Management of large radicular cyst by conservative surgical approach: a case report

Abstract

Radicular cysts are the most common cystic lesions which affect the jaw. They are most common among all the jaw cysts and comprise about 52% to 68% of the entire cysts which affect the human jaw. They are generally symptomless and are diagnosed during routine radiologic investigations. The treatment of radicular cysts includes conventional nonsurgical root canal therapy when lesion is localized or surgical treatment like enucleation, marsupialization or decompression when lesion is large. This case report presents the successful surgical management of a large infected radicular cyst which was associated with maxillary central incisor with open apex.

Keywords: Enucleation; Infected radicular cyst; MTA.

[Table/Fig-1]:

Intraoral picture showing extent of lesion

[Table/Fig-2]:

(a) and (b) IOPA xray, (c) True Occlusal radiograph and (d) OPG showing large unilocular radiolucency involving 21, 11, 12 and 13

[Table/Fig-3]:

CT scan images of the lesion (a) showing 21 involvement with lesion in saggital plane (c and d) in transverse plane (b) 3D reconstruction of the images

[Table/Fig-4]:

Surgical pictures (a) full thickness flap eleveated (b) after surgical enucleation of the Cyst (c) enucleated tissue (d) placement of MTA after apicoectomy and (e) after placement of 3-0 Silk sutures

[Table/Fig-5]:

Histopathological picture showing the cystic cavity was lined by non-keratinized stratified squamous epithelium with mixed inflammatory infiltration present(a) at 10x and (b) 40 X magnification

[Table/Fig-6]:

Followup radiographs showing appreciable healing of the lesion (a and b) IOPA’s (c) OPG after 1 year of follow-up