Periapical Radiolucency 8, 9
History of trauma ~10 yrs. ago. Came for esthetic consult. 8/9 Splinted for +1 mobility with lingual wire.
CBCT shows thin cortical plates, but well defined apex radiolucency. No symptoms. No fistula/no tenderness to palpation. I have older periapical 2D xrays for comparison.
(Connective tissue will be extended onto 10)
I am suspicious of the apical lesion.
What is the best approach?
1. If keeping the 8/9: Enucleation/Apicoectomy/histology + bone fill, then NEW CBCT in 4 months, internal bleach, 2 ceramic crowns.
2. If removing 8/9: Enucleation/Apicoectomy/histology + bone fill, then NEW CBCT in 4 months, PET where there is facial bone, proximal PET where there is no facial bone, 2 implants, connective tissue graft.