Clinicopathological study of periapical scars

Background/purpose: Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 P...

Full description

Bibliographic Details
Main Authors: Yi-Pang Lee, Ming-Jay Hwang, Yang-Che Wu, Ming-Jane Lang, Yu-Hsueh Wu, Chun-Pin Chiang
Format: Article
Language:English
Published: Elsevier 2021-10-01
Series:Journal of Dental Sciences
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S199179022100101X
id doaj-2f3e1181053340c2b55d55bf668ab22e
record_format Article
spelling doaj-2f3e1181053340c2b55d55bf668ab22e2021-08-24T04:07:18ZengElsevierJournal of Dental Sciences1991-79022021-10-0116411401145Clinicopathological study of periapical scarsYi-Pang Lee0Ming-Jay Hwang1Yang-Che Wu2Ming-Jane Lang3Yu-Hsueh Wu4Chun-Pin Chiang5Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, TaiwanDepartment of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanSchool of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, TaiwanDepartment of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, TaiwanDepartment of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan; Corresponding author. Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, No. 1, University Road, Tainan 701, Taiwan.Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan.Background/purpose: Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. Materials and methods: The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. Results: The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. Conclusion: PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.http://www.sciencedirect.com/science/article/pii/S199179022100101XPeriapical scarClinical featureRadiographic featureHistopathological feature
collection DOAJ
language English
format Article
sources DOAJ
author Yi-Pang Lee
Ming-Jay Hwang
Yang-Che Wu
Ming-Jane Lang
Yu-Hsueh Wu
Chun-Pin Chiang
spellingShingle Yi-Pang Lee
Ming-Jay Hwang
Yang-Che Wu
Ming-Jane Lang
Yu-Hsueh Wu
Chun-Pin Chiang
Clinicopathological study of periapical scars
Journal of Dental Sciences
Periapical scar
Clinical feature
Radiographic feature
Histopathological feature
author_facet Yi-Pang Lee
Ming-Jay Hwang
Yang-Che Wu
Ming-Jane Lang
Yu-Hsueh Wu
Chun-Pin Chiang
author_sort Yi-Pang Lee
title Clinicopathological study of periapical scars
title_short Clinicopathological study of periapical scars
title_full Clinicopathological study of periapical scars
title_fullStr Clinicopathological study of periapical scars
title_full_unstemmed Clinicopathological study of periapical scars
title_sort clinicopathological study of periapical scars
publisher Elsevier
series Journal of Dental Sciences
issn 1991-7902
publishDate 2021-10-01
description Background/purpose: Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. Materials and methods: The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. Results: The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. Conclusion: PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.
topic Periapical scar
Clinical feature
Radiographic feature
Histopathological feature
url http://www.sciencedirect.com/science/article/pii/S199179022100101X
work_keys_str_mv AT yipanglee clinicopathologicalstudyofperiapicalscars
AT mingjayhwang clinicopathologicalstudyofperiapicalscars
AT yangchewu clinicopathologicalstudyofperiapicalscars
AT mingjanelang clinicopathologicalstudyofperiapicalscars
AT yuhsuehwu clinicopathologicalstudyofperiapicalscars
AT chunpinchiang clinicopathologicalstudyofperiapicalscars
_version_ 1721197904530505728