PMC10098460_01
Diagnostic radiographs and clinical features of the surgical procedure. (a) Preoperative panoramic and (b, c) periapical radiographs showing a large periradicular lesion (asterisk). (d) Bony cavity after cyst enucleation. (e) The resected root surface. (f) The root-end cavity filled with mineral trioxide aggregate
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F1
A radiographic examination revealed a large periradicular lesion in the anterior region (Fig. 1a-c). After infiltration with local anaesthesia, a full mucoperiosteal flap was reflected, and the cystic tissue was enucleated (Fig. 1d). Louis, MO, USA) (Fig. 1e). Then, the prepared root-end cavity was filled with a mineral trioxide aggregate (Endocem MTA; Maruchi, Wonju, Korea) (Fig. 1f, Fig. 2a, b).
Postoperative radiographic and histologic features. (a) Panoramic and (b) periapical radiographs after surgery. (c) Fibrous connective tissue lined by stratified squamous epithelium (40x). (d) Infiltration of chronic inflammatory cells (200x)
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F2
The excised tissue was sent to an oral pathologist and diagnosed as a radicular cyst with stratified squamous epithelium (Fig. 2c) and infiltration of chronic inflammatory cells (Fig. 2d).
Radiographic features on follow-up examinations. (a) 1-year follow-up panoramic and (b) periapical radiographs. Note the resorbed apical portion of the roots (white triangles). (c) 4.5-year follow-up panoramic and (d) periapical radiographs. Complete bony healing was verified, and the root resorption did not progress further. The periodontal ligament space was seen as a narrow radiolucency between the root and the lamina dura (yellow triangle)
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F3
Finally, the pulp of #41 was found to be sensible on a 1-year follow-up visit (Fig. 3a). Furthermore, root resorption limited to the apex of the teeth was also observed (Fig. 3b). Pulp sensibility was maintained (Fig. 3c), and root resorption did not progress (Fig. 3d).