The patient is a healthy, 46-year-old female. In the area of tooth #15 (4) there was an inflammatory lesion that presented with pain and another clinical symptoms. The tooth had a prosthetic restoration with a crown and was blocked with another crown on tooth #14 (5).
It was decided to perform an apicoectomy of tooth #15 (4). One-step microsurgery was done with radicular cyst removal (with histopathology), root resection of #15 (4) with retrograde MTA filling (two canals). The bone defect was filled with Bond Apatite® (1 cc). By the operation both cortical laminas were destroyed, the buccal after making the trepanation hole and from the sinus site because of a cyst with reactive inflammatory changes in sinus.
The patient reported medium pain and discomfort in the first two days after surgery. Good healing and bone remodeling were observed during the 4 years of follow up, without any inflammation. The patient reported no clinical symptoms. The cortical lamina from sinus site was reconstructed after 4 months. CBCT after 4 years confirmed good healing of the bone and stability of regenerated cortical both laminas.