The patient is a 42-year-old male. He is healthy and suffered a trauma one year earlier in a bicycle fall. He complained of oedema and pain in the region of the lower incisors. During the intra-oral examination, a fistula was identified in the area of tooth #31 (24) and #32 (23). The complementary exams confirmed the existence of a large apical cyst, encompassing the apex of teeth #31 (24) and #41 (25).
Pre-surgical endodontics of teeth #41 (25) and #31 (24).
The surgery took place two weeks after the initial images were taken. The second week included antibiotic therapy. Opening of a flap is done in the cervical area from tooth #33 (22) to tooth #43 (28). It encompasses the papillae, with two vertical releases distal of #33 (22) and #43 (27). Total removal of the cyst is completed with retro closure of the root canal. Immediate bone graft with Augma Bond Apatite®, followed by sutures, maintaining tension in the flap. Augma Shield™ is placed throughout the extension of the sutured flap.