Olgu Sunumu
BibTex RIS Kaynak Göster

Geniş Periapikal Lezyonlu Dişlerin Cerrahi Olmayan Kök Kanal Tedavisi: Olgu Serisi

Yıl 2021, Cilt: 2 Sayı: 2, 57 - 64, 19.12.2021

Öz

Bu olgu serisinde geniş periapikal lezyonlu ve kemik kaybı olan kronik apikal periodontitis tanısı konan üç adet mandibular büyük azı dişe cerrahi olmayan kök kanal tedavisi yapılıp 12 ay süre ile klinik ve radyografik olarak değerlendirilmiştir. Dişler rubber dam ile izole edildikten sonra giriş kavitesi hazırlanıp çalışma boyu apeks bulucu ile belirlenmiştir. Kanallar Reciproc R25(VDW) ile şekillendirilip preparasyonu sırasında %5 NaOCl ve sonunda %17 EDTA, %5 NaOCl ardından distile su ve %2 klorheksidin irrigasyon solüsyonları ile irrige edilmiştir. İki hafta boyunca kalsiyum hidroksit kanal içi medikament olarak kullanılmıştır ve lateral kondensasyon tekniği ile dolum yapılmıştır. Tedavi sonrası birinci ve üçüncü ay kontrollerinde alınan radyografilerde periapikal lezyonlarda iyileşme görülmüştür. Tedavi öncesi ve 12. Ayda çekilen takıp röntgenlerin karşılaştırılması ile defekt boyutundaki azalma ve tedavinin başarılı olduğunu tespit edilmiştir. Dişlerin 12.ay klinik kontrollerinde asemptomatik olduğu gözlenmiştir.

