J Korean Assoc Oral Maxillofac Surg.  2016 Aug;42(4):205-208. 10.5125/jkaoms.2016.42.4.205.

The treatment of actinomycosis mimicking a retained root tip: a confusing case

• Cho JY

• KMID: 2350072
• DOI: http://doi.org/10.5125/jkaoms.2016.42.4.205

Abstract

Actinomycosis is an infection caused by the actinomyces genus and is associated with trauma or previous infection. A 58-year-old male patient was referred from a private dental clinic for root extraction of the lower right molar. The x-ray showed fractured root-like material distal to the distal root of the lower right second molar. A biopsy during extraction of the root-like material was performed, which revealed a sequestrum with actinomycosis by a pathological examination. In this case, the radiopacity of the suspicious lesion was higher than that of the surrounding alveolar bone, which confused it with the root tip. The diagnosis of actinomycosis required long-term antimicrobial therapy, which is very different from simple extraction or removal of sequestrum.

Keyword

Actinomycosis; Tooth root; Antimicrobial; Therapy

MeSH Terms

Actinomyces
Actinomycosis*
Biopsy
Dental Clinics
Diagnosis
Humans
Male
Meristem*
Middle Aged
Molar
Tooth Root

Figure

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  Fig. 1 Initial appearance of the lesion mimicking a retained root tip (arrow).

• 

  Fig. 2 Initial dental X-ray (arrow, lesion with root-like radiopacity).

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  Fig. 3 Initial panoramic view (arrow, lesion, confused with a retained root tip after extraction).

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  Fig. 4 Histopathological result of the biopsy (arrow, sulfur granule; H&E staining, ×400).

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  Fig. 5 A. One month after the operation. B. Five months after the operation. C. Five months after the operation (arrow, healed alveolar crest). D. Ten months after the operation.

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