Remoção de lesão periapical, apicectomia e retro-obturação com MTA.

Abstract

Pulp necrosis occurs because of the presence of microorganisms or because a dental trauma sequel due to the inhibition of the vascular and nervous supply to the pulp. Teeth with pulp necrosis may present the formation of an apical lesion when the microorganisms cause an inflammatory disorder of the periapical tissues, resulting in reabsorption of the periapical bone with a radiolucent radiographic image. Apical lesions may be chronic or may suffer resurgence. The most common are granuloma, abscess and periapical cyst. This work is a clinical case study, performed at the UNISC Dentistry clinic, in a male patient, leucoderma, 45 years old who presented sensitivity, edema, recurrent fistula and altered coloration in the vestibular mucosa of the anterior region of the right maxilla. The treatment definition was based on clinical and radiographic informations (panoramic and periapical). Thus, the objective of this study is to present the clinical case with the removal of a resurgent apical lesion, through the apicoectomy, canal preparation for the retrograde obturation and through the apical closure with the MTA. During the surgical procedure the apical curettage material was stored and sent to the histopathological examination and the definitive diagnosis was of abscessed granuloma. In the postoperative follow-up the patient in the first weeks presented the disappearance of the edema, of the sensitivity and the scarring of the soft tissues involved. The bone tissue scarring verification is being conducted at the UNISC Dentistry clinic, though periodic radiographic shots that present radiopaque areas, which characterize the new bone formation in the involved region.