Successful treatment of cystic lesion combining Cystectomy, Nonsurgical Endodontics and Vital Pulp Therapy of Mature Permanent Mandibular Molars: a Case Report with 19 Months Follow-Up

BACKGROUND: Clinical examination revealed large periapical lesion. Patient was referred for endodontic treatment of right mandibular first and second molars before planed cystectomy. The aim of this case report is to present the clinical approach to preserve healthy pulp tissue by combining nonsurgical root canal treatment and vital pulp therapy for mature mandibular molar. METHODS: A minimally invasive endodontic therapy treatment with combination of nonsurgical root canal treatment and vital pulp therapy was performed. Osteotomies around wisdom teeth were performed, wisdom teeth extracted, and cyst was removed. RESULTS: At the 19 months follow-up appointment patient had no complaints, radiographically full regeneration of periapical bone was observed. CONCLUSIONS: A minimally invasive endodontic therapy treatment with combination of nonsurgical root canal treatment and vital pulp therapy for mature mandibular molar before a planned cystectomy could be considered as a treatment option showing good long-term results.