We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

Citations

Citations to this article as recorded by  

• Prognosis of Vital Teeth Involved in Large Cystic Lesions After a Surgical Intervention: A Longitudinal Ambidirectional Cohort Study
  Khalid A. Merdad, Maha Shawky, Khalid A. Aljohani, Rawia Alghamdi, Saja Alzahrani, Omar R. Alkhattab, Abdulaziz Bakhsh
  Dentistry Journal.2025; 13(2): 83.     CrossRef
• Assessing the efficacy of apicoectomy without retrograde filling in treating periapical inflammatory cysts
  Jeong-Kui Ku, Woo-Young Jeon, Seung-O Ko, Ji-Young Yoon
  Journal of the Korean Association of Oral and Maxillofacial Surgeons.2024; 50(3): 140.     CrossRef
• Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases
  Changmo Sohn, Jihye Ryu, Inhye Nam, Sang-Hun Shin, Jae-Yeol Lee
  Journal of the Korean Association of Oral and Maxillofacial Surgeons.2022; 48(6): 342.     CrossRef
• The effectiveness of antibacterial treatment of the root canal in chronic apical periodontitis using an erbium-chromium laser
  M. A. Postnikov, A. Yu. Rozenbaum, S. E. Chigarina, D. N. Kudryashov, M. B. Khaikin, I. V. Khramova, G. N. Belanov
  Endodontics Today.2022; 20(2): 115.     CrossRef
• Factors Associated with Incomplete Endodontic Care
  Carla Y. Falcon, Anthony R. Arena, Rebecca Hublall, Craig S. Hirschberg, Paul A. Falcon
  Journal of Endodontics.2021; 47(9): 1398.     CrossRef
• Tratamento cirúrgico e conservador de cisto periapical de grande proporção: relato de caso
  Maraísa Aparecida Pinto Resende, Neuza Maria Souza Picorelli Assis, Augusto César Sette-Dias, Evandro Guimarães de Aguiar, Bruno Salles Sotto-Maior
  HU Revista.2018; 43(2): 191.     CrossRef

This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.

