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      Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities

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          Abstract

          Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.

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          Factors affecting the long-term results of endodontic treatment.

          The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment.
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            Cleaning and shaping the root canal.

            H Schilder (1974)
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              Mechanisms of antimicrobial activity of calcium hydroxide: a critical review.

              Literature review The primary function of calcium hydroxide as a routine intracanal medicament is to provide antimicrobial activity. However, the mechanisms of antimicrobial activity of calcium hydroxide are not well known. Physicochemical properties of this substance may limit its effectiveness in disinfecting the entire root canal system. In addition, calcium hydroxide is not effective against all bacterial species found in root canal infections. Association with other medicaments may enhance the efficacy of the intracanal medication in eliminating residual bacteria in the root canal system.
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                Author and article information

                Journal
                Eur Endod J
                Eur Endod J
                European Endodontic Journal
                Kare Publishing (Turkey )
                2548-0839
                2020
                14 July 2020
                : 5
                : 2
                : 54-67
                Affiliations
                [1 ]From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
                [2 ]Department of Restorative Dentistry, Dental Branch, Shiraz Azad University, Shiraz, Iran
                [3 ]Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
                Author notes
                Article
                EEJ-5-54
                10.14744/eej.2020.42714
                7398993
                32766513
                7447bfb1-282c-4252-8fef-20db02f65f1e
                Copyright: © 2020 European Endodontic Journal

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                : 10 September 2019
                : 09 July 2020
                Categories
                Original Article

                cone-beam computed tomography,cyst,granuloma,periradicular lesion,root canal treatment

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