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National Journal of Maxillofacial Surgery
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Year : 2022  |  Volume : 13  |  Issue : 2  |  Page : 294-297

Langerhans cell histiocytosis simulating endodontic periapical lesion: Are we prepared to diagnose and manage it? A case report

1 Stomatology and Oral and Maxilofacial Surgery Center, Hospital Heliópolis, São Paulo, SP, Brazil
2 Graduate Dentistry Program, Ibirapuera University, São Paulo, SP, Brazil
3 Graduate Program in Implantology, University of Santo Amaro, School of Dentistry, São Paulo, SP, Brazil

Correspondence Address:
Prof. Luiz Felipe Palma
Ibirapuera University, Av. Interlagos, 1329 - Chácara Flora, São Paulo, SP, 04661-100
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njms.njms_19_22

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Many aggressive non-endodontic radiolucent lesions show very similar clinical and radiographical features to periapical lesions of endodontic origin. Since the treatments of endodontic and non-endodontic lesions differ markedly, a precise diagnosis is imperative. Thus, the present study aimed at presenting a clinical case on the diagnosis and management of a Langerhans cell histiocytosis (LCH) lesion mimicking a periapical lesion of endodontic origin. A 51-year-old male patient was referred to a private dental office due to slight pain from the region of tooth 36. Although no sign of prosthetic or endodontic failure was noted, radiographical examination revealed a radiolucent image with poorly defined borders associated with the periapical region of the tooth. Apicoectomy and bone curettage were then performed and, given the clinical and laboratory features, the definitive diagnosis of solitary eosinophilic granuloma was made. The surgical treatment was sufficient for the remission of the symptoms, and recurrence was not observed. Given the current case, dentists should be aware of LCH lesions as they may mimic endodontic periapical pathoses, leading to misdiagnosis and therapeutic complications. Moreover, alveolar bone lesions may be the first or only sign of LCH in many cases.

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