NON-SURGICAL MANAGEMENT OF LARGE PERIAPICAL LESIONS: TWO CASE RE- PORTS

10. Uluslararası Endodonti Sempozyumu, Antalya, Turkey, 19 - 22 May 2024, pp.343-344, (Summary Text)

Publication Type: Conference Paper / Summary Text
City: Antalya
Country: Turkey
Page Numbers: pp.343-344
Kütahya Health Sciences University Affiliated: Yes

Ecenur Tuzcu, Gülsen Kiraz, Safa Kurnaz

Kütahya Health Sciences University, Faculty of Dentistry, Department of Endodontics

Aim: Teeth with large periapical lesions (PLs) can be successfully treated with root canal treatment (RCT). This case report presents the treatment process and outcomes of two cases with large PLs that healed using only RCT, without the need for surgical intervention.
Case Reports:

Case 1: A 16-year-old male patient presented to our clinic with a complaint of pain in the left upper jaw. Clinical and radiographic examination revealed a crown fracture on tooth number 22 and a large PL around the affected tooth. In the first session, chemomechanical preparation of the root canals was completed, and calcium hydroxide was placed. In the second session, the patient’s symptoms had completely resolved, but an instrument fracture complication occurred in the apical region during the removal of calcium hydroxide from the root canal. The root canals were filled and the permanent restoration was completed in the same session. The patient was given a follow-up appointment.

Case 2: A 50-year-old male patient was found to have a large PL involving teeth number 35, 36, and 37 on
a radiograph taken during a routine dental examination. The patient’s electric pulp test and cold test on the affected teeth were negative. In the first session, chemomechanical preparation of the affected teeth was com- pleted, and calcium hydroxide was placed in the root canals. In the second session, the affected teeth were found to be asymptomatic, and the root canals were filled and permanent restorations were completed. The patient was given a follow-up appointment.

Results: At the 6-month, 1-year and 1.5-year follow-ups of the patients, it was observed that the relevant teeth were asymptomatic and functional, and the PLs were healed.

Conclusion: In teeth with large PLs of odontogenic origin, healing can be achieved with RCT alone, even in the presence of complications, with correct indications and effective treatment.

Keywords: Calcium hydroxide, Periapical healing, Periapical lesion, Root canal treatment

PS – 056

CERRAHİSİZ YÖNTEMLERLE GENİŞ PERIAPİKAL LEZYONLARIN TEDAVİSİ: İKİ OLGU SUNUMU

Ecenur Tuzcu, Gülsen Kiraz, Safa Kurnaz

Kütahya Sağlık Bilimleri Üniversitesi Diş Hekimliği Fakültesi, Endodonti Anabilim Dalı

Amaç: Geniş periapikal lezyonlu dişler kök kanal tedavisi (KKT) ile başarılı bir şekilde tedavi edilebilirler. Bu olgu sunumunda, cerrahi müdahaleye ihtiyaç duyulmadan, yalnızca KKT ile iyileşen iki geniş periapikal lezyonlu vakanın tedavi süreci ve sonuçları değerlendirilmiştir.
Olgu Sunumu:

Olgu 1: 16 yaşında erkek hasta sol üst çenede ağrı şikayetiyle kliniğimize başvurdu. Hastanın klinik ve radyografik muayenesinde 22 numaralı dişte kron kırığı ve ilgili dişin periapikalinde geniş periapikal lezyon tespit edildi. Tedavinin birinci seansında kök kanallarının kemomekanik preparasyonu tamamlandı ve kalsiyum hidroksit yerleştirildi. İkinci seansta ise hastanın semptomlarının tamamen iyileştiği görüldü ancak kök kanalından kalsiyum hidroksitin uzaklaştırılması esnasında apikal bölgede alet kırığı komplikasyonu gelişti. Aynı seansta kök kanalları doldurularak daimi restorasyonu tamamlandı. Hastaya kontrol randevusu verildi.

Olgu 2: 50 yaşında erkek hastanın rutin dental muayenesinde radyografide 35, 36 ve 37 numaralı dişleri içeren geniş periapikal lezyon tespit edildi ve ilgili dişlerin elektrikli pulpa testi ve soğuk testine negatif cevap verdiği tespit edildi. İlk seansta kök kanallarının kemomekanik preparasyonu tamamlandı ve kök kanallarına kalsiyum hidroksit yerleştirildi. İkinci seansta ilgili dişlerin asemptomatik olduğu görüldü ve kök kanalları doldurularak daimi restorasyonları tamamlandı. Hastaya kontrol randevusu verildi.

Bulgular: Hastaların 6 ay, 1 yıl ve 1,5 yıllık kontrollerinde ilgili dişlerin asemptomatik ve fonksiyonda olduğu, periapikal lezyonların ise iyileştiği gözlendi.

Sonuç: Odontojenik kaynaklı geniş periapikal lezyonlara sahip dişlerde, doğru endikasyon ve etkili bir tedavi ile komplikasyon varlığında dahi sadece kök kanal tedavisi ile iyileşme sağlanabilir.

Anahtar Kelimeler: Kalsiyum hidroksit, Kök kanal tedavisi, Periapikal iyileşme, Periapikal lezyon