Statement of Problem: Failure of ENDODONTIC TREATMENT is determined on the basis of radiographic findings and clinical signs and/ or symptoms of the treated teeth. Purpose: The purpose of this study was to determine ENDODONTIC TREATMENT failure in relation to various factors influencing it in teeth with PERIAPICAL lesions (clinically and radiographically). Materials and Methods: Teeth which had PERIAPICAL lesions before TREATMENT were selected from a series of teeth treated by ENDODONTICs’ postgraduate students over 5-year period (1997-2001) in Faculty of Dentistry Tehran university of Medical Science. post operative follow up in 50 patients was possible .The patient’s ages ranged between 16 to 62 years old. 40 of patients were female and 10 were male. At the recall appointment, first the clinical information (pain, swelling, tenderness to palpation, percussion, …) were recorded in a questionnaire form, then two radiographies were obtained from each tooth. The radiographies were assessed separately by three to five endodontists. Strindberg"s criteria were used to Judge the failure of ENDODONTIC TREATMENT. The observation period ranged from 1 to 5 years. The Data were analyzed statistically by using chi-square, Fisher’s exact test and MC Nemar test. Results: Among different factors considered in this study, Fistula and sensation to percussion were reduced significantly (MC Nemar test, P=0.004). There were no significant difference between the extention of root canal filling, age and type of coronal restoration and ENDODONTIC failure which may be due to the small sample size of this study. Conclusion: The rate of ENDODONTIC failure was 16%, which means 84% success rate, which is similar to results obtained from previous studies. The high success rate of ENDODONTIC TREATMENT in teeth with PERIAPICAL lesion may be explained by the fact that obturation has a definitive effect on reducing inflammation in periradicular area.

The TREATMENT of necrotic permanent teeth with immature apices is a daunting challenge. Apexification has been traditionally used to treat immature permanent teeth with lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that filling materials can be confined to the root canal. The authors present a case report of the successful TREATMENT of a traumatized tooth with an open apex that was weakened due to a long-standing infection and thin dentin walls. In this case, we first used a triple antibiotic to disinfect the canal and then placed a calcium-enriched mixture (CEM) cement plug. Follow-up evaluations were performed 15 months after TREATMENT. The CEM-cement appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps.

Long-term success of ENDODONTIC TREATMENT is dependent on adequate and appropriate cleaning and shaping of the root canal along with proper and correct obturation of the entire prepared space. This article aims to report an exceptional non-surgical and orthograde ENDODONTIC TREATMENT of maxillary right central incisor with an extensive radiolucent lesion in a 17-year-old male. Six and 20-month follow-ups showed significant changes, including bone formation and PERIAPICAL healing within the lesion. The patient was asymptomatic. After 20 months, complete radiographic and clinical healing of the PERIAPICAL lesion was observed.

Introduction: An important consideration in ENDODONTIC TREATMENT is the elimination of microorganisms, including fungi, from the complex three- dimensional root canal system. Candida Albicans (CA) has a major role in ENDODONTIC TREATMENT failure as the most important fungus isolated from the root canal system. The present study was carried out to evaluate the presence of CA in the teeth requiring ENDODONTIC reTREATMENT, with or without PERIAPICAL lesions.Materials and Methods: This study was carried out on 60 root canals from human molars requiring ENDODONTIC reTREATMENT. The root canals were randomly divided into two equal groups of 30 canals with versus without PERIAPICAL lesions. Samples were collected from the root canals and cultured on MacConkey and blood agar culture media. The samples suspected of having CA were streaked on Sabouraud's Dextrose Agar (SDA) and evaluated under a light microscope. Data was analyzed and compared using Chi- square and Kappa tests.Results: CA was found in 11 patients (36.7%) with PERIAPICAL lesions. In the patients without PERIAPICAL lesions only 4 samples demonstrated CA in the root canal systems (13.3%). The difference between the two groups as to the presence of CA was statistically significant (p<0.037).In addition, evaluation of salivary samples revealed 15 cases (50%) of CA presence in the patients with PERIAPICAL lesions and 16 cases (53.3%) of CA in the patients without PERIAPICAL lesions, demonstrating no statistically significant difference between the two groups.Conclusion: Considering the fact that the presence of CA in the root canal systems of teeth with PERIAPICAL lesions was more noticeable and statistically significant compared to the teeth without PERIAPICAL lesions, the elimination of this microorganism from the root canal system, using appropriate intracanal solutions and medications is of utmost importance.