Citations

Citations to this article as recorded by  

• Periapical cemento‐osseous dysplasia masquerading as asymptomatic chronic apical periodontitis in a Chinese woman: A case report
  Yunjing Ma, Dong Fang, Mei Ji
  Clinical Case Reports.2024;[Epub]     CrossRef
• Benign Fibro-Osseous Lesions of The Jaw: A Retrospective Analysis
  Saim Yanık, Mehmet Emrah Polat
  European Journal of Therapeutics.2024; 30(5): 760.     CrossRef
• Radiological follow-up of cemento-osseous dysplasia on cone-beam computed tomography
  Stefan F. Nemec, Steffen Schneider, Klaus M. Friedrich, Michael Weber, Ursula Schwarz-Nemec
  Journal of Cranio-Maxillofacial Surgery.2024; 52(5): 644.     CrossRef
• Cemento osseous dysplasia(COD) of the mandibular teeth misdiagnosed as periapical lesion; cone beam CT-based case report
  Won-Jeong Han
  The Journal of The Korean Dental Association.2024; 62(7): 432.     CrossRef
• Surgical Management of Infection Secondary to Cemento-osseous Dysplasia
  Farin Ebrahimi, Faraz Ebrahimi, Jingang An
  Journal of Craniofacial Surgery.2023;[Epub]     CrossRef
• Florid osseous dysplasia mimicking odontogenic infections: A report of two cases and literature review
  A. Wajdi Bin Mohammed, Mohammed Mubarak Aldosari, Osama A. Alharbi, Ahmed Alzahrani, Abdullah M. Alsoghier
  Saudi Journal of Oral Sciences.2023; 10(3): 195.     CrossRef
• Radiolucent lesions that may resemble inflammatory periapical lesions: A review article
  Hamad Albagieh, Mohammed Aldosari, Abdulmajeed Alkhathlan, Nawaf Alfawaz, Mohammed Almutairi
  The Saudi Dental Journal.2023; 35(8): 916.     CrossRef
• Cemento-Osseous Dysplasia: A Detailed Comparison of the 2005 and 2017 WHO Classifications and Case Analysis
  Jiankang Zhang, Yunbo Yu, Wei Tang, Jian Pan, Wei Jing
  Cureus.2023;[Epub]     CrossRef
• The bony changes after mandibular incisors retraction on a severe skeletal Class II bimaxillary protrusion extraction patient with periapical cemento-osseous dysplasia
  Huijuan Wang, Yiwen Zhou, Baochao Li, Ling Huang, Huang Li
  AJO-DO Clinical Companion.2022; 2(5): 496.     CrossRef
• Cemento-ossøs dysplasi – en diagnostisk utfordring
  Stig Løvold, Sivakami Rethnam Haug
  Den norske tannlegeforenings Tidende.2022;[Epub]     CrossRef
• A retrospective cone beam computed tomography analysis of cemento-osseous dysplasia
  Birsay Gumru, Melda Pelin Akkitap, Sevilay Deveci, Ender Idman
  Journal of Dental Sciences.2021; 16(4): 1154.     CrossRef
• Florid Cemento-osseous Dysplasia: A Report of Two Cases and Literature Review
  Prashanth Panta, Imran Shahid, Mukund Seshadri
  The Journal of Contemporary Dental Practice.2021; 22(3): 304.     CrossRef
• Natural history of florid osseous dysplasia of the jaws with important clinical implications
  Camile S. Farah, Marie Anne T. Matias
  Australian Endodontic Journal.2021; 47(3): 684.     CrossRef
• Clinical assessment of cemento‐osseous dysplasia based on three‐dimensional diagnostic imaging: A case report
  Naoki Shibata, Kyoko Inamoto, Munetaka Naitoh, Eiichiro Ariji
  Australian Endodontic Journal.2021; 47(1): 105.     CrossRef
• Odontogenic Cysts
  Arvind Babu Rajendra Santosh
  Dental Clinics of North America.2020; 64(1): 105.     CrossRef
• Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia
  Andrea Brody, Attila Zalatnai, Krisztian Csomo, Andrea Belik, Csaba Dobo-Nagy
  BMC Oral Health.2019;[Epub]     CrossRef
• Florid Cemento-Osseous Dysplasia of Osteolytic Stage Showing Cyst-Like Findings on CT and MRI: A Case Report
  Kotaro Ito, Naohisa Hirahara, Norihito Iizuka, Eri Sawada, Shunya Okada, Masaaki Suemitsu, Kayo Kuyama, Takashi Kaneda
  International Journal of Oral-Medical Sciences.2019; 17(3-4): 137.     CrossRef
• Oral management of a patient with cemento-osseous dysplasia: a case report
  Camila de Nazaré Alves de Oliveira KATO, Juliana Diogo de Almeida SAMPAIO, Tânia Mara Pimenta do AMARAL, Lucas Guimarães ABREU, Cláudia Borges BRASILEIRO, Ricardo Alves MESQUITA
  RGO - Revista Gaúcha de Odontologia.2019;[Epub]     CrossRef
• Retrospective Study of 383 Cases of Fibro-Osseous Lesions of the Jaws
  Camila de Nazaré Alves de Oliveira Kato, Laiz Fernandes Mendes Nunes, Loliza Luiz Figueiredo Houri Chalub, Adriana Etges, Tarcília Aparecida Silva, Ricardo Alves Mesquita
  Journal of Oral and Maxillofacial Surgery.2018; 76(11): 2348.     CrossRef
• Successful Implant Placement in a Case of Florid Cemento-Osseous Dysplasia: A Case Report and Literature Review
  Nasrin Esfahanizadeh, Hila Yousefi
  Journal of Oral Implantology.2018; 44(4): 275.     CrossRef
• Recurrent symptomatic cemento-osseous dysplasia: A case report
  Chang-Ki Min, Kwang-Joon Koh, Kyoung-A Kim
  Imaging Science in Dentistry.2018; 48(2): 131.     CrossRef
• Cemento-Osseous Dysplasias: Imaging Features Based on Cone Beam Computed Tomography Scans
  Paulo Henrique Pereira Cavalcanti, Eduarda Helena Leandro Nascimento, Maria Luiza dos Anjos Pontual, Andréa dos Anjos Pontual, Priscylla Gonçalves Correia Leite de Marcelos, Danyel Elias da Cruz Perez, Flávia Maria de Moraes Ramos-Perez
  Brazilian Dental Journal.2018; 29(1): 99.     CrossRef
• Florid cemento-osseous dysplasia: a contraindication to orthodontic treatment in compromised areas
  Alberto Consolaro, Sergio Rafael Baggio Paschoal, Jose Burgos Ponce, Dario A. Oliveira Miranda
  Dental Press Journal of Orthodontics.2018; 23(3): 26.     CrossRef
• Clinical, demographic, and radiographic analysis of 82 patients affected by florid osseous dysplasia: an international collaborative study
  Débora Lima Pereira, Fábio Ramôa Pires, Márcio Ajudarte Lopes, Román Carlos, John Marshal Wright, Paras Patel, Willie van Heerden, Andre Uys, Pablo Agustin Vargas
  Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2016; 122(2): 250.     CrossRef
• Cone beam CT as an aid to diagnosing mixed radiopaque radiolucent lesions in the mandibular incisor region
  Unni Krishnan, Manal Al Maslamani, Alex J Moule
  BMJ Case Reports.2015; : bcr2014207617.     CrossRef
• Benign Fibro-Osseous Lesions of the Craniofacial Area in Children and Adolescents: A Review
  D.V. Rogozhin, F. Bertoni, D. Vanel, M. Gambarotti, A. Righi, I.V. Bulycheva, D.M. Konovalov, A.G. Talalaev, V.Yu. Roshin, A.P. Ektova, M.V. Bolotin, A.V. Lopatin
  Arkhiv patologii.2015; 77(4): 63.     CrossRef
• Dysplasie osseuse floride mandibulaire : un cas de découverte fortuite et revue de la littérature
  Eugénie Massereau, Ugo Ordioni, Maud Guivarc’h, Guillaume Royer, Jean-Hugues Catherine
  Médecine Buccale Chirurgie Buccale.2015; 21(2): 101.     CrossRef