Akademik Veri Yönetim Sistemi
IFEA 2024 World Endodontic Congress (IFEAWEC), Glasgow, İngiltere, 11 - 14 Eylül 2024, ss.2
Objective
Cyst-like periapical lesions are thought to occur due
to root canal infection. Treatment approaches for large periapical lesions vary
from endodontic treatment with or without surgery to tooth extraction. Mandibular
premolars can exhibit various anatomical variations and considered as the most
challenging teeth for root canal treatment. Due to these numerous anatomical differences, the root canal system of all premolars must be explored before and during
treatment. In this case report, we aimed to demonstrate the non-surgical
endodontic treatment of a large cyst-like lesion of a mandibular
first premolar with Vertucci-5 root canal anatomy.
Case presentations
An 18-year-old male patient was admitted to our clinic
due to pain in left mandibular region. The radiographic examination showed a
large periapical lesion on the area of tooth 34. Since
different canal anatomy was suspected in tooth 34 during
the radiographic examination, cone beam computed tomography (CBCT) was
requested from the patient. After examination of CBCT images, it was decided
that tooth 34 had Vertucci-5 root canal anatomy.
Non-surgical endodontic treatment was planned. After pus drainage was stopped,
calcium hydroxide as intracanal medicament was used for 2 weeks. At the end of
2 weeks, root canal treatment was performed under an
operation microscope and rubber dam isolation. At the 6-month
follow-up, it was observed that there was evidence of developing bone
and the patient's symptoms had resolved.
At the 1st year follow up, almost complete healing and formation of new
trabecular bone, were observed.
Conclusion
Large cyst-like periapical lesions can be treated with
non-surgical endodontic treatment. For a successful root canal treatment, it is of great
importance to carefully examine the root canal anatomy and use magnifying tools
in the treatment.