A Short Case Study: Tooth No. 30—Cyst or Granuloma?
I hope you’re doing well and being safe during this unprecedented time. I wanted to share a very interesting case with you.
A patient came in with pain on tooth No. 30. It had a previous root canal performed. The pre-op radiograph showed inadequate cleaning, shaping, and obturation. In addition, there was a large lesion on the distal root and a smaller one on the mesial root. This prompted some questions.
Q: Is it a cyst or a granuloma?
A: The only way to really find out is to do a biopsy preoperatively.
Q: Can cysts heal after root canal therapy?
A: Yes and no. Pocket or bay cysts will heal after root canal therapy, but not true cysts, which have to be surgically removed.
Q: If the lesion is large, is it a cyst?
A: No. The size of the lesion can’t specify its etiology.
Q: How often are cysts found in previously treated teeth?
A: Only about 20% of the time.
I performed endodontic retreatment in two visits using calcium hydroxide for two weeks. I obturated the canals with warm vertical compaction with Kerr Pulp Canal Sealer EWT. A six-month recall showed very nice healing on both roots.
The lesion on the distal will take a little longer due to its large size. Studies show that it can take up to eight years before the bone completely repairs.
This was not a cyst. It was a granuloma. I hope you learned something today!
Case Courtesy: Dentistry Today