Management of large radicular cyst associated with amalgam particles in cystic lining

The failure of amalgam retrofilling and presence of an associated cystic lesion makes surgical endodontic intervention inevitable. Amalgam retrofilling can also give rise to mucoperiosteal tattoo formation and allow incorporation of amalgam particles in the cystic lining. Such a finding has not yet been reported in the endodontic literature. This case report describes the successful endodontic management of a large radicular cyst associated with failed amalgam retrofilling, mucoperiosteal tattoo and amalgam particles dispersed in the epithelial cystic lining. All four mandibular incisors associated with the lesion presented with Weine Type II canal anatomy. The follow-up revealed clinical and radiographic signs of healing.