Management of Cystic Lesions in Endodontics
Department of Conservative Dentistry and Endodontics Seema Dental College And Hospital, Rishikesh
INTRODUCTION
Successful endodontic therapy depends on complete periapical repair and regeneration. In cases where conventional root canal therapy fails to eliminate the lesion, surgery is the last alternative.1 Periapical surgery aims to remove periapical pathology followed by achieving complete wound healing and regeneration of the bone and periodontal tissue.2,3 In modern endodontic practice, the number of indications for endodontic periapical surgery is decreasing, but still periapical surgery accounts for 3%–10% of typical endodontic practice.4 The most commonly used root end filling material is MTA because it provides superior sealing ability when compared with Amalgam, IRM and Super EBA. MTA is the best root-end filling material. This material is almost non-resorbable and non-toxic, having bacteriostatic properties to heal, and offers a good apical seal.
Histological examination showed the stimulation of cementum and hard tissue formation with minimal inflammatory response after using this hydrophilic material MTA.5Hence, in this study we have used MTA in the apical third of root to form a good apical seal in the fractured root.
CASE REPORT
A 18-year female patient came to the Department of Conservative Dentistry and Endodontics, Seema dental college and hospital with the complaint of pain in relation to the maxillary left anterior region. On diagnosis patient gave history pain i.r.t 22 and 23 since last 3 months.
On clinical examination, there was grade I mobility . On radiographic examination revealed a well-defined periapical radiolucency of about 1.1 × 1.0 cm around the apices of maxillaryleft lateral incisor and canine. Both the teeth tested responsive to thermal and electric pulp testing. There was only mild tenderness to percussion and palpation. The diagnosis was irreversible puilpitis with chronic apical abscess with respect to maxillary lateral incisor and canine.
Pre-Op
Flap Raised
Cavity Prepared
Mta Placed
Bone Graft Placed
Mta Placed
Bone Graft Placed
MANAGEMENT
The treatment plan was decided as cystic anucleation in the maxillary left lateral incisor and canine followed by root end resection.
After effective local anesthesia with 2% lignocaine, bleeding points were marked after that a full-thickness Luebke Ochsenbein flap was reflected. A large defect was visible in the cortical plate with the Lateral incisor, which was enlarged to aid in complete curettage of the granulation tissue (which was sent for biopsy). This was followed by irrigation with betadine (Win Medicare; Win Medicare Dental Products, New Delhi, India) and sterile saline solution. Root end resection done. After that MTA was placed into the defect and completely used as root end filling material in teeth. The flap was repositioned and closed with 4-0 silk suture.After suture placement removal applicance placed in oral cavity for support and for proper healing.
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How to cite this article
Dr. Annil Dhingra, Dr. Shalini Sharma, Dr. Mayuri Kumari. Management of Cystic Lesions in Endodontics. Guident. 2019 Mar;12(4). Available from: https://guident.in/articles/endodontics/management-of-cystic-lesions-in-endodontics.html
