A Combination of Enucleation and Apicoectomy as an Alternative Treatment for Removing Radicular Cysts

Introduction: Radicular cysts are asymptomatic lesions that occur in the periapical area of ??the tooth due to caries, pulp necrosis, or trauma. Various surgical approaches of enucleation and marsupialization can be performed to remove radicular cysts. The combination of enucleation and apicoectomy is an alternative treatment that can be used to remove radicular cysts without extracting the causative tooth. Case Report: A 37 years old female patient came with chief complaints of a lump on the upper front gum. The patient had a history of trauma to her front teeth approximately three years ago, then the patient underwent endodontic treatment, and tooth was restored with Porcelain Fused Metal (PFM). The patient underwent enucleation of the radicular cyst followed by apicoectomy. Retrograde obturation is performed using Mineral Trioxide Aggregate (MTA), and a bone graft is administered to help regenerate bone defects. The patient was followed up one week and three months after surgery, there were no complaints or recurrence in this case. Conclusion: The combination of enucleation and apicoectomy is an alternative treatments to eliminating periapical abnormalities that can be performed to preserve existing teeth. Retrograde filling using MTA can prevent recurrence due to reducing the canal gap and apical seal, which is a good prognosis.