Enucleation and apicoectomy in the treatment of radicular cysts: clinical insights

Radicular cysts are the most common inflammatory odontogenic cysts, typically arising from epithelial remnants in response to pulpal necrosis and periapical inflammation. While many are asymptomatic and discovered incidentally on radiographs, larger lesions may cause swelling, displacement of adjacent structures, and cortical plate expansion. Treatment modalities vary depending on size, location, and response to endodontic therapy.
This case report describes the management of a radicular cyst in the anterior maxilla, on an 18years old patient, apicotomy and endo-filling with biocompatible material.
Clinical and radiographic evaluation revealed a persistent periapical radiolucency consistent with a radicular cyst. An apicoectomy was performed with complete enucleation of the cystic lesion. The apical portion of the root was resected, and a biocompatible filling was placed. Histopathological examination confirmed the diagnosis of a radicular cyst. Postoperative follow-up over six months demonstrated satisfactory healing with no signs of recurrence.
Apicoectomy combined with cyst enucleation is an effective surgical approach for managing persistent radicular cysts unresponsive to conventional endodontic treatment.