Repair of a periapical lesion with characteristics of a periapical cyst

Abstract

This study aims to describe the repair through a clinical case of an extensive periapical lesion with a diagnosis suggestive of periapical cyst. A 33-year-old female patient was referred to a private practice for endodontic treatment of tooth 11. Clinically, the patient was asymptomatic, with a negative response to the cold pulp sensitivity test, and no pain to vertical and horizontal percussion. Periapical radiographic examination showed extensive periapical bone radiotransparency suggestive of a periapical cyst. Treatment was initiated with coronary opening, root canal exploration, and root canal preparation using the modified Oregon apex crown preparation technique, associated with 2.5% sodium hypochlorite as an irrigating solution. Calcium hydroxide paste was applied as an intracanal medication for a period of 30 days and the coronary access was sealed with glass ionomer. In the following session, after verifying the absence of clinical signs and symptoms, it was decided to fill the root canal system using the active lateral condensation technique associated with Bio-C Sealer bioceramic endodontic cement. After the 24-month preservation period, tissue repair and bone neoformation of the area were observed, as well as the absence of clinical signs. It is concluded that conservative endodontic treatment is capable of determining the success of the therapy.