The Recurrent cases of the Periapical Lesions

Abstract

  Bilateral upper second incisors of 20 years old woman showing the recurrence of the periapical lesion after the long period of healing process. Both teeth were clinically diagnosed as cysts. Large periapical rarefaction areas caused by previous maltreatments were shown on the pictures. Usual non-surgical endodontic treatments were performed and several smear slides of the exudates from the canals were made to know the pathological changes of the periapical tissues. Chloramphenicol was dressed into the canals as a disinfectant. Both canals were obturated with canals (Grossman's sealer) and guttapercha points using lateral condensation method.

  X-ray pictures taken 3 years after the initial treatments showed remarkable improvement of the periapical lesions. Recurrences of the periapical lesions were found on the pictures taken 7 years after the treatments. Surgical curretage was tried on the right second incisor and the histopathological slides of the periapical tissue showed the re-establishment of the cyst.

  The proliferation of the microorganisms remaining at the apical area of the tooth was considered as a main cause of the recurrence.