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Management of radicular cyst: endodontic retreatment associated to marsupialization and enucleation

Marcos Sergio Endo, João Matheus Scherbaum Eidt, Carolina Ferrairo Danieletto, Liogi Iwaki Filho, Nair Narumi Orita Pavan

In cases of extensive lesions, treatment of radicular cysts includes an association of endodontic conservative approach with surgical intervention. This case report aims to describe the diagnosis, treatment and proservation of a large radicular cyst, in the anterior maxilla. The patient came to the Dental Clinic of the State University of Maringá, asymptomatic, with facial asymmetry and swelling in the investigated region. Radiographically, there was a well-defined radiolucent image surrounding the apexes of the teeth #21, #22, #23 and #24. After obtaining a diagnosis by clinical, radiographic and tomographic examinations, the treatment plan consisted primarily of endodontic retreatment of tooth 21, in a single session, using mechanized systems (Mtwo) and irrigation with 2% chlorhexidine gel with saline solution. After, marsupialization surgical procedure was performed to reduce the intracystic pressure and, therefore, the size of the lesion. Proservation after 30, 60 and 210 days indicated a reduction of the cyst, the patient was asymptomatic and there were no signs of recurrence. After eight months, enucleation was performed followed by bovine bone graft. We conclude that endodontic retreatment, marsupialization and enucleation have proven effective methods in the removal of radicular cyst, promoting bone repair.

Keywords: Radicular cyst. Marsupialization. Enucleation. Endodontics.

How to cite: Endo MS, Eidt JMS, Danieletto CF, Iwaki Filho L, Pavan NNO. Management of radicular cyst: endodontic retreatment associated to marsupialization and enucleation. Dental Press Endod. 2016 Sept-Dec;6(3):18-25. DOI: http://dx.doi.org/10.14436/2358-2545.6.3.018-025.oar

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