ABSTRACT
A periapical lesion is located in the apical region of the teeth. Most of the cases can be classified as periapical granuloma, periapical abscess, and periapical cyst which are distinguished from each other based on radiographs. Usually, periapical lesions greater than 5 mm in diameter are surgically removed but can be treated with non-surgical root canal treatment. Biomechanical preparations for non-surgical root canal treatment can remove bacteria from root canals and prevent re-infection after obturation. A 44-year-old woman complained of discomfort while chewing with her right mandibular second incisor. On clinical examination, the composite restoration of tooth 42 had discoloration in the proximal part. Negative vitality and positive percussion were found. Radiographic examination showed a well-defined radiolucent margin at the root apex with a diameter of 7 mm. After rubber dam placement, cavity access using endo access bur. Root canal preparation was performed using the crown down technique until size 25/.06. Final irrigation was performed using 5.25% NaOCl, aquadest, 17% EDTA, aquadest, and 2% Chlorhexidine. Calcium hydroxide was used as an intracanal medicament. On day 19, the evaluated radiographs showed a size decrease to 3,8 mm and the percussion test showed a negative response. Obturation was done using a warm vertical compaction technique with a bioceramic sealer. At 4 months of follow-up examinations, periapical radiographs confirmed that complete healing had occurred around the periapical of affected teeth. Non-surgical root canal treatment and the use of a bioceramic sealer can be the less invasive treatment option for extensive periapical lesions.
