Cilde fistülizasyonu olan ve olmayan geniş periradikuler lezyonların cerrahi olmayan endodontic tedavisi: iki olgu sunumu ve derleme

Öz

Bu olgu sunumunun amacı cilde fistülizasyonu olan ve olmayan geniş periradiküler lezyonu olan iki vakanın sunumu ile birlikte, tanı ve tedavi prensiplerini sunarak, diğer rapor edilmiş vakaları özetlemektir. Birinci vaka mandibular kesici dişlerinden kaynaklanan çene ucu cilt fistülizasyonu olan 23 yaşında bir kadındı. Iki yıldır mevcut olan lezyonda ara sıra pürülan bir sıvı drene olmaktaydı. Ikinci vaka ise radyografik olarak sol mandibular ikinci premolar diş kökünün apikalinde sınırları belirsiz geniş bir radyolusent lezyonu olan 46 yaşında bir kadındı. Her iki vakada da, cerrahi olmayan endodontik tedaviyi takiben lezyonlar tamamen iyileşti. İzleyen 3, 6 ve 12 aylarda kontrolleri yapıldı. Birinci vakada fistül iki hafta içinde küçük çukur şeklinde bir skarla iyileşirken, her iki vakada da 1 yılın sonunda radyografik olarak tam bir kemik iyileşmesi görüldü. Anahtar kelimeler: geniş periapikal lezyon, diş kaynaklı cilt fistülü, cerrahi olmayan endodontik tedavi, taşkın kalsiyum hidroksit

Anahtar Kelimeler

• Geniş periapikal lezyon
• diş kaynaklı cilt fistülü
• cerrahi olmayan endodontik tedavi
• taşkın kalsiyum hidroksit

Non-Surgical Endodontic Treatment of Large Periradicular Lesions with and without Cutaneous Sinus Tract: Report of Two Cases and Review

Öz

The purposes of this report are to report two cases of large periradicular lesions with and without cutaneous sinus tract and to present diagnostic guidelines, treatment guidelines and to summarize other reported cases. The first case was 23 year-old women with a draining cutaneous sinus tract on the chin, which originated from mandibular incisors. The lesion had been present for two years and had been occasionally draining purulent fluid. The second case was 46 year-old women with a large non-demarcated radiolucent lesion located in apical portion of the mandibular left second premolar root. The patient had exhibited slight discomfort in the premolar region. In both cases, the lesions completely resolved following non-surgical endodontic treatment. Recall visits were performed after 3, 6 month and 12-month period. In the first case, the sinus tract completely healed within two weeks with a small dimple-like scar, one-year recall radiography demonstrated completed bony repair. Keywords: large periapical lesion, odontogenic cutaneous sinus tract, non-surgical treatment, extruded kalsiyum hidroksit

Anahtar Kelimeler

• large periapical lesion
• odontogenic cutaneous sinus tract
• non-surgical treatment
• extruded calcium hydroxide

Kaynakça

1. Maalouf EM, Biological perspectives on the non-surgical endodontic periradicularpathosis. Int Endod J 1994; : 154-162. Gutmann JL. management of
2. Morse DR, Seltzer S, Sinai I, Biron G. Endodontic classification. J Am Dent Assoc 1977; 94: 685-689. Torabinejad M, Walton RE.
3. Principles and Practice of Endodontics. nd ed. Philadelphia: W. B. Saunders Co., 29-51. Kaban LB. Draining skin lesions of dental origin: the path of spread of chronic odontogenic PlastReconstrSurg1980; 66:711-717. infection.
4. Donohue WB, Maisonneuve C. Sinus tracts of odontogenic origin in the face Assoc1984;1:199-102. Cioffi Can Dent GA, Terezhalmy GT,
5. Parlette HL. Cutaneous draining sinus tract: an odontogenicetiology. J Am AcadDermatol 1986; 14:94-100.
6. Scott MJ Jr, Scott MJ Sr. Cutoneousodontogenic AcadDermatol 1980; 2:521-24. sinus.J Am Sundqvist of dental studies
7. Odontogical Dissertations no: 7 Umea, Sweden: Umea University 1976. pulps. Ingle JI.
8. Endodonticinstrumentsandinstrumentation. DentClin North Am 1957;11:805. following biopsy and histologic study of periapical lesions. Oral Surg Oral Med Oral Pathol 1958; 11: 650-653.

