INTERDISCIPLINARY MANAGEMENT OF DEEP CARIOUS LESIONS WITH CHRONIC PERIAPICAL ABSCESSES AND ODONTOGENIC CYSTS: A RETROSPECTIVE CLINICAL STUDY
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Keywords
Deep Carious Lesions, chronic periapical abscesses pathology, odontogenic cysts, pulp vitality tests, CBCT imaging.
Abstract
Deep carious lesions extending to the pulp can lead to chronic periapical pathology and, in some cases, the development of odontogenic cysts. These complex lesions demand an interdisciplinary management approach involving endodontic, surgical, and restorative disciplines to ensure complete resolution and functional restoration.
Methodology: A retrospective clinical study was conducted on 12 patients (aged 18–45) diagnosed with deep carious lesions associated with chronic periapical abscesses and radiographically evident odontogenic cysts. Diagnostic evaluation included clinical examination, pulp vitality tests, periapical radiographs, and CBCT imaging. All patients underwent endodontic treatment followed by surgical enucleation of the cystic lesion. Bone grafts were placed when necessary, and definitive restorations were completed after healing.
Results: All patients exhibited resolution of clinical symptoms post-endodontic treatment. Surgical enucleation was successful in all cases, with histopathological confirmation of radicular cysts in 10 patients and dentigerous cysts in 2 patients. Radiographic follow-up over 6 months showed progressive bone healing in 11 cases, with one case showing delayed healing but no recurrence. All treated teeth remained functional and asymptomatic.
Conclusion: An interdisciplinary approach is crucial for the successful management of deep carious lesions complicated by chronic periapical abscesses and odontogenic cysts. Coordinated endodontic, surgical, and restorative interventions result in favorable clinical and radiographic outcomes, preservation of natural dentition, and reduced risk of recurrence.
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Dr. Muhammad Yousaf
Assistant Professor of Community and Preventive Dentistry, Bacha Khan College of Dentistry, Mardan, Pakistan
Dr. Nazish
Dental Surgeon Bolan Medical Complex Hospital Quetta / FCPS (PGT) Oral and Maxillofacial Surgery, Armed Force Institute of Dentistry, Rawalpindi, Pakistan
Dr. Asfand Khan
Assistant Professor Oral Pathology, Abbottabad International Dental College, Abbottabad, Pakistanc
Dr. Aamna Javed
Assistant Professor Oral Pathology, Abbottabad International Dental College, Abbottabad, Pakistan
Dr. Zubair Nasir
Assistant Professor Community and Preventive Dentistry, Shifa College of Dentistry, Pakistan
Muhammad Arslan Muzaffar
Assistant Professor Operative Dentistry, Frontier Medical and Dental College, Abbottabad, Pakistan