REAGGRAVATION OF EXTENSIVE PERIAPICAL LESION: CASE REPORT

Abstract

It´s article has the objective of describe a case of an extensive periapical lesion that turned acute again. This case happened in a patient treated on the Clinic of basic attention II (CABII) of the University of Odontology of Pernambuco (FOP). After the clinical and radiographic exam, the probable diagnosis was a periapical granuloma on the tooth eleven. According to the step-down technic, a decreasing sequence of Gattes Glidden drills was utilized. After that, manual endo files were used until the real length of the instrument. After this step the radiographic of the odontometry was done. The apical procedure continued until the dental file number 90. In each change of file, an irrigation of 5 ml of sodium hypochlorite 2, 5% was done. In addition, utilizing the endo file number 15 the cleaning of the forame was realized. The medication endodontic was done with calcium hydroxide (ultracal®), and the seal up with glass ionomer. Four days after of the beginning of the endodontic treatment the patient related ache and fever. Clinically, an increase of volume was observed on the region of platina. This inflammatory process was diagnosed as flare-up or Abcess Fenix. To resolve the case, the seal up coronary was removed, irrigation was done, introduction of the Ultracal® and the new the seal up coronary. After that, a draining of the pus was realized. In this step was used a scalpel blade number 15-C. It was prescribed antibiotic therapy, analgesics therapy and anti-thermal therapy. One week later the patient returns to the clinic very better, without the inflammatory process and absence of Symptomatology. Thus, we can conclude that it´s necessary to realize a disinfecting penetration safer, avoiding the imbalance of the bacterian flora and the development of Abscess Fenix due to the periapical lesion flares.