This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right ...This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional.展开更多
Aims: This article describes the apical infection in endodontically treated tooth 4.5 that spread to adjacent tooth 4.4. Case Report: A 52-year-old woman was referred for the presence of radiolucency extending from to...Aims: This article describes the apical infection in endodontically treated tooth 4.5 that spread to adjacent tooth 4.4. Case Report: A 52-year-old woman was referred for the presence of radiolucency extending from tooth 4.5 and mental foramen. Spontaneous symptoms were present. Tooth 4.5 showed poor-quality endodontics. The vitality of tooth 4.4 was negative, even though no mechanical trauma had been reported, nor was caries present. Both teeth were sensitive to percussion. Endodontic re-treatment of 4.5 and endodontic treatment of 4.4 were performed in a single visit. A large amount of endodontic sealer squeezed mesially from the root of tooth 4.5, where a partial horizontal root fracture was hypothesized. 6-, 12-, and 18-month radiographic follow-ups, by both periapical and cone-beam computed tomography (CBCT) analyses, showed incomplete osseous healing. CBCT excluded root fracture on 4.5. Local symptoms were still present. Clinical and radiological conditions led to extractions, and a cystic lesion was enucleated for histopathologic analyses. Histopathologic diagnosis was a periapical cyst. The supposed partial horizontal root fracture of 4.5 was actually a large lateral canal. Although the root canal treatments followed high standards in terms of quality, a persistent chronic infection developed histologically. The cystic lesion was one consistent reason for the unsuccessful healing of 4.5.展开更多
Background:Periapical endodontic surgery(PES)for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously...Background:Periapical endodontic surgery(PES)for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously undergone endodontic treatment.Treatment methods are performed when the effectiveness of orthograde canal revision is questionable or when such treatment cannot be performed.The effectiveness of these methods varies from study to study.Objective:clinical evaluation of the efficacy of periapical endodontic surgery for root amputation and immediate implant placement with simultaneous tooth extraction in the proximate and long-term treatment.Materials and methods:The study included 183 patients between the ages of 24 and 63.Patients were divided into 2 groups;group I-endodontic surgery was performed to resect the apex of the tooth root(108 patients)and group II-an operation to install an implant with simultaneous tooth extraction(75 patients).In group I,in 36 cases,PES was performed in the area of the first molars and premolars,and 72 cases in the area of incisors and canines.In group II,75 patients received 231 implants.Results:In all 108 patients of group I in the postoperative period and within 1 month,the wounds healed without complications.In none of the 36 operated premolars and molars,there was no definitive elimination of the radiographic bone loss(Rude grade 2 and 3)after 12 months.In the area of incisors and canines,complete healing was observed only in 37.5%of cases(I class according to Rud).In group II,out of 184 implants installed immediately after tooth extraction,one was removed one month after implantation.In other cases,all implants were successfully integrated with the subsequent fabrication of prosthetic construction.Conclusion:The complex“implant(installed in the socket of the tooth immediately after its removal)-bone-soft tissues-prosthetic construction”is stable over time in terms of functional and aesthetic parameters,preservation of bone tissue,and mucous membrane.展开更多
文摘This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional.
文摘Aims: This article describes the apical infection in endodontically treated tooth 4.5 that spread to adjacent tooth 4.4. Case Report: A 52-year-old woman was referred for the presence of radiolucency extending from tooth 4.5 and mental foramen. Spontaneous symptoms were present. Tooth 4.5 showed poor-quality endodontics. The vitality of tooth 4.4 was negative, even though no mechanical trauma had been reported, nor was caries present. Both teeth were sensitive to percussion. Endodontic re-treatment of 4.5 and endodontic treatment of 4.4 were performed in a single visit. A large amount of endodontic sealer squeezed mesially from the root of tooth 4.5, where a partial horizontal root fracture was hypothesized. 6-, 12-, and 18-month radiographic follow-ups, by both periapical and cone-beam computed tomography (CBCT) analyses, showed incomplete osseous healing. CBCT excluded root fracture on 4.5. Local symptoms were still present. Clinical and radiological conditions led to extractions, and a cystic lesion was enucleated for histopathologic analyses. Histopathologic diagnosis was a periapical cyst. The supposed partial horizontal root fracture of 4.5 was actually a large lateral canal. Although the root canal treatments followed high standards in terms of quality, a persistent chronic infection developed histologically. The cystic lesion was one consistent reason for the unsuccessful healing of 4.5.
基金This study was approved by the Local Ethics Comittee of Sechenov University(No.11-13)all the patients have signed informed consents.
文摘Background:Periapical endodontic surgery(PES)for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously undergone endodontic treatment.Treatment methods are performed when the effectiveness of orthograde canal revision is questionable or when such treatment cannot be performed.The effectiveness of these methods varies from study to study.Objective:clinical evaluation of the efficacy of periapical endodontic surgery for root amputation and immediate implant placement with simultaneous tooth extraction in the proximate and long-term treatment.Materials and methods:The study included 183 patients between the ages of 24 and 63.Patients were divided into 2 groups;group I-endodontic surgery was performed to resect the apex of the tooth root(108 patients)and group II-an operation to install an implant with simultaneous tooth extraction(75 patients).In group I,in 36 cases,PES was performed in the area of the first molars and premolars,and 72 cases in the area of incisors and canines.In group II,75 patients received 231 implants.Results:In all 108 patients of group I in the postoperative period and within 1 month,the wounds healed without complications.In none of the 36 operated premolars and molars,there was no definitive elimination of the radiographic bone loss(Rude grade 2 and 3)after 12 months.In the area of incisors and canines,complete healing was observed only in 37.5%of cases(I class according to Rud).In group II,out of 184 implants installed immediately after tooth extraction,one was removed one month after implantation.In other cases,all implants were successfully integrated with the subsequent fabrication of prosthetic construction.Conclusion:The complex“implant(installed in the socket of the tooth immediately after its removal)-bone-soft tissues-prosthetic construction”is stable over time in terms of functional and aesthetic parameters,preservation of bone tissue,and mucous membrane.
