Rapidly Progressing Radicular Cyst in an Endodontically Treated Tooth: Diagnostic Challenges, Advanced Imaging, and...

Area of Science:

• Dentistry
• Endodontics
• Oral Pathology

Background:

• Radicular cysts following root canal therapy (RCT) are uncommon but pose diagnostic challenges.
• Rapid progression can lead to symptoms shortly after endodontic treatment.
• Conventional radiography may fail to detect small periapical lesions.

Purpose of the Study:

• To report a case of a radicular cyst after RCT.
• To highlight the diagnostic utility of CBCT in such cases.
• To demonstrate the effectiveness of surgical management and long-term tooth retention.

Main Methods:

• Case presentation of a 29-year-old female with post-RCT discomfort.
• Clinical examination and conventional radiography.
• Diagnosis confirmed by Cone-Beam CT (CBCT).
• Surgical intervention: cystectomy and root-end filling with calcium-enriched mixture cement.
• Histopathological analysis for diagnosis confirmation.

Main Results:

• CBCT identified a periapical cystic lesion not visible on conventional radiographs.
• Histopathology confirmed a benign radicular cyst.
• Surgical treatment resulted in smooth postoperative recovery.
• One-year follow-up showed normal periodontal ligament appearance and tooth retention.

Conclusions:

• CBCT is crucial for detecting subtle periapical lesions after RCT.
• Surgical management (cystectomy and root-end filling) is effective for resolving radicular cysts.
• Successful treatment ensures long-term tooth function and retention.