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The periapical lesion in the above case 1. Nair PNR. New perspectives on
report showed an estimated repair rate of radicular cysts: Do they heal? Int
4.5 mm2 after 1 month. The rate of repair Endod J. 1998;31:15560.
was calculated by dividing the size 2. Saatchi M. Healing of large
differential between the initial and follow- periapical lesion: A nonsurgical
up visits by the number of elapsed months. endodontic treatment approach.
The calculated rate was in accordance to Aust Endod J. 2007;33:13640,.
the average rate of repair of 4 mm2 after 1 3. Athanassiadis B, Abbott PV,
month as reported by Fernandes et al. [12]. Walsh LJ. The use of calcium
The rate of repair is directly related to age, hydroxide, antibiotics and biocides
with the highest rate in patients 19 years of as antimicrobial medicaments in
age or younger (58.8%) [13]. endodontics. Aust Dent J.
2007;52:S64-82,.
As reported by Orstavik, approximately 4. Sato I, Ando-Kurihara N, Kota K,
half of the lesions heal completely in one Iwaku M, Hoshino E. Sterilization
year and the majority (86%) heal within of infected root- canal dentine by
two years post-treatment. Radiographic topical application of a mixture of
signs of definite, but incomplete, healing ciprofloxacin, metronidazole and
were apparent at one year post-treatment in minocycline in situ. Int Endod J.
89% of lesions that subsequently fully 1996;29:11824.
healed indicating that observation of 5. zan , Er K. Endodontic
healing on a radiograph is a strong treatment of a large cyst-like
predictor of total healing [14]. periradicular lesion using a
Radiographic signs such as density change combination of antibiotic drugs: A
within the lesion, trabecular reformation case report. J Endod. 2005;31:898
and lamina dura formation confirmed 900.
healing in the present case, particularly 6. Murphy WK, Kaugars GE, Collet
when associated with the clinical finding WK, Dodds RN. Healing of
that the tooth was asymptomatic and the periapical radiolucencies after
surrounding soft tissue was healthy. nonsurgical endodontic therapy.
Oral Surg Oral Med Oral Pathol.
CONCLUSION 1991;71:6204.
Patient co-operation, fear and anxiety and 7. Safavi K, Nakayama TA. Influence
damage to developing permanent teeth are of mixing vehicle on dissociation
important factors to be considered when of calcium hydroxide in solution. J
using surgical approach in paediatric Endod. 2000;26:649 51.
patients, thus conservative approach
a) b) c)
Figure 3. (a) Post-operative radiograph demonstrating a decrease in the size of the periapical
radiolucency to 12 x 13mm in diameter. (b) Radiograph after 3 months demonstrating a
decrease in size of the periapical radiolucency to 8 x 9mm. (c) Radiograph after follow-up of
18 months, showing almost complete resolution of the periapical lesion.