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La Rosa GRM, Priolo CY, Abiad RS, Romeo VR, Ambu E, Pedullà E. Assessment of bone regeneration after maxillary radicular cyst enucleation with or without bone grafting materials: a retrospective cohort study. Clin Oral Investig 2024; 28:213. [PMID: 38480533 PMCID: PMC10937747 DOI: 10.1007/s00784-024-05612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. RESULTS Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). CONCLUSION Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. CLINICAL RELEVANCE Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Carlotta Ylenia Priolo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roula S Abiad
- Endodontic Division, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Virginia Rosy Romeo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Emanuele Ambu
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Sabeti M, Ihsan MS, Kharat P, Azarpazhooh A. The effect of hard tissue defects on the clinical outcome of endodontic microsurgery: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:7079-7089. [PMID: 37932638 PMCID: PMC10713757 DOI: 10.1007/s00784-023-05341-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/14/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The purpose of this systematic review was to appraise the existing literature on the effect of hard tissue defects on the clinical outcome of endodontic microsurgery (EMS). METHODS MEDLINE (PubMed), Embase, Web of Science, Cochrane Library and grey literature were searched from January 2000 to May 2023. Study selection and data extraction were performed in duplicate. Eligible studies were critically appraised for the risk of bias using the Cochrane Risk of bias tool. The quality of evidence was assessed using GRADE. Review Manager (RevMan Computer program Version 5.4, The Cochrane Collaboration, 2020) was utilized and the Mantel Haenszel fixed or random effects model was applied, depending on the heterogeneity of the studies. Meta-analysis was performed to estimate the Risk ratio (RR) and 95% Confidence Interval (CIs) to correlate the effects of these factors on treatment outcomes. RESULTS Nineteen studies were included. The EMS overall pooled success rate was 84.5%. Five characteristics of hard tissue were identified. The size of the lesion (Small ≤ 5 mm: 78.4% vs. Large > 5 mm: 63.3%, RR = 1.12, 95% CI 1.00-1.26, P ≤ .05), significantly affected the outcomes of EMS. Endodontic lesions exhibited slightly better outcomes than endodontic-periodontal lesions (81.4% vs. 68.2%, RR = 1.14 95% CI 0.98-1.33, P > .05). Cases with the height of the buccal bone > 3 mm also exhibited slightly better outcomes (91.5% vs. 71.4%, RR = 1.20, 95% CI 0.88-1.62, P > .05). Additionally, through and through lesions exhibited better outcomes when grafting was completed during the EMS procedure both in 2D (RR = 1.12 95% CI 0.97-1.29, P > .05) and 3D evaluation ((RR = 1.28 95% CI 0.69-2.37 P > .05). The overall quality of evidence was graded as low to high. CONCLUSION With a low to high quality of evidence, the size of the lesion is a key prognostic variable that significantly affects the outcome of EMS, as lesions ≤ 5 mm exhibit better outcomes as compared to larger lesions. CLINICAL SIGNIFICANCE The presence of hard tissue defects can affect the outcome of endodontic microsurgery (EMS). The presented data can aid the clinicians' decision-making process by examining certain pre-operative prognostic variables, when considering EMS as a treatment option. Clinical cases with more favorable hard tissue characteristics lead to a better prognosis in EMS.
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Affiliation(s)
- Mohammad Sabeti
- Advanced Specialty Program in Endodontics, UCSF School of Dentistry, 707 Parnassus Ave. Room- D 3226, San Francisco, CA, 94143-0758, USA.
