Non-surgical Approach to a Maxillary Cyst-Like Lesion: Orthograde Endodontic Treatment With Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Decontamination of the Canal System

The aim of this study is to describe the nonsurgical resolution of a large periapical cyst-like lesion through traditional endodontic treatment, supported by neodymium-doped yttrium aluminum garnet (Nd:YAG) laser activation of the irrigants. A 16-year-old girl was referred to our service with swelling of the right hemiface, pus, pain, and intraoral swelling of the labial mucosa extending from the right upper incisor (element 11) to the right upper canine (element 13). The radiological examination, a cone beam computed tomographic scan provided at the first appointment, confirmed the presence of a large cyst-like lesion extending from the right upper central incisor to the right upper canine. The right upper central and lateral incisors underwent endodontic treatment with the support of an Nd:YAG laser to enhance the decontamination action of the irrigants. The one-year follow-up showed complete healing of the lesion. This successful outcome supports the potential for healing of cyst-like lesions through nonsurgical treatment. However, the role of the Nd:YAG laser in endodontics requires further study.