(TC03) Endodontic Lesions: Distinguishing Granulomas, Cysts, and Abscesses for Optimal Treatment Strategies

Abstract: Within the field of endodontics, differentiating periapical lesions such as apical granulomas, cysts, and abscesses is crucial for tailoring effective and targeted treatment approaches. These lesions often originate from dental infections, each requiring a unique therapeutic strategy. Granulomas represent organized inflammatory nodules that develop in response to chronic infection, while cysts manifest as epithelial-lined sacs filled with fluid or keratin. Abscesses, in contrast, result from acute infection and present as collections of pus within the periapical region. The purpose of this table clinic is to diagnose a periapical radiolucency (PARL) associated with teeth #9 and #10 in a healthy 78-year-old female patient. Infection and necrosis of the pulp often lead to apical periodontitis, seen as apical granulomas or radicular cysts. In most cases, apical periodontitis is initially treated with orthograde endodontic treatment, but if a lesion develops into a cyst, then endodontic therapy alone is not sufficient, and endodontic surgery is required. The ability to differentiate these lesions not only improves the overall success rate of endodontic therapies but also enhances patient satisfaction, ensuring long-term oral health and wellbeing.