Lack of periradicular healing and gradually increasing swelling two years after intentional extrusion of calcium hydroxide into periapical lesion: report of a case

A 40-year-old female patient with noncontributory medical history presented to the postgraduate clinic of the Department of Endodontology, Aristotle University of Thessaloniki, Greece. Her chief complaint was a gradually increasing swelling in the left side of her maxilla, during the preceding 2 months. After clinical examination, the radiologic and computerized tomographic scan examinations revealed the presence of a radiopaque foreign material in contact with the apex of tooth #22, confined within the limits of a radiolucent area. On dental anamnesis and after communication with her dentist, it was concluded that calcium hydroxide was deliberately extruded for the healing of the large lesion. The patient was scheduled for periapical surgery. The histopathologic features of the lesion revealed the presence of a periapical cyst and the absence of foreign body giant cells. After an observation period of 1 year, healing was uneventful.