(TC42) Cystic Decompression, an Evidence-Based Approach in the Management of Large Periapical Lesions

Abstract: Despite considerable progress in modern endodontic microsurgical techniques, large periapical lesions encompassing multiple root apices still pose a technical challenge. Cystic decompression is an evidence-based and predictable approach aimed at reducing periapical lesion size prior to surgery while minimizing the risks of surgical complications to the adjacent dentition. This procedure, originally described by Patterson in 1964, involves an incision placed through the mucoperiosteum covering the lesion, aspiration with subsequent irrigation of the lesion, then placement of radiopaque tubing into the depth of the lesion which is attached to the mucosa with a suture. This residual tubing will permit drainage of the lesion over a period of time following the procedure and allows the patient to irrigate the lesion at home. The patient should be followed up frequently to evaluate healing and reduced lesion size. Once there are signs of sufficient healing, the tubing can be removed and the definitive treatment can be performed. The objective of this table clinic is 1. to demonstrate the utility of cystic decompression in the management of large periapical lesions through the presentation of several contemporary cases, and 2.) to present armamentarium, technical know-how and follow up times relevant in each case.