Actinomycosis is a granulomatous infection of the cervicofacial, thoracic, abdominal and cerebral regions. Cervicofacial actinomycosis usually presents as a palpable mass, which is sometimes painfull and may be associated with a draining sinus tract. PERIAPICAL actinomycosis is a cervicofacial form of actinomycsis. PERIAPICAL actinomycosis is a persisting PERIAPICAL lesion that usually does not respond to routine ENDODONTIC TREATMENT and persists for a long period of time. In this case report, the healing of a cutaneous and PERIAPICAL lesion associated with actinomycosis following routine root canal TREATMENT and PERIAPICAL surgery is presented.

Introduction: Health of PERIAPICAL tissues has been considered as an index for the evaluation of ENDODONTIC outcomes. The present study sought to assess the pattern of PERIAPICAL lesion extension in anterior teeth using cone-beam computed tomography (CBCT). Methods and Materials: In this descriptive study‚ 199 CBCT images belonged to patients aging from 15 to 79 were assessed according to PERIAPICAL lesion extension in the regions of maxillary and mandibular anterior teeth. Maximum PERIAPICAL lesion extensions in three orthogonal planes were measured and recorded in millimeters and were assessed according to age‚ gender‚ dental arch and tooth type. Statistical analysis was performed using percentages‚ repeated measure ANOVA and Bonferroni tests. The significant level was set at 0. 05. Results: The highest average of lesion extension, in both maxilla and mandible, was in vertical dimension‚ followed by horizontal buccolingual and horizontal mesiodistal dimensions‚ respectively. There were significant differences between the vertical and mesiodistal (P=0. 004) and also mesiodistal and buccolingual (P=0. 010) PERIAPICAL lesion extension dimensions. In addition, there were significant differences in maxilla and mandible (P=0. 012). In maxilla, there were no significant differences between the three tooth types (P=0. 346) but in the mandibular arch, there were significant differences between central-canine (P=0. 004) and lateral-canine (P=0. 026). According to independent variables, only gender had a significant effect on the lesion extension in anterior regions of maxilla and mandible (P=0. 001). The PERIAPICAL lesion extensions were significantly higher in men compared with women. Conclusions: The bone destruction_as a consequence of PERIAPICAL inflammatory process_ was greatest in the vertical, and lowest in the horizontal mesiodistal dimensions. That way, the extension in buccolingual dimension, which could not be detected in the 2-D imaging techniques, was rather high in the present study. Thus CBCT, as a 3-D imaging technique, could be recommended for the precise evaluation of lesion extension in the PERIAPICAL area.

Introduction: The purpose of this review is to investigate the contribution of non-surgical ENDODONTIC TREATMENT in the healing process of large PERIAPICAL lesions as well as looking over other potential non-surgical ENDODONTIC TREATMENT options. Materials and Methods: two females and one male patient were referred to the private office, complaining of having pain in the anterior maxillary region which was pertinent to the presence of a large PERIAPICAL lesion, and subsequently were managed by a non-surgical ENDODONTIC approach using cold ceramic. The archive of PubMed and Google Scholar databases was also searched for finding relevant articles in which a nonsurgical ENDODONTIC approach was performed to improve the healing process of large PERIAPICAL lesions. Results: Clinical examination of the case series subjects revealed no signs and symptoms following TREATMENT while relative improvement of the lesion and apical closure was apparent in radiographs 7 months, 9 months, and 4 years subsequently. In twenty-two reviewed clinical trials, a total number of 107 teeth with large PERIAPICAL lesions were treated by nonsurgical ENDODONTIC approaches using MTA, biodentine, gutta-percha, and bioceramic iRoot Bp plus. Complete healing occurred in 38 cases (35. 5%) after 12-17 months. Conclusions: Although surgical interventions have been used previously in the management of large PERIAPICAL lesions, a nonsurgical ENDODONTIC approach with cold ceramic seems to be effective, leading to complete healing of the PERIAPICAL lesion in treated subjects. Further clinical research is recommended to identify the effectiveness of cold ceramic for the TREATMENT of extensive PERIAPICAL lesions.