Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1346-1355
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1346
Microsurgical management of radicular cyst using guided tissue regeneration technique: A case report
Juan Carlos Gómez Mireles, Eugenia Karina Martínez Carrillo, Katia Alcalá Barbosa, Evangelina Gutiérrez Cortés, Javier González Ramos, Luis Antonio González Gómez, Rubén Alberto Bayardo González, Sarah Monserrat Lomelí Martínez
Juan Carlos Gómez Mireles, Luis Antonio González Gómez, Periodontics Specialty, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
Eugenia Karina Martínez Carrillo, Endodontics Specialty, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
Katia Alcalá Barbosa, Endodontics Specialty, Department of Clinics, Centro Universitario de Los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Mexico
Evangelina Gutiérrez Cortés, Specialty in Oral Pathology, Surgical-Stomatological Department, Autonomous University of Guadalajara, Zapopan 45129, Mexico
Javier González Ramos, Independent Researcher, Guadalajara 44340, Mexico
Rubén Alberto Bayardo González, Sarah Monserrat Lomelí Martínez, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
Sarah Monserrat Lomelí Martínez, Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
Sarah Monserrat Lomelí Martínez, Master of Public Health, Department of Well-being and Sustainable Development, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Mexico
Author contributions: Gómez Mireles JC, Martínez Carrillo EK, Alcalá Barbosa K, Gutiérrez Cortés E and Lomelí Martínez SM contributed to diagnosis, surgical treatment and manage of patients; González Ramos J, González Gómez LA and Bayardo González RA contributed to acquisition and analysis of data; Gómez Mireles JC, Lomelí Martínez SM, Martínez Carrillo EK, Alcalá Barbosa K drafted manuscript and critically revised manuscript; Gómez Mireles JC, Martínez Carrillo EK and Lomelí Martínez SM contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sarah Monserrat Lomelí Martínez, PhD, Academic Research, Adjunct Associate Professor, Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Av. Universidad 1115, Col. Lindavista, Ocotlán 47810, Mexico. sarah.lomeli@academicos.udg.mx
Received: December 12, 2023
Peer-review started: December 12, 2023
First decision: December 31, 2023
Revised: January 9, 2024
Accepted: February 6, 2024
Article in press: February 6, 2024
Published online: March 6, 2024
Abstract
BACKGROUND

Radicular cyst is a lesion of odontogenic origin that arises from epithelial remains due to periapical periodontitis caused by inflammatory reactions generated at the apex of affected teeth with infected or necrotic pulps. The therapeutic management of radicular cysts is controversial. There is only one case report of enucleation of a radicular cyst managed with microsurgery and apicoectomy, but without the use of the guided tissue regeneration (GTR) technique in the same surgical procedure. The present clinical case describes the management of a radicular cyst with microsurgical approach, performance of an apicoectomy of the tooth associated with the entity, application of GTR technique, use of a resorbable membrane of type I bovine collagen, and bovine xenograft.

CASE SUMMARY

A 68-year-old patient presented with a radicular cyst from an upper lateral incisor. The microsurgical management used was aimed at enucleating the chemical membrane, performing apicoectomy of the tooth along with careful and precise retrograde filling, and implementing GTR technique using a resorbable collagen membrane and bovine xenograft. The diagnosis of radicular cyst was confirmed using histopathological analysis. The patient underwent follow-up evaluations at 10 and 30 d postoperatively. At 4 months postoperative evaluation, she remained asymptomatic, and radiographs showed significant periapical healing with adequate bone formation.

CONCLUSION

These results suggest that microsurgical management using the GTR technique with collagen membrane and xenograft, contributes to bone regeneration.

Keywords: Odontogenic cysts, Apical periodontal cyst, Dental root end cyst, Case report

Core Tip: The radicular cyst is a lesion of odontogenic origin whose therapeutic management is controversial. However, the present clinical case describes the management of a radicular cyst using a microsurgical approach, and the performance of an apicoectomy of the tooth associated with the entity, followed by the guided tissue regeneration technique, implementation of a resorbable type I bovine collagen membrane, and bovine xenograft. The diagnosis was based on clinical findings that were confirmed with histopathology analysis. This case underlines the importance of clinical, periapical radiographic, and cone-beam computed tomography evaluation as guides for an accurate diagnosis in order to enhance the development of an appropriate treatment plan for a radicular cyst.