Periapical Bone Healing of a Large Radicular Cyst Following Surgical Endodontic Treatment Without Regenerative...

This case report highlights the conservative management of a large peri-apical lesion involving multiple teeth of the maxilla where the lesion eroded the maxilla's palatal, buccal, and nasal plates with a mobile central incisor. Affected teeth were splinted and treated with root canal treatment, followed by a surgical approach to remove the cystic lining and retrograde filling with MTA. No regenerative graft or scaffold was placed on the bony defect, and the patient was followed regularly. Over two and a half years, the cystic lesion showed positive signs of healing with new bone formation, thereby reducing the cystic space; the teeth were asymptomatic, and the mobile incisor became stable. The lesion volume decreased 77% from 2.951 to 0.682 cm³. This shows that in young patients with economic constraints and in facilities with very limited feasibility for regenerative techniques, proper non-surgical endodontic treatment followed by enucleation of the cyst with periodic review calls can aid in saving teeth with a compromised prognosis.