SURGICAL MANAGEMENT OF APICAL CYSTIC LESION BY ENUCLEATION AND PARENDODONTIC SURGERY: CASE REPORT
DOI:
https://doi.org/10.66104/yemcfc14Keywords:
Odontogenic cyst; Parendodontic surgery; Periapical lesion; Apicoectomy.Abstract
Introduction: Periapical cystic lesions of inflammatory origin represent one of the most prevalent pathological conditions in the oral cavity, frequently associated with unresolved endodontic infectious processes. When they reach large proportions, these lesions pose significant diagnostic and therapeutic challenges, requiring a careful surgical approach for their complete resolution. Early diagnosis, based on the correlation between clinical, imaging, and histopathological findings, is crucial for adequate treatment planning and a favorable prognosis. Objective: To report a clinical case of surgical enucleation of a large inflammatory periapical cyst associated with parendodontic surgery, describing the diagnosis, surgical planning, procedural steps, and postoperative follow-up. Case report: A 42-year-old male patient presented to the clinic complaining of a slight swelling in the anterior region of the maxilla associated with tooth 21, which had been previously endodontically treated. Following clinical, radiographic, and tomographic evaluation, a diagnosis of inflammatory periapical cyst was established and confirmed by histopathological examination. Treatment consisted of complete enucleation of the lesion, apicoectomy with retrograde filling using MTA, re-filling of the root canal, filling of the bone defect with bovine bone graft, and coverage with an absorbable collagen membrane. The patient is under postoperative follow-up, with satisfactory clinical evolution, absence of symptoms, and adequate healing. Conclusion: The association between surgical enucleation, parendodontic surgery, and guided bone regeneration proved to be an effective approach for the management of extensive apical cystic lesions, enabling the preservation of the dental element and satisfactory tissue repair, reinforcing the relevance of the integration between endodontics and surgery for the treatment of complex periapical lesions.
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Copyright (c) 2026 Giuseppe Mazzaglia, Maria Nayara Quaresma Bezerra, Leonardo Gomes Mendes, Emerson Eduardo Toldo, Cíntia Moreira Gonçalves, Vitor Rodrigues da Silva, Leonardo Rinaldi, Ricardo Henrique dos Santos Cabral, Emanuel Enzo Rodrigues Azevedo, Júlio César de Souza Araújo, Wesley Francisco Ferreira da Silva, João Paulo Machado Macias, Yuri Pablo dos Santos Andrade, Maria Eduarda da Conceição Silva, Adria Myllene Pinto de Barros
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