enflamatuvar cevap sonucu ortaya çıkmaktadırlar. Geniş periapikal lezyonlu dişlerin tedavisi; cerrahi olmayan ortograd kök kanal tedavisinden, apikal cerrahiye hatta çekime kadar değişmektedir. İlk seçenek olarak bu dişlerin tedavisinin cerrahi gerektirmeyen kök kanal tedavisi ile yapılması gerektiği düşünülmekte ve kanal içi medikaman olarak kullanılan kalsiyum hidroksitle Ca OH yapılan endodontik tedavinin, uzun dönem takiplerde başarılı sonuçlar verdiği bildirilmektedir. Aynı zamanda cerrahi işlemler çocuk hastalar için her yönden daha travmatik olmakta ve sağlıklı dokulara zarar verme riski bulunmaktadır. Bu olgu sunumunda; özellikle adolesanlarda ortaya çıkabilecek geniş periapikal lezyonlu dişlerde, ara seanslarda Ca OH 2 kullanılarak yapılan ortograd kök kanal tedavisinin etkin bir yöntem olarak uygulanabileceğini 4 olguyla açıklamak amaçlanmıştır. En az bir yıl takip süresi sonucunda bu dişlerin, cerrahi müdahale gerekmeksizin geleneksel kök kanal tedavisi ve kanal içi medikaman olarak kalsiyum hidroksit uygulaması ile uzun bir süre almasına rağmen tedavi edilebileceği sonucuna varılmıştır

