PERIAPICAL CYST IN THE ANTERIOR REGION OF THE MAXILLA: CASE REPORT

• DOI: https://doi.org/10.22533/at.ed.1595292515083

• Palavras-chave: Apicoectomy; Radicular cyst; Maxilla

• Keywords: Apicoectomy; Radicular cyst; Maxilla

• Abstract:

  The periapical cyst or root cyst, considered an inflammatory odontogenic cyst, is a lesion most commonly found in the anterior region of the maxilla. It is characterized by being single, slow-growing, and discovered on routine radiographs. This lesion does not present painful symptoms and can reach large proportions, presenting characteristics such as mobility, swelling, and sensitivity. Objective: The objective of this study was to report a clinical case of periapical cyst, highlighting the diagnosis, endodontic therapy, and proposed surgical treatment. Case report: A 55-year-old female patient, ASA I, attended the clinic for endodontic evaluation of teeth 14, 13, 12, and 11 due to pressure in that area over the previous months, although she reported no pain. Periapical radiographic examinations and cone beam computed tomography revealed an extensive radiolucent, unilocular lesion with precise boundaries, mainly covering the palatal and apical regions of teeth 11, 12, 13, and 14, originating from the apical region of tooth 12. After completion of the retreatment (11 and 12) and endodontic treatment (13 and 14), the patient was referred to hospital care. The hospital physical examination revealed extensive swelling of the palatal mucosa in the region from tooth 22 to tooth 16, with the mucosa appearing pink and of normal texture. However, on palpation, the lesion was found to be fluctuant, suggesting liquid content with . Based on the clinical and radiographic findings, the surgeon made a clinical diagnosis of odontogenic cyst of  
  inflammatory/infectious. Cystic enucleation and surgical resection and apicoectomies were performed on elements 11, 12, and 13. The final histopathological diagnosis was Radicular Cyst. After 12, 15, and 30 days of the surgical procedure, the patient returned and showed favorable progress, reported no pain, and the healing pattern was satisfactory. Conclusion: Inflammatory radicular cysts are a common odontogenic lesion in the anterior region of the maxilla and can cause significant bone expansion, even in asymptomatic patients. This case highlights its occurrence in a 55-year-old female patient with normal blood tests and an extensive radiolucent lesion involving multiple teeth. The diagnosis was obtained through clinical, radiographic, and histopathological examinations. Treatment included endodontic treatment of the affected teeth, apicoectomy, and complete enucleation of the lesion, which provided effective control and minimized the risk of recurrence. This case reinforces the importance of individualized and multidisciplinary planning aimed at preserving the anatomical, functional, and aesthetic aspects of the patient.