Restor Dent Endod.  2012 May;37(2):123-126.

Vital tooth with periapical lesion: spontaneous healing after conservative treatment

• Kim HJ
• Lee SJ
• Jung IY
• Park SH

Abstract

It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

Keyword

Neurogenic inflammation; Periapical lesion; Vital tooth

MeSH Terms

Bacteria
Dental Pulp Cavity
Dental Pulp Necrosis
Necrosis
Neurogenic Inflammation
Periapical Periodontitis
Pulpitis
Tooth

Figure

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  Figure 1 Preoperative periapical view and clinical photograph. (a) Periapical radiolucency on #35; (b) Cervical abrasion.

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  Figure 2 Preoperative panorama view. Periapical radiolucency was observed at the apex of mandibular left second premolar.

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  Figure 3 Periapical view taken 2 years ago.

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  Figure 4 Location of mental foramens (dotted line) and periapical radiolucency (arrow).

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  Figure 5 Periapical view and clinical photograph after class V Resin filling.

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  Figure 6 Three-month follow up. (a) Periapical view. Distal proximal caries was detected; (b) Photograph taken after class II resin filling.

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  Figure 7 Six-month follow up. Periapical view.

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  Figure 8 Nine-month follow up. Periapical view.

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  Figure 9 Fourteen-month follow up. Clinical photographs.

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  Figure 10 Fourteen-month follow up. Horizontal shift periapical view.

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  Figure 11 One year before implant surgery: Note that the posterior area of mandibular left segment was edentulous.

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