case_images: PMC8154279_01
case_images: Intraoral picture of lesion in buccal vestibule of the mandibular left side.
case_images: CRID2021-5570758.001.jpg
case_images: PMC8154279_01_CRID2021-5570758.001.jpg
case_images: fig1
case_images: Intraoral preoperative periapical radiograph showing an irregular periapical radiolucency involving both #33 and #34. (a) Tracing was made using gutta-percha point done. (b, c) Other periapical angles.
case_images: CRID2021-5570758.002.jpg
case_images: PMC8154279_01_CRID2021-5570758.002.jpg
case_images: fig2
case_images: These finding were more investigated through radiographical examination, an orthopantomogram (OPG) (Figure 3) and periapical radiograph for tooth #34 (Figure 2) were taken.
case_images: Orthopantomogram showing multiple missing teeth and endodontic treatment of tooth #34.
case_images: CRID2021-5570758.003.jpg
case_images: PMC8154279_01_CRID2021-5570758.003.jpg
case_images: fig3
case_images: These finding were more investigated through radiographical examination, an orthopantomogram (OPG) (Figure 3) and periapical radiograph for tooth #34 (Figure 2) were taken.
case_images: (a, b) Intraoral photograph after bone removal. (c) Necrotic bony trabeculae with actinomycosis filaments on the trabecular surface (black circle) and extensive sclerosis of bone showing prominent resting and reversal lines (**).
case_images: CRID2021-5570758.004.jpg
case_images: PMC8154279_01_CRID2021-5570758.004.jpg
case_images: fig4
case_images: In addition, trabecular surface and bone sequestrum of the necrotic bone were showing actinomycosis colonies (Figure 4).
case_images: H&E stain showing bacterial invasion in the bone causing resorption. Bacteria (black arrow) and resorption of bone (black stars).
case_images: CRID2021-5570758.005.jpg
case_images: PMC8154279_01_CRID2021-5570758.005.jpg
case_images: fig5
case_images: Postoperative periapical radiograph showing endodontic treatment of both teeth #33 and #34.
case_images: CRID2021-5570758.006.jpg
case_images: PMC8154279_01_CRID2021-5570758.006.jpg
case_images: fig6
case_images: Obturation of the remaining canal with gutta-percha and AH 26 sealer, with continuous wave compaction, temporized with cavit and silver glass ionomer (Ketac) as temporary (Figure 6). Tooth #33, a conventional RCT, carried out following the same steps of tooth #34 but obturation was made using gutta-percha and AH 26 sealer (Figure 6), and then the tooth was restored with temporary filling.
case_images: 1-year recall periapical radiograph showing healing of the lesion.
case_images: CRID2021-5570758.007.jpg
case_images: PMC8154279_01_CRID2021-5570758.007.jpg
case_images: fig7
case_images: The patient was followed up at six months and one year period with no evidence of lesion recurrence (Figure 7).