Kist Benzeri Geniş Periapikal Lezyonların Cerrahi Olmayan Endodontik Tedavisi: Olgu

Yıl 2013, Cilt: 23 Sayı: 3, 375 - 379, 01.03.2013

Dr. Neslihan Şimşek Dr. Alper Kuştarcı

Öz

Treatments of large preapikal lesions generally combine various endodontic treatment options and requires long term patient follow up. Even though, apical surgical treatment could be an option in these cases, conventional root canal treatment should be the first choice. 15-year-old male patient who had a swelling that occurs from time to time at the palate referred to Endodontics clinic. During the radiologic examination cyst like lesions were determined on the apices of the maxillary left lateral and the maxillary right lateral seperately. After three years of root canals obturation with endodontic treatment without the need for a surgical treatment, a complete clinical and radiological healing of the periapical cyst-like lesions was observed. The aim of this case report is to present, primarily treatment of large periapical lesions should be orthograde method, and to provide a perspective to resort the surgical treatment when absence of healing during the routine controls.

Anahtar Kelimeler

Large periapical lesion; periapical cyst.

KİST BENZERİ GENİŞ PERİAPİKAL LEZYONLARIN CERRAHİ OLMAYAN ENDODONTİK TEDAVİSİ: OLGU SUNUMU

Öz

Büyük periapikal lezyonların tedavisi; cerrahi ile kombine endodontik tedavi seçeneklerini ve tedavi sonrası uzun süreli takipleri gerektirebilmektedir. Apikal cerrahi seçeneği böyle olgularda düşünülebilsede de geleneksel kök kanal tedavisi ilk tercih olmalıdır. 15 yaşındaki erkek hasta zaman zaman üst çenesinin damak kısmında meydana gelen şişlik nedeni ile Endodonti kliniğine başvurmuştur. Radyolojik muayene esnasında üst çene sol lateral ve sağ lateral dişlerin apekslerinde kist görünümlü lezyonlar saptanmıştır. Kök kanal tedavilerinin tamamlanmasından üç yıl sonra, cerrahi tedaviye gereksinim duymadan endodontik tedaviyle periapikal kist görünümlü lezyonların klinik ve radyolojik olarak tamamen iyileştiği görüldü. Bu olgu sunumunun amacı; büyük periapikal lezyonların öncelikle ortograd yöntemle tedavi edilmesi ve yapılan rutin kontrollerde lezyonda iyileşme olmadığı durumlarda cerrahi yöntemlere başvurulması fikrine bir bakış açısı daha sağlayabilmektir.

Anahtar Kelimeler

Büyük periapikal lezyon, periapikal kist

Kaynakça

• Yamasaki M, Nakane A, Kumazawa M, Hashioka. Application of the International Classification of Diseases to dentistry and stomatology. World Health Organization. 3rd ed. Geneva: WHO 1995: 66Nair PNR. Apical periodontitis: a dynamic encounter between root canal infection and host response. Periodontol 2000 1997;13:121-48.
• Bhaskar SN. Periapical lesion-types, incidence and clinical features. Oral Surg Oral Med Oral Pathol 1966;21:657–71.
• Çalışkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J 2004;37:408–16.
• Nair PNR. Non-microbial etiology: periapical cysts sustain post-treatment apical periodontitis. Endod Topics 2003;6:96-113.
• Bender IB. A commentary on General Bhaskar’s hypothesis. Oral Surg Oral Med Oral Pathol 1972;34:469–76.
• Freedland JB, Charlotte NC. Conservative reduction of large periapical lesions. Oral Surg Oral Med Oral Pathol 1970;29:455-64.
• Nair PNR. Review, New perspectives on radicular cysts: do they heal? Int Endod J 1998;31:155–60. Nair PNR, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;81:93-102.
• Ricucci D, Pascon EA, Pitt Ford TR, Langeland K. Epithelium and bacteria in periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:239-49.
• Eversole RL. Clinical Outline of Oral Pathology: Diagnosis and Treatment. 2nd ed. Philadelphia, PA: Lea & Febiger 1984:203–59.
• Weiger R, Rosendahl R, Löst C. Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesion. Int Endod J 2000;33:219–26.
• Soares JA, Brito-Junior M, Silveira FF, Nunes E, Santos SMC. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci 2008;50:107-11.
• Öztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J 2002;35:73–8.
• Fernandes M, De Ataide I. Non-surgical management of a large periapical lesion using a simple aspiration technique: a case report. Int Endod J 2010;43:536–42.
• Özan Ü, Er K. Endodontic Treatment of a Large Cyst-Like Periradicular Lesion Using a Combination of Antibiotic Drugs: A Case Report. J Endod 2005;31:898-900.
• Martin SA. Conventional Endodontic Therapy of Upper Central Incisor Combined with Cyst Decompression: A Case Report. J Endod 2007;33:753-7.
• Matsumoto T, Nagai T, Ida K, Ito M, Kaswai Y, Hariba N et al. Factors affecting successful prognosis of root canal treatment. J Endod 1987;13:239–42.
• Sjögren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 1990;16:498 –504.
• Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg Oral Med Oral Pathol 1984;57:82-94.
• Bhaskar SN. Nonsurgical resolution of radiculer cysts. Oral Surg Oral Med Oral Pathol 1972; 34:458–68.
• Sjögren U, Figdor D, Spangberg L, Sundquvist G. The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J 1991;24:119-25.
• Çalışkan MK, Şen BH. Endodontic treatment of teeth with apical periodontitis using calcium hydroxide: a long-term study. Endod Dent Traumatol 1996;12:215-21.
• Çalışkan MK, Türkün M. Periapical repair and apical closure of a pulpless tooth using calcium hydroxide. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:683-7.
• Çelik K, Belli S. [Periapical Cysts and Relationships with Root Canal Therapy: Review] Turkiye Klinikleri J Dental Sci 2012;18:64-9.
• Franzen R, Gutknecht N, Falken S, Heussen N, Meister J. Bactericidal effect of a Nd:YAG laser on Enterococcus faecalis at pulse durations of 15 and 25 ms in dentine depths of 500 and 1,000 μm. Lasers Med Sci 2011; 26:95-101.
• Lee MT, Bird PS, Walsh LI. Photo-activated disinfection of the root canal: a new role for lasers in endodontics. Aust Endod J 2004; 30:93-8.
• Pirnat S, Lukac M, Ihan A. Study of the direct bactericidal effect of Nd:YAG and diode laser parameters used in endodontics on pigmented and nonpigmented bacteria. Lasers Med Sci 2011; 26:755-61.
• Kuştarcı A, Siso Hergüner Ş, Şimşek N, Kırmalı Ö. [Microleakage of composite restorations after application of different KTP laser energy densities.] SDÜ Sağlık Bilimleri Dergisi 2012; 3:119-25.
• Meire MA, De Prijck K, Coenye T, Nelis HJ, De Moor RJG. Effectiveness of different laser systems to kill Enterococcus faecalis in aqueous suspension and in an infected tooth model. Int Endod J 2009;42:351-9. Yazışma Adresi
• Dr. Neslihan ŞİMŞEK İnönü Üniversitesi Diş Hekimliği Fakültesi Endodonti AD Malatya 44280, Türkiye [e-mail] Telefon: [phone] Faks : 090 422 3411107