From Volume 40, Issue 2, March 2013 | Pages 114-119
Teeth with periapical lesions can undergo successful orthodontic treatment, but conventional protocols indicate that such teeth should be endodontically stabilized prior to such treatment. A case report is presented where such endodontic stabilization was not possible, yet a chronic periapical lesion resolved as orthodontic treatment progressed. This paper will discuss the possible causes of the initial lesion, and reasons why it resolved without endodontic treatment.
Conventional protocols indicate that teeth with periapical lesions should be endodontically stabilized prior to orthodontic treatment, since the movement of such teeth may otherwise cause a delay in the healing process. Furthermore, areas of root resorption resulting from both orthodontic movement and periapical lesions are repaired by newly formed cementum in the majority of cases.1
The following is a report of an adult orthodontic patient who presented with a Class II division 1 malocclusion, complicated by a deep overbite causing extensive trauma to the anterior palatal soft tissues. One of the upper central incisors initially had an extensive chronic periapical radiolucency, however, during the course of the orthodontic treatment, this lesion resolved without endodontic treatment. The report will discuss the possible implications of the occlusion in the development and subsequent resolution of this periapical lesion.
A 46-year-old woman was referred to the Orthodontic Department of Peterborough and Stamford Hospital by her general dentist, with a complaint of prominent and spaced upper incisor teeth. Clinical examination (Figures 1–3) revealed:
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