Endodontology
Comparative radiographic and histological analyses of periapical lesion development

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Objective

The present study evaluated the dynamics of the development of periapical lesions.

Study design

Root canals from dogs' teeth were exposed to the oral environment, and then sealed for 7 days (Group A), 15 days (Group B), 30 days (Group C), and 60 days (Group D). After each experimental period, radiographs were taken to detect periapical bone resorption. In addition, histological sections from the periapical region were prepared. The radiographic and histological results were analyzed by ANOVA and Tukey's, Wilcoxon, and Pearson's tests. Significance level was set at 5%.

Results

Lesions were radiographically visible at 15 and 30 days, and had similar size at these periods (P > .05). At 60 days, lesions were larger than in the other periods (P < .05). Bone resorption was detected histologically at 7 days. The greatest values of bone resorption were observed at the 30- and 60-day periods (P < .05). The results of the methods of evaluation were similar only at the 30-day period. There was no correlation between the radiographic and histological results.

Conclusions

Periapical radiography did not provide detection of periapical lesion in its initial stages. The periapical lesions became more evident radiographically when the bone resorption area increased.

Section snippets

Materials and Methods

The second, third, and fourth mandibular premolars and the second and third maxillary premolars of 4 approximately 1-year-old mongrel dogs were selected for treatment, totaling 64 roots that were randomly assigned to 4 groups. The experimental protocols were in accordance with the Institutional Animal Care and Use Committee.

The animals were anesthetized intravenously with 3% sodium thiopental (Thionembutal; Abbott Laboratórios do Brasil Ltda., Rio de Janeiro, RJ, Brazil) and periapical

Results

The mean values for the areas of radiographically and histologically detected periapical lesions at different periods of lesion formation are presented in Fig. 3, Fig. 4.

The results of ANOVA and Tukey's test showed no statistically significant difference (P > .05) between the sizes of the periapical lesions detected radiographically at the experimental periods of 7 and 15 days, and 15 and 30 days. At 60 days, the lesions were significantly larger (P < .05) than those detected at the earlier

Discussion

Periapical radiography is the most widely used method for visualization of periapical lesions, but it has some limitations.10, 11, 12 Several factors can affect the radiographic evaluation of bone lesions, such as variable thickness of the cortical layer, angle of incidence of the x-ray beam, composition of the mineralized tissues, lesion location, and mode of x-ray film processing.10 Periapical radiography is poor in detecting periapical bone resorption involving only medullar bone before it

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