Periapical surgery in the lower anteriors

Periapical surgery in the lower anteriors

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Periapical surgery in the lower anteriors


A 30-year old man had visited Sujay’s Dental Care complaining of loose lower front teeth with gum swelling.

Patient had a history of orthodontic alignment of lower teeth and existing fixed retainer on lower anteriors.

before-and-after-image-interdisciplinary-management-case-smile-story-1Evidence-Based Dentistry:

As a part of Evidence-based treatment, we took full mouth OPG. After examining OPG x-ray of the teeth, our team of dentists decided for

  • Root canal treatment wrt 41,31,32
  • Periapical cyst enucleation  wrt 41, 31,32
  • Apicoectomy wrt 41,31,32
  • MTA and Bone graft placed.
  • Fixed orthodontic retainers was given.
  • Crowns wrt the lower anteriors


evidence-based-dentistry-bannerTratment Procedure:

  • Preoperative radiographs, CBCT and models were made.
  • Root canal treatment was done wrt 31,32,41.
  • Full thickness flap was raised on the labial aspect of the mandibular anteriors.
  • The periapcal cyst wrt 31,32,41 was enucleated.
  • Apicoectomy was done wrt 31,32,41 and MTA was sealed at the apices.
  • Bone graft was placed in the defect, membrane was placed and sutured.
  • Fixed orthodontic retainer was placed lingually.
  • Patient was kept on a regular observation.
  • A panoramic radiograph done 4 months  postoperatively showed satisfactory healing.
  • Crowns were fabricated wrt mandibular incisors.


A regular follow up every 6 months is advised.

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