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Periodontal granuloma. Diagnostic. Treatment.


State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of Moldova

Background and Aim

Studying the adresability of patients with periapical granuloma, diagnosing and stabilizing the
therapeutic conservative algorithm of treatment chronic granulomatous apical periodontics.

Methods and Materials

The present study is based on a descriptive approach, which aims to identify and quantify the
demographic, medical and dental aspects observed in a lot of patients from Ungheni town in relation
to the chronic granulomatous periapical pathology between January 1 and June 31, 2019.

The current research consisted of two parts:

1. Clinical examination performed by dentists;

2. Collecting data from patient records.

Patient examination methodology:

- Accuses and anamnesis;

- The objective clinical examination;

- Complementary examination: retro-alveolar radiography.

Retro-alveolar radiography was used at various stages :

- Preoperative;

- During treatment;

- Postoperative;

- Recall

Patients were informed about the long-term prognosis and a decision was made for conservative non-
surgical treatment based on Ca Hydroxide.

During instrumentation, I used sol. EDTA 17%, was subsequently irrigated with 2.5% NaOCl solution and
0.05% chlorhexidine.

The channels were dried using sterile paper cones and initially filled with calcium hydroxide paste, which
was changed every 2 weeks for 3 months and the access cavity was sealed.

Finally the tooth was sealed with gutta-percha cones and sealant AH 26 using cold lateral condensation

In the clinical study were included 77 patients between the ages of 13 and 67 years, among them (43%)
women and (57%) men . Those from the rural area dominate with 67%, whereas the subjects category is
addressed late with massive destruction . The most common cause of chronic periodontitis for these
patients is the complications of dental caries.

The analysis of medical records ,we can see that in the pluriradicular teeth we can encounter more
frequently periapical granuloma, because the ability to get control of the infection is lower and the root
canal anatomy is often non-standard.

Acute exacerbation is prevalent in March 25%, April 29%, a period characterized by decreased immunity
of the organsim. The exacerbation of various associated chronic conditions results in the diminution of
the general and local reactivity of the organism.

The efficiency of the treatment based on Ca Hydroxide constituted 63%, reducing the periapical index
(PAI) from the value PAI-4 to PAI-2. For the other 2 categories, when the lesion becomes larger or
remains of the same size, the option for surgery should be considered.


1.Although periodontitis is the most common infectious disease, it is treatable and can be prevented.

2.Reducing the incidence and prevalence of periodontal disease may reduce its associated systemic
diseases and complications.

3.Chronic granulomatous periodontitis has asymptomatic evolution; Rarely - do patients experience

nociceptive sensations. Radiography is necessary in diagnosing the pathology concerned.

4.Monitoring the healing of periapical lesions is essential through regular examinations.