PMC3674742_01
Preoperative photo showing presence of sinus tract with respect to 12 and 13.
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fig1
The clinical examination revealed intraoral swelling in palatal region accompanied with salty discharge with respect to teeth 11, 12, and 21, and a sinus opening with respect to the apex on buccal aspect of 12 and 13 (Figures 1 and 2).
Pre-operative photo showing swelling of the palatal soft tissue.
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fig2
The clinical examination revealed intraoral swelling in palatal region accompanied with salty discharge with respect to teeth 11, 12, and 21, and a sinus opening with respect to the apex on buccal aspect of 12 and 13 (Figures 1 and 2).
Pre-operative IOPA radiograph showing well-defined large periapical lesion.
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fig3
The IOPA radiographic examination revealed a large radiolucent lesion with a well-defined border in the periapical area of teeth 11, 12, and 21 suggestive of periapical cyst (Figure 3).
Pre-operative CBCT image in coronal plane showing presence of a large periapical lesion.
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fig4
CBCT examination revealed presence of periapical radiolucency with respect to 11, 12, 13, and 21 in sagittal, coronal, and axial planes and reconstructed three-dimensional image (Figures 4, 5, 6, and 7).
Pre-operative CBCT image in sagittal plane.
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fig5
CBCT examination revealed presence of periapical radiolucency with respect to 11, 12, 13, and 21 in sagittal, coronal, and axial planes and reconstructed three-dimensional image (Figures 4, 5, 6, and 7).
Pre-operative CBCT image in axial plane showing disruption of buccal and palatal cortex.
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fig6
CBCT examination revealed presence of periapical radiolucency with respect to 11, 12, 13, and 21 in sagittal, coronal, and axial planes and reconstructed three-dimensional image (Figures 4, 5, 6, and 7).
Reconstructed 3D CBCT image.
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fig7
CBCT examination revealed presence of periapical radiolucency with respect to 11, 12, 13, and 21 in sagittal, coronal, and axial planes and reconstructed three-dimensional image (Figures 4, 5, 6, and 7).
PMC3674742_02
Postobturation IOPA radiograph.
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fig8
The endodontic treatment was performed as per standard procedures in both cases under rubber dam isolation (Figures 8 and 33).
Surgical incision on palatal aspect.
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fig9
This was followed by endodontic surgery (apicoectomy) (Figures 9, 10, 11, 12, 34, 35, 36, and 37), during which biopsy specimens were taken for histopathologic examination (Figures 13 and 38).
Flap reflection.
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fig10
This was followed by endodontic surgery (apicoectomy) (Figures 9, 10, 11, 12, 34, 35, 36, and 37), during which biopsy specimens were taken for histopathologic examination (Figures 13 and 38).
Flap retraction and exposure of bony defect.
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fig11
This was followed by endodontic surgery (apicoectomy) (Figures 9, 10, 11, 12, 34, 35, 36, and 37), during which biopsy specimens were taken for histopathologic examination (Figures 13 and 38).
Suturing.
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fig12
This was followed by endodontic surgery (apicoectomy) (Figures 9, 10, 11, 12, 34, 35, 36, and 37), during which biopsy specimens were taken for histopathologic examination (Figures 13 and 38).
Lesional tissue stored in formalin for histopathological examination.
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fig13
This was followed by endodontic surgery (apicoectomy) (Figures 9, 10, 11, 12, 34, 35, 36, and 37), during which biopsy specimens were taken for histopathologic examination (Figures 13 and 38).
Splinting of mobile teeth using composite.
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fig14
Splinting with composite was done in the first case of the mobile teeth for 4 weeks (Figure 14).
Tooth preparation.
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fig15
Then tooth preparation was done followed by temporisation of the involved teeth with acrylic crowns (Figures 15, 16, 39, and 40).