Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report
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 formati...
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Elsevier
2025-09-01
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| Series: | Advances in Oral and Maxillofacial Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667147625000445 |
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| author | B. Doumari S. Dhoum Z. EL Hajjioui M. Jabri |
| author_facet | B. Doumari S. Dhoum Z. EL Hajjioui M. Jabri |
| author_sort | B. Doumari |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-99cecc6048bb4b339e16fb7642f9c84d |
| institution | Matheson Library |
| issn | 2667-1476 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Oral and Maxillofacial Surgery |
| spelling | doaj-art-99cecc6048bb4b339e16fb7642f9c84d2025-07-02T04:50:55ZengElsevierAdvances in Oral and Maxillofacial Surgery2667-14762025-09-0119100558Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case reportB. Doumari0S. Dhoum1Z. EL Hajjioui2M. Jabri3Corresponding author.; Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Hassan II University, Casablanca, MoroccoDepartment of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Hassan II University, Casablanca, MoroccoDepartment of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Hassan II University, Casablanca, MoroccoDepartment of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Hassan II University, Casablanca, MoroccoRadicular 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.http://www.sciencedirect.com/science/article/pii/S2667147625000445Post-traumatic radicular cystOpen apexApexificationBiodentineSurgical enucleationImmature permanent teeth |
| spellingShingle | B. Doumari S. Dhoum Z. EL Hajjioui M. Jabri Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report Advances in Oral and Maxillofacial Surgery Post-traumatic radicular cyst Open apex Apexification Biodentine Surgical enucleation Immature permanent teeth |
| title | Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report |
| title_full | Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report |
| title_fullStr | Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report |
| title_full_unstemmed | Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report |
| title_short | Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report |
| title_sort | post traumatic radicular cyst involving multiple anterior teeth open apex management and surgical enucleation a case report |
| topic | Post-traumatic radicular cyst Open apex Apexification Biodentine Surgical enucleation Immature permanent teeth |
| url | http://www.sciencedirect.com/science/article/pii/S2667147625000445 |
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