Department of Specialized Endodontics, Faculty of Medical Sciences, School of Dentistry, University of El Salvador, Buenos Aires, Argentina.
Department of Reconstructive Sciences, University of Connecticut, School of Dental Medicine, Farmington, Connecticut.
J Endod. 2022 Mar;48(3):375-378. doi: 10.1016/j.joen.2021.12.005. Epub 2021 Dec 21.
Postendodontic periapical fibrous scars (PFScs) comprise a type of radiolucent healing that is frequently misinterpreted as a pathological lesion. A combined clinical, radiologic, and histologic correlation is essential for a reliable diagnosis. This report presents a case of a patient with a long-term persistent asymptomatic postendodontic radiolucency that was misdiagnosed as endodontic failure and referred for endodontic retreatment and periapical surgery. To reach a definitive diagnosis, a core bone biopsy needle (CBBn) technique was performed on the area of the radiolucency. The material obtained was processed for histologic analysis and the lesion was determined to be a PFSc. In conclusion, the use of a CBBn before any invasive treatment allowed the clinician to distinguish between PFSc and other persisting pathosis, such as periapical granuloma or cystic lesions.
牙后根尖纤维性瘢痕（PFScs）是一种常见的影像学表现，易被误诊为病理性病变。为了获得可靠的诊断，必须进行临床、影像学和组织学的综合分析。本报告介绍了一例长期无症状的牙后根尖放射透光区的患者，该患者被误诊为根管治疗失败，并被转诊进行根管再治疗和根尖手术。为了明确诊断，在放射透光区进行了核心骨活检针（CBBn）技术。对获得的组织进行了组织学分析，确定病变为 PFSc。总之，在任何侵袭性治疗之前使用 CBBn 可以让临床医生区分 PFSc 和其他持续存在的病变，如根尖肉芽肿或囊性病变。
