Successful nonsurgical management of large periapical lesion – a case report

This article presents a case where an extensive inflammatory change in the periapical tissues was successfully treated by conservative root canal treatment. A patient was referred to a specialist endodontic clinic for apicoectomy of tooth 22. Despite the presence of extensive changes in the bone, it was chosen not to perform resection and instead to perform conservative root canal treatment to decompress the cyst through the root canal. The treatment was successful, as confirmed over an 8-year observation period. Cone beam computed tomography (CBCT) was used to diagnose the lesions and monitor the healing process. A CBCT scan performed after the treatment indicated that sealer had been introduced beyond the anatomical opening; however, this did not disturb the healing of the periapical tissue. This case is an example confirming the value of limiting the hasty use of endo-surgical or surgical treatment.