Regression of periapical granulomas

The therapeutic principle of any inflammatory disease usually characterized by identifying and eliminating the cause. In the case of periapical granulomas with adequate endodontic treatment characterized by filling the root canal and, if possible, of accessory canals, will be the elimination of the offending agent represented by the microbiota of infected root canals. Bacteria and their products that may remain in small quantities, compared to the potential early aggressive, tend to be neutralized by products used in endodontic therapy, based on biomechanical, along with the irrigating solution, especially antibiotics and calcium hydroxide.

In 60 to 70% of cases of endodontic treatment of teeth with pulp necrosis and chronic periapical success is characterized by regression of the lesion over a few months of the radiographic point of view.However, the ossification process reorganization and apical periodontal tissue begins as soon as adequate endodontic treatment completed. The inflammatory exudate in a few days will be resorbed by inflammatory cells with tissue debris, and microbial cell.  Inflammatory cells will be replaced in a few days and weeks to young proliferating cells arising from surrounding tissues such as periodontal ligament and endosteum. It is expected that over 3 to 4 weeks the tissue is in rapid process of structural reorganization and the inflammatory component is reduced to small pockets in order to clean these areas.Without the mediators of inflammation and its units osteoremodeladoras clasts are demobilized and return to be reabsorbed surfaces covered with cementoblasts proliferating from the surrounding area, returning to form tissue or cementóide osteocemento, reinserting periodontal fibers to restore a normal functional apical periodontium. . However, only a few months after the radiographic area can return to "normal." (IN: DENTAL PRESS) (IN: DENTAL PRESS)

Case Study:

History: Male, 32 years. He arrived at the office referred to the treatment endodotico element 36. Not refer pain and had no clinically visible changes. The vitality test was negative.

Radiographic findings: There was an extensive carious lesions in the distal crown. We observed an absence of integrity of lamina dura and a slight radiolucent lesion at the root of it.

Proposed treatment: endodontic treatment in two sessions.

Final manual instrumentation: Biomechanical file 40 Distal 35 Mesial.
Hypochlorite solution with 5.25%.

Systemic medication: Amoxicillin 500 mg for 7 days.

  Obturation Technique: Hybrid Tagger Endofill endodontic cement (Dentsply).

8 months after patient went to a conduit preparation and noted the presence of the hard layer integrates and no periapical changes.