Clinicopathological study of periapical scars.

Clinical feature Histopathological feature Periapical scar Radiographic feature

Journal

Journal of dental sciences
ISSN: 2213-8862
Titre abrégé: J Dent Sci
Pays: Netherlands
ID NLM: 101293181

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 11 05 2021
entrez: 6 9 2021
pubmed: 7 9 2021
medline: 7 9 2021
Statut: ppublish

Résumé

Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs.
MATERIALS AND METHODS METHODS
The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed.
RESULTS RESULTS
The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue.
CONCLUSION CONCLUSIONS
PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.

Identifiants

pubmed: 34484581
doi: 10.1016/j.jds.2021.05.008
pii: S1991-7902(21)00101-X
pmc: PMC8403787
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1140-1145

Informations de copyright

© 2021 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest relevant to this article.

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Auteurs

Yi-Pang Lee (YP)

Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Ming-Jay Hwang (MJ)

Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Yang-Che Wu (YC)

School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.

Ming-Jane Lang (MJ)

Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Yu-Hsueh Wu (YH)

Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan.
Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan.

Chun-Pin Chiang (CP)

Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.

Classifications MeSH