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JOURNAL OF ENDODONTICS Copyright 9 1990 by The American Association of Endodontists
VOL. 16, No. 8, AUGUST 1990
CASE REPORT Resolution of a Periapical Radiolucency without Root Canal Filling Jerome C. Donnelly, DMD
Placement of root canal filling often occurs at or shortly after the canal preparation appointment. Therefore, there are few examples of long-term results after canal preparation without root canal filling. The following case report shows resolution of an apical radiolucency 3 yr after root canal preparation without root canal filling. On March 30, 1989, the examination dentist referred a 28yr-old male to the endodontic service for completion of root canal treatment on the maxillary fight lateral incisor. Patient examination revealed the maxillary right lateral incisor had mesial composite and lingual temporary restorations. The tooth was asymptomatic with normal responses to percussion and palpation and no periodontal probing depths greater than 3 mm. The patient reported he developed a toothache about 3 yr ago and sought treatment at an Army dental clinic in West Germany. The dental record showed the maxillary right lateral incisor had had a pulpectomy on March 13, 1986, with canal preparation on March 26, 1986. The treatment record did not
This case report shows a maxillary right lateral incisor with resolution of a 7-mm periapical radio|ucency 3 yr after root canal preparation without root canal filling.
Successful root canal treatment includes proper diagnosis of the problem followed by what Taylor calls "the endodontic triad" (l). This includes access, canal preparation, and root canal filling. Of the three elements of the triad, many endodontists emphasize the importance of access and canal preparation over that of the root canal filling (2-4). To confirm the importance of canal preparation, Weine (4) shows a maxillary left second bicuspid with canal preparation in November. At the next appointment 5 wk later, a trial fill X-ray showed that resolution of a small apical radiolucency occurred without filling the root canal.
FiG 1. A, Initial film. B, Length of tooth film. C, Three years after instrumentation.
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mention use of irrigants, intracanal medication, or antibiotics. The preoperative X-ray in the record dated March 13, 1986 (Fig. 1A) and the guide file X-ray taken March 26, 1986 (Fig. 1B) shows the maxillary right lateral incisor with multiple resotrations and a circular 7-mm periapical radiolucency. The military police arrested the patient shortly before his appointment scheduled to complete the root canal filling. He then spent 2 yr in a military prison in Europe. Thus, the maxillary right lateral incisor received no further treatment after March 26, 1986. The X-ray of the maxillary right lateral incisor taken on March 30, 1989 (Fig. 1C) shows evidence of an instrumented, flared, and unfilled root canal. There is total resolution of the periapical radiolucency and restoration of an intact lamina dura. There were no complications after root canal filling at this appointment.
Resolution without Fill
395
SUMMARY This case report shows a maxillary right lateral incisor with resolution of a 7-mm periapical radiolucency 3 yr after root canal preparation without root canal filling. The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. Dr. Donnelly is chief, Department of Endodontics, Schofield Barracks Main Dental Clinic, USA Dental Activity, Hawaii 96857.
References 1. Taylor GN. Advanced techniques for intracanal preparation and filling in routine endodontic therapy. Dent Clin North Am 1984:819, 2. Huer MA. The biomechanics of endodontic therapy, Dent Clin North Am 1963:269. 3. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974:269. 4. Weine FS. Endodontic Therapy. St. Louis: CV Mosby, 1972:256.
JOURNAL OF ENDODONTICS Copyright 9 1990 by The American Association of Endodontists
VOL. 16, No. 8, AUGUST 1990
CASE REPORT Resolution of a Periapical Radiolucency without Root Canal Filling Jerome C. Donnelly, DMD
Placement of root canal filling often occurs at or shortly after the canal preparation appointment. Therefore, there are few examples of long-term results after canal preparation without root canal filling. The following case report shows resolution of an apical radiolucency 3 yr after root canal preparation without root canal filling. On March 30, 1989, the examination dentist referred a 28yr-old male to the endodontic service for completion of root canal treatment on the maxillary fight lateral incisor. Patient examination revealed the maxillary right lateral incisor had mesial composite and lingual temporary restorations. The tooth was asymptomatic with normal responses to percussion and palpation and no periodontal probing depths greater than 3 mm. The patient reported he developed a toothache about 3 yr ago and sought treatment at an Army dental clinic in West Germany. The dental record showed the maxillary right lateral incisor had had a pulpectomy on March 13, 1986, with canal preparation on March 26, 1986. The treatment record did not
This case report shows a maxillary right lateral incisor with resolution of a 7-mm periapical radio|ucency 3 yr after root canal preparation without root canal filling.
Successful root canal treatment includes proper diagnosis of the problem followed by what Taylor calls "the endodontic triad" (l). This includes access, canal preparation, and root canal filling. Of the three elements of the triad, many endodontists emphasize the importance of access and canal preparation over that of the root canal filling (2-4). To confirm the importance of canal preparation, Weine (4) shows a maxillary left second bicuspid with canal preparation in November. At the next appointment 5 wk later, a trial fill X-ray showed that resolution of a small apical radiolucency occurred without filling the root canal.
FiG 1. A, Initial film. B, Length of tooth film. C, Three years after instrumentation.
394
Vol. 16, No. 8, August 1990
mention use of irrigants, intracanal medication, or antibiotics. The preoperative X-ray in the record dated March 13, 1986 (Fig. 1A) and the guide file X-ray taken March 26, 1986 (Fig. 1B) shows the maxillary right lateral incisor with multiple resotrations and a circular 7-mm periapical radiolucency. The military police arrested the patient shortly before his appointment scheduled to complete the root canal filling. He then spent 2 yr in a military prison in Europe. Thus, the maxillary right lateral incisor received no further treatment after March 26, 1986. The X-ray of the maxillary right lateral incisor taken on March 30, 1989 (Fig. 1C) shows evidence of an instrumented, flared, and unfilled root canal. There is total resolution of the periapical radiolucency and restoration of an intact lamina dura. There were no complications after root canal filling at this appointment.
Resolution without Fill
395
SUMMARY This case report shows a maxillary right lateral incisor with resolution of a 7-mm periapical radiolucency 3 yr after root canal preparation without root canal filling. The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. Dr. Donnelly is chief, Department of Endodontics, Schofield Barracks Main Dental Clinic, USA Dental Activity, Hawaii 96857.
References 1. Taylor GN. Advanced techniques for intracanal preparation and filling in routine endodontic therapy. Dent Clin North Am 1984:819, 2. Huer MA. The biomechanics of endodontic therapy, Dent Clin North Am 1963:269. 3. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974:269. 4. Weine FS. Endodontic Therapy. St. Louis: CV Mosby, 1972:256.
