Nonsurgical Root Canal Therapy of Large Cyst-like Inflammatory Periapical Lesions and Inflammatory Apical Cysts

Louis Lin, Domenico Ricucci, Jarshen Lin, Paul Rosenberg

Research output: Contribution to journalArticle

Abstract

It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.

Original languageEnglish (US)
Pages (from-to)607-615
Number of pages9
JournalJournal of Endodontics
Volume35
Issue number5
DOIs
StatePublished - May 2009

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Root Canal Therapy
Cysts
Radicular Cyst
Dental Pulp Cavity
Periapical Periodontitis
Infection
Granuloma
Wound Healing
Abscess
Apoptosis

Keywords

  • Apical cysts
  • apoptosis
  • large cyst-like periapical lesions
  • regression of apical cysts

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Nonsurgical Root Canal Therapy of Large Cyst-like Inflammatory Periapical Lesions and Inflammatory Apical Cysts. / Lin, Louis; Ricucci, Domenico; Lin, Jarshen; Rosenberg, Paul.

In: Journal of Endodontics, Vol. 35, No. 5, 05.2009, p. 607-615.

Research output: Contribution to journalArticle

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