Kaynakça

  • 1. Bass CC. An Effective Method of Personal Oral Hygiene. J La State Med Soc. 1954;106(2):57-73.
  • 2. Nair P. Pathobiology of Primary Apical Periodontitis. Pathwayof the Pulp. 9 st Edition, St Lous: CV Mosby, 2006: 541–542
  • 3. Podshadley AG, Haley JV. A Method for Evaluating Oral Hygiene Performance. Public Health Reports. 1968;83(3):259.
  • 4. Bhaskar SN. Periapical Lesions: Types, Incidence, and Clinical Features. Oral Surg. Oral Med. Oral Pathol. 1966;21(5):657–671.
  • 5. Lin LM, Huang GT, Rosenberg PA. Proliferation of Epithelial Cell Rests, Formation of Apical Cysts, and Regression of Apical Cysts After Periapical Wound Healing. J Endod. 2007;33(8):908–916.
  • 6. Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J. 2020;5(2):54–67.
  • 7. Pitcher B, Alaqla A, Noujeim M, Wealleans JA, Kotsakis G, Chrepa V. Binary Decision Trees for Preoperative Periapical Cyst Screening Using Cone-beam Computed Tomography. J. Endod. 2017;43(3):383–388.
  • 8. Ricucci D, Roças IN, Hernandez S, Siqueira Jr JF. “True” Versus “Bay” Apical Cysts: Clinical, Radiographic, Histopathologic,and Histobacteriologic Features. J Endod. 2020;46(9):1217–1227.
  • 9. Oliveros-López L, Fernández-Olavarría A, Torres-Lagares D, Serrera-Figallo MA, Castillo-Oyagüe R, Segura-Egea JJ, GutiérrezPérez JL. Reduction Rate By Decompression as A Treatment of Odontogenic Cysts. Med Oral Patol Oral Cir Bucal. 2017;22(5):643– 650.
  • 10. Dwivedi S, Dwivedi CD, Chaturvedi TP, Baranwal HC. Management of A Large Radicular Cyst: A Non-Surgical Endodontic Approach. Saudi Endod J. 2014;4(3):145–148.
  • 11. Bhaskar SN. Nonsurgical Resolution of Radicular Cysts. Oral Surg Oral Med Oral Pathol. 1972;34(3):458-468.
  • 12. 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(1):82–94.
  • 13. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of Non-Surgical Retreatment And Endodontic Surgery: A Systematic Review. J Endod. 2009;35(7):930- 937.
  • 14. Simon JH. Incidence of Periapical Cysts In Relation To The Root Canal. J Endod. 1980;6(11):845-848.
  • 15. Nair PR, Pajarola G, Schroeder HE. Types And Incidence of Human Periapical Lesions Obtained With Extracted Teeth. Oral Surg Oral Med Oral Pathol Oral Radial Endod. 1996;81(1):93-102.
  • 16. Eversole LR. Clinical Outline of Oral Pathology: Diagnosis And Treatment. USA, 2001.
  • 17. Tronstad L, Andreasen JO, Hasselgren G, Kristerson L, Riis I. PH Changes In Dental Tissues After Root Canal Filling With Calcium Hydroxide. J Endod. 1981;7(1):17-21
  • 18. Vertucci FJ. Root Canal Morphology And Its Relationship to Endodontic Procedures. Endod Top. 2005;10(1):3-29
  • 19. Kottoor J, Velmurugan N, Surendran S. Endodontic Management of A Maxillary First Molar With Eight Root Canal Systems Evaluated Using Cone-Beam Computed Tomography Scanning: A Case Report. J Endod. 2011;37(5):715-719.
  • 20. Ørstavik D. Time‐Course And Risk Analyses of The Development And Healing of Chronic Apical Periodontitis In Man. Int Endod J. 1996;29(3):150-155
  • 21. 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(5):607-615.
  • 22. Kakehashi S, Stanley H, Fitzgerald R. The Effects of Surgical Exposures of Dental Pulps In Germ-Free And Conventional Laboratory Rats. Oral Surg Oral Med Oral Pathol. 1965;20(3):340-349.
  • 23. Park E, Shen Y, Haapasalo M. Irrigation of The Apical Root Canal. Endod Top. 2012;27(1):54-73.
  • 24. Strindberg LZ. The Dependence of The Results of Pulp Therapy On Certain FactorsAn Analytical Study Based On Radiographic And Clinical Follow-Up Examination. Acta Odontol Scand. 1956;14:1-175.
  • 25. Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic Analysis of Teeth With Failed Endodontic Treatment And The Outcome of Conservative Re-Treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):86-93.
  • 26. Nakamura VC, Candeiro GTdM, Cai S, Gavini G. Ex Vivo Evaluation of Three Instrumentation Techniques On E. Faecalis Biofilm Within Oval Shaped Root Canals. Braz Oral Res. 2015;29(1):1-7.
  • 27. Bernardes RA, Rocha EA, Duarte MAH, Vivan RR, de Moraes IG, Bramante AS. Root Canal Area Increase Promoted By The EndoSequence And ProTaper Systems: Comparison By Computed Tomography. J Endod. 2010; 36(7): 1179-1182.
  • 28. Vivan RR, Duque JA, Alcalde MP, Só MVR, Bramante CM, Duarte MAH. Evaluation of Different Passive Ultrasonic Irrigation Protocols On The Removal of Dentinal Debris From Artificial Grooves. Braz Dent J. 2016;27:568-572.
  • 29. McComb D, Smith DC. A Preliminary Scanning Electron Microscopic Study of Root Canals After Endodontic Procedures. J Endod. 1975;1(7):238-242.
  • 30. Abou-Rass M, Piccinino MV. The Effectiveness of Four Clinical Irrigation Methods On The Removal of Root Canal Debris. Oral Surg Oral Med Oral Pathol. 1982;54(3):323- 328.
  • 31. Mobaraki B, Yeşildal Yeter K. Quantitative Analysis of SmearOFF And Different Irrigation Activation Techniques On Removal of Smear Layer: A Scanning Electron Microscope Study. Microsc Res Tech. 2020;83(12):1480-1486.
  • 32. Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN,Siqueira Jr JF. Influence of The Apical Preparation Size And The Irrigant Type On Bacterial Reduction In Root Canal– Treated Teeth With Apical Periodontitis. J Endod. 2017;43(7):1058-1063.
  • 33. Zehnder M. Root Canal Irrigants. J Endod. 2006;32(5):389-398
  • 34. Siqueira Jr JF, Lopes HP. Mechanisms of Antimicrobial Activity of Calcium Hydroxide: A Critical Review. Int Endod J. 1999;32(5):361–369.
  • 35. Fava LR, Saunders WP. Calcium Hydroxide Pastes: Classification And Clinical Indications. Int Endod J. 1999;32(4):257–282.
  • 36. Kayahan MB, Malkondu Ö, Canpolat C, Kaptan F, Bayırlı G, Kazazoglu E. Periapical Health Related To The Type of Coronal Restorations And Quality of Root Canal Fillings in A Turkish Subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(1):58-62.
  • 37. Kanat A. Güncel Teknikler İle Endodontik Tedavileri Tamamlanan Dişlerin Periapikal Durumunun Değerlendirilmesi: Bir Retrospektif Çalışma, 2016.
  • 38. Endodontology ESO. Quality Guidelines For Endodontic Treatment: Consensus Report of The European Society of Endodontology). Int Endod J. 2006;39(12):921-930.
  • 39. Santos Soares SM, Brito-Júnior M, de Souza FK, Zastrow EV, Cunha CO, Silveira FF, Nunes E, César CA, Glória JC, Soares JA. Management of Cyst-Like Periapical Lesions by Orthograde Decompression And LongTerm Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series. J Endod. 2016;42(7):1135–1141.
  • 40. Nair P. On The Causes of Persistent Apical Periodontitis: A Review). Int Endod J. 2006;39(4):249-281.

