Authors : Dr. Parikshit P. S.; Dr. Sandhya Khasnis; Dr. Nischitha A.

Volume/Issue : Volume 11 - 2026, Issue 9 - September

Google Scholar : https://tinyurl.com/y8xx4f6t

DOI : https://doi.org/10.38124/ijisrt/26sep541

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Periapical inflammatory lesions associated with necrotic teeth are common consequences of microbial infection of the root canal system. Among these lesions, radicular cysts may present as well-defined, unilocular periapical radiolucencies, particularly in the anterior maxilla. Although large or cyst-like lesions have traditionally been considered for periapical surgery, contemporary endodontic treatment emphasizes elimination of the intraradicular microbial challenge through adequate chemomechanical preparation, irrigation, intracanal medication when indicated, and three-dimensional obturation. This case report describes the successful nonsurgical management of a large periapical cyst-like lesion associated with a non-vital maxillary anterior tooth.

Keywords : Periapical Cyst; Radicular Cyst; Cyst-Like Periapical Lesion; Nonsurgical Endodontic Treatment; Root Canal Treatment; Chemomechanical Preparation; Periapical Healing; Apical Periodontitis; Conservative Endodontics

References :

1. Nair PN. New perspectives on radicular cysts: do they heal after nonsurgical endodontic therapy? Int Endod J. 1998;31:155–165.
2. Lin LM, Huang GTJ, Rosenberg PA. Proliferation of epithelial cell rests of Malassez in periapical lesions. J Endod. 2007;33:1108–1112.
3. Ricucci D, Siqueira JF Jr. Fate of the tissue in apical periodontitis lesions following root canal treatment. J Endod. 2010;36:123–132.
4. Siqueira JF Jr, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008;34:1291–1301.
5. Zehnder M. Root canal irrigants. J Endod. 2006;32:389–398.
6. Saini A, Nangia D, Sharma S, Kumar V, Chawla A, Logani A, et al. Outcome and associated predictors for nonsurgical management of large cyst-like periapical lesions: a CBCT-based prospective cohort study. Int Endod J. 2023;56(2):146–163.
7. Karamifar K, Tondari A, Saghiri MA. Endodontic periapical lesion: an overview on the etiology, diagnosis and current treatment modalities. Eur Endod J. 2020;5(2):54–67.
8. Li et al. Nonsurgical minimally invasive endodontic treatment of large periapical lesions: a report of three cases. Open Dent J. 2024;18.
9. Setzer FC, et al. Management of large radicular lesions using decompression: a case series and review of the literature. J Endod. 2019;45(5):651–659.
10. Rao NR, Mujeeb A, Kottur AA, Mathur A, Snigdha NTS, Karobari MI. Root canal therapy used in conjunction with follow-ups for the nonsurgical handling of an enormous periapical lesion of endodontic origin: clinical case record. Clin Case Rep. 2024;12.