IADR Abstract Archives
Trucut Needle Use For Periapical Lesion Biopsy: Three Case Reports.
Objectives: To correlate clinical and radiographic healing outcome in cases of persistent apical periodontitis using regenerative endodontic procedures with the histopathological findings obtained using trucut needle as a biopsy tool.
Methods: Three cases with persistent apical periodontitis in the upper incisor teeth in need of root canal retreatment were selected. Preoperative cone beam computed tomography and periapical radiograph using paralleling device were taken for proper case selection and as a base line for lesion evaluation. According to predetermined measurements taken from both CBCT and periapical radiograph the Trucut needle (16 gauge and 10 cm length) was inserted through the mucosa until reaching the periapical lesion, and activated to obtain 3mm tissue biopsy which was immediately placed in sterile Eppendorf containing 10% buffered formalin. Tissue was processed and stained with hematoxylin and eosin for histopathological evaluation. The biopsy was taken preoperatively and one week after complete treatment using regenerative endodontic procedures. Clinical and radiographic follow up was done at 1, 3, 6 and 9 months for two cases and at 1 and 3 months for the third case to correlate the histopathological findings with the healing outcome.
Results: All preoperative lesions examined showed dense infiltration of chronic inflammatory cells, delicate connective tissue stroma and endothelial cell proliferation. After one week, reduction in number of inflammatory cells was evident and increase in number of fibroblasts was also seen.The two cases examined after 9 months showed reduction in lesion size radiographically and were asymptomatic, also the third case examined after 3 months showed reduction in the lesion size radiographically and was asymptomatic.These clinical and radiographic findings can be correlated with the histopathological findings indicating that healing is dependent upon the cell type that first repopulates the lesion.
Conclusions: Trucut needle can be a useful conservative tool in obtaining periapical lesion biopsy for histopathological diagnosis and healing evaluation with minimal discomfort and post-operative pain for the patient.
Methods: Three cases with persistent apical periodontitis in the upper incisor teeth in need of root canal retreatment were selected. Preoperative cone beam computed tomography and periapical radiograph using paralleling device were taken for proper case selection and as a base line for lesion evaluation. According to predetermined measurements taken from both CBCT and periapical radiograph the Trucut needle (16 gauge and 10 cm length) was inserted through the mucosa until reaching the periapical lesion, and activated to obtain 3mm tissue biopsy which was immediately placed in sterile Eppendorf containing 10% buffered formalin. Tissue was processed and stained with hematoxylin and eosin for histopathological evaluation. The biopsy was taken preoperatively and one week after complete treatment using regenerative endodontic procedures. Clinical and radiographic follow up was done at 1, 3, 6 and 9 months for two cases and at 1 and 3 months for the third case to correlate the histopathological findings with the healing outcome.
Results: All preoperative lesions examined showed dense infiltration of chronic inflammatory cells, delicate connective tissue stroma and endothelial cell proliferation. After one week, reduction in number of inflammatory cells was evident and increase in number of fibroblasts was also seen.The two cases examined after 9 months showed reduction in lesion size radiographically and were asymptomatic, also the third case examined after 3 months showed reduction in the lesion size radiographically and was asymptomatic.These clinical and radiographic findings can be correlated with the histopathological findings indicating that healing is dependent upon the cell type that first repopulates the lesion.
Conclusions: Trucut needle can be a useful conservative tool in obtaining periapical lesion biopsy for histopathological diagnosis and healing evaluation with minimal discomfort and post-operative pain for the patient.