PMC5738583_01
Preoperative radiographic examination: CBCT panoramic reconstruction, showing low-density image extending from the distal root of 36 (a), englobing the radicular part of 37 and the crown of 38 at baseline; axial cut showing extension of the lesion in buccolingual view, with thinning of the buccal cortical without interruption and displacement of 37 in the lingual direction; cross-sectional view at the level of 37 (b), showing clearly the displacement in lingual direction (c).
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Radiographically, it extended from the distal part of 36, englobing the root of 37 and the crown of 38, invading the body of the mandible within the limits of the buccal and lingual cortices without perforation, and extending apically close to the inferior alveolar canal (Figure 1).
Bone lid was prepared using the piezoelectric device, bone lid was freed using an angulated bone chisel, lesion was removed, and bone lid was replaced in situ.
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The beveled bony lid was freed with an angulated bone chisel using a gentle luxation with progressive movements in order to avoid any possible fracture (Figure 2). Digital pressure was used trying to move the lid in all directions, thus ensuring its proper repositioning in its original place and optimizing its stability (Figure 2).
8-month radiographic examination: CBCT panoramic reconstruction, showing partial healing of the lesion and normal eruption of 37 (a); axial cut showing partial healing of the lesion and almost normal position of 37 (b); cross-sectional view at the level of 37 showing partial healing of the lesion (c).
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It revealed an almost complete radiographic bone healing at the previously diseased site (Figure 3).