Abstract
Introduction: Many lesions of endodontic origin require surgical management, often due to the possible diagnosis of odontogenic cysts and tumors in the jaw bones. A root cyst is a benign inflammatory lesion, typically presenting as either a painful or painless, slow-growing, expansile mass that appears well-demarcated with an osteosclerotic shell on radiographic imaging. After treatment, large osseous defects often remain, and the use of a graft to fill the void can accelerate healing and prevent complications from failure to fill by the host tissue.
Case Presentation: A 65-year-old female patient with multiple chronic cardiac conditions underwent endodontic microsurgery and bone grafting to treat a root cyst in the anterior right maxilla. The cyst, which caused damage to both cortical plates, was treated in a single step. A retrograde fill of the apex was performed, followed by grafting with biphasic calcium sulfate (Bond Apatite®) to regenerate the osseous defect.
Clinical Discussion: Histologically, the root cyst consisted of multilayered epithelium and connective tissue containing areas rich in inflammatory cells with some fibrotic fragments. Surgical removal of the cyst, followed by curettage of the surrounding bone and defect grafting, provided predictable healing and satisfactory clinical results. The use of biphasic calcium sulfate allowed for tenting of the surgical area without the need for a membrane, simplifying the procedure and reducing the risk of soft tissue ingrowth during healing. The material gradually converted to host bone over a period of 3 to 6 months.
Conclusion: This case, along with supporting literature, suggests that biphasic calcium sulfate is an effective graft material for repairing osseous defects following the removal of cysts and tumors in the jaw. Its use eliminates the need for resorbable membranes, simplifying procedures and reducing costs without compromising clinical outcomes.