European Journal of Biomedical and Pharmaceutical Sciences

TRAUMATIC RADICULAR CYST OF THE ANTERIOR MAXILLA WITH PALATAL AND NASAL FLOOR INVOLVEMENT: A CASE REPORT

*Dr. Dheeraj Kumar, Dr. Sudhanshu Shekhar, Dr. Akanksha Srivastava

ABSTRACT

Introduction: Radicular cysts are the most common inflammatory odontogenic cysts, arising from epithelial rests of Malassez secondary to pulpal necrosis. Trauma-induced radicular cysts involving the anterior maxilla with extension to the nasal floor are relatively uncommon and may present as large osteolytic lesions requiring combined endodontic and surgical management. Case Presentation: A 40-year-old male presented to the Department of Oral and Maxillofacial Surgery with pain and swelling in the upper anterior maxillary region for three months. The patient reported a history of facial trauma following a fall from a tractor several years earlier. Clinical examination revealed localized swelling involving the anterior maxilla. Aspiration yielded brown-coloured cystic fluid. Electric pulp testing demonstrated non-vitality of teeth 11, 12, and 21. Cone-beam computed tomography (CBCT) revealed a well-defined radiolucent lesion involving the periapical region of the maxillary incisors, with extension up to the nasal floor and associated palatal cortical bone destruction. Root canal treatment of the involved teeth was performed, followed by surgical enucleation and apicectomy under general anaesthesia. Histopathological examination confirmed the diagnosis of a radicular cyst. Outcome: Healing was uneventful, with satisfactory postoperative recovery and preservation of adjacent teeth. Conclusion: Traumatic pulpal necrosis may remain undetected for years before presenting as a large radicular cyst. CBCT plays a crucial role in evaluating lesion extent and surgical planning. Combined endodontic therapy, cyst enucleation, and apicectomy provide predictable outcomes for extensive anterior maxillary lesions.

Keywords: Radicular cyst, apicectomy, enucleation, CBCT, odontogenic cyst.