| | - Mohammad Saqib Ihsan
- UCSF Advanced Specialty Program in Endodontics, 707 Parnassus Ave. Room- D 3226, San Francisco, CA, 94143-0758, USA
| | - Piyusha Kharat
- UCSF, School of Dentistry, 707 Parnassus Ave, San Francisco, CA, 94143-0758, USA
| | - Amir Azarpazhooh
- University of Toronto, Faculty of Dentistry, 455-124 Edward St, Toronto, ON, M5G1G6, Canada
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Remschmidt B, Rieder M, Gsaxner C, Gaessler J, Payer M, Wallner J. Augmented Reality-Guided Apicoectomy Based on Maxillofacial CBCT Scans. Diagnostics (Basel) 2023; 13:3037. [PMID: 37835780 PMCID: PMC10572956 DOI: 10.3390/diagnostics13193037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Implementation of augmented reality (AR) image guidance systems using preoperative cone beam computed tomography (CBCT) scans in apicoectomies promises to help surgeons overcome iatrogenic complications associated with this procedure. This study aims to evaluate the intraoperative feasibility and usability of HoloLens 2, an established AR image guidance device, in the context of apicoectomies. Three experienced surgeons carried out four AR-guided apicoectomies each on human cadaver head specimens. Preparation and operating times of each procedure, as well as the subjective usability of HoloLens for AR image guidance in apicoectomies using the System Usability Scale (SUS), were measured. In total, twelve AR-guided apicoectomies on six human cadaver head specimens were performed (n = 12). The average preparation time amounted to 162 (±34) s. The surgical procedure itself took on average 9 (±2) min. There was no statistically significant difference between the three surgeons. Quantification of the usability of HoloLens revealed a mean SUS score of 80.4 (±6.8), indicating an "excellent" usability level. In conclusion, this study implies the suitability, practicality, and simplicity of AR image guidance systems such as the HoloLens in apicoectomies and advocates their routine implementation.
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Affiliation(s)
- Bernhard Remschmidt
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Marcus Rieder
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria
| | - Jan Gaessler
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Juergen Wallner
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
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Mora-Carabalí M, Contreras A, Rodríguez P, Zamora I, Rodríguez M. Tomographic, microbiological and histological characterization of secondary apical periodontitis: case series. Braz Dent J 2023; 34:123-132. [PMID: 36888839 PMCID: PMC10027100 DOI: 10.1590/0103-6440202304590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/07/2021] [Indexed: 03/08/2023] Open
Abstract
This case series included a tomographic, microbiological, and histopathological description of 15 secondary apical periodontitis (SAP) lesions obtained by apical microsurgery performed in 10 patients to better understand the etiology and pathogenesis of SAP. Preoperative tomographic analyses were performed through Cone beam computerized tomography - Periapical index (CBCT-PAI), and apical microsurgeries were then carried out. The removed apices were used for microbial culturing and for molecular identification using PCR for the detection of 5 strict anaerobic bacteria (P. gingivalis, P. intermedia, P. nigrescens, T. forsythia, and T.denticola) and 3 viruses Herpes simplex viruses (HSV), Cytomegalovirus (CMG) and Epstein-Barr Virus (EBV) by nested PCR. The removed apical lesions were histologically described. Univariate statistical analyses were performed by using STATA MP/16 (StataCorp LLC, College Station, TX, United States). CBCT-PAI analyses revealed PAI 4 and PAI 5 score lesions that involved cortical plate destruction. Eight SAPs were positive by culture, while nine SAP lesions were positive by PCR. Fusobacterium species were the most frequently cultured organisms in 7 SAP lesions, followed by D. pneumosintes in 3. In contrast, by single PCR, T. forsythia and P. nigrescens were detected in 5 lesions, T. denticola in 4 lesions, and P. gingivalis in 2 lesions. Twelve periapical lesions were granulomas, and the remaining three SAP lesions were radicular cysts. In conclusion, this case series study revealed that secondary apical lesions presented tomographic involvement of PAI 3 to 5, and that most SAP lesions were apical granulomas containing anaerobic and facultative microorganisms.
