Primary endodontic lesion summarizing an endo-perio lesion

Abstract

This study aims to present a clinical case of retreatment with the regression of an endodontic lesion, which simulated an endospinal lesion, with monthly changes of calcium hydroxide paste (UltraCal®) and preservation of the lesion repair. A 47-year-old female patient was referred for dental treatment due to the need for retreatment in elements 45 and 46.  On clinical examination, the presence of a periodontal pocket fistula of more than 10 millimeters on the mesia and distal surface, respectively, was observed. Cone-beam computed tomography demonstrated the presence of filling material, as well as periapical and lateral bone radiotransparency.  The retreatment was performed with rotary instrumentation (Reciproc Blue®), and the preparation of the canal with Reciproc Blue. 2.5% Sodium Hypochlorite was used as an irrigating solution, and the intracanal medication used was calcium hydroxide paste (UltraCal®) and crown sealing was done with glass ionomer cement.  After 3 months, a regression of the lesion was observed, at 6 months, treatment success was observed only with endodontic therapy, without the need for periodontal treatment, confirming the diagnosis of primary endodontic lesion with secondary periodontal involvement. It is concluded that endodontic retreatment associated with intracanal medication determined clinical and radiographic success, ruling out the need for periodontal therapy.