Actinomycosis is a chronic and less common infectious process that established by Actinomyces israilii. Involvement of faciocervical region is more common than thoracic and visceral types and typically involves the angle of mandible and with less occurrence rate the upper jaw may also be involved Periodical lesions of maxilla that involved in this process by Actinomyces israilii are rare and common site of them is the PERIAPICAL area of central incisors of maxilla. A subject is a 31 year old woman who after multiple effort of endodontic and surgical procedures eventually with meticolous surgical debridement and pathologic examination with diagnosis of PERIAPICAL actinomycosis was treated with penicilin for 10 weeks and after that showed no sign and symptom in involved area.

Introduction: Some of PERIAPICAL lesions could be observed in a radiograph but the exact diagnosis is reach after microscopic evaluation. Unfortunately, in many cases PERIAPICAL lesions are not diagnose because lack of a radiograph and then the dentist may pull the lesion out completely or incompletely. In this situation remains of the lesion can creat next problems.Objective: Determine frequency of PERIAPICAL lesions among extracted TEETH and classify them according to microscopic evaluation.Materials and Methods: This is a cross- sectional study. It was done in dental’s offices and clinics in Rasht during 8 weeks, forty two lesions were collected among 5900 extracted TEETH. The information was recorded and the lesions were sent within formalin10% to Pathology Laboratory in Poursina Hospital. The lesions were sliced by microtome, Stained (H and E), and then they were observed by a pathologist. The lesions were classified and statistical analysis was done by EPI calculator and SPSS 11.5.Results: 42 TEETH (0.71%) had PERIAPICAL lesions among 5900 extracted TEETH. After microscopic evaluation the lesions were classified as PERIAPICAL granuloma (57.14%), PERIAPICAL cyst (33.33%) and other lesions (9.53%). In this study the frequency of the lesions was similar in both sex, and patients often were between 3rd to 5th decades of their life. The must frequent location of the lesions in the jaw was in the posterior of maxilla, posterior of mandible, anterior of maxilla and anterior of mandible consequently.Conclusion: Almost there are seven PERIAPICAL lesions among 1000 extracted TEETH.Although the frequency of PERIAPICAL lesions seems to be infrequent, all the PERIAPICAL lesions should be sent to laboratory because lesions like mural ameloblastoma and traumatic bone cyst might be needed different treatment.

Purpose: Dental abscess is considered as one of the most common complications of untreated caries in children. Microorganisms are known as major causes for the pulp and periradicular pathosis. Black - pigmented, gram-negative anaerobes, belonging to species of porphyromonas and prevotella (bacteroides) play an importantrolein causing clinical signs and symptoms related to pulp and periradicular disease. The aim of this investigation was to assess the presence of two main pathogenic microorganisms named porphyromonas gingival is and prevotella melaninogenica in abscessed primary TEETH.Methods & Materials: Forty children aged 4-10 years were selected with no systemic disease and no antibiotic consumption during the last two weeks of sampling. Selected TEETH were presenting swelling and pain at observation stage as signs of acute abscess. The diagnostic technique of porphyromonas gingivalis and prevotella melaningenica was the use of DNA formulation reading by means of PCR technique.Results: Results showed that of the 40 samples, 35(%87.5) were positive for porphyromonas gingivalis, 34(%85) were positive for prevotella melaninogenica. However, it seems that more work is required for more precise antibiotic therapy of dental abscess in children.Conclusion: The presence of two well known species of microorganisms in PERIAPICAL abscess of primary TEETH was confirmed.

Background and Aim: The presence of Beta-lactamase gene in microorganisms is believed to be responsible for resistance of subsequent INFECTIONs to routine and penicillin derivates antibiotics. As such bacterial resistance has been a continuing and evolving problem in the management of the case efforts are centered on the distribution of such gene to provoke clinicians to use alternative antimicrobial agents. This investigation was aimed at the presence of the beta - lactamase gene in microorganisms responsible for peri-apical INFECTIONs of primary TEETH.Methods & Materials: Samples were taken from dental abscess of infected TEETH from a group of 40 children attending the pediatric dental clinic. They aged 4-10 with at least 1 infected primary tooth with no systemic background.Attempts were made to make sure none of the selected cases had received any antibiotics during the last two weeks prior to sampling. The rapid and fine rapid polymerase chain reaction technique (PCR) was used to identify the gene transcript including any beta - lactamase gene presence. Data were analyzed by chi-square test.Results: Assessing the collected data and a further analysis revealed the presence rate of beta - lactamase at 63.2% of the cases.Conclusion: As the presence of the beta - lactamasegene was approved in more than 60% of the cases a definite need for a more appropriate and precise antibiotic therapy of infected primary TEETH is recommended.

