Keywords
Conservative treatment
Periapical periodontitis
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Abstract
Objective: To report a clinical case regarding the non-surgical endodontic treatment of two teeth with apical periodontitis, associated with clinical and radiographic follow-up demonstrating rapid regression of the periapical pathology. Case details: A 35-year-old female patient reported pain while eating. Clinical examination revealed extensive carious lesions on teeth 11 and 12. Radiographically, a well-defined radiolucent area was observed in the apical region, suggestive of a periapical lesion (Ørstavik PAI: score 4) associated with the aforementioned teeth. Based on clinical tests and radiographic findings, a diagnosis of symptomatic apical periodontitis in tooth 11 and asymptomatic apical periodontitis in tooth 12 of pulpal necrotic origin was established. The treatment consisted of necropulpectomy using the Crown-Down technique, with 2.5% sodium hypochlorite irrigation and intracanal medication with HPG paste for one week. Root canal obturation was performed using the active lateral condensation technique associated with Sealer 26® cement. Final consideration: Clinical and radiographic follow-up was performed every three months over one year, showing an effective approach with no pain symptoms and rapid reduction of the periapical bone rarefaction (PAI score: 1).
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