9. Delaune GF. A clinical, roentgenographic, and periapical lesions. Oral Surg Oral Med Oral Pathol 1964;7: 467-472. frequency and distribution of periapical cysts and granuloms. Oral Surg Oral Med Oral Pathol1968;25: 861-8. of Lalonde ER, Luebkerg. The Grossman LI. Endodontic Practise. th ed. Philedelpia. PA. USA: Lea &Febiger , 1981, 106.
10. Simon JH. Incidence of periapical cysts in relation to the root canal. J Endod ; 6: 845-848. of cannulization through the involved teeth. J Endod 1984; 10: 215-220. lesions using repair and apical closure of a pulpless tooth using calcium hydroxide. Oral Surg Oral Med Oral Pathol 1997;84,:683-687.
11. Periapical lesions accidentally filled with calcium hydroxide. Int Endod J. 2002; 35: 958. teeth associated with a large periapical lesion. Int Endod J2002 ;35 :73-8.
12. Odontogenic cutaneous sinus tract. J Endod1992; 18: 304-306. tracts of dental origin in children. J Dent Child 1976;43:167-171.
13. Periapical granulomas and cysts. An investigation of 1,600 cases. Scand J Dent Res 1970;78:241-50. of odontogenic sinus tracts in patients referred for endodontic therapy. J Endod ;29:798-800.
14. Murphy JB. Cervical necrosis and sinus tract dentoalveolar infection: report of a case. J Oral MaxillofacSurg 1986;44: 894-896.
15. Rio CE, Knott JW. Cutaneous sinus tracts of dental etiology. Oral Surg Oral Med Oral Pathol 1988; 66:608-614.
16. Grossman ME. Cutaneous sinus of dental origin: a diagnosis requiring clinical and radiologic correlation. Cutis 1989; 43: 22- Rosenberg SL, formation secondary to a
17. McWalter GM, Alexander JB, del Held JL, Yunakov MJ, Barber RJ, Hodges TP, Cohen DA, Deck D. Odontogenic Physician 1989; 40:113-116.
18. Ben-Naji A, Gnanasekhar JD. Cutaneous sinus tracts of dental origin to the chin and cheek: Int1993;24:729-733 odontogenic sinus tract draining to the midline of the submental region: report of a case. J Dermatol 1996; 23:284-286. unusual facial sinus. Aust Dent J 1996;41: 8.
19. Hutson B, Cederberg RA. Cutaneous odontogenic sinus tract to the chin: a case report.Int Endod J 1997;30:352-355.
20. Wu SK, Huang SK. Cutaneous sinus tract caused by vertical root fracture. J Endod1997;23:593-595.
21. M, Matsumoto K. A case of an odontogenic cutaneous sinus tract. Int Endod J 1999;32: 328-331.
22. Christensen ED, Sorensen GW. Unusual recurrent facial lesion. Arch Dermatol ;135:595-598. Diagnosis and treatment of cutaneous facial sinus tracts of dental origin. J Am Dent Assoc 1999;130: 832-836.
23. Cutaneous sinus tract from remaining tooth fragment CraniofacSurg 2000;11: 254-257. DA,
24. Bradford RJ, Nijole AR, Joseph EV. Hwang K, Kim CW, Lee SI. of edentulous maxilla. J Gulec AT, Seckin D, Bulut S, Sarfakoglu E. Cutaneous sinus tract of dental origin. Int J Dermatol2001; 40:650- of dental origin: a case report. Dent Update ;29: 170-171.
25. Extraoral sinus tract misdiagnosed as an endodontic lesion. J Endod 2003;29:841-3.
26. Mittal N, Gupta P. Management of extra oral sinus cases: a clinical dilemma. J Endod 2004; 30:541-547
