Conservative multidisciplinary management and CBCT follow-up of an extensive traumatic-inflammatory maxillary lesion: a clinical and radiological case report

Abstract

Objective

The aim of this case report was to describe the conservative multidisciplinary management and CBCT-based follow-up of an extensive traumatic-inflammatory periapical lesion involving the anterior maxilla, associated with pulp necrosis, external apical root resorption, and compromised tooth stability.

Methods

A 58-year-old male patient presented with discoloration and mobility of the maxillary incisors following a history of dental trauma. Clinical and radiological examinations revealed a large periapical lesion associated with apical resorption and root canal calcifications. Endodontic treatment was performed using a reciprocating instrumentation system, followed by apexification and root canal obturation with a bioactive calcium silicate-based material. Dental stabilization was achieved using a fiber-reinforced composite splint. Surgical decompression of the lesion was performed through a palatal incision with placement of a drainage tube.  Serial CBCT examinations with linear measurements were used to monitor the healing process during follow-up.

Results

Follow-up clinical and radiological evaluations demonstrated progressive reduction in lesion size and early signs of bone regeneration in the affected region. Tooth mobility decreased, soft tissue healing was completed without complications, and the patient remained asymptomatic throughout the observation period. Imaging confirmed favorable healing dynamics and stabilization of the involved teeth.

Conclusions

 This case documents the multidisciplinary conservative management of an extensive traumatic-inflammatory periapical lesion and its clinical and radiographic evolution during follow-up. Serial CBCT assessment allowed detailed radiographic monitoring of lesion reduction and early bone healing, while the favorable outcome appeared to result from the combined effects of infection control, tooth stabilization, decompression, bioactive material application, and host tissue repair.