Large Cyst of the Front Maxilla

The patient is a 66 year old female with many health issues and illnesses including diabetes and a post oncology treatment of operation propter Ca colli, radio and chemotherapy 2022.

The cyst showed up a few years after endodontic and prosthetic treatment in the front maxilla. The first clinical symptom was numbness of the front palate. The X-rays showed a large cyst with perforation of the nasal cave bottom, on the palatal side. Moreover, the incisive nerve was inside the cyst, that’s why the patient experienced numbness of palatal tissue.

Surgery was performed with a root resection of teeth #11 (8), #21 (9), #22 (10), cyst enucleation (with histopathology examination-confirmed radicular cyst) and backfill of the root canals with MTA. The incisive nerve was gently separated from the cyst during the cyst removal and left to self-regenerate. Dedicated microtools were used, and degranulation and bone curettage were done with special Augma burs. The bone defect was filled with Bond Apatite (3 cc).

Good healing and no clinical symptoms were observed in the 6 month follow-up period. Moreover, after that period a 100% regeneration of external cortical lamina was seen in CBCT scans! The numbness of the front palate disappeared after 4 months.