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Vital tooth with periapical lesion: spontaneous healing after conservative treatment


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Vital tooth with periapical lesion: spontaneous healing after conservative treatment

Article information

Restor Dent Endod. 2012;37(2):123-126
Publication date (electronic) : 2012 May 18
doi : https://doi.org/10.5395/rde.2012.37.2.123
Hyun-Joo Kim, DDS, Seung-Jong Lee, DDS, PhD, Il-Young Jung, DDS, PhD, Sung-Ho Park, DDS, PhD
Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea.
Correspondence to Sung-Ho Park, DDS, PhD. Professor, Department of Conservative Dentistry, Yonsei University College of Dentistry, 134 Shinchon-dong, Seodaemun-gu, Seoul, Korea 120-752. TEL, +82-2-2228-3147; FAX, +82-2-313-7575; sunghopark@yuhs.ac
Received 2011 December 27; Revised 2012 March 05; Accepted 2012 April 06.

Abstract

It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

Keywords: Neurogenic inflammation; Periapical lesion; Vital tooth

Notes

No potential conflict of interest relevant to this article was reported.

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Article information Continued

©Copyights 2012. The Korean Academy of Conservative Dentistry.
(open-access) :

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1

Figure 1

Preoperative periapical view and clinical photograph. (a) Periapical radiolucency on #35; (b) Cervical abrasion.

Figure 2

Figure 2

Preoperative panorama view. Periapical radiolucency was observed at the apex of mandibular left second premolar.

Figure 3

Figure 3

Periapical view taken 2 years ago.

Figure 4

Figure 4

Location of mental foramens (dotted line) and periapical radiolucency (arrow).

Figure 5

Figure 5

Periapical view and clinical photograph after class V Resin filling.

Figure 6

Figure 6

Three-month follow up. (a) Periapical view. Distal proximal caries was detected; (b) Photograph taken after class II resin filling.

Figure 7

Figure 7

Six-month follow up. Periapical view.

Figure 8

Figure 8

Nine-month follow up. Periapical view.

Figure 9

Figure 9

Fourteen-month follow up. Clinical photographs.

Figure 10

Figure 10

Fourteen-month follow up. Horizontal shift periapical view.

Figure 11

Figure 11

One year before implant surgery: Note that the posterior area of mandibular left segment was edentulous.