OJST  Vol.3 No.5 , August 2013
Clinical, radiological and histological diagnoses of periapical periodontitis spreading to the adjacent tooth: A case of endodontic failure

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.

Cite this paper
Cianconi, L. and Mancini, M. (2013) Clinical, radiological and histological diagnoses of periapical periodontitis spreading to the adjacent tooth: A case of endodontic failure. Open Journal of Stomatology, 3, 287-291. doi: 10.4236/ojst.2013.35048.
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