Non-Surgical Root Canal Treatment of Teeth with Large Periapical Lesions: Case Series

Yıl 2021, Cilt: 2 Sayı: 2, 57 - 64, 19.12.2021

Öz

In this case series, three mandibular molars with large periapical lesion and bone loss diagnosed as chronic apical periodontitis were treated with non-surgical root canal treatment and evaluated clinically and radiographically for 12 months. The teeth were isolated with a rubber dam, the access cavity was prepared and the working length was determined with the apex locator. The canals were shaped with Reciproc R25(VDW) and irrigated with 5% NaOCl irrigation solution during preparation and finally with 17% EDTA, 5% NaOCl, then distilled water and 2% chlorhexidine irrigation solutions at the end of the preparation. Calcium hydroxide was used as an intracanal medicament for two weeks and three-dimensional filling was performed with the lateral condensation technique. In periapical lesions, improvement was detected in the periapical radiographs taken at the first and third month controls. The reduction in the size of the defect showed that the treatment was successful by comparing the follow-up x-rays taken before the treatment and at the 12th month. The teeth were asymptomatic at the 12th month clinical controls.

Kaynakça

  • 1. Bass CC. An Effective Method of Personal Oral Hygiene. J La State Med Soc. 1954;106(2):57-73.
  • 2. Nair P. Pathobiology of Primary Apical Periodontitis. Pathwayof the Pulp. 9 st Edition, St Lous: CV Mosby, 2006: 541–542
  • 3. Podshadley AG, Haley JV. A Method for Evaluating Oral Hygiene Performance. Public Health Reports. 1968;83(3):259.
  • 4. Bhaskar SN. Periapical Lesions: Types, Incidence, and Clinical Features. Oral Surg. Oral Med. Oral Pathol. 1966;21(5):657–671.
  • 5. Lin LM, Huang GT, Rosenberg PA. Proliferation of Epithelial Cell Rests, Formation of Apical Cysts, and Regression of Apical Cysts After Periapical Wound Healing. J Endod. 2007;33(8):908–916.
  • 6. Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J. 2020;5(2):54–67.
  • 7. Pitcher B, Alaqla A, Noujeim M, Wealleans JA, Kotsakis G, Chrepa V. Binary Decision Trees for Preoperative Periapical Cyst Screening Using Cone-beam Computed Tomography. J. Endod. 2017;43(3):383–388.
  • 8. Ricucci D, Roças IN, Hernandez S, Siqueira Jr JF. “True” Versus “Bay” Apical Cysts: Clinical, Radiographic, Histopathologic,and Histobacteriologic Features. J Endod. 2020;46(9):1217–1227.
  • 9. Oliveros-López L, Fernández-Olavarría A, Torres-Lagares D, Serrera-Figallo MA, Castillo-Oyagüe R, Segura-Egea JJ, GutiérrezPérez JL. Reduction Rate By Decompression as A Treatment of Odontogenic Cysts. Med Oral Patol Oral Cir Bucal. 2017;22(5):643– 650.
  • 10. Dwivedi S, Dwivedi CD, Chaturvedi TP, Baranwal HC. Management of A Large Radicular Cyst: A Non-Surgical Endodontic Approach. Saudi Endod J. 2014;4(3):145–148.
  • 11. Bhaskar SN. Nonsurgical Resolution of Radicular Cysts. Oral Surg Oral Med Oral Pathol. 1972;34(3):458-468.
  • 12. 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(1):82–94.
  • 13. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of Non-Surgical Retreatment And Endodontic Surgery: A Systematic Review. J Endod. 2009;35(7):930- 937.
  • 14. Simon JH. Incidence of Periapical Cysts In Relation To The Root Canal. J Endod. 1980;6(11):845-848.
  • 15. Nair PR, Pajarola G, Schroeder HE. Types And Incidence of Human Periapical Lesions Obtained With Extracted Teeth. Oral Surg Oral Med Oral Pathol Oral Radial Endod. 1996;81(1):93-102.
  • 16. Eversole LR. Clinical Outline of Oral Pathology: Diagnosis And Treatment. USA, 2001.
  • 17. Tronstad L, Andreasen JO, Hasselgren G, Kristerson L, Riis I. PH Changes In Dental Tissues After Root Canal Filling With Calcium Hydroxide. J Endod. 1981;7(1):17-21
  • 18. Vertucci FJ. Root Canal Morphology And Its Relationship to Endodontic Procedures. Endod Top. 2005;10(1):3-29
  • 19. Kottoor J, Velmurugan N, Surendran S. Endodontic Management of A Maxillary First Molar With Eight Root Canal Systems Evaluated Using Cone-Beam Computed Tomography Scanning: A Case Report. J Endod. 2011;37(5):715-719.
