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Sérgio André Quaresma1, Rui Pereira da Costa2,1, Beatriz Batalha1

  • 1Department of Endodontics, School of Dentistry of Lisbon, Universidade de Lisboa, Lisboa, Portugal.

Brazilian Dental Journal
|March 9, 2022
PubMed
Summary

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A challenging endodontic case involving a periapical cyst in a mandibular molar required a surgical approach after conventional retreatment failed. Surgical intervention successfully reduced exudate and led to lesion resolution, demonstrating an alternative treatment strategy.

Area of Science:

  • Dentistry
  • Endodontics
  • Oral Surgery

Background:

  • Periapical cysts and abscesses pose complex endodontic challenges.
  • Conventional endodontic retreatment may not always resolve persistent infections and exudate.

Observation:

  • An 18-year-old female presented with a previously treated mandibular molar exhibiting a large periapical abscess and cystic lesion.
  • Persistent purulent exudate during chemo-mechanical preparation prevented canal obturation, necessitating an alternative approach.

Findings:

  • A surgical approach, including a decompression technique, was employed to manage the persistent exudate.
  • Cone-beam computed tomography (CBCT) and periapical radiographs at one-year follow-up showed near-complete resolution of the periapical radiolucency.

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Implications:

  • Surgical intervention can be a viable option for complex endodontic cases refractory to conventional treatment.
  • This case highlights the importance of considering surgical approaches for persistent periapical lesions and exudate.
  • CBCT imaging is valuable for diagnosing and monitoring the resolution of periapical lesions.