Nonsurgical Management of Periapical Lesions of Mandibular First Molar - Case Report

Periapical lesions develop from non-vital teeth. In teeth with non-hermetic root canal filling, the presence of microleakage bacteria will invade the root canal and reach the periradicular area and cause inflammation so that it develops into periapical lesions as a form of failure of root canal treatment. Periapical lesions should be treated with a non-surgical endodontic procedure with a fair success rate. The purpose of this case report was to evaluate conventional endodontics as non-surgical management of teeth with a periapical lesion in previously treated teeth. Case: A 25-year-old female patient came to a private practice with a complaint of cavity in her lower left molar. One month ago, she had a throbbing tooth pain for which she took analgesic medication. The tooth was treated by root canal treatment about 6 years ago. The patient had no history of systemic disease. Case Management: Occlusal Adjustment, non-vital root canal treatment, the core build-up (fibre reinforced composite) and full coverage direct composite restoration. Conclusion: Adequate root canal treatment affects the success of endodontic treatment, in this case, there was very good progress in healing of the periapical lesion. Periapical lesions develop from non-vital teeth. In teeth with non-hermetic root canal filling, the presence of microleakage bacteria will invade the root canal and reach the periradicular area and cause inflammation so that it develops into periapical lesions as a form of failure of root canal treatment. Periapical tissue develops in response to microbial assumption and their by-products that infiltrate the periradicular tissues and activate the host's immune reaction. A dynamic encounter between the host's immune response and microbial infective factors at the interface of the periodontal membrane and infected pulpal tissue results in various periapical lesions.[1,2,3] Periapical lesions should be treated with a non-surgical endodontic procedure with a fair success rate. Microbial elimination or minimization from the pulp system using efficient chemo mechanical preparation can lead to a successful treatment.[1,4,5] The aim of this case report is to evaluate conventional endodontics as non-surgical management of teeth with a periapical lesion.