Case report of conservative non-surgical management of open apex with large periapical lesion with 2-year follow-up

A periapical lesion develops from an inflammatory process arising from pulpal necrosis of a non-vital tooth. Radiographically, lesion was round or oval with well-circumscribed radiolucent image involving the apex of the tooth. Nonsurgical management of periapical lesions has shown to have a high success rate. This paper presents a case report of conservative non-surgical management of a periapical lesion associated with permanent maxillary left central incisor and left lateral incisor in a 14-year-old male patient with open apex. Root canal treatment was done together with cystic aspiration of the lesion. The lesion was periodically followed up and significant bone formation was seen at the periapical region of affected teeth at about 12 months. Thus, conservative management large periapical lesion with open apex provided favorable clinical and radiographic outcome.