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Affiliation(s)
- Marla Mora-Carabalí
- School of Dentistry, - Faculty of Health, Universidad del Valle, Cali- Colombia
| | - Adolfo Contreras
- School of Dentistry, - Faculty of Health, Universidad del Valle, Cali- Colombia
| | - Patricia Rodríguez
- School of Dentistry, - Faculty of Health, Universidad del Valle, Cali- Colombia
| | - Ingrid Zamora
- School of Dentistry, - Faculty of Health, Universidad del Valle, Cali- Colombia
| | - Martha Rodríguez
- School of Dentistry, - Faculty of Health, Universidad del Valle, Cali- Colombia
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Córdova-Malca F, Coaguila-Llerena H, Garré-Arnillas L, Rayo-Iparraguirre J, Faria G. Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e35. [DOI: 10.5395/rde.2022.47.e35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/08/2022] [Accepted: 05/22/2022] [Indexed: 11/11/2022]
Affiliation(s)
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Lucía Garré-Arnillas
- Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, Peru
| | - Jorge Rayo-Iparraguirre
- Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, Peru
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Zmener O, Pameijer CH, Boetto AC. Noninvasive Endodontic Periapical Biopsy of a Periapical Fibrous Scar: Case Report. J Endod 2021; 48:375-378. [PMID: 34952102 DOI: 10.1016/j.joen.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 12/26/2022]
Abstract
Post-endodontic periapical fibrous scars (PFSc) comprise a type of radiolucent healing that is frequently misinterpreted as a pathological lesion. A combined clinical, radiological and histological correlation is essential for a reliable diagnosis. This report presents a case of a patient with a long-term persisting asymptomatic post-endodontic radiolucency that was misdiagnosed as endodontic failure and referred for endodontic retreatment and periapical surgery. In order to reach a definitive diagnosis, a core bone biopsy needle (CBBn) technique was performed of the area of the radiolucency. The material obtained was processed for histological analysis and the lesion was determined to be a PFSc. In conclusion, the use of a CBBn prior to any invasive treatment allowed the clinician to distinguish between PFSc and other persisting pathosis, such as periapical granuloma or cystic lesions.
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Affiliation(s)
- Osvaldo Zmener
- Professor Emeritus, Department of Specialized Endodontics, Faculty of Medical Sciences, School of Dentistry, University of El Salvador, Buenos Aires, Argentina
| | - Cornelis H Pameijer
- Professor Emeritus, Department of Reconstructive Sciences, University of Connecticut, School of Dental Medicine, Farmington, CT, USA..
| | - Ana Cecilia Boetto
- Asociate professor, Department of Endodontics, Faculty of Dentistry, University of Córdoba, Argentina
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Schvartzman Cohen R, Goldberger T, Merzlak I, Tsesis I, Chaushu G, Avishai G, Rosen E. The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth. MEDICINA-LITHUANIA 2021; 57:medicina57090991. [PMID: 34577915 PMCID: PMC8464687 DOI: 10.3390/medicina57090991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022]
Abstract
Background and Objectives: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. Materials and Methods: All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012–2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. Results: A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. Conclusions: the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.
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Affiliation(s)
- Ruth Schvartzman Cohen
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
- Correspondence: (R.S.C.); (T.G.)
| | - Tomer Goldberger
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
- Correspondence: (R.S.C.); (T.G.)
| | - Ina Merzlak
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
| | - Igor Tsesis
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
| | - Gavriel Chaushu
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
| | - Gal Avishai
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
| | - Eyal Rosen
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
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Abstract
Background/purpose Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. Materials and methods The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. Results The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. Conclusion PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.
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Dumitrescu A, Martu MA, Nemtoi A, Sirghe A, Chelaru L, Tatarciuc D, Dumitrescu AM, Haba D. Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa. ACTA ACUST UNITED AC 2021; 57:medicina57080840. [PMID: 34441046 PMCID: PMC8401138 DOI: 10.3390/medicina57080840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.
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Affiliation(s)
- Alexandra Dumitrescu
- Department of Oral and Maxillofacial Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.D.); (A.S.); (D.H.)
| | - Maria-Alexandra Martu
- Department of Periodontology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Correspondence: ; Tel.: +40-742-189-178
| | - Alexandru Nemtoi
- Department of Health and Human Development, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720225 Suceava, Romania;
| | - Ana Sirghe
- Department of Oral and Maxillofacial Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.D.); (A.S.); (D.H.)
| | - Liliana Chelaru
- Department of Morpho-Functional Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (L.C.); (A.-M.D.)
| | - Diana Tatarciuc
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania;
| | - Ana-Maria Dumitrescu
- Department of Morpho-Functional Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (L.C.); (A.-M.D.)
| | - Danisia Haba
- Department of Oral and Maxillofacial Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.D.); (A.S.); (D.H.)
