Endodontic retreatment of teeth with cystic lesions and root perforation: clinical case report

Abstract

Introduction: The main cause of endodontic treatment failure may be related to lapses in technique such as microorganisms left within theroot canal and iatrogenesis.These problems may be resolved through retreatment and, if necessary, parendodontic surgery. Objective: We describe endodontic retreatment followed by parendodontic surgery in a patient with periapical lesions in the roots of teeth 21 and 22, and follow-up exams over 5 years and 5 months. Case report: Tooth 21 presented a vestibular fistula and purulent secretions during biomechanical preparation. Whereas tooth 22 had a perforation in the cervical third that extended to the region of the periodontal ligament in the middle third. Discussion: After application of intracanal medication for 2 months, the teeth were obturated, the lesion removed and the perforation filled with mineral trioxide aggregate (MTA). After histopathological examination, the lesion tissue was diagnosed as a periapical cyst. Conclusion: The proservation of the clinical case showed that with the persistence of a fistula and a periapical cystic lesion, surgical retreatment was the most efficient option for eliminating infection and repairing periapical tissues.