Surgical Management of Radicular Cyst with Platelet-rich Fibrin Placement followed by Nonvital Bleaching of a Discolored Maxillary Left Central Incisor (21)

Radicular cyst is an inflammatory odontogenic cyst that is most common among all cystic lesions of the jaw. It arises from the epithelial cell rests of Malassez and associated with pulpal necrosis of a nonvital tooth. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. This article presents the case report of a 18-year-old female patient who reported with a chief complaint of discolored tooth in the upper left front region of jaw for 5 years. Based on the clinical, radiological, and histopathological findings, final diagnosis made was of pulpal necrosis with infected radicular cyst with 21,22 and 23. Treatment planning included root canal therapy for 21, 22 and 23, root end filling using mineral trioxide aggregate (MTA) with 21, orthograde MTA apical barrier with 22 and 23, surgical enucleation of the cystic lesion, apicectomy for 21.22 and 23 followed by nonvital bleaching. The patients’ follow-up was recorded at 3 and 6 months’ posttreatment. The patient remained asymptomatic during the follow-up period. Complete regeneration of bone with periapical healing was observed during the 6 months’ follow-up.