Manejo cirúrgico de incisivo central superior com retentor intrarradicular e periodontite apical crônica: 12 meses de acompanhamento ; Surgical management of maxillary central incisor with intraradicular retainer and chronic periapical lesion: a 12-month follow-up

Introduction: Periapical surgery is one of the options used to treat root canal therapy failure cases mostly associated with residual bacteria located in areas inaccessible to the immune system. Objective: This case report presents the surgical management of a 17-year-old male patient with periapical lesion involving root apices of teeth #9 and #10, with history of trauma. Methods: Tooth #9 was subjected to endodontic treatment and restoration with intraradicular retainer, whereas tooth #10 has positively responded to pulp sensitivity test. Clinical, radiographic and tomographic exams were used to determine treatment plan. Results: Thus, surgical management applied to the lesion was associated with apicoectomy, retro-end cavity and retro-end filling, as well as with Mineral Trioxide Aggregate (MTA) of tooth #9. Histopathological examinations have shown apical periodontal cyst. Postoperative radiographic and tomographic evaluations have shown tissue repair in the injured area, whereas clinical examination did not show any signs and symptoms of failure, although it showed pulp vitality preservation in tooth #10. Conclusion: Therefore, it is possible concluding that establishing proper diagnosis and planning are major factors enabling successful surgical therapy. ; Introdução: A cirurgia periapical é uma das opções de tratamento utilizadas em casos de falha da terapia endodôntica, principalmente nos casos associados a bactérias localizadas em áreas inacessíveis ao sistema imunológico. Objetivo: Este relato de caso apresenta o manejo cirúrgico de um paciente do sexo masculino, 17 anos, com uma lesão periapical envolvendo os ápices radiculares dos elementos 21 e 22, com histórico de trauma. Métodos: O elemento 21 apresentava tratamento endodôntico e restauração com retentor intrarradicular, enquanto o elemento 22 respondeu positivamente ao teste de sensibilidade pulpar. Exames clínico, radiográfico e tomográfico foram utilizados para a elaboração do plano de tratamento. O tratamento cirúrgico foi realizado no ...