Assessment of constant periapical lesions and their connection with endodontic failures after apical microsurgery

Abstract

Background: Periapical lesions can be appreciated in the teeth that have underwent root canal treatment leading to more complications. Radiographic as well as histological evaluation is important for definitive diagnosis. Aim: The aim of this study was to examine the histology of constant periapical radiolucent lesions that are associated with root canal treated teeth and also to find association between histological findings and radiographic size of lesion as well as existence or nonappearance of a radiopaque lamina. Materials and Methods: The study included 60 incisors and canines allotted for apical microsurgery. Two observers studied the diameter of periapical radiolucent lesions and the existence or nonappearance of radiopaque lamina. During apical microsurgery, biopsy specimens were collected and after tissue processing oral pathologist examined the specimen under a light microscope. Histological features of the specimen were taken into consideration, and the diagnosis of abscess, cyst, granuloma, and scar tissue were given. Pearson’s chi-square test was used to study the established relationship between histological diagnosis and lesion size. Results: Results indicated that 68.33% of lesions were granulomas, 23.33% were cysts, 5% were abscesses, and 3.33% were scar tissue. Conclusion: According to histological results, most of the lesions in this study were granulomas, followed by cysts. Abscesses and scar tissues were rare.

Keywords

• histopathological diagnosis
• microsurgery
• periapical cyst
• periapical granuloma
• radiographic