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Schweitzer C, Garrido M, Paredes R, Stoore C, Reyes M, Bologna-Molina R, Fernández A, Hernández Rios M. Localization of interleukin-6 signaling complex in epithelialized apical lesions of endodontic origin. Clin Oral Investig 2021; 25:4075-4083. [PMID: 33411000 DOI: 10.1007/s00784-020-03738-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/08/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We aimed to determine the immunolocalization patterns of the interleukin (IL)-6 signaling complex in epithelialized and non-epithelialized apical lesions of endodontic origin (ALEOs). MATERIALS AND METHODS Epithelialized (n = 8) and non-epithelialized (n = 7) ALEOs were obtained from teeth with indication of extraction in patients with clinical diagnosis of apical periodontitis. All tissues were subjected to routine processing for histopathologic examination and primary antibodies for IL-6, IL-6 receptor (R), and glycoprotein (gp)-130 were used for immunohistochemistry and double immunofluorescence co-localization. RESULTS IL-6, IL-6R, and gp-130 were immunolocalized in endothelial cells and mononuclear leukocytes in a diffuse pattern within the connective tissue of epithelialized and non-epithelialized ALEOs. In the epithelialized lesions, two different patterns were identified: IL-6 signaling complex was localized within the proliferating epithelium in a diffuse intracellular pattern and in a cell membrane localization pattern within the mature epithelial lining, showing a decreased intensity towards the surface layers. CONCLUSIONS IL-6, IL-6R, and gp-130 localized to mononuclear inflammatory cells, vascular endothelial cells, and immature proliferating epithelia in a diffuse pattern and in mature lining epithelia in a localized cell membrane pattern, supporting a role for epithelial proliferation during cyst formation. Additional cell membrane co-localization of IL-6 receptor complex suggests classic signaling involvement in addition to trans-signaling.
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Affiliation(s)
- C Schweitzer
- Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile
| | - M Garrido
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile
| | - R Paredes
- Faculty of Veterinary Medicine, Faculty of Life Sciences, Universidad Andrés Bello, Av. República 440, 8320000, Santiago, Chile
| | - C Stoore
- Faculty of Veterinary Medicine, Faculty of Life Sciences, Universidad Andrés Bello, Av. República 440, 8320000, Santiago, Chile
| | - M Reyes
- Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile
| | - R Bologna-Molina
- Faculty of Dentistry, Universidad de la República, General las Heras 1925, 11600, Montevideo, Uruguay
| | - A Fernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile
- Faculty of Dentistry, Universidad Andrés Bello, Av. República 440, 8320000, Santiago, Chile
| | - Marcela Hernández Rios
- Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile.
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, Independencia, 8380000, Santiago, Chile.
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Kruse C, Brüel A, Spin-Neto R, Wenzel A, Kirkevang LL. Effect of a formalin-based fixation method on bone mineral content in human ex-vivo specimens. Acta Odontol Scand 2021; 79:212-217. [PMID: 33047633 DOI: 10.1080/00016357.2020.1832701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Histopathology of formalin-fixated human ex-vivo specimens may be used as reference standard for evaluation of diagnostic index tests like CBCT or MRI. The aim was to estimate changes in bone mineral content (BMC) over time in human ex-vivo bone specimens fixated in a formalin-based solution for 24 h followed by storage in an alcohol-based medium for six months, assessed by dual-energy X-ray absorptiometry (DXA). METHODOLOGY Bone specimens (n = 19) from human ex-vivo mandibles donated for science were included. BMC was measured by DXA before fixation (D0), after 24 h of immersion fixation in a formalin-based solution (D1), and hereafter every 30 days (M1-M6) during storage in a 30% ethanol-based storage medium for 6 months. Changes in BMC from D0 to D1 and from D0 to M6 were calculated and mean change in BMC estimated. RESULTS Mean change in BMC from D0 to D1 was -0.73% (95% CI -1.75%; 0.29%), and from D0 to M6 -1.19% (95% CI -2.14%; -0.23%). CONCLUSIONS No changes in BMC of ex-vivo human bone specimens were found after 24 h formalin-based immersion fixation. After six months storage in an ethanol-based medium, BMC mean loss of 1% was detected. In this range, changes in BMC are not clinically relevant.
