Radicular Cyst Secondary to Dental Trauma in a Young Permanent Tooth: A Case Report of Diagnosis and Surgical Management.

Rezumat

Background:

Traumatic injury to immature permanent teeth may result in delayed pulpal necrosis and periapical pathology that can remain clinically undetected for several years. Management is challenging because incomplete root development is associated with an open apical foramen, short roots, and thin dentinal walls, increasing the risk of fracture and compromising long-term tooth survival. This case report describes a delayed radicular cyst arising in a previously traumatized and pulpotomized immature permanent maxillary central incisor.

Case Presentation:

A 14-year-old child presented with an intraoral swelling in relation to the maxillary left central incisor (21). The patient had sustained trauma to the same tooth approximately 7 years earlier, when the tooth was still immature, and pulpotomy had been performed. Intraoral periapical radiography demonstrated an open apex associated with 21. Further evaluation with cone-beam computed tomography (CBCT) was performed to determine the exact location and extent of the cystic lesion. Based on the clinical and radiographic findings, a radicular cyst associated with the traumatized tooth was diagnosed.

 Treatment and Outcome:

Apical surgery with apicectomy and surgical removal of the cystic lesion was performed. The excised tissue was submitted for histopathological examination, which supported the diagnosis of a radicular cyst. Following surgical management and healing, the involved anterior tooth was restored with a full ceramic crown. At the documented 3-month postoperative follow-up, satisfactory clinical healing and an acceptable aesthetic result were observed.

 Conclusion:

 This case highlights the possibility of delayed periapical complications following trauma and pulpotomy in an immature permanent tooth. A long interval between trauma and clinical symptoms does not exclude late pathology. Careful clinical examination, appropriate radiographic assessment, histopathological confirmation, conservative tooth-preserving surgery, and long-term follow-up are important for achieving a favorable outcome in traumatized young permanent teeth.