Microsurgical apicoectomy with retro filling in a patient with extensive periapical lesion in maxilla - A case report

The goal of modern dentistry should be to maintain patients’ dentition for as long as possible. Microsurgical apicoectomy is a predictable and safe solution worth considering in the treatment of periapical diseases. The aim of our work was to present a method of dealing with a large lesion in the maxilla. The article describes surgical management in a case of a large periapical cyst with probable traumatic origin. A 45-year-old male patient reported a large radiolucent area in the region of the teeth 11–13, suggesting bone resorption with an irregular contour. The procedure consists of curettage of periapical bone, root resection, and retrograde filling. Surgery was carried out with local infiltration anesthesia. A sulcular, full-thickness flap was designed. The resection of the root apices of teeth 11 and 12 was performed, and retrograde filling was implemented. The patient was recalled after 5 days for the removal of sutures and evaluation of treatment. The patient underwent the procedure without any complications and did not report pain or swelling after surgery. During the control visit, there was a bone reconstruction visible on periapical X-rays. Minimal scarring was noticeable, and the patient was content with the esthetic result without any pain or discomfort. Endodontic microsurgery is a widely studied procedure. It is recommended to use suitable equipment, instruments, and materials that match biological concepts.