The Clinical Conundrum of Periapical Lesions: Granuloma or Cyst?


Authors : Dr. Preeya Jagadeesha; Dr. Rohan R Vernekar; Dr. Prima Prakash; Dr. Dhanya Rao; Dr. Raghavendra Kini; Dr. Priyal Rohan

Volume/Issue : Volume 9 - 2024, Issue 11 - November


Google Scholar : https://tinyurl.com/ynfmjhss

Scribd : https://tinyurl.com/yzrw74za

DOI : https://doi.org/10.38124/ijisrt/IJISRT24NOV175

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Abstract : Periapical lesions typically arise as a result of pulp disease, often due to untreated dental caries, secondary to trauma or periodontal disease. There is a cascade of pathologies one leading to another. Periapical lesion usually represents sequelae of pulpitis. [1] This case report documents a puzzling dental situation in a 20-year- old female. Initial clinical evaluation suggested an infected root stump, however, histopathological examination revealed a periapical granuloma. We highlight the systematic analysis and decision making process leading to the revised diagnosis, underscoring the importance of integrated clinical and histopathological assessment in resolving complex dental dilemmas.

Keywords : Case Report, Periapical Abscess, Periapical Cyst, Periapical Granuloma, Periapical Lesions

References :

  1. Syed Ismail, Prabu Mahin1; Apoorva, K2; Manasa, N2; Rama Krishna, R2; Bhowmick, Siddhartha3; Jain, Shilpa4,. Clinical, radiographic, and histological findings of chronic inflammatory periapical lesions – A clinical study. Journal of Family Medicine and Primary Care 9(1):p 235-238, January 2020. | DOI: 10.4103/jfmpc.jfmpc_715_19
  2. Alzahrani O, Komo H, Howait M. Healing and Spontaneous Realignment of Displaced Roots With Periapical Granuloma After Microsurgical Endodontic Treatment (Three Years' Follow-up): A Case Report. Cureus. 2024 Jan 10;16(1):e52020. doi: 10.7759/cureus.52020. PMID: 38205085; PMCID: PMC10777889.
  3. Brad W. Neville, Douglas D. Damm, Carl M. Allen, Angela C. Chi, 3 - Pulp and Periapical Disease, Editor(s): Brad W. Neville, Douglas D. Damm, Carl M. Allen, Angela C. Chi,Color Atlas of Oral and Maxillofacial Diseases, Elsevier, 2019,Pages 79-92,ISBN 9780323552257
  4. RamanPreet Bhullar Kaur, Amandeep Bhullar, Shreenivas Vanaki, R.S. Puranik, M. Sudhakara, Mamta Kamat, A comparative histopathological & bacteriological insight into periapical lesions: An analysis of 62 lesions from north Karnataka, Indian Journal of Dentistry, Volume 4, Issue 4, 2013, Pages 200-206,ISSN 0975-962X,
  5. 5 Ingle JI, et al. (2019). Ingle's Endodontics. 7th ed. Chapter 14: Periapical Lesions
  6. Parameswaran, A. Grossman's endodontic practice - 14th edition. Endodontology 33(2):p 118, Apr–Jun 2021. | DOI: 10.4103/0970-7212.318141
  7. Rajendran, R & Sundharam, Sivapatha. (2006). Shafer's Text Book of Oral Pathology. 

Periapical lesions typically arise as a result of pulp disease, often due to untreated dental caries, secondary to trauma or periodontal disease. There is a cascade of pathologies one leading to another. Periapical lesion usually represents sequelae of pulpitis. [1] This case report documents a puzzling dental situation in a 20-year- old female. Initial clinical evaluation suggested an infected root stump, however, histopathological examination revealed a periapical granuloma. We highlight the systematic analysis and decision making process leading to the revised diagnosis, underscoring the importance of integrated clinical and histopathological assessment in resolving complex dental dilemmas.

Keywords : Case Report, Periapical Abscess, Periapical Cyst, Periapical Granuloma, Periapical Lesions

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