title: Calculus-like deposit at apex of tooth with refractory apical periodontitis.
abstract: It is generally accepted that bacteria in or outside the root canal are the reason for apical periodontitis and endodontic failures. This case report presents a 60-year-old woman with a periapical lesion and a fistulous tract which did not respond to conventional root canal treatment. During periapical surgery, granulomatous tissue was removed and a calculus-like deposit was observed on the root surface. A radicular cyst was diagnosed. Nine months after this calculus-like deposit had been removed and the cyst enucleated, complete recovery of the bone had occurred. It is suggested that the presence of the calculus-like deposit at the apex of the tooth or its effects may in part have delayed the healing of the periapical inflammation in spite of apparently adequate endodontic treatment.
authors.affiliation: Dental Department, National Cheng Kung University Hospital, Taiwan, ROC.
authors.forename: W M
authors.initials: WM
authors.lastname: Harn
authors.forename: Y H
authors.initials: YH
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Yuan
authors.forename: C H
authors.initials: CH
authors.lastname: Chung
authors.forename: P H
authors.initials: PH
authors.lastname: Huang
mesh_terms: D002908:Chronic Disease; D003728:Dental Calculus / Q000150:complications / Q000382:microbiology / Q000601:surgery; D003751:Dental Fistula / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000150:complications* / Q000601:surgery / Q000628:therapy; D011842:Radicular Cyst / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D019233:Retreatment; D012390:Root Canal Therapy; D019227:Tooth Apex; D017211:Treatment Failure