Reparo de lesões apicais após endodontias : estudo de casos.

Abstract

Normally, a periapical lesion in non-vital teeth is characterized by aggression over these tissues with the presence of microorganisms originating from inside of the root canal. On the X-ray analysis, it presents as a radiolucent area circumscribed over the dental apex region as result of the loss of bone tissue in that field. To do an endodontic treatment and go along with the periapical repair using X-ray analysis and absence of patient’s symptoms through the process. There are presented two young patients diagnosed with extensive periapical lesion on the tooth (46). One of them had a fistula originated by a pulp floor drilling. These patients had received the endodontic treatment and subsequent a permanent restoration. On the tooth that had the drilling was made a treatment using MTA (Mineral trioxide aggregate) previously the endodontic sealing. The chemical preparation of the canals recommended the use of 1% sodium hypochlorite as an irrigating solution, after that the use of EDTA to clean up the dentinal tubules and take the Calcium Hydroxide (Callen) as the medication for that situation for sixty days. The apical repair based on the stimulus of bone neoformation may take months or even years to occur and several factors might interfere in the repair. The examples of these factors are the protocol treatment and the appropriate coronal sealing after the endodontic treatment. In the preset study there was clinical silence for both cases, also happened the healing of the fistula presented. Radiographically, nine months after the endodontic treatment, there was an evident regression of the extensive periapical lesion. However, the same results did not was noticed in the tooth that was submitted to radiographic control after two months of treatment.