Surgical treatment of inflammatory periapical cyst in the maxilla associated with apicectomy: case report

Abstract

Objective: The present study aims to report the surgical treatment of an inflammatory periapical cyst located in the maxilla, describe the surgical technique used in the procedure, and evaluate the success of the apicoectomy and apical sealing with bioceramic cement. Case report: A 19-year-old female patient was referred for evaluation, reporting pain and swelling in the anterior maxillary region. A CT scan revealed a hypodense expansive lesion involving the apex of tooth 22. One of the diagnostic hypotheses was an inflammatory periapical cyst, and excisional biopsy was recommended. Enucleation of the lesion, apicoectomy, and sealing of the apex with biomaterial were performed. The collected material was sent for histological examination, which showed fragments of an inflammatory cystic lesion lined by non-keratinized stratified squamous epithelium. The connective tissue capsule presented an inflammatory infiltrate and several blood vessels, confirming the diagnosis of a periapical cyst. Over 11 months of follow-up, there was significant bone regeneration and no signs of recurrence. Conclusion: The reported case confirmed data from the literature indicating that the combination of enucleation with apicoectomy and retrograde filling is the ideal treatment for periapical cysts with these characteristics, as this technique resulted in significant improvement during follow-up.