![]() ![]() ![]() Furthermore, extraradicular factors such as periapical actinomycosis, foreign body reaction to extruded root canal filling, other foreign materials or endogenous cholesterol crystals can interfere with post-treatment healing of apical periodontitis (6). This is due to the complex root canal system, with accessory canals, ramifications and anastomoses, which cannot be accessed, cleaned or filled by conventional techniques (5). Even when the canal is correctly cleaned and filled, it is possible that the periapical periodontitis will persist, observing a radiotransparent image which may be asymptomatic. However, when the infection is not completely eliminated, the periapical lesion remains, being considered a treatment failure (4). Treatment consists of the elimination of the infectious agents by root canal treatment, allowing healing of the lesion (3). Exposure of the dental pulp to bacteria and their by-products, acting as antigens, may elicit nonspecific inflammatory responses as well as specific immunological reactions in the periradicular tissues, and cause the periapical lesion (1,2).Īpical periodontitis is usually produced by an intraradicular infection. Periapical lesions resulting from necrotic dental pulp are among the most frequently occurring pathologies found in alveolar bone. Key words: Periapical lesion, chronic periapical periodontitis (periapical granuloma), radicular cyst, scar tissue. The aim of this study is to review and update the etiopathogenic and histological aspects of chronic post-endodontic periapical lesions. Scar tissue is a reparative response by the body, producing fibrous connective tissue. ![]() The radicular cyst is characterized by the presence of a cavity, partially or wholly lined by epithelium. The most frequent is the periapical granuloma, constituted by a mass of chronic inflammatory tissue, in which isolated nests of epithelium can be found. From the histological point of view, it can be classified as chronic periapical periodontitis (periapical granuloma), radicular cyst, and as scar tissue. The chronic inflammatory periapical lesion is the most common pathology found in relation to alveolar bone of the jaw. Even when carrying out a correct cleansing and filling of canals, it is possible that periapical periodontitis will persist in the form of an asymptomatic radiolucency, giving rise to the post-endodontic periapical lesion. Treatment consists in the elimination of the infectious agents by endodontia. Private PracticeĪpical periodontitis is produced in the majority of cases by intraradicular infection. Valencia University Medical and Dental School Director of the Master of Oral Surgery and Implantology. (1) Student of Master of Oral Surgery and Implantology. The post-endodontic periapical lesion: Histologic and etiopathogenic aspectsĬelia Carrillo García 1, Francisco Vera Sempere 2, Miguel Peñarrocha Diago 3, Eva Martí Bowen 4
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