Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report

B. Doumari, S. Dhoum, Z. EL Hajjioui, M. Jabri
{"title":"Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report","authors":"B. Doumari,&nbsp;S. Dhoum,&nbsp;Z. EL Hajjioui,&nbsp;M. Jabri","doi":"10.1016/j.adoms.2025.100558","DOIUrl":null,"url":null,"abstract":"<div><div>Radicular cysts are the most common inflammatory odontogenic cysts, typically arising from chronic periapical infection following pulp necrosis. Post-traumatic radicular cysts involving immature teeth with open apices are uncommon and present unique clinical challenges due to incomplete root formation. This case report describes the management of a large post-traumatic radicular cyst affecting multiple maxillary anterior teeth (teeth 11, 12, and 13) in a 27-year-old patient, discovered incidentally during routine radiographic examination.</div><div>Clinical examination revealed pulp necrosis and an open apex on tooth 11, with teeth 12 and 13 also non-vital. Radiographs and CBCT confirmed a well-demarcated radiolucent lesion with buccopalatal expansion and cortical bone resorption, consistent with a radicular cyst. Treatment included conventional root canal therapy for teeth 12 and 13, and apexification with Biodentine for tooth 11. Surgical enucleation of the cyst was performed via a full-thickness mucoperiosteal flap, achieving complete removal of the lesion.</div><div>Biodentine, a bioactive calcium silicate-based material, was used to create an apical plug, promoting hard tissue formation and providing a reliable apical barrier, thus facilitating root canal obturation in the immature tooth. Histopathology confirmed an inflammatory radicular cyst. At 13-month follow-up, the patient was asymptomatic, with radiographic evidence of significant bone regeneration, although a residual bony defect remained. Long-term follow-up was recommended to monitor complete healing and prevent recurrence.</div><div>This case highlights the importance of early diagnosis and a multidisciplinary approach combining modern endodontic materials and surgical intervention in managing post-traumatic radicular cysts involving open apex teeth, ultimately preserving tooth structure and function.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100558"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Oral and Maxillofacial Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667147625000445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Radicular cysts are the most common inflammatory odontogenic cysts, typically arising from chronic periapical infection following pulp necrosis. Post-traumatic radicular cysts involving immature teeth with open apices are uncommon and present unique clinical challenges due to incomplete root formation. This case report describes the management of a large post-traumatic radicular cyst affecting multiple maxillary anterior teeth (teeth 11, 12, and 13) in a 27-year-old patient, discovered incidentally during routine radiographic examination.
Clinical examination revealed pulp necrosis and an open apex on tooth 11, with teeth 12 and 13 also non-vital. Radiographs and CBCT confirmed a well-demarcated radiolucent lesion with buccopalatal expansion and cortical bone resorption, consistent with a radicular cyst. Treatment included conventional root canal therapy for teeth 12 and 13, and apexification with Biodentine for tooth 11. Surgical enucleation of the cyst was performed via a full-thickness mucoperiosteal flap, achieving complete removal of the lesion.
Biodentine, a bioactive calcium silicate-based material, was used to create an apical plug, promoting hard tissue formation and providing a reliable apical barrier, thus facilitating root canal obturation in the immature tooth. Histopathology confirmed an inflammatory radicular cyst. At 13-month follow-up, the patient was asymptomatic, with radiographic evidence of significant bone regeneration, although a residual bony defect remained. Long-term follow-up was recommended to monitor complete healing and prevent recurrence.
This case highlights the importance of early diagnosis and a multidisciplinary approach combining modern endodontic materials and surgical intervention in managing post-traumatic radicular cysts involving open apex teeth, ultimately preserving tooth structure and function.
累及多前牙的创伤后神经根囊肿:开放治疗和手术摘除1例报告
根状囊肿是最常见的炎症性牙源性囊肿,通常由牙髓坏死后的慢性根尖周感染引起。创伤后神经根囊肿涉及未成熟的牙齿开放的尖端是罕见的,目前独特的临床挑战,由于不完整的根形成。这个病例报告描述了一个27岁的病人在常规放射检查中偶然发现的创伤后大的根状囊肿,影响了多颗上颌前牙(第11、12和13颗牙齿)。临床检查发现第11颗牙牙髓坏死,牙尖裂开,第12、13颗牙也无生机。x线片和CBCT证实了一个界限清晰的透明病变,伴有颊腭扩张和皮质骨吸收,与根状囊肿一致。治疗包括12号和13号牙的常规根管治疗,11号牙的生物牙定根尖治疗。通过全层粘骨膜瓣手术摘除囊肿,实现病灶的完全切除。生物牙本质是一种生物活性的硅酸钙基材料,用于制造根尖塞,促进硬组织形成并提供可靠的根尖屏障,从而促进未成熟牙齿的根管封闭。组织病理学证实为炎症性神经根囊肿。在13个月的随访中,患者无症状,影像学证据显示骨再生明显,但仍有骨缺损残留。建议长期随访,监测完全愈合,防止复发。本病例强调了早期诊断和多学科方法结合现代根管材料和手术干预治疗创伤后根状囊肿的重要性,最终保留了牙齿的结构和功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信