28M. Dental trauma occurred ~15