RESUMEN
BACKGROUND: Radicular cysts are one of the most common odontogenic cystic lesions found in the jaw. Nonsurgical treatment of large radicular cysts is a topic of ongoing debate, and there is still no clear consensus on the most effective therapies. The apical negative pressure irrigation system aspirates the cystic fluid and releases the static pressure in the radicular cyst, representing a minimally invasive approach for decompression. In this case, the radicular cyst was in close proximity to the mandibular nerve canal. We used nonsurgical endodontic treatment with a homemade apical negative pressure irrigation system and the prognosis was good. CASE SUMMARY: A 27-year-old male presented to our Department of General Dentistry with complaints of pain in the mandibular right molar when chewing. The patient had no history of drug allergies or systemic disease. A multidisciplinary management approach was designed and included root canal retreatment with a homemade apical negative pressure irrigation system, deep margin elevation and prosthodontic treatment. According to a 1-year follow-up period, the patient showed a favorable outcome. CONCLUSION: This report reveals that nonsurgical treatment with an apical negative pressure irrigation system may provide new insights into the treatment of radicular cysts.
RESUMEN
BACKGROUND: Palato-radicular groove (PRG) is defined as an anomalous formation of teeth. The etiology of PRG remains unclear. The prognosis of a tooth with a PRG is unfavorable. The treatment of combined periodontal-endodontic lesions requires multidisciplinary management to control the progression of bone defects. Some researchers reported cases that had short-term observations. The management of teeth with PRGs is of great clinical significance. However, to date, no case reports have been documented on the use of bone regeneration and prosthodontic treatment for PRGs. CASE SUMMARY: This case reported the management of a 40-year-old male patient with the chief complaint of slight mobility and abscess in the upper right anterior tooth for 15 d and was diagnosed with type II PRG of tooth 12 with combined endodontic-periodontal lesions. The accumulation of plaque and calculus caused primary periodontitis and a secondary endodontic infection. A multidisciplinary management approach was designed that included root canal therapy, groove sealing, a periodontal regenerative procedure, and prosthodontic treatment. During a 2-year follow-up period, a good prognosis was observed. CONCLUSION: This report indicates that bone regeneration and prosthodontic treatment may contribute to the long-term favorable prognosis of teeth with PRGs.