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Affiliation(s)
- Casper Kruse
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lise-Lotte Kirkevang
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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12
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Alim-Uysal BA, Dincer AN, Yurtgezen B, Guneser MB. Does the Endodontic Education Level Affect Decision-Making for Endodontically Treated Teeth With Apical Periodontitis? A Web-Based Survey. Int Dent J 2021; 71:477-483. [PMID: 33612264 PMCID: PMC9275181 DOI: 10.1016/j.identj.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives The management of endodontically treated teeth with apical periodontitis is debated among clinicians. The aim of this study was to evaluate treatment choices for endodontically treated teeth with different sizes of periapical lesions among endodontists, endodontics postgraduate students, general dental practitioners, and undergraduate students who had fulfilled their theoretical and clinical training in endodontics. Materials and Methods Periapical lesion images (no periapical lesion and 1-mm, 3-mm, and 5-mm periapical lesions) were formed on 4 different radiographs with a software program, and the survey included 16 radiographs that were emailed to 1881 participants. Treatment options included extraction, surgical or nonsurgical retreatment, and wait and see. The χ2 test was used to compare the responses of the participants. Results The survey was returned by 1039 participants (55.23%). There were statistically significant differences among the responses of all participants for all cases (P < .05), except a case with a broken file and no lesion (P = .918). All participants decided to extract at an increased size from a 1-mm periapical lesion to a 5-mm periapical lesion. At all lesion sizes, general dental practitioners planned retreatment less when compared with other groups. Conclusions This survey study showed that there was a positive correlation between endodontic education level and retreatment decision-making. Dentists who confront seemingly hopeless endodontically treated teeth such as an instrument fracture, a missing canal, or a large periapical lesion should consult with an endodontist before making the decision to extract the tooth.
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Affiliation(s)
- Betul Aycan Alim-Uysal
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey.
| | - Asiye Nur Dincer
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Mehmet Burak Guneser
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
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Comparison of Cone Beam Computed Tomography and Digital Radiography in Detecting Separated Endodontic Files and Strip Perforation. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The separation of endodontic files and strip perforation are among procedural intraoperative complications which may ultimately lead to the failure of root canal treatment. The aim of the present study was to compare the diagnostic potential of cone beam computed tomography (CBCT) and digital periapical radiographs in detecting separated rotary files and strip perforation in filled canals. Fifty human mandibular molars were selected for this study. The teeth were randomly divided into two groups based on endodontic errors (i.e., file separation and strip perforation). In each group, 25 of 50 mesial canals were randomly chosen for simulating the errors, while the other 25 canals were considered as the control group. In group one, a simulation of the separation of rotary files was performed using ProTaper F2 files. Strip perforation of the root canals in group two was achieved by number 2 and 3 Gates Glidden drills in the coronal third of the root canals. Digital periapical radiographs in two different horizontal angles and high-resolution CBCT scans were obtained from the teeth mounted on a dry human mandible with simulated soft tissue covering. Three experienced observers who were unaware of the study groups evaluated the digital periapical and CBCT image sets in two separate readings. Intraobserver and interobserver agreements, as well as accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated and compared. Intraobserver and interobserver agreements ranged from poor to excellent and poor to good, respectively. The accuracy, sensitivity, specificity, PPV, and NPV for digital radiography in detecting separated files were 0.950, 0.813, 0.957, 0.929, and 0.880, respectively. The same values for CBCT were 0.747, 0.667, 0.900, 0.833, and 0.783, respectively. For the diagnosis of strip perforation, these values were 0.855, 0.800, 0.909, 0.889, and 0.833 for periapical radiography and 0.955, 1.000, 0.920, 0.926, and 1.000 for CBCT. In conclusion, CBCT was superior for diagnosing strip perforation of the filled root canals, while digital periapical radiographs performed better in the detection of separated rotary files.
