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Case Reports
. 2024 Sep 17;16(9):e69586.
doi: 10.7759/cureus.69586. eCollection 2024 Sep.

Healing of a Large Periapical Lesion Using Non-Surgical Root Canal Retreatment: A Case Report

Haya Alyousef  1 , Amani A Almohaimeed  1
Affiliations
Case Reports

Healing of a Large Periapical Lesion Using Non-Surgical Root Canal Retreatment: A Case Report

Haya Alyousef et al. Cureus. .

Abstract

This case report highlights the successful healing of a large periapical lesion through non-surgical root canal retreatment. A 29-year-old male patient presented with a significant radiolucency associated with teeth #21 and #22, initially treated non-surgically. Despite the lesion's size, the treatment, which included thorough canal disinfection and obturation, led to substantial healing. A follow-up cone-beam computed tomography (CBCT) scan after one year confirmed the buccal cortical bone reformation and improvement in the incisive canal area except for the apical region of #21. Subsequently, root canal retreatment was performed for #21. Complete healing was achieved after two years, demonstrating that even extensive periapical lesions can be effectively treated with non-surgical endodontic retreatment, avoiding invasive surgical intervention.

Keywords: cone-beam computed tomography (cbct); effective disinfectant protocol; large periapical lesion; non-surgical endodontic treatment; single-visit endodontic treatment; teeth requiring non-surgical endodontic treatment.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Prince Sultan Military Medical City IRB committee issued approval PSMMC #1851793. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Periapical radiograph demonstrating large peri-apical lesion in the upper anterior region related to teeth #21 and #22.
Figure 2
Figure 2. (A) Coronal view; mesiodistal extent of the lesion. (B) Sagittal view; buccolingual extent. (C) Axial view shows resorption of buccal cortical bone and the incisive canal (D) 3D reconstruction. (Red arrows) The lesion location.
Figure 3
Figure 3. Immediate post-operative radiograph.
Figure 4
Figure 4. One-year follow-up.
Figure 5
Figure 5. (A) Coronal view, (B) sagittal view, and (C) axial view: healing of the lesion, reformation of buccal cortical bone and incisive canal, except around the apical area of tooth #21. (D) 3D reconstruction.
Figure 6
Figure 6. Two-year follow-up periapical radiograph showing complete lesion healing.
Figure 7
Figure 7. Two-year follow-up using cone-beam computed tomography: healing of the lesion.
See this image and copyright information in PMC

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