Conservative reduction of large periapical lesions.

T he clinician is often confronted with the problem of treating an extensive periapical lesion which may be cystic as a result of pulpal pathosis. Surgical management by curettement and/or apical resection has usually been the accepted procedure for such lesions. However, in cases in which extensive periapical lesions are visualized on the roentgenograms, a surgical approach can create complications by injuring the vitality of the adjacent teeth and may possibly cause an anatomic deformity. The purpose of this article is (1) to question the need for surgical treatment of the extensive periapical lesion and (2) to present a method of treating the lesion with minimal surgical intervention and injury to any of the related structures in cases of extensive regions of rarefaction.