Presence of periapical cyst

The patient is a young man who presented at Balaji Dental and Craniofacial Hospital, Chennai, with pain in the upper left central incisor, which had previously undergone root canal treatment elsewhere. Radiographic investigations conducted revealed a periapical cyst in relation to the tooth. Dr S M Balaji, Cranio-Maxillofacial Surgeon, decided to perform enucleation of the periapical cyst followed by retrograde filling of the root apex with Mineral Tri-Aggregate (MTA) and filling of the bony defect with Bio-Oss.

Cyst removal with filling of defect

The patient was taken to the operating room and a mucogingival flap was raised to the level of the root apex. A window was created in the bone and the cyst was removed in its entirety. The root apex was cut (apicoectomy) and removed following which the stump was retrograde filled with MTA. The bony defect was then closed with Bio-Oss and the flap was sutured back into anatomical position.

Successful resolution of infection

The patient underwent regular post-operative checkups over a period of six months and x-rays showed complete resolution of the infection with filling in of the bony defect with new bone.