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References

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Spontaneous resolution of a periapical lesion during orthodontic treatment: a case report

From Volume 40, Issue 2, March 2013 | Pages 114-119

Authors

M Bainbridge

BDS, MFDS RCS(Eng)

Specialty Registrar in Orthodontics, Cardiff Dental School

Articles by M Bainbridge

RRJ Cousley

BSc, BDS, MSc, FDS RCS(Eng), MOrth RCS(Eng), FDS(Orth) RCS(Eng)

Consultant Orthodontist, Peterborough and Stamford Hospitals NHS Foundation Trust, UK

Articles by RRJ Cousley

Abstract

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.

Clinical Relevance: This report illustrates the possible combined roles of trauma, occlusion and periodontal disease in the development of a perio-endo lesion, and how orthodontic treatment potentially relieved some of the exacerbating factors, thus enabling resolution of the infection without endodontic treatment.

Article

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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