Discoloration of a previous RCT treated tooth

A 27-year-old male came for the discoloration of a previous root canal treatment for tooth 22. The patient had a history of trauma around 10 years back, and the tooth had multiple episodes of pain and swelling. The lesion healed after the completion of root canal treatment which was almost 5 years back. However, for the last few months, the tooth started to cause discomfort with a slight pain during biting or chewing. Tooth also became darker and blackish in color. management options?


There is radiolucency involving adjacent tooth also.Check for vitality of this adjacent tooth and TOP for both. The adjacent tooth most probably will be non vital.Proceed with RCT with sufficient sitting of intracranial medicament.If patient becomes asymptomatic and you see lesion regressing then go ahead with non-surgical treatment. If no regression then surgical treatment can be planned.CBCT images are bit blurred and discoloration is common in RCT treated teeth sp. after trauma so dont worry about that.
Later after rct is done,lesion reduced and patient is asymptomatic go ahead with all ceramic crowns for best esthetic outcome and opaque to mask discoloration.
Radicular cyst from past history of trauma and we'll defined unilocular radiolucency bounded by sclerotic border, as its progressive and breach of labial bone. DD can be unicystic ameloblastoma , though it's incidence seems less in this case. I think tentative diagnosis is definitely a radicular cyst. Treatment would be surgical removal and biopsy. With or without grafting based on surgeons decision. Endo for 22.
Radicular cyst...with 21,and there is clear extrusion of gp with 21 but there is radiolucency with 22 adjoining areas , I would suggest apicoectomy with enmasse cystic removal filled with prf/bone graft and a retrograde filling with mta of 21, then wait and watch for 1month at revaluation nothing might be needed for 22.
The radiolucency irt 22 is large oval and has well demarcated margins highly suggestive of Radicular cyst (may be infected). Rx sugical intervention + biopsy Treatment plan for 22 can be set only after seeing the prognosis of tooth. Thank you doctor.
radicular cyst d/d ameloblastoma surgically remove grafting is must it's up-to 1 cm endo with 22 after pain subside do intraradicular bleaching
Ameloblastoma Radicular cyst Advise surgical excision
P/d-Radicular cyst.