Non-surgical Management of a Large Endodontic Lesion Using Diode Laser-Assisted Decompression and Photobiomodulation...

Introduction: Endodontic periapical (PA) lesions are common sequelae of pulpal infections and often require root canal therapy (RCT) for resolution. Large lesions near vital anatomical structures are more important. A minimally invasive approach involving both diode laser-assisted disinfection and photobiomodulation therapy (PBMT) might be more suitable as both are less invasive while suppressing deep infection and promoting tissue healing. Case Report: A 58-year-old female patient presented with a mandibular radicular cyst that extended from teeth #25 to #28 with a complicated buccal cortical perforation and proximity to the mental foramen. Treatment consisted of multi-visit root canal therapy with diode laser disinfection in the canals (980 nm, 200-µm fiber, 1 W, 1 second. for every 2 mm canal length, 4 passes) and PBMT (0.5 W, 30 seconds per point, 6 points; 7 sessions over 4 weeks) for the canals. Conclusion: This case demonstrates that a large PA lesion was resolved through a distinctive diode‑laser and PBMT, achieving significant healing in 10 months.