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Aim. The aim of study was to assess the root-filled teeth with periapical lesions by using Periapical and Endodontic Status Scale (PEES) index. Materials and method. The study group included 166 filled root canals (70 molars and premolars) in 42 patients (gender: 12 males, 32 females; mean age 35.90 ± 10.571 yrs.) treated in Clinical Base of Faculty of Dental Medicine, U.M.F. “Grigore T.Popa” Iasi. The evaluation of root canals and periapical areas was performed by using the two components of Periapical and Endodontic Status Scale (PEES) index, COPI and ETTI. Results. Distribution of COPI components in the study group was as follows: COPI D: 30,7% D1, 69,3% D3; COPI R: 27,1% R1, 70,5% R2, 2,4% R3; COPI S: S1 16,3%, S2 21,7%, S3 62%. Distribution of ETTI components in the study group was as follows: ETTI L: 42,2% L1, 43,4% L2, 5,4% L3, 5,4% L4, 3,6% L5; ETTI H: 36,7% H1, 63,3% H2; ETTI CS: 10,8% CS1, 89,2% CS2; ETTI CF: 3,6% CF1, 9% CF2, 5,4% CF3, 81,9% CF5. Conclusions. In endodontically treated teeth with apical periodontitis, PEES indices allowed to detect 62% of root canals with periapical lesions with diameter over 5 mm, while more than two thirds of teeth roots had periapical lesions extended in cortical bone (69,3%) affecting more than one root (70,2%). All teeth roots with apical radiolucency and non-treated root canals as well as roots with perforations or resorptions had apical lesions with diameter over 5 mm extended in cortical bone. The presence of apical radiolucency more than one root was associated to overfilling or root resorption.

Objectives: The aim of this study was to evaluate the variation in the size of periapical lesions in patients with ENT cancer before and after radiotherapy by using the imaging examination represented by CT. Materials and methods: our study included 35 cancer patients-34 men and one female, with ENT cancer, under treatment at the Regional Institute of Oncology, Iasi. They were examinated by four endodontist, two radiologists and an ENT doctor. We measured the size of the periapical lesions before and after radiotherapy. Results: We found the change in the dimensions of periapical lesions: their maximum overall size was initially 5.4591 ± 3.88509 mm; after radiotherapy the global maximum size reached 7.0000 ± 3.37510, reaching 14.00 mm. The observed difference was statistically significant, so it could be stated that radiotherapy accentuates the severity of periapical lesions systematically. Before radiotherapy, the most extensive periapical lesions were observed in the case of laryngeal neoplasm ( with an average of 6.6778 ± 4.17246 mm) and nasopharyngeal neoplasm ( with an average of 6.000 ± 2.82843 mm) and the lowest ones were found in the case of the neoplasm of the oropharynx (with an average of 4.0000 ± 3.74166 mm). After radiotherapy, we found an increase in the size of the periapical lesions in the case of all five types of neoplasm investigated. The most extensive lesions were observed in the case of the neoplasm of the oropharynx, with an average of 7.6000 ± 3.84708 mm, followed by the neoplasm of the larynx, with an average of 7.4000 ± 3.33999 and the neoplasm of the oral cavity, with an average of 7.4000 ± 4.33590 mm. Disscusions: In terms of expectancy and quality of life of patients can only be achieved through a multidisciplinary approach. As soon as the dentist diagnoses a pontetially malignant disorder in the ENT sphere, patients should undergo an ENT screening complete for detecting lesions in any area of the upper aerodigestive tract. After radiotherapy an increase in the size of the periapical lesions is observed. The ENT doctor must encourage the patients with ENT cancer to extract their teeth with periapical lesions before the implementation of radiotherapy to avoid the risk of postradiotherapy osteoradionecrosis. Conclusions: By using CT, the increase in the size of periapical lesions after radiotherapy is observed in patients with cancer in the ENT sphere.

The aim of this study is to investigate the possibilities of diagnosis and post-treatment monitoring of chronic periapical lesions. Materials and method. Five cases of chronic periapical lesions in various stages of evolution located in the posterior dental group, were exposed and described. Patients were included in the treatment within the Clinical Education Base “M. Kogălniceanu” of the Faculty of Dentistry, U.M.F. “Grigore T.Popa” Iaşi. All patients were treated using mechanical and chemical treatment followed by application of Ca (OH) 2 paste for a period of 14 days. Root closure was performed by cold lateral condensation associated with Endoflas sealant (Sanlor, Columbia). Coronary restorations were performed with Ketac Molar glassionomer cement (3M / ESPE) and Filtek250 composite resin (3M / ESPE). CBCT images (pretreatment, 3 months posttreatment) were obtained using PaX-Uni3D (TVAPANO04, VATECH) and the dimensions of periapical lesions in coronal-apical, mesial-distal and buccal-oral sections were measured using the Ez3D 2009 Plus software application. CBCT parameters were set for 20 second exposure time, 85 kV, 5mA. The mean values ​​of the CBCT-PAI index pre-treatment and at 3 months post-treatment were recorded. Results. All investigated cases showed a reduction in CBCT-PAI indices at 3 months post-treatment following the healing processes of periapical pathology. Conclusion. CBCT examination and CBCT-PAI index are precise, reliable and reproducible tools in the evaluation of the post-treatment evolution of the chronic periapical lesions.

The aim of this paper is to compare the detection rate of chronic periapical lesions using radiographic exam and CBCT. Materials and methodsThe study group included 12 patients with 30 teeth with root canal fillings (aged at least 24 months). An assessment of the periapical status was performed using radiographic exam (ortopantomograph) and CBCT. The recorded data were compared to determine periapical lesions detection accuracy related to dental group, the type and extension of periapical lesions. ResultsThe detection rate of incipient periapical lesions for teeth with old root canal fillings is higher for CBCT (17%) compared with radiographic exam (10%). In the case of the extended periapical lesions, the detection rate is similar for radiography and CBCT (44%). ConclusionCBCT can be recommended in clinical situations of teeth treated endodonticallyor pulp necrotic untreated teeth associated with mild periapical symptoms and the failure of radiographic exam to detect the presence of periapical lesion.