case_images: PMC10895385_01
case_images: Preoperative orthopantomogram indicating expansion of the periapical pathology in relation to teeth 36 and 37.
case_images: cureus-0016-00000053031-i01.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i01.jpg
case_images: FIG1
case_images: However, a radiographic assessment using an orthopantomogram revealed a sizable periapical pathology associated with teeth 36 and 37 (Figure 1).
case_images: CBCT of the lower right mandibular area showing a buccolingual expansion of bone at the region pertaining to teeth 36 and 37.. CBCT: Cone beam computed tomography
case_images: cureus-0016-00000053031-i02.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i02.jpg
case_images: FIG2
case_images: Importantly, no downward displacement of the inferior alveolar canal or compression of the inferior alveolar nerve was observed (Figure 2).
case_images: Rubber dam isolation and access opening done with teeth 36 and 37.
case_images: cureus-0016-00000053031-i03.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i03.jpg
case_images: FIG3
case_images: Access opening was performed using a BR-45 round bur and a safe-end bur (EX-24 Mani, Japan) (Figure 3).
case_images: CBCT evaluation following endodontic treatment of teeth 36 and 37.. CBCT: Cone beam computed tomography
case_images: cureus-0016-00000053031-i04.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i04.jpg
case_images: FIG4
case_images: Obturation of the radicular space was done followed by placement of permanent composite resin (Spectrum, Dentsply Sirona, USA), which was confirmed using a cone beam computed tomography in teeth 36 and 37 (Figure 4).
case_images: Reflection of full-thickness mucoperiosteal flap showing cystic enucleation, apical resection of teeth 36 and 37 followed by placement of Biodentine.
case_images: cureus-0016-00000053031-i05.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i05.jpg
case_images: FIG5
case_images: A retrograde filling using Biodentine  (Septodont, France) was placed as restorative material of 3mm thickness (Figure 5).
case_images: Transalveolar extraction done with tooth 38 and bone plating with the placement of mini-screws in the 36 and 37 region.
case_images: cureus-0016-00000053031-i06.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i06.jpg
case_images: FIG6
case_images: Suturing of the reflected flap
case_images: cureus-0016-00000053031-i07.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i07.jpg
case_images: FIG7
case_images: (A) Immediate post-operative IOPA; (B) Three months follow-up IOPA; (C) Six months follow-up IOPA; (D) One year follow-up IOPA.. IOPA: Intraoral periapical radiograph
case_images: cureus-0016-00000053031-i08.jpg
case_images: PMC10895385_01_cureus-0016-00000053031-i08.jpg
case_images: FIG8