Conservative and surgical treatment of chronic periapical lesions

Abstract

Introduction. Chronic apical periodontitis is an osseous lesion of the apical periodontium affecting the apical alveolar bone and the root apex by necrosis and resorption under the influence of granulation tissue, which appears as reaction tissue. It is one of the most current problems in contemporary dental therapy. If etiopathogenetic is not treated correctly, it will progress with the destruction of adjacent tissues, evolving from one form to another, frequently resulting in severe complications. Conservative treatment methods do not always completely remove the focus of odontogenic infection. Thus, in cases where an endodontic lesion cannot be resolved by conventional endodontic (re)treatment, surgical treatment is the treatment of choice to save the tooth. Apical resection is one of the best options, helping preserve the teeth on the dental arch. Aim of study. To evaluate the clinical effectiveness of endodontic treatment with the calcium hydroxide preparation "Apexdent" in root canals with periapical changes for tissue regeneration, as well as the therapeutic tactics in teeth that do not respond to endodontic treatment. Methods and materials. The study comprised 10 patients, 6 women and 4 men aged between 35 and 50 years, who were examined clinical and paraclinical. The patients were subjected to root canal treatment performed with the calcium hydroxide preparation "Apexdent". Given the diversity and severity of clinical forms of apical periodontitis, 3 of the 10 cases were not treated with the help of calcium hydroxide preparations, requiring surgical treatment. Results. The clinical study determined that the calcium hydroxide preparation "Apexdent" contributed to the destruction of the pathogenic flora in the root canal. In cases where the periapical processes were not cured with the help of root canal treatment, surgical treatment was resorted to. Conclusion. Calcium hydroxide preparations proved favourable results in the treatment of apical periodontitis. However, in some cases, the pathological processes were stopped using surgical treatment methods. affecting the apical alveolar bone and the root apex by nec rosis and resorption under the influence of granulation tissue, which appears as reaction tissue. I t is one of the most current problems in contemporary dental therapy. If etiopathogenetic is not treated correctly, it will progress with the destruction of adjacent tissues, evolving from one form to another, frequently resulting in severe complications. Conservative treatment methods do not alway s completely remove the focus of odontogenic infection. Thus, in cases where an endodontic lesion cannot be resolved by conventional endodontic (re)treatment, surgical treatmen t is the treatment of choice to save the tooth. Apical resection is one of the best options, hel ping preserve the teeth on the dental arch. Aim of study. To evaluate the clinical effectiveness of endodontic tre atment with the calcium hydroxide preparation "Apexdent" in root canals with periapical changes for tissue regeneration, as well as the therapeutic tactics in teeth that do not r espond to endodontic treatment. Methods and materials. The study comprised 10 patients, 6 women and 4 men aged between 35 and 50 years, who were examined clinical and paraclinical. The patients were subjected to root canal treatment performed with the calcium hydroxide prepara tion "Apexdent". Given the diversity and severity of clinical forms of apical p eriodontitis, 3 of the 10 cases were not treated with the help of calcium hydroxide preparations, requiring surg ical treatment. Results. The clinical study determined that the calcium hydroxide prepa ration "Apexdent" contributed to the destruction of the pathogenic flora in t he root canal. In cases where the periapical processes were not cured with the help of root canal treatment, surgical treatment was resorted to. Conclusion. Calcium hydroxide preparations proved favourable results in the treatment of apical periodontitis. However, in some cases, the pathological pr ocesses were stopped using surgical treatment methods.