Periapical surgery in the lower anteriors

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Age: 30                                                                                   Gender: Male

Type of the Case:  Periapical surgery in the lower anteriors.

Chief Complaint: Patient complained of loose  lower front teeth with gum swelling.

Dental History: Had a history of orthodontic alignment of lower teeth and existing fixed retainer on lower anteriors.

Pre Operative:

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Clinical Findings:

  • Existing fixed retainer on lower anteriors
  • Discolouration wrt 31
  • Anterior deep bite
  • Attrited lower anteriors.
  • Grade 1 mobile 31
  • Radiograhically, periapical cyst wrt 41,31,32

During The Procedure:

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Alternative Treatment Plan:

  • Extraction wrt 31,32,41 followed by replacement

Treatment Plan:

  • 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

Treatment 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.

Post Operative:

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Follow Up:

  • A regular follow up every 6 months is advised.

Treatment Done By :

dr-sujay-gopal

     Dr.Sujay Gopal (Implantologist) FICOI

       dr-rohith-ganiga

Dr.Rohith Ganiga (Prosthodontist) MDS

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