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Case Reports in Medicine
Volume 2016, Article ID 3830987, 7 pages
http://dx.doi.org/10.1155/2016/3830987
Case Report

Decompression of a Large Periapical Lesion: A Case Report of 4-Year Follow-Up

1Department of Endodontics, Course of Dentistry, University of Fortaleza, Fortaleza, CE, Brazil
2Department of Bucco-Maxillofacial Surgery, Course of Dentistry, University of Fortaleza, Fortaleza, CE, Brazil

Received 26 September 2016; Accepted 17 November 2016

Academic Editor: Indraneel Bhattacharyya

Copyright © 2016 Claudio Maniglia-Ferreira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.