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Kharat N, Waghmare P, Sarkar M, Nawal S, Sahu T, Dheeraj M. Assessment of Constant Periapical Lesions and Their Connection with Endodontic Failures after Apical Microsurgery. J Pharm Bioallied Sci 2020; 12:S233-S237. [PMID: 33149463 PMCID: PMC7595500 DOI: 10.4103/jpbs.jpbs_68_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/02/2020] [Accepted: 03/09/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Periapical lesions can be appreciated in the teeth that have underwent root canal treatment leading to more complications. Radiographic as well as histological evaluation is important for definitive diagnosis. Aim: The aim of this study was to examine the histology of constant periapical radiolucent lesions that are associated with root canal treated teeth and also to find association between histological findings and radiographic size of lesion as well as existence or nonappearance of a radiopaque lamina. Materials and Methods: The study included 60 incisors and canines allotted for apical microsurgery. Two observers studied the diameter of periapical radiolucent lesions and the existence or nonappearance of radiopaque lamina. During apical microsurgery, biopsy specimens were collected and after tissue processing oral pathologist examined the specimen under a light microscope. Histological features of the specimen were taken into consideration, and the diagnosis of abscess, cyst, granuloma, and scar tissue were given. Pearson’s chi-square test was used to study the established relationship between histological diagnosis and lesion size. Results: Results indicated that 68.33% of lesions were granulomas, 23.33% were cysts, 5% were abscesses, and 3.33% were scar tissue. Conclusion: According to histological results, most of the lesions in this study were granulomas, followed by cysts. Abscesses and scar tissues were rare.
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Affiliation(s)
- Neetu Kharat
- Department of Conservative Dentistry and Endodontics, RKDF Dental College & Research Center, Bhopal, Madhya Pradesh, India
| | - Pallavi Waghmare
- Department of Conservative Dentistry and Endodontics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Mousumi Sarkar
- Department of Endodontist and Dental Specialist, Bishop James Memorial Hospital & Health Care Centre, Jalpaiguri, West Bengal, India
| | - Sangeeta Nawal
- Department of Conservative Dentistry and Endodontics, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Trilok Sahu
- Department of Conservative Dentistry and Endodontics, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Munish Dheeraj
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Jammu, Jammu and Kashmir, India
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Tsesis I, Krepel G, Koren T, Rosen E, Kfir A. Accuracy for diagnosis of periapical cystic lesions. Sci Rep 2020; 10:14155. [PMID: 32843680 PMCID: PMC7447813 DOI: 10.1038/s41598-020-71029-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 07/30/2020] [Indexed: 01/16/2023] Open
Abstract
Clinical differentiation between cystic lesions of endodontic and non-endodontic origin is of importance because correct diagnosis may affect treatment decision making. Most radicular cysts are treated with conservative approaches and, therefore, are not surgically removed. The objective of this study was to determine the accuracy of clinical diagnosis of periapical lesions as compared to the histological findings, and to evaluate various associated factors. All biopsy specimens submitted for histological evaluation from 2002 to 2009 were assessed. Only cases of periapical lesions with complete patient data and clinical diagnosis were included. Sensitivity, specificity and accuracy of the clinical diagnosis were calculated and various patient-related factors were evaluated. Of the 4,908 cases, 183 met inclusion criteria. Histologically, there were 171 lesions of radicular cysts and 12 cases of non-endodontic cysts, including OKC and Incisive Canal Cyst. The diagnostic accuracy for clinical diagnosis for radicular cysts was 91.84% and 91.84% for non-endodontic cysts. There was a high accuracy of clinical differentiation between cystic lesions of endodontic and non-endodontic origin. However, some non-endodontic lesions may be incorrectly diagnosed clinically as lesions of endodontic origin. Histological evaluation may be necessary for the correct diagnosis. Further clinical studies are needed to evaluate clinical examination and histological diagnosis of periapical lesions.
