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Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition. [ABSTRACT FROM AUTHOR]

Actinomycosis is sometimes associated with a radicular cyst (RC). This retrospective study evaluated the clinical and histopathological features of 6 RCs with actinomycosis (AM/RCs). The demographic data and clinicopathological features of 6 AM/RCs were collected and analyzed. The 6 AM/RCs were taken from 2 male and 4 female patients, and 3 were found in the maxilla and the other 3 in the mandible. The involved teeth included maxillary or mandibular incisors (2 cases) and maxillary or mandibular first and second molars (4 cases). The most common symptom was pain (5 cases) and the more frequent signs were sinus tract and pus discharge (4 cases). Microscopically, the actinomycotic colony presented as a mass with filamentous bacteria arranging in a sun-ray pattern at the periphery. The mean actinomycotic colony number was 7.7 ± 6.6 colonies per slide. Due to the severe inflammation in all 6 AM/RCs, the stratified squamous epithelial lining was completely abolished in 2 cases and partially destroyed in 4 cases with the residual epithelial lining varying from approximately 10%–50%. Our results indicate that pain is the most common symptom and sinus tract and pus discharge are the two frequent signs of our 6 AM/RCs. The stratified squamous epithelial lining was either completely abolished (2 cases) or partially destroyed (4 cases) in 6 AM/RCs. Thus, if the endodontically-treated tooth shows a recurrent sinus tract and poor response to repeated conventional root canal treatments, periradicular actinomycotic infection should be highly suspected. [ABSTRACT FROM AUTHOR]