Question 155 · LDEK · Cysts of the jaws

A 45-year-old patient came in with reoccurring pain and swelling in the central maxillary incisors. Clinical examination revealed: the teeth painful on vertical percussion, slight pain in the 11 and 12 vestibule region. A prosthetic crown on the tooth 12 and a big filling in the tooth 11. Edema at the palatine side of the involved region. No pathological movement of the involved teeth. No constitutional symptoms. The X-ray of the 11 and 12 region is showed below. What is your diagnosis and treatment?

1. AA. diagnosis - acute purulent periapical inflammation with periapical granuloma; treatment - on the day of admission drainage of the abscess, opening of the involved teeth, antibiotic administration depending on patient’s medical history and a follow up the next day.
2. BB. diagnosis - purulent inflammation of the odontogenic cyst; treatment - on the day of admission drainage of the abscess, opening of the involved teeth, antibiotic administration depending on patient’s medical history and a follow up the next day.
3. CC. diagnosis - odontogenic cyst; treatment - on the day of admission resection of the roots of the involved teeth with antibiotic prophylaxis, a follow up the next day.
4. DD. diagnosis - acute purulent inflammation of the periapical tissues with periapical granuloma. treatment - on the day of admission drainage of the abscess, opening of the involved teeth, antibiotic therapy and a follow up the next day.
5. EE. diagnosis - purulent inflammation of the odontogenic cyst. treatment - on the day of admission enucleation of the cyst. A follow up in 7 days.