Management of a Large Periradicular Lesion: Combination of Surgical and Nonsurgical Methods and 4 Years Follow–up

Inflammatory periapical lesions are one of the major complications of dental injuries. Here we report a case of large cyst-like periradicular lesion from the apices of 31, 41, 42 in an 18-yr-old boy that was managed by using nonsurgical and surgical endodontic methods. During endodontic procedure, 2.5 % sodium hypochlorite solution was used for irrigation and calcium hydroxide paste was used for the intracanal dressing. Because of presence of large periapical lesion a combined approach was planned.The lesion was curetted surgically and the canal treatment was completed in the same session using canal paste with gutta-percha and AH-plus.Considerable radiographic resolution of the periapical lesion was observed 12 months after the root canal filling and no symptoms were recorded at 48 monhts review.