Management of large periapical cystic lesion by aspiration and nonsurgical endodontic therapy using calcium hydroxide paste.

Aim: To report a case of conservative nonsurgical management of periapical lesions.

Background: Small periapical lesions of endodontic origin usually heal by conventional endodontic therapy alone. Larger periapical lesions presumed to be cystic may require additional treatment protocols to aid in regression. Conservative nonsurgical management of such lesions eliminates the possible complications of surgery and has wider patient compliance and acceptance.

Case Description: A periapical cystic lesion associated with maxillary central incisor and lateral incisor was treated conservatively using buccal aspiration decompression followed by conventional endodontic therapy employing calcium hydroxide iodoform paste as intracanal medicament is reported.

Clinical Significance: The treatment was successful as evidenced by relief of symptoms and radiographic evaluation.

Conclusion: Large periapical cyst-like lesions can resolve by nonsurgical endodontic therapy employing calcium hydroxide intracanal interappointment medicament.