KMID : 1034420220470030026
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Restorative Dentistry & Endodontics 2022 Volume.47 No. 3 p.26 ~ p.26
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Persistent pain after successful endodontic treatment in a patient with Wegener¡¯s granulomatosis: a case report
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Machado Ricardo
Pereira Jorge Aleixo Vitali Filipe Colombo Bolan Michele Rivero Elena Riet Correa
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Abstract
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Wegener¡¯s granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient¡¯s systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.
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KEYWORD
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Case reports, Granulomatosis with polyangiitis, Root canal therapy, Toothache
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