Multidisciplinary approach in the management of large infected periapical cystic lesion in the mandibular anterior region with platelet-rich fibrin

Periapical cysts are considered as the most prevalent odontogenic cystic lesions of the jaws. These cystic lesions are usually asymptomatic; however, once infected, they result in tumefaction of the affected region. Current noninvasive diagnostic methods such as computed tomography, magnetic resonance imaging, and cone-beam computed tomography help in accurate assessment of size and nature of these lesions, which determine proper treatment planning and prognosis of the affected tooth. Management of these cystic lesions depends upon their extent. Periapical localized cysts can be managed by nonsurgical root canal therapy, whereas large periapical cysts require multidisciplinary approach involving an endodontist and an oral surgeon. Accelerated healing of soft and hard tissues near these lesions can be done using tissue engineering scaffolds such as platelet-rich fibrin and platelet-rich plasma. This case report presents successful multidisciplinary management of a large infected periapical cyst which was associated with mandibular incisors.