Kaynakça

  • Yıldırım T., Gençoğlu N. Use of mineral trioxide aggregate in the treatment of large periapical le- sions: reports of three cases. Eur. J. Dent. 4:468- 474, 2010.
  • Venugopal P., Kumar A., Jyothi KN. Successful Healing Of Periapical Lesions with Non-Surgical Endodontic Approach. J. Dent. Sci. Res. 2:1-6, 2011.
  • Nair PNR. Review: New perspectives on radicu- lar cysts: do they heal? Int. Endod. J. 31:155– 160, 1998.
  • Siqueira JF Jr. Strategies to treat infected root ca- nals. J. Calif. Dent. Assoc. 29:825-837, 2001.
  • Calıskan MK. Prognosis of large cyst-like peria- pical lesions following nonsurgical root canal tre- atment: a clinical review. Int. Endod. J. 37:408– 416, 2004.
  • Simon JHS. Incidence of periapical cysts in re- lation to the root canal. J. Endod. 6:845–848, 1980.
  • Lin S., Guttmacher Z., Steif M., Braun R. Apical root end resection (Apicoectomy) as treatment op- tion in cases of dental trauma in young patient. Refuat Hapeh Vehashinayim. Apr;28:30-34, 73, 2011.
  • Lieblich, SE. Endodontic surgery. Dent. Clin. North Am. 56:121-132, 2012.
  • Lin LM., Huang GTJ., Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. J. Endod. 33:908–916, 2007.
  • Broon NJ., Bortoluzzi EA., Bramante CM. Repair of large periapical radiolucent lesions of endo- dontic origin without surgical treatment. Aust. En- dod. J. 33:36–41, 2007.
  • Riccitiello F., Stabile P., Amato M., Rengo S., D’ambrosio C. The treatment of the large peri- radicular endodontic injury. Minerva Stomatol. 60:417-426, 2011.
  • Tolasaria S., Das UK. Surgical and nonsurgical management of bilateral periapical lesions in the maxillary anterior region. J. Surg. Tech. Case Rep. 3:44-48, 2011.
  • Wang X., Li YG., Pan XY. Clinical evaluation of large periapical lesions following apical surgery. Hua Xi Kou Qiang Yi Xue Za Zhi. 28:641-645, 2010.
  • Von Arx T., Alsaees M., Salvi GE. Five-year chan- ges in periodontal parameters after apical sur- gery. J. Endod. 37: 910-918, 2011.
  • Ricucci D., Russo J., Rutberg M., Burleson JA., Spangberg LSW. A prospective cohort study of endodontic treatments of 1,369 root canals: re- sults after 5 years. Oral Surg. Oral Med. Oral Pat- hol. Oral Radiol. Endod. 112:825-842, 2011.
  • Öztan MD. Endodontic treatment of teeth associ- ated with a large periapical lesion. Int. Endod. J. 35:73-78, 2002.
  • Kalaskar R., Tiku A., Damle SG. Periapical re- pair and apical closure of a pulpless tooth using calcium hydroxide--a case report. J. Indian Soc. Pedod. Prev. Dent. 22:158-161, 2004.
  • Saatchi M. Healing of large periapical lesion: A non-surgical endodontic treatment approach. Aust. Endod. J. 33;136–140, 2007.
  • Shuping GB., Ørstavik D., Sigurdsson A., Trope M. Reduction of intracanal bacteria using nickel- titanium rotary ınstrumentation and various medi- cations. J. Endod. 26:751-755, 2000.
  • Waltimo T., Trope M., Haapasalo M., Ørstavik D. Clinical efficacy of treatment procedures in endodontic infection control and one year follow- up of periapical healing. J. Endod. 31:863-866, 2005.
  • Ørstavik D. Intracanal Medication: Pitt Ford TR. Harty’s Endodontics in Clinical Practice. Elsevier Science Limited, Fifth Edition, 2004, 95-112.
  • Johnson WT., Noblett WC. Cleaning and sha- ping: Torabinejad M., Walton RE. Endodontics Principles And Practice. Saunders Elsevier, Fourth Edition, 2009, 258-286.
  • Siqueira JF Jr., Lopes HP. Mechanisms of antimic- robial activity of calcium hydroxide: a critical re- view. Int. Endod. J. 32:361-369, 1999.
  • Leonardo MR., Almeida WA., Ito IY., Silva LAB. Radiographic and microbiologic evaluation of posttreatment apical and periapical repair of root canals of dogs’ teeth with experimentally in- duced chronic lesion. Oral Surg. Oral Med. Oral Pathol. 78:232–238, 1994.
  • Gomes IC., Almeida NS., Salles MR., Gomes GC. Diffusion of calcium through dentin. J. En- dod. 22:590-595, 1996.
  • Nerwich A., Figdor D., Messer HH. pH changes in root dentin over a 4-week period following root canal dressing with calcium hydroxide. J. Endod. 19:302-306, 1993.
  • Bystrom A., Claesson R., Sundqvist G. The an- tibacterial effect of camphorated paramonoch- lorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod. Dent. Traumatol. 1:170-175, 1985.
  • Leonardo MR., Silveira FF., Silva LAB., Filho MT., Utrilla LS. Calcium Hydroxide Root Canal Dres- sing. Histopathological Evaluation of Periapical Repair at Different Time Periods. Braz. Dent. J. 13:17-22, 2002.
  • Andreasen JO., Farik B., Munksgaard EC. Long- term calcium hydroxide as a rootcanal dressing may increase risk of root fracture. Dent. Trauma- tol. 18:134-137, 2002.
  • Peters CI., Koka RS., Highsmith S., Peters OA. Calcium hydroxide dressings using different pre- paration and application modes: density and dis- solution by simulated tissue pressure. Int. Endod. J. 38:889–895, 2005.
  • Gibson R., Howlett P., Cole BOI. Efficacy of spirally filled versus injected non-setting calcium hydroxide dressings. Dent. Traumatol. 24:356– 359, 2008.
  • Staehle HJ., Thoma C., Miiller HP. Comparative in vitro investigation of different methods for tem- porary root canal filling with aqueous suspensi- ons of calcium hydroxide. Endod. Dent. Trauma- tol. 13:106-112, 1997.
  • Sigurdsson A., Stancill R., Madison S. Intracanal placement of Ca(OH)2: A comparison of techni- ques. J. Endod. 18;367-370, 1992.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Mine Bozkurt Bu kişi benim

Canan Dağ Bu kişi benim

Mustafa Dağ Bu kişi benim

Nurhan Özalp Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 5 Sayı: 4

Kaynak Göster

Vancouver Bozkurt M, Dağ C, Dağ M, Özalp N. Geniş Periapikal Lezyonlu Dişlerin Cerrahi Olmayan Yöntemle Tedavisi. ADO Klinik Bilimler Dergisi. 2012;5(4):1034-41.