Statement of problem: As for other dental treatments, root canal therapy may lead to failure. Correction of these conditions will be faced with problems and complexities, particulary if any PERIAPICAL lesion is peresent.Purpose: The aim of this study was to evaluate the success rate of retreament in TEETH with apical lesions.Materilas and method: In this descriptive study 60 TEETH with failed root canal therapy which had been retreated by an endodontist were reevaluated clinically and radiographically between 6 to 12 monthis after retreatment. Clinical examinations were performed by a clinician and comparison with the primary symptoms, recorded in patiants file, was obtained. PERIAPICAL radiographs were prepared by parallel technique and E speed film with the same proccessing conditions. Periapicel lesion size was evaluated and comparison was made before and 6-12 month after retreament, using Photoshop software (version7). The data were analyzed by chi-square test and agreemental tables.Results: Statistically, there was no correlation between variables and success rate. The success and failure percentage of retreatment was 81.7% and 5%, respectively and 13.3% of cases were uncertain. The most success rate was observed in group of 31-40 years old (95%), keeping in mind that most patients were in this age group. The least success was in group over 50 years old.Conclusion: According to this study, the high success rate could be expected in retreatment of TEETH with PERIAPICAL lesion.

Introduction: Foraminal Enlargement (FE) is a cleaning performed in the apical-most region of the tooth, in order to optimize root disINFECTION. This systematic review evaluated the influence of FE during root canal treatment on bacterial reduction and repair of the PERIAPICAL lesion. Materials and Methods: Searches in PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, Embase, Scielo, Lilacs and OpenGrey were performed until January-2024. Ex vivo and in vivo studies evaluating the effects of FE in the bacterial reduction and repair of the PERIAPICAL lesion were included, respectively, followed by risk of bias assessment (modified version of Joanna Briggs Institute’s for ex vivo studies and Systematic Review Centre for Laboratory animal Experimentation’s risk of bias tools for in vivo studies). The meta-analysis was not feasible and a qualitative summary for each outcome was provided. Results: Of 950 studies, 2 in vivo studies were eligible, using animal models with infected TEETH. Of these two, PERIAPICAL repair was evaluated with hematoxylin-eosin stain, and FE improved PERIAPICAL healing. Regarding ex vivo studies, 3 were eligible, using extracted human TEETH. The inoculations in ex vivo models were performed with Enterococcus (E. ) faecalis, and FE reduced E. faecalis in the ex vivo models. Conclusions: Foraminal enlargement seems to increase bacterial reduction within the root canal, and provide major PERIAPICAL tissue repair on the histological analysis in animal studies. However, caution is necessary when translating these results to the clinical environment.

Pulp and PERIAPICAL diseases are directly or indirectly caused by oral bacteria and various bacteria species play role in root canal INFECTION. The purpose of this study was to investigate bacterial flora in the apical third of TEETH with PERIAPICAL lesion.Forthy TEETH with PERIAPICAL lesion from 40 patients, extracted. Five mm of the apex of each TEETH was cut under anerobic condition using sterile bur. The content of root canals were transferred to two blood agar cultures including an aerobic and anerobic (Hydrogen 5%, CO2 10% Nitrogen 85%) condition using sterile files.Ten intact TEETH extracted dueto orthdontic treatments as control group. After the formation of colonies, the types of bacterial species were recognized according to morphologic properties of cultured colonies, gram staining technique and using microscope and biochemical tests.The results showed that 126 bacteria belonging to 17 different species were isolated 62 bacteria from 126 bacteria were obligate anerobic and the sum of obligate and factitive anerobic bacteria were 118 in number (94%). Almost all the specimens (39 out of 40) showed bacterial growth and at least one anerobic bacterium species was detected in each of them. This confirms that the root canal INFECTIONs are caused by various species. Sterptococcus species were the most common strain, bacteroid species which the peptococcous were the most common.At least 26 specimens (95% of all spescimens) had a strain of bacteroid in root canal INFECTION.Based on the results of this study, bacteria play a very important role in root canal intection and our study indicated that anerobic bacteria had the most efficacy.

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.

Background and Aim: The main goal of root canal treatment is to prevent or treat apical periodontitis. The aim of the present study was to assess the coronal restoration status, root canal filling quality, PERIAPICAL health condition, and related factors in endodontically treated TEETH at the Dental Faculty of Islamic Azad University of Medical Sciences, Tehran, Iran, in 2011-12. Materials and Methods: In this descriptive, historical cohort study, a total of 160 TEETH submitted to endodontic treatment were clinically and radiographically reexamined one year (minimum) postoperatively. Each volunteer answered a questionnaire on demographic and socioeconomic factors. They were also questioned about the factors related to endodontic and restorative treatments. The restoration and root canal filling quality was classified according to the modified criteria introduced by Tronstad et al. The PERIAPICAL status was evaluated according to the PERIAPICAL index (PAI) scores. Results: PERIAPICAL lesions (diseased/failure) were most prevalent in Inadequate Restoration/ Inadequate Root Canal Filling group (70%) followed respectively by Inadequate Restoration/Adequate Root Canal Filling group (52. 2%), Adequate Restoration/ Inadequate Root Canal Filling group (30%), and Adequate Root Canal Filling/ Adequate Restoration group (15. 5%). Conclusion: According to the results, an efficient appointment scheduling system has the greatest impact on the completion of coronal restoration after endodontic treatments. Provision of adequate root canal filling and perfect coronal restoration can reduce the prevalence of postoperative PERIAPICAL lesions and increase the success rate of endodontic treatments.