MANAGEMENT OF ENDODONTIC FAILURE IN LOWER ANTERIOR TEETH BY APICECTOMY IN AN ADOLESCENT PATIENT

Endodontic failure may occur due to the persistence of periapical pathology despite adequately performed root canal treatment. When nonsurgical retreatment is not feasible, surgical endodontic intervention becomes necessary. Apicectomy is a conservative surgical procedure aimed at eliminating periapical pathology while preserving the natural tooth. This case report presents the surgical management of an apical inflammatory cyst associated with endodontic failure in a 13-year-old male patient who reported pain in the lower anterior region of the jaw. The patient had a history of traumatic occlusion and prior root canal treatment involving the mandibular incisors. Clinical and radiographic examination revealed a persistent inflammatory radicular cyst associated with teeth 31 and 41. The treatment plan included surgical enucleation of the cystic lesion followed by apicectomy and retrograde filling of the involved teeth. The surgical procedure comprised apical root resection, thorough periapical curettage, and retrograde sealing. Postoperative follow-up demonstrated satisfactory clinical resolution and progressive radiographic healing of the periapical region. This case underscores the role of apicectomy as an effective tooth-preserving surgical option for managing persistent periapical lesions in adolescent patients when conventional nonsurgical retreatment is not indicated