PMC8629659_01
A diffuse, fluctuant, and tender swelling in the right cheek.
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fig1
(a) Intraoral radiograph showed radiolucency in relation to the apex of the upper right second premolar. (b) CBCT radiograph showed a radiolucent image related to the apical part of #15 with bone resorption, discontinuity of the buccal and maxillary sinus cortical.
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Intraoral radiographs showed radiolucency in relation to the apex of the upper right second premolar (#15) treated endodontically (Figure 2(a)).
(a) MRI images revealed a subcutaneous high STIR signal fat stranding in both cheeks due to previous filler injection with adjacent mild oedema denoting a reactive inflammatory one. (b) Axial cuts displayed high signal intensity and an expansible lesion in the left cheek, with a buccal bone discontinuity.
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fig3
No signs of osteomyelitis were noticed (Figure 3(a)). The same high signal was observed in the right cheek (Figure 3(b)).
Surgical extraction of tooth 15 with closure of the site to avoid oro-antral communication.
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Treatment plan was proposed as surgical extraction of #15 with closure of the site to avoid an oro-antral communication, as well as a root canal treatment of #14 (Figure 4).
Healing after 15 days.
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Complete healing two months later.
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