This case report described the complete resolution of a large osteolytic lesion following a nonsurgical endodontic retreatment using a premixed bioceramic sealer. A 30‐year‐old healthy patient presented a large radiographic osteolytic lesion of 16 × 9 mm in correspondence with Teeth #42, #41, and #31. Clinical examinations revealed positive percussion tests and increased mobility of all incisors. The microbiological profile of the root canals was assessed through paper point sample collection, DNA extraction, and next‐generation sequencing, revealing markedly different proportions of bacteria genera in the affected teeth. A secondary endodontic treatment was then performed, combining manual, rotary, and reciprocating protocols. A premixed bioceramic‐based sealer (CeraSeal) was used for obturation due to the presence of wide and wet apexes. Radiographic (x‐rays and CBCT) and clinical evaluations reported the progressive healing of the lesion over 30 months. This outcome supports the use of conservative treatments as a valid alternative to endodontic surgery for the management of extensive periapical lesions.
Spinelli et al. (Wed,) studied this question.