PERIAPICAL LESIONS: CURRENT MODALITIES

Verica Toneva Stojmenova; Sonja Rogoleva Gjurovski

doi:10.35120/medisij010125t

Authors

Verica Toneva Stojmenova Faculty of medical sciences, University “Goce Delcev” Stip, R. N. Macedonia, Author
Sonja Rogoleva Gjurovski Faculty of medical sciences, University “Goce Delcev” Stip, R. N. Macedonia, Author

DOI:

https://doi.org/10.35120/medisij010125t

Keywords:

periapical lesions, endodontic treatment, surgical treatment

Abstract

Nonsurgical and surgical endodontic treatment have a rate of high success of periapical lesions. There is a need for less invasive methods that have better outcomes. Treatment of some periapical lesions (like cysts) are a matter of debate and the best possible way to treat them is still unclear. The patient should also participate in decision-making process. The clinician should inform him about the advantages and disadvantages of endodontic-noninvasive and surgical-invasive procedure. The therapeutic options for these lesions are a wide range of treatment from endodontic treatment to different surgical options. We like to find out and present the best way to heal the periapical lesion. We wanted to know whenever surgical or non-surgical treatment is better, and if using some specific procedures might improve healing the lesion. We conducted a search of medical and dental literature up. We searched the following electronic databases: MEDLINE via PubMed and Embase Ovid. Inclusion and exclusion criteria were used to reach the aim of this review study. We place restriction about language (only those articles that are written on English) and publication date (articles that are not older than 2010 year). We excluded duplicate article. We searched the reference lists of included studies and of relevant systematic reviews for additional studies. We handsearched the reference list of the studies retrieved and journals in the fields of endodontics and oral surgery. Every periapical lesion should firstly begin with good performed endodontic treatment. Endodontic treatment is not successful in all the cases and surgical approach is needed. Some cases might fail because of multipurpose factors such as: foreign body reaction, the size of the periapical lesion, biofilm, oral health and oral hygiene. A surgical approach is an option in cases when periapical lesion is large. Marsupialization might be proper of alternative treatment for those lesions in some cases. Surgical retrograde treatment is also an option for treating teeth with postoperative periapical lesion. The procedure can be performed with hand endodontic instruments to clean and shape the root canal especially the untreated part. The advantages, disadvantages and modalities of treatment of periapical lesions are discussed in this review. There is no evidence that a surgical approach leads to better results compared with non‐surgical treatment. It is difficult to draw conclusions, as the evidence currently available on the electronic database. There are several options for treatment to eliminate the clinical problems of periapical lesions but furder research is necessary, especially to understand the effects of surgical and non-surgical approaches, and to determinate which procedures provide the best results for periapical lesion healing and postoperative quality of dental life.

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