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Affiliation(s)
- Igor Tsesis
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gal Krepel
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Koren
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Rosen
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anda Kfir
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Yoo YJ, Kim DW, Perinpanayagam H, Baek SH, Zhu Q, Safavi K, Kum KY. Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years. J Clin Med 2020; 9:jcm9072210. [PMID: 32668578 PMCID: PMC7409012 DOI: 10.3390/jcm9072210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/03/2020] [Accepted: 07/10/2020] [Indexed: 01/23/2023] Open
Abstract
The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.
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Affiliation(s)
- Yeon-Jee Yoo
- Department of Comprehensive Treatment Center, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Dong-Won Kim
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
| | - Hiran Perinpanayagam
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada;
| | - Seung-Ho Baek
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
| | - Qiang Zhu
- Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (Q.Z.); (K.S.)
| | - Kamran Safavi
- Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (Q.Z.); (K.S.)
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea; (D.-W.K.); (S.-H.B.)
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital for Persons with Special Needs, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-2656
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17
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Evaluation of concordance between clinical and histopathological diagnoses in periapical lesions of endodontic origin. J Dent Sci 2020; 15:132-135. [PMID: 32595891 PMCID: PMC7305430 DOI: 10.1016/j.jds.2020.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background/purpose: Periapical lesions of endodontic origin are often diagnosed based on the clinical and radiological presentations that may be different from the histological diagnoses. The purpose of this study was to assess the concordance between the clinical diagnosis of these lesions and the histopathological diagnoses and to analyze their clinical and pathological features. Materials and methods Biopsies of periapical lesions of endodontic origin diagnosed in the histopathology laboratory between 2006 and 2017 were retrieved from the database and used to conduct this retrospective review. Clinical data were obtained, and tissue samples were re-evaluated. The overall agreement between the clinical and histological diagnoses was tested utilizing the Cohen kappa (k). Results A total of 317 periapical biopsy specimens were included in this study which consisted of 137 periapical granulomas, 174 periapical cysts, and six periapical scars. Generally there was weak overall agreement between the clinical and histological diagnoses of periapical granuloma and periapical cysts (Cohen kappa, k = 0.059). Conclusion The findings of this study indicate that clinical/radiographic examinations are not able to preoperatively determine whether a periapical lesion is a cyst or a granuloma and highlights the importance of developing a reliable nonsurgical diagnostic method to differentiate periapical lesions.
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Truschnegg A, Rugani P, Kirnbauer B, Kqiku L, Jakse N, Kirmeier R. Long-term Follow-up for Apical Microsurgery of Teeth with Core and Post Restorations. J Endod 2020; 46:178-183. [DOI: 10.1016/j.joen.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/20/2019] [Accepted: 11/08/2019] [Indexed: 01/02/2023]
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19
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Estrela C, Carmo Souza PO, Barbosa MG, Aburad de Carvalhosa A, Batista AC, Pinto Júnior DDS, Yamamoto-Silva FP, de Freitas Silva BS. Mesenchymal Stem Cell Marker Expression in Periapical Abscess. J Endod 2019; 45:716-723. [DOI: 10.1016/j.joen.2019.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/27/2019] [Accepted: 03/16/2019] [Indexed: 12/31/2022]
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20
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Genetic Polymorphisms in RANK and RANKL are Associated with Persistent Apical Periodontitis. J Endod 2019; 45:526-531. [DOI: 10.1016/j.joen.2018.10.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/27/2018] [Accepted: 10/08/2018] [Indexed: 11/18/2022]
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21
