A case of periradicular surgery: apicoectomy and obturation of the apex, a bold act

This paper reports a case of a recurrent periapical cyst treated with enucleation of the lesion, apicoectomy, and root end obturation on a lower left first molar. In the case of conventional root canal treatment failure, non-surgical retreatment is the preferred option in most of the cases. Several factors such as a complex root canal system or previous procedural accidents may impede the success of non-surgical retreatment. The authors have performed root-end resection and preparation under local anesthesia on a lower left first molar; The root canal filling is placed within the new cavity to close the path of communication between the infected root canal system and periradicular structures with an intermediate restorative material. The lesion was fully enucleated and sent for histopathology. The 29-year-old female patient was followed up at 2 weeks, 3 and 6 months presenting as a functional and symptomless tooth. Radiographic findings showed a clear and progressive refilling of the cavity with bone. All these factors highlight a positive prognosis for the tooth after periradicular surgery, which is now considered a valid treatment to keep the tooth as a functional unit in the oral cavity.