Background: The distinction between radicular cysts and apical granulomas is important in treatment decision.Objectives: The current study aimed to differentiate these two lesions based on radiography images.Patients and Methods: The material consisted of 138 radiographs obtained using Kodak E -speed, in patients aged 29 to 47, divided into two groups: 109 granulomas and 29 radicular cysts. Size of radiography images was measured; the tooth then was extracted and examined in pathologist lab. The results were analyzed by SPSS.15 andROCcurve was created to find cut-off point to differentiate PERIAPICAL granuloma and radicular cysts.Results: Average size of radiography in PERIAPICAL granuloma was 7.4mmand for a radicular cyst was 11.1 mm. Cut-off point was 8.2 mmand the area under curve (AUC) was 0.63. Also, the tests were 83% sensitive and 79% specific.Conclusions: Based on 8.2mmcut-off point could differentiate 83% PERIAPICAL granulomas and 79% radicular cysts from radiography images.

Introduction. This fascinating disorder is also known as Sinus Histiocytosis. It is very rare, probably less than 1000 cases reported in the literature. R.D.D affects lymph nodes, although extranodal involvement has been reported such as: Centaral nervous system (CN.S). All of the cases of R.D.D with CN.S involvement without other sites involvement are 11 cases. Methods. The case is a male patient, 26y/o, with a history of head trauma 2 years ago that has been resulted to unconsciousness. He has been referred to a hospital and brain CT scan and brain M.R.I has been done for him. In M.R.I a brain tumor with left orbit and sphenoidal sinus involvement and compression effect on frontal lobe has been seen. A neurosurgeon operated him and the pathological report was Rosai-Dorfman DISEASE. Then he was referred to radiation therapy department.Results. Treatment approach in CN.S involvement cases consists of surgery, radiotherapy and chemotherapy. Discussion. Over all, response has been inferior to those expected with malignant hematopoietic neoplasms.

Background and Objective: Odontogenic keratocyst is a developmental odontogenic cyst. It is to be considered for histopathological features and clinical behavior. It has aggressive behavior and tendency to recurrence and it has been named benign cystic neoplasm. OKCs have different radiographic appearance such as unilocular to multilocular radiolucency. In some cases, they have been observed in the interradicular area but in rare cases they can be found in PERIAPICAL radiolucency in apex of non-vital teeth that may be mistaken with lesions of endodontic origin and cause mistreatment.Case Report: A 33 year old male patient came to clinic because of swelling in the anterior region of mandible that was repaired with endodontic treatment. In the histological diagnosis of radiolucent lesion, inflamed odontogenic keratocyst was reported.Conclusion: Diagnosis based on clinical finding may risky because it can lead to inappropriate treatment. In most of the cases, microscopic examination of all material surgically removed is necessary for diagnosis. This is especially recommended when treatment of lesion is not successful with routine treatment.

Introduction: Health of PERIAPICAL tissues has been considered as an index for the evaluation of endodontic outcomes. The present study sought to assess the pattern of PERIAPICAL lesion extension in anterior teeth using cone-beam computed tomography (CBCT). Methods and Materials: In this descriptive study‚ 199 CBCT images belonged to patients aging from 15 to 79 were assessed according to PERIAPICAL lesion extension in the regions of maxillary and mandibular anterior teeth. Maximum PERIAPICAL lesion extensions in three orthogonal planes were measured and recorded in millimeters and were assessed according to age‚ gender‚ dental arch and tooth type. Statistical analysis was performed using percentages‚ repeated measure ANOVA and Bonferroni tests. The significant level was set at 0. 05. Results: The highest average of lesion extension, in both maxilla and mandible, was in vertical dimension‚ followed by horizontal buccolingual and horizontal mesiodistal dimensions‚ respectively. There were significant differences between the vertical and mesiodistal (P=0. 004) and also mesiodistal and buccolingual (P=0. 010) PERIAPICAL lesion extension dimensions. In addition, there were significant differences in maxilla and mandible (P=0. 012). In maxilla, there were no significant differences between the three tooth types (P=0. 346) but in the mandibular arch, there were significant differences between central-canine (P=0. 004) and lateral-canine (P=0. 026). According to independent variables, only gender had a significant effect on the lesion extension in anterior regions of maxilla and mandible (P=0. 001). The PERIAPICAL lesion extensions were significantly higher in men compared with women. Conclusions: The bone destruction_as a consequence of PERIAPICAL inflammatory process_ was greatest in the vertical, and lowest in the horizontal mesiodistal dimensions. That way, the extension in buccolingual dimension, which could not be detected in the 2-D imaging techniques, was rather high in the present study. Thus CBCT, as a 3-D imaging technique, could be recommended for the precise evaluation of lesion extension in the PERIAPICAL area.

Background and purpose: PERIAPICAL inflammatory lesions are localized PERIAPICAL bone reactions that result from pulp necrosis and inflammation or periodontal DISEASEs. Inappropriate treatments are often considered as one of the main factors associated with apical periodontitis. This study was done to evaluate PERIAPICAL radiolucencies in panoramic radiographs. Materials and methods: In this cross-sectional study, 332 panoramic radiographs of patients attending Sari School of Dentistry (2016-2019) were assessed. The PERIAPICAL Index was used to evaluate the presence of PERIAPICAL lesions. Also, the quality of treated teeth was determined by optimal quality indices. Data analysis was done in SPSS V. 016 Results: PERIAPICAL lesions (PAI = III-V) were seen in 75. 4% of the teeth investigated and in 90. 2% of teeth with root canal therapy (RCT) and 68% of untreated teeth. PERIAPICAL radiolucencies were mostly found in RCT teeth with inadequate filling density and length. The prevelance of lesions were higher in males. The presence of lesions increased in jaws from the anterior to the posterior, and the frequency of lesions was higher in the maxilla than the mandible. Conclusion: The frequency of PERIAPICAL lesions in RCT teeth was very high. The findings showed that the quality of density and length of filling has a significant effect on prevelance of preapical lesions. Poor RCT leads to low success rate in the treatment of teeth.

Introduction: Foraminal Enlargement (FE) is a cleaning performed in the apical-most region of the tooth, in order to optimize root disinfection. This systematic review evaluated the influence of FE during root canal treatment on bacterial reduction and repair of the PERIAPICAL lesion. Materials and Methods: Searches in PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, Embase, Scielo, Lilacs and OpenGrey were performed until January-2024. Ex vivo and in vivo studies evaluating the effects of FE in the bacterial reduction and repair of the PERIAPICAL lesion were included, respectively, followed by risk of bias assessment (modified version of Joanna Briggs Institute’s for ex vivo studies and Systematic Review Centre for Laboratory animal Experimentation’s risk of bias tools for in vivo studies). The meta-analysis was not feasible and a qualitative summary for each outcome was provided. Results: Of 950 studies, 2 in vivo studies were eligible, using animal models with infected teeth. Of these two, PERIAPICAL repair was evaluated with hematoxylin-eosin stain, and FE improved PERIAPICAL healing. Regarding ex vivo studies, 3 were eligible, using extracted human teeth. The inoculations in ex vivo models were performed with Enterococcus (E. ) faecalis, and FE reduced E. faecalis in the ex vivo models. Conclusions: Foraminal enlargement seems to increase bacterial reduction within the root canal, and provide major PERIAPICAL tissue repair on the histological analysis in animal studies. However, caution is necessary when translating these results to the clinical environment.