  • 20. Ørstavik D. Time‐Course And Risk Analyses of The Development And Healing of Chronic Apical Periodontitis In Man. Int Endod J. 1996;29(3):150-155
  • 21. 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(5):607-615.
  • 22. Kakehashi S, Stanley H, Fitzgerald R. The Effects of Surgical Exposures of Dental Pulps In Germ-Free And Conventional Laboratory Rats. Oral Surg Oral Med Oral Pathol. 1965;20(3):340-349.
  • 23. Park E, Shen Y, Haapasalo M. Irrigation of The Apical Root Canal. Endod Top. 2012;27(1):54-73.
  • 24. Strindberg LZ. The Dependence of The Results of Pulp Therapy On Certain FactorsAn Analytical Study Based On Radiographic And Clinical Follow-Up Examination. Acta Odontol Scand. 1956;14:1-175.
  • 25. Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic Analysis of Teeth With Failed Endodontic Treatment And The Outcome of Conservative Re-Treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):86-93.
  • 26. Nakamura VC, Candeiro GTdM, Cai S, Gavini G. Ex Vivo Evaluation of Three Instrumentation Techniques On E. Faecalis Biofilm Within Oval Shaped Root Canals. Braz Oral Res. 2015;29(1):1-7.
  • 27. Bernardes RA, Rocha EA, Duarte MAH, Vivan RR, de Moraes IG, Bramante AS. Root Canal Area Increase Promoted By The EndoSequence And ProTaper Systems: Comparison By Computed Tomography. J Endod. 2010; 36(7): 1179-1182.
  • 28. Vivan RR, Duque JA, Alcalde MP, Só MVR, Bramante CM, Duarte MAH. Evaluation of Different Passive Ultrasonic Irrigation Protocols On The Removal of Dentinal Debris From Artificial Grooves. Braz Dent J. 2016;27:568-572.
  • 29. McComb D, Smith DC. A Preliminary Scanning Electron Microscopic Study of Root Canals After Endodontic Procedures. J Endod. 1975;1(7):238-242.
  • 30. Abou-Rass M, Piccinino MV. The Effectiveness of Four Clinical Irrigation Methods On The Removal of Root Canal Debris. Oral Surg Oral Med Oral Pathol. 1982;54(3):323- 328.
  • 31. Mobaraki B, Yeşildal Yeter K. Quantitative Analysis of SmearOFF And Different Irrigation Activation Techniques On Removal of Smear Layer: A Scanning Electron Microscope Study. Microsc Res Tech. 2020;83(12):1480-1486.
  • 32. Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN,Siqueira Jr JF. Influence of The Apical Preparation Size And The Irrigant Type On Bacterial Reduction In Root Canal– Treated Teeth With Apical Periodontitis. J Endod. 2017;43(7):1058-1063.
  • 33. Zehnder M. Root Canal Irrigants. J Endod. 2006;32(5):389-398
  • 34. Siqueira Jr JF, Lopes HP. Mechanisms of Antimicrobial Activity of Calcium Hydroxide: A Critical Review. Int Endod J. 1999;32(5):361–369.
  • 35. Fava LR, Saunders WP. Calcium Hydroxide Pastes: Classification And Clinical Indications. Int Endod J. 1999;32(4):257–282.
  • 36. Kayahan MB, Malkondu Ö, Canpolat C, Kaptan F, Bayırlı G, Kazazoglu E. Periapical Health Related To The Type of Coronal Restorations And Quality of Root Canal Fillings in A Turkish Subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(1):58-62.
  • 37. Kanat A. Güncel Teknikler İle Endodontik Tedavileri Tamamlanan Dişlerin Periapikal Durumunun Değerlendirilmesi: Bir Retrospektif Çalışma, 2016.
  • 38. Endodontology ESO. Quality Guidelines For Endodontic Treatment: Consensus Report of The European Society of Endodontology). Int Endod J. 2006;39(12):921-930.
  • 39. Santos Soares SM, Brito-Júnior M, de Souza FK, Zastrow EV, Cunha CO, Silveira FF, Nunes E, César CA, Glória JC, Soares JA. Management of Cyst-Like Periapical Lesions by Orthograde Decompression And LongTerm Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series. J Endod. 2016;42(7):1135–1141.
  • 40. Nair P. On The Causes of Persistent Apical Periodontitis: A Review). Int Endod J. 2006;39(4):249-281.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Endodonti
Bölüm Olgu Sunumu
Yazarlar

Babak Mobarakı

Solmaz Mobaraki

Yayımlanma Tarihi 19 Aralık 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 2 Sayı: 2

Kaynak Göster

APA Mobarakı, B., & Mobaraki, S. (2021). Geniş Periapikal Lezyonlu Dişlerin Cerrahi Olmayan Kök Kanal Tedavisi: Olgu Serisi. Van Diş Hekimliği Dergisi, 2(2), 57-64.