Abstract
Background
Calcifying odontogenic cyst (COC) can be misdiagnosed as a lesion of endodontic origin
when it is in close proximity to the periradicular tissue, and pulp sensibility tests
are indispensable for differential diagnosis. However, when the adjacent teeth are
necrotic or already endodontically treated, diagnosis becomes challenging.
Case Description
In this case report, a maxillary canine with an inadequate root canal treatment was
considered as the source of an endodontic infection. Eight months after the retreatment,
the patient sought treatment for a buccal intraoral swelling and a deep periodontal
pocket and was referred for cone-beam computed tomography with a provisional diagnosis
of a vertical root fracture. The tomography revealed an extensive lesion buccally
to the roots of the canine and the adjacent vital lateral incisor. An unusual extended
external resorption of the root of the vital lateral incisor was also evident. This
finding shifted the diagnostic thinking toward a lesion of nonendodontic origin. The
lesion was surgically enucleated, and the histopathologic examination confirmed the
diagnosis of a COC.
Practical Implications
Clinicians always must bear in mind the chance of a nonendodontic lesion masquerading
as a lesion of endodontic origin. Cone-beam computed tomography should be considered
in cases of doubt or in lesions refractory to endodontic treatment, as it can provide
information on the clinicopathologic features of the lesion.
Key Words
Abbreviation Key:
CBCT (Cone-beam computed tomography), COC (Calcifying odontogenic cyst), VRF (Vertical root fracture)
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Biography
Dr. Stefopoulos is in private practice limited to endodontics, Patras, Greece.
Biography
Dr. Melakopoulos is an oral and maxillofacial surgeon, Department of Oral and Maxillofacial Surgery, Hygeia Hospital, Athens, Greece.
Biography
Dr. Tosios is an associate professor, Department of Oral Pathology, Dental School of Athens, National and Kapodistrian University of Athens, Athens, Greece.
Biography
Dr. Kerezoudis is a professor, Department of Endodontics, Dental School of Athens, National and Kapodistrian University of Athens, Athens, Greece
Article Info
Publication History
Published online: November 21, 2022
Publication stage
In Press Corrected Proof
Footnotes
Disclosures. None of the authors reported any disclosures.
Identification
DOI: https://doi.org/10.1016/j.adaj.2022.10.005
Copyright
© 2022 American Dental Association. All rights reserved.
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