{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:44:03Z","timestamp":1784371443427,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Large periapical cyst-like lesions pose challenges for nonsurgical management. This study evaluated the clinical and radiological outcomes of conventional endodontic therapy alone versus endodontic therapy with decompression in treating such lesions. Methods: Ten patients with CBCT-confirmed periapical lesions &gt;5 mm were randomly assigned to two groups. Group 1 received standard root canal treatment with calcium hydroxide; Group 2 received the same protocol plus decompression. Lesion dimensions were measured in three planes using CBCT at baseline, 12 months, and 24 months. Results: Both groups showed significant lesion size reduction over time. At 12 months, Group 2 had a significantly greater mean reduction (8.49 \u00b1 5.09 mm) compared to Group 1 (4.36 \u00b1 1.46 mm) (p = 0.008). At 24 months, both groups had comparable outcomes (Group 1: 1.12 \u00b1 0.98 mm; Group 2: 2.41 \u00b1 5.15 mm; p = 0.356), with most lesions nearly or fully resolved. Histopathology confirmed radicular cysts in decompressed cases. Conclusions: Conservative endodontic therapy is effective for large periapical lesions. Adjunctive decompression accelerates early healing, particularly in extensive cases, potentially reducing the need for surgical intervention. CBCT is valuable for monitoring healing.<\/jats:p>","DOI":"10.3390\/jcm14176127","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:42:21Z","timestamp":1756485741000},"page":"6127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nonsurgical Endodontics and Decompression-Based Management of Extensive Periapical Cystic-Like Lesions: A Comparative and Radiological Study with A Two-Year Follow-Up"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0959-7918","authenticated-orcid":false,"given":"Roxana","family":"Talpo\u0219-Niculescu","sequence":"first","affiliation":[{"name":"Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4837-2693","authenticated-orcid":false,"given":"Ioana","family":"Veja","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, Faculty of Dentistry, \u201cVasile Goldi\u0219\u201d, Western University of Arad, Str. Liviu Rebreanu 86, 310045 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-1854","authenticated-orcid":false,"given":"Carina Sonia","family":"Neagu","sequence":"additional","affiliation":[{"name":"Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6375-4705","authenticated-orcid":false,"given":"Laura Cristina","family":"Rusu","sequence":"additional","affiliation":[{"name":"Discipline of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0218erban","family":"Talpo\u0219-Niculescu","sequence":"additional","affiliation":[{"name":"Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300062 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-3161","authenticated-orcid":false,"given":"M\u0103lina","family":"Popa","sequence":"additional","affiliation":[{"name":"Discipline of Pedodontics, Pediatric Dentistry Research Center, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-2397","authenticated-orcid":false,"given":"Lumini\u021ba Maria","family":"Nica","sequence":"additional","affiliation":[{"name":"Discipline of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/j.joen.2008.07.028","article-title":"Clinical implications and microbiology of bacterial persistence after treatment procedures","volume":"34","author":"Siqueira","year":"2008","journal-title":"J. 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