Root Canal Treatment and Endodontic Surgery on Maxillary Incisor with Radicular Cyst

Radicular cyst is an odontogenic cyst located at the apical or lateral side of the radix, due to chronic inflammation after pulp necrose. It contains a combination of inflammatory tissue and malassez epithelial cells which extensively proliferates. Treatment options for radicular cyst are conventionally followed by surgical endodontic. The aim of study was to treat maxillary incisisor with necrotic pulp and radicular cyst. A female 35-year-old patient came to Gadjah Mada University Dental Hospital. She felt inconvenience with her broken central incisive restoration. Past dental history revealed that there was composite resin restoration that had been filled since 10 years ago and asymptomatic. Tooth vitality test shows negative results. Clinical examination showed negative results to percussion test and palpation, slight mobility was detected. Periapical radiograf showed a radiolucent area with radiopaque border around the apical teeth with diameter approximately 2.5 mm. The treatment began with step-back technique root canal treatment and lateral condensation technique obturation. Apicoectomy and enucleation were performed 4 weeks after root canal treatment. One week post-treatment control showed there was no pain detected and normal healing process happened. Conclusion: Apicoectomy and enucleation are treatment of choice for the management radicular cyst to restore tooth function.