Strategic Orthograde Biodentine Obturation and Regenerative Surgical Management of a Persistent Radicular Cyst Refractory to Nonsurgical Endodontic Therapy: A One-Year Follow-Up Case Report.
- 1Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
- 2Department of Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
Abstract
Large cyst-like periapical lesions may persist despite adequate nonsurgical endodontic therapy and often present a significant therapeutic challenge. The present case report highlights the effective management of a persistent radicular cyst associated with traumatized maxillary anterior teeth using orthograde Biodentine® obturation and regenerative endodontic surgery. A 24-year-old male patient with a previous history of road traffic injury presented with Ellis class IV fractures involving teeth 11, 12, 21, and 22 and associated extensive periapical radiolucent pathology. Nonsurgical root canal treatment was performed; however, persistent exudation from teeth 21 and 22 persisted despite repeated applications of calcium hydroxide and triple antibiotic paste. While teeth 11 and 12 were conventionally obturated using gutta-percha and sealer, teeth 21 and 22 underwent orthograde Biodentine® obturation prior to surgical intervention. Surgical management included lesion curettage, apicoectomy, and regenerative reconstruction of the osseous defect using bone graft, injectable platelet-rich fibrin, leukocyte platelet-rich fibrin, and a barrier membrane. Following satisfactory healing, definitive prosthetic rehabilitation was completed using a digital workflow and full-coverage restorations. One-year follow-up demonstrated resolution of clinical symptoms, substantial radiographic bone regeneration, and satisfactory esthetic and functional outcomes. Orthograde Biodentine® obturation combined with regenerative surgical management may be a useful treatment option for persistent periapical lesions that fail to respond to prolonged nonsurgical therapy.
Related
- Next-generation smart polymeric hydrogels for chronic wound management: integrating antimicrobial, immunomodulatory and regenerative strategies.
- Regenerative Medicine in the Management of Musculoskeletal Pain: Mechanisms, Clinical Applications, and Future Directions.
- Advances in diabetic foot ulcer management: a narrative review of novel antibiotics, nanotechnology, and regenerative therapeutics
- Do non-steroidal anti-inflammatory medications or opioids increase the risk of nonunion after surgical and nonsurgical treatment of tibial shaft fractures?
- Evaluation of the Impact of Osteoporosis and Rheumatoid Arthritis on the Outcomes of Nonsurgical Endodontic Therapy: A Prospective Cohort Study
BibTeX
@article{khose2026strategic,
title = {{Strategic Orthograde Biodentine Obturation and Regenerative Surgical Management of a Persistent Radicular Cyst Refractory to Nonsurgical Endodontic Therapy: A One-Year Follow-Up Case Report.}},
author = {Suraj Khose and Rushikesh Mahaparale and Prasad Shirke and Pranali Suryavanshi and Trupti Kadam and Abhijeet Taksale and Siddhartha Varma},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117016},
url = {https://europepmc.org/article/MED/42948808},
note = {CC BY},
}
RIS
TY - JOUR
TI - Strategic Orthograde Biodentine Obturation and Regenerative Surgical Management of a Persistent Radicular Cyst Refractory to Nonsurgical Endodontic Therapy: A One-Year Follow-Up Case Report.
AU - Suraj Khose
AU - Rushikesh Mahaparale
AU - Prasad Shirke
AU - Pranali Suryavanshi
AU - Trupti Kadam
AU - Abhijeet Taksale
AU - Siddhartha Varma
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.117016
UR - https://europepmc.org/article/MED/42948808
AB - Large cyst-like periapical lesions may persist despite adequate nonsurgical endodontic therapy and often present a significant therapeutic challenge. The present case report highlights the effective management of a persistent radicular cyst associated with traumatized maxillary anterior teeth using orthograde Biodentine® obturation and regenerative endodontic surgery. A 24-year-old male patient with a previous history of road traffic injury presented with Ellis class IV fractures involving teeth 11, 12, 21, and 22 and associated extensive periapical radiolucent pathology. Nonsurgical root canal treatment was performed; however, persistent exudation from teeth 21 and 22 persisted despite repeated applications of calcium hydroxide and triple antibiotic paste. While teeth 11 and 12 were conventionally obturated using gutta-percha and sealer, teeth 21 and 22 underwent orthograde Biodentine® obturation prior to surgical intervention. Surgical management included lesion curettage, apicoectomy, and regenerative reconstruction of the osseous defect using bone graft, injectable platelet-rich fibrin, leukocyte platelet-rich fibrin, and a barrier membrane. Following satisfactory healing, definitive prosthetic rehabilitation was completed using a digital workflow and full-coverage restorations. One-year follow-up demonstrated resolution of clinical symptoms, substantial radiographic bone regeneration, and satisfactory esthetic and functional outcomes. Orthograde Biodentine® obturation combined with regenerative surgical management may be a useful treatment option for persistent periapical lesions that fail to respond to prolonged nonsurgical therapy.
SN - 2168-8184
ER -