Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2014, vol. 20, issue 5
Subject Collection: Oral and Dental Medicine
Pages: 638-641
DOI: 10.5272/jimab.2014205.638
Published online: 06 November 2014

J of IMAB 2014 Oct-Dec;20(5):638-641
Angela GusiyskaCorresponding Autor.
Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria.

Introduction: The pathogenesis of internal and external resorptive processes in the dental tissues and those of the periapical zone is not fully understood, but the main purpose, either in teeth with internal resorption or in teeth with periapical lesions, is decontamination of the endodontic space and subsequent three-dimensional obturation in order to isolate periapical and oral tissues and prevent reinfection.
Purpose: The aim of this article is to analyze in vivo some key characteristics of the apical zone in teeth with chronic apical periodontitis.
Material and Methods: To facilitate the clinical protocol after the radiographic analysis and assessment of patency, the working lengths of 153 root canals (n = 153) in 106 teeth were determined. The clinical widths of the apical narrowing were measured by using the last instrument (ISO 0.02 tapered file), which can move freely through the apical narrowing after electrometric determination of the working length (Raypex 5 /VDW, Germany/).
Results and Discussion: Determination of working width and working length is important for realizing the first stage of decontamination – maximum instrumentation of the endodontic space and choice of a clinical protocol. The classification of root canals in a particular group according to the relative patency or lysed apical opening is important for the selection of obturation technique, which is essential for reducing the microleakage in the zone.
Conclusion: Since the target of this work were teeth with CAP, in the majority of the cases with clinical findings of root canals with preexisting filling, radicular pins, obliteration, separated canal instruments, perforations at different levels, via falsa or thresholds, the access to the apical zone was not subjected to a closely observed instrumental clinical protocol. In the treatment of each case, however, the clinical principles of modern endodontic treatment were closely observed.

Key words: apical zone, chronic apical periodontitis, external apical resorption,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Gusiyska A. In vivo analysis of some key characteristics of the apical zone in teeth with chronic apical periodontitis. J of IMAB. 2014 Oct-Dec;20(5):638-641. doi:

Correspondence to: Dr. Angela Gusiyska, PhD, Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University – Sofia; 1, Sv. Georgi Sofiyski Blvd, 1431 Sofia, Bulgaria; E-mail:

1. LeGeros RZ. Properties of osteoconductive biomaterials: calcium phosphates. ClinOrthop Relat Res. 2002 Feb;395:81-98. [PubMed]
2. Mäntylä P, Stenman M, Kinane DF, Tikanoja S, Luoto H, Salo T, et al. Gingival crevicular fluid collagenase-2 (MMP-8) test stick for chair-side monitoring of periodontitis. J Periodont Res. 2003 Aug;38(4):436-439. [PubMed] [CrossRef]
3. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006 Feb;72(1):75-80. [PubMed]
4. Wang CY, Stashenko P. Characterization of bone-resorbing activity in human periapical lesions. J Endod. 1993 Mar;19(3):107-11. [PubMed] [CrossRef]
5. Friedman S. Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failures). Endod Topics. 2002 Mar;1(1):54-78. [CrossRef]
6. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral & Maxillofacial Pathology. (Philadelphia, USA) W. B. Saunders Co, 2002; 107-136;589-601.
7. Seltzer S. Endodontology. 2-nd ed. Philadelphia: Lea & Febiger. 1988;444-6.
8. Gusiyska A. Orthograd treatment of chronic apical periodontitis – biological approach. [Dissertation]. Faculty of Dental Medicine, Sofia; 2012. 254 p. [in Bulgarian]
9. Grootvelt M, Baysan A, Siddiqui N, Sim J, Silwood C, Lynch E. History of clinical applications of ozone. – In: Lynch E. Ozone: the revolution in dentistry. Quintessence. 2004; Chapter 1.2.
10. Murugan R, Ramakrishna S. Development of cell-responsive nanophase hydroxyapatite for tissue engineering. Am J Biochem Biotech. 2007; 3(3):118-124. [CrossRef]
11. Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink P, Van der Sluis LW. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computational Fluid Dynamics model. Int Endod J. 2010 Oct;43(10):874-81. [PubMed] [CrossRef]
12. Brunson M, Heilborn C, Johnson DJ, Cohenca N. Effect of apical preparation size and preparation taper on irrigant volume delivered by using negative pressure irrigation system. J Endod. 2010 Apr;36(4):721-4. [PubMed] [CrossRef]
13. Camões IC, Salles MR, Chevitarese O. Ca2+ diffusion through dentin of Ca(OH)2 associated with seven different vehicles. J Endod. 2003 Dec;29(12):822-5. [PubMed]
14. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986 Feb;2(1):20-34. [PubMed] [CrossRef]
15. de Souza-Filho FJ, Soares Ade J, Vianna ME, Zaia AA, Ferraz CC, Gomes BP. Antimicrobial effect and pH of chlorhexidine gel and calcium hydroxide alone and associated with other materials. Braz Dent J. 2008; 19(1):28-33. [PubMed] [CrossRef]
16. Card SJ, Sigurdsson A, Ørstavik D, Trope M. The effectiveness of increased apical enlargement in reducing intracanal bacteria. J Endod. 2002 Nov;28(11):779-783. [PubMed] [CrossRef]
17. Nair PN, Sjögren U, Krey G, Kahnberg KE, Sundqvist G. Intraradicular bacteria and fungi in root filled asymptomatic human teeth with therapy resistant periapical lesions: a long term light and electron microscope follow-up study. J Endod. 1990 Dec;16(12):580-588. [PubMed] [CrossRef]
18. Peters LB, Wesselink PR, van Winkelhoff AJ. Combinations of bacterial species in endodontic infections. Int Endod J. 2002 Aug;35(8):698-702. [PubMed] [CrossRef]
19. Vier F, Figueiredo J. Prevalence of different periapical lesions associated with human teeth and their correlation with the presence and extension of apical external root resorption. Int Endod J. 2002 Aug;35(8):710-719. [PubMed] [CrossRef]
20. Marroquin BB, El-Syed MA, Willershausen-Zonnchen B. Morphology of the physiological foramen: I. Maxillary and mandibular molars. J Endod. 2004 May;30(5):321-8. [PubMed] [CrossRef].

Received: 15 July 2014
Published online: 06 November 2014

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