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Yasin-Ertem S, Altay H, Hasanoglu-Erbasar N. The evaluation of apicectomy without retrograde filling in terms of lesion size localization and approximation to the anatomic structures. Med Oral Patol Oral Cir Bucal 2019; 24:e265-e270. [PMID: 30818321 PMCID: PMC6441604 DOI: 10.4317/medoral.22834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/26/2019] [Indexed: 11/05/2022] Open
Abstract
Background The purpose of this study was to evaluate of the patients who underwent apical resection. Besides assess the classification of resection side, localization, lesion size, approximation of anatomic structures and the purpose of the apical surgery retrospectively. Material and Methods In this stutdy 782 patients and 1191 apical resection applied tooth evaluated. 504 of the patients were famale and 278 were male. Patients age was between 13 and 76 years old and operated between January 2016 and January 2017. The study includes incisor, canine and premolar teeth which had the apical resection as the first time. Operation side evaluated from orthopantomograph and periapical radiographs. Results There were 1191 teeth operated and 966 of them in maxilla and 225 of them in mandible. The number of the incisor teeth were 871, 177 were canine, 129 were premolar and one of them was molar. The total amount of 468 patients had operated by just 1 tooth, 454 of the operated teeth had cyst on the operation side. Premolar and molar side 21 of the 93 lesion had approximation with maxillar sinus. On the other hand in maxilla 39 of 569 lesion had approximation with nasal cavity. In mandibula 1 of the 15 lesion, which involved mandibular premolar teeth, had approximation with mental foramen. Conclusions Apical resection operation mostly done for one tooth, and the lesion size was less than 10 milimeters. Furthermore apical resection mostly done for incisors cause of odontogenic cyst. Key words:Apical resection, gender, maxillary sinus, mental foramen, odontogenic cyst.
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Affiliation(s)
- S Yasin-Ertem
- Oral & Maxillofacial Surgery, Department Dentistry, Faculty Ankara Yildirim Beyazit, University Ankara Turkey, Adress: Guclukaya Mah., Fatih Cad Cagla Sok. No:2, 06280 Kecioren,Ankara,
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Kontogiannis TG, Tosios KI, Kerezoudis NP. Effect of calcium hydroxide as intracanal medicament on the expression of caspase-9 located within the radicular cyst epithelium. AUST ENDOD J 2019; 45:352-356. [PMID: 30632228 DOI: 10.1111/aej.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Abstract
Apoptosis (a programmed cell death mechanism) within the radicular cyst epithelium has still not been correlated with any clinical factor. This study aimed to investigate the effect of calcium hydroxide on apoptosis, via the detection of caspase-9. Thirty radicular cysts collected during apicoectomies and stored in paraffin were retrospectively retrieved. Conservative endodontic treatments had been carried out either without (group (a) n = 14), or with calcium hydroxide application (group (b), n = 16) before obturation. All cysts were immunohistochemically stained for caspase-9 to record apoptosis of the epithelium. Statistical analysis followed. The frequency of caspase-9 immunoreactivity in the cystic epithelium in the two groups was 42.86% and 93.75% of cysts respectively. This difference was statistically significant (P = 0.04 < 0.05). In cysts larger than (or equal to) 10 mm, caspase-9 was more frequently expressed. It was found calcium hydroxide appears to enhance the expression of caspase-9, especially in large lesions.
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Affiliation(s)
- Taxiarchis G Kontogiannis
- Department of Endodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos I Tosios
- Department of Oral Pathology, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos P Kerezoudis
- Department of Endodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
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Clinician-centered Outcomes Assessment of Retreatment and Endodontic Microsurgery Using Cone-beam Computed Tomographic Volumetric Analysis. J Endod 2018; 44:1251-1256. [DOI: 10.1016/j.joen.2018.03.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/27/2018] [Accepted: 03/30/2018] [Indexed: 01/11/2023]
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Decompression of a Large Periapical Lesion: A Case Report of 4-Year Follow-Up. Case Rep Med 2017; 2016:3830987. [PMID: 28058049 PMCID: PMC5183744 DOI: 10.1155/2016/3830987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/17/2016] [Indexed: 02/06/2023] Open
Abstract
This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.
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