Regressão de lesão periapical extensa decorrente de periodontite apical sintomática mediante retratamento endodôntico com uso de pdt– relato de caso

Abstract

INTRODUCTION: Symptomatic apical periodontitis can result from primary contamination of the root canal system (SCR) or from an endodontic failure. In order to improve the decontamination, perform a new cleaning and modeling and reduce

the number of persistent microorganisms inside the SCR, photodynamic therapy (PDT), shaking the irrigating solution with mechanical or ultrasonic means and intracanal medication can be performed. OBJECTIVE: To report a clinical case of endodontic retreatment resulting from symptomatic apical periodontitis, associated with the use of intracanal medication, photodynamic therapy and agitation of the irrigating solution. METHODOLOGY: Endodontic retreatment was performed on tooth 26 of a patient diagnosed with symptomatic apical periodontitis, where the absence of endodontic treatment was observed. MV2 canal and a large hypodense image involving the three roots and in contact with the maxillary sinus. RESULTS: Right after the first session, the patient reported a complete absence of painful symptoms. After 6 months a visual reduction of the periapical lesion was observed through periapical radiography and after 18 months of the beginning of the treatment and 12 months of the final filling, a significant reduction of the lesion was observed through CBCT. CONCLUSIONS: Additional decontamination and disinfection techniques associated with medication changes are very effective.