Endodontic treatment of a tooth with a periapical lesion suggesting a periapical cyst - Control and 6 months

Abstract

A 43-year-old female patient, classified as ASA I, was referred to the private practice of an endodontist. Clinical examination revealed pain on vertical and horizontal percussion and a negative response to the cold pulp sensitivity test performed with Endofrost -50°C refrigerant gas (Roeko, Langenau, Germany). After radiography, extensive periapical bone rarefaction was observed, suggesting a periapical cyst in tooth 22. After coronal opening, drainage was performed via the root canal. The canal was prepared with Logic rotary instruments (40.01 and 40.05). Since a periapical cyst was suspected, foraminal debridement was performed with a 45.01 instrument, three millimeters beyond the foramen, facilitating drainage of the fluid accumulated in the periapical region. Intracanal medicament was performed with Ultracal for 15 days and, as drainage persisted, it was renewed with calcium hydroxide paste associated with iodoform for 30 days. Root canal obturation was performed using the single cone technique associated with the bioceramic endodontic cement Bio-C Sealer. Control was performed 6 months after the completion of therapy. It is concluded that conventional endodontic treatment performed within technical standards is sufficient to determine the success of the therapy, allowing periapical bone neoformation with medullary bone formation.