Enucleation of Inflammatory Radicular Cyst Associated with Apicoectomy with Retrobturação: case report

• DOI: https://doi.org/10.22533/at.ed.515742618026

• Palavras-chave: Radicular Cyst. Periapical Diseases. Oral Surgical Procedures.

• Keywords: Radicular Cyst. Periapical Diseases. Oral Surgical Procedures.

• Abstract:

  Radicular cysts account for about 60% of all odontogenic cystic lesions and are classified by the World Health Organization (WHO) as odontogenic cysts of inflammatory origin, as they result from epithelial proliferation from an inflammatory process, mainly due to pulp necrosis in teeth affected by caries (MARTIN; SPEIGHT, 2017). 
  Lopes and Siqueira (2020) state that the origin of root cysts always comes from a granuloma that has become epithelialized, although not all granulomas become root cysts. Maintaining the cause, infection within the root canal systems, can cause epithelial proliferation to increase, generating a root cyst, which is the result of a long-term endodontic infection.
  This is a lesion that preferentially affects the anterior region of the maxilla and is usually asymptomatic, unless there is a secondary bacterial infection. Because of this, it is characterized as a radiographic finding in routine examinations, where it appears as a unilocular, radiolucent, rounded or oval image with well-defined boundaries surrounding the apex of a devitalized tooth. It is also possible to observe the loss of the hard lamina along the involved root, since the dimensions vary from 5 mm to several centimeters, and this is a factor taken into account when choosing the appropriate treatment (SILVA, 2018).
  Currently, there are several treatment options for radicular cysts, such as: conservative treatments (through conventional endodontic treatment of the devitalized tooth, with or without apicoectomy), surgical treatments such as tooth extraction (followed by periapical curettage), marsupialization, decompression, and cystic enucleation. Each case must be thoroughly analyzed, and regardless of the technique chosen, the dental surgeon must be aware that the origin of the lesion is microbial, therefore, the treatment must be effective in eliminating these microorganisms (MENDONÇA, 2017).
  In the presence of extensive cystic lesions, one of the recommended treatment methods is enucleation associated with root apicoectomy of the dental unit involved in the lesion, as well as retrofilling with a high-quality biocompatible material, with mineral trioxide aggregate (MTA) being the ideal material (DANTAS, 2014).