27. Sheehan DJ, Potter BJ, Davis LS. Cutaneous odontogenic origin: unusual presentation of a challenging diagnosis. South Med J. Feb;98(2):250-252. Arjumand B, Hussain SM, Afridi Z. Nonsurgical endodontic management of cutaneously draining odontogenic sinus. J Ayub Med Coll Abbottabad. 2006 Apr- Jun;18(2):88-89.
28. FG, Araşjo GS, de Pontes Lima RK, Rodrigues VM, de Toledo Leonardo R. Conservative treatment of patients with periapical lesions associated with extraoral sinus Dec;33(3):131-135. Pasternak-Jşnior B, Teixeira CS, Silva-Sousa Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies. IntEndod J. 2009 Mar;42(3):271-276.
29. Caliskan MK, Sen BH, Ozinel MA. Treatment of extraoral sinus tracts from traumatized teeth with apical periodontitis. Endod& Dental Traumatol1995;11:115
30. Thoma KH. Oral Surgery, 4th ed. St Louis, USA: Mosby. 1963; 733. Harrison epithelized oral sinus tract. Oral Surg Oral Med Oral Pathol1976;42: 511-517.
31. Bender IB, Selzer S. The oral fistulas: ıts diagnosis and treatment. Oral Surg Oral Med, Oral Pathol1961;14:1367-1376.
32. Spear KL, Sheridan PJ, Perry HO. Sinus tract to the chin and jaw of dental origin. J Am AcadDermatol1983;8:486
33. Byström A, Claesson R, Sandqvist G. The comphoratedparamonochlorophenol, camphorated and calcium hydroxide in the treatment of infected root canals. Endod& Dental Traumatol1985;1:170-175. YT, Sousa-Neto MD. JW, Larson WJ. The antibacterial effect of
34. Sjögren U, Figdor D, Spanberg L, Sundqvist G. The antimicrobial effect of calcium intracanal J1991;24:119-125. Boutsioukis Removalefficacy variouscalciumhydroxide/chlorhexidineme dicamentsfromtherootcanal. Int Endod J ;39:55-61. as a Int dressing. Endod Lambrianidis T, Kosti E, M. of JF,
35. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. IntEndod J 1999;32:361-369.
36. TanomaruFilho M, Silva LAB, Ito IY. Effect of biomechanical preparation and calcium hydroxide pastes on the anti-sepsis of root canal systems in dogs. J Appl Oral Science 2005;12:110-117.
37. MA, Ito IY, Bonifácio KC. Evaluation biofilm and microorganisms on the external root surface in human teeth. J Endod 2002;28:815-818. conserving the dental pulp--can it be done?
38. Is it worth it? Oral Surg Oral Med Oral Pathol1989;68: 628-39. and the expanded endodontic role of calcium hydroxide. In: Gerstein H. Techniques
39. Philadelphia, Saunders., 1983,238-39. permanent hydroxide. I. Follow-up of periapical repair and apical closure of immature roots. Odontol Revy 1972;23:27-44. HP. Soares JA, Leonardo MR,
40. Leonardo MR, Silva LAB, Rossi Stanley HR. Pulp capping: Webber R.T. Traumatic Injuries In Clinical Endodontics, Cvek M. Treatment of non-vital incisors with calcium Tronstad L, Hasselgren G, Kristerson L, Riis I. Ph changes in dental tissues after root canal filling with calcium hydroxide. J Endod ;7:17-21. YM. Apexification of immature apices of pulpless permanent anterior teeth with calcium hydroxide. J Endod1987;13: 285- Andreasen JO,
41. Ghose LJ, Baghdady VS, Hikmat Sonat B, Dalat D, Gunhan O. Periapical tissue reaction to root fillings with Sealapex. Int Endod J1990;23:46-52.
42. Orstavik D, Kerekes K, Molven O. Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study. Int Endod J1991;24:1-7.
43. Apical closure of mature molar roots with