MACHADO, Manoel Eduardo de Lima et al. Análise de diagnósticos radiográficos periapicais sugestivos de lesões refratáriasAnalysis of periapical radiographic diagnosis that suggest persistent lesion. Rev. Assoc. Paul. Cir. Dent. []. 2016, 70, 2, pp. 141-146. ISSN 0004-5276.

Periapical fibrous scars may have similar radiographic appearance of periapical lesions that can result in incorrect diagnosis. The aim of this study was a confrontation between the radiographic and histopathologic diagnosis of teeth that were endodontically treated and presented "persistent periapical lesions" detected radiographically after 18 months of treatment. Ten patients undergoing adequate endodontic treatment and presenting persistent radiolucent image at 18 months post-treatment, had surgery Paraendodontic indicated. During surgery, the tissue around the apex was removed and immersed in 10% formalin solution for histological processing by HE staining. The apex oh the tooth was removed and immersed in 2% glutaraldehyde for scanning electron microscopy processing. Among the 10 radiographically suggestive cases of persistent periapical lesion, only 1 case was confirmed diagnosis of cyst, 1 case of granuloma, and the other 8 cases were fibrous scar. In neither case was observed the presence of bacteria, only inflammatory infiltrate and the presence of defense cells such as lymphocytes and neutrophils, red blood cells, connective tissue and collagen. It can be concluded that the conventional radiography is not conclusive point in the diagnosis of periapical lesions.

: diagnosis; cicatrix; radiography..