Assistant professor Kong Abdulaziz university Jeddah, Makkah, Saudi Arabia
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Introduction: Several pathologies might be presented adjacent to the apices of endodontically healthy teeth. These lesions are often treated by surgical enucleation leaving the fate of pulpal vitality unknown. The aim of the presented study is to investigate the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws.
Methods: The records of 338 biopsies submitted to the institute’s histopathology laboratory for were reviewed to include the cases that met the inclusion criteria. 81 biopsies related to surgical enucleation of lesions not related to the healthy pulpal status of the involved teeth were included of which 22 patients were recalled. Teeth were examined clinically and radiographically to assess their vitality after at least 8 months follow up.
Results: There were seven different pathological lesions diagnosed histologically. The follow-up period ranged between 7-72 months, and 12 cases (54.6%) have developed pulp necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal response to sensibility testing for all the teeth adjacent to the lesion. 10 out of the 12 cases (83%) that underwent pulpal necrosis were associated with cystic lesions, whereas, the remaining two were associated with granulomas.
Conclusion: The incidence of pulp necrosis of vital teeth associated with periapical lesions not related to their pulpal status is high and might warrant intentional RCT of these teeth prior to the surgical enucleation of the lesion.
