The effects of periapical lesion healing on bonedensity

Abstract

Öz: Operative dental procedures may promote pulpal infections, such as tooth cavity, trauma and teeth abrasion, anaerobic microorganism colonization causing total pulp necrosis, and periapical lesions that result in bone destruction in the periapical region. Periapical radiographs are important tools for identifying periapical pathologies. However, given that the imaging system shows three-dimensional formations in two dimensions, the knowledge about the actual size of the lesion and the real relationship with the anatomic structures is limited. These limitations force clinicians to choose the high resolution and current imaging methods that show all the details of the oral structures, such as conic beam computed tomography (CBCT). CBCT is a highly effective diagnostic device for early period bone lesion detection in which the gray value for bone density is measured in Hounsfield unit (HU). Other than using CBCT, bone mineral density measurement can be done to assess the healing of existing lesions. When the periapical lesion is healing, a series of formation and destruction processes follow each other. On the one hand, mediators and tissues that must be removed from the region are destroyed by host defense cells; on the other hand, cells included in the repair process provide new tissue generation and remodelling to provide the pre-disease anatomic properties in the lesion region. This review discusses recent studies using current three-dimensional imaging methods, compared with traditional methods for bone damage due to periapical lesion formation and healing after suitable treatment. This study aims to investigate the advantages and shortcomings of existing treatment and diagnosis approaches in endodontic periradicular lesion diagnosis and treatment. The findings highlight promising diagnosis and treatment tools and suggest the expansion of minimally invasive approaches to eliminate the problems in periapical lesions.