Integrated Surgical–Regenerative Management of a Radicular Cyst with Mineral Trioxide Aggregate and Titanium-prepared Platelet-rich Fibrin

The main type of inflammatory odontogenic cysts that occur after pulpal necrosis is the radicular cyst. The condition remains symptom-free most of the time, but palatal swellings appear when the tissues become infected or enlarge. Treatment of this large radicular cyst in the maxillary anterior region requires a multidisciplinary approach between endodontic and surgical methods that includes mineral trioxide aggregate (MTA) and titanium-prepared platelet-rich fibrin (T-PRF), as described in this case report. This case report presents painless swelling related to teeth 11–13, with a clearly marked periapical radiolucency that appeared on the radiographic examination. The patient received root canal treatment for the affected teeth before undergoing surgical cyst removal and apicoectomy treatment for tooth number 12. Histopathology confirmed a radicular cyst. The patient showed steady progress in bone regeneration without any signs of recurrence during the 1-, 3-, 6-, and 12-month follow-up assessments. This report highlights the treatment of large radicular cysts results through a combined endodontic surgical procedure with regenerative therapy, which uses MTA and T-PRF for predictable healing. This case presents a unique clinically integrated treatment modality that offers a predictable management for extensively large periapical lesions, particularly in an esthetically concerned region. Cone-beam computed tomography functions as an essential tool that helps assess surgical results and track patient recovery over time.