ArticleClinical case reports2025
Persistent Periradicular Lesion Associated With Concurrent Root Fracture and Odontogenic Keratocyst: A Case Report.
Article in Clinical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Persistent periradicular lesions in root canal-treated teeth present a diagnostic challenge, as they may result from failed endodontic treatment, root fracture, or non-endodontic pathoses. Accurate diagnosis is essential, given the significant differences in their management. This report describes a case of a persistent periradicular lesion associated with a root canal-treated maxillary lateral incisor in a 45-year-old male. Despite nonsurgical root canal retreatment, a chronic apical abscess persisted. Cone-beam computed tomography revealed a well-defined radiolucency and a suspected root fracture. Exploratory surgery with methylene blue staining confirmed the root fracture. Histopathological examination of the curetted intraosseous lesion revealed a cystic lumen lined by para-keratinized stratified squamous epithelium with palisaded basal cells and surface corrugation, confirming the diagnosis of an odontogenic keratocyst (OKC). The co-occurrence of a root fracture and an OKC is a rare finding. This case underscores the non-specific clinical and radiographic features of such entities that can mimic endodontic disease. A definitive diagnosis and successful treatment planning depend on the correlation of clinical, radiographic, and histopathological findings, highlighting the critical role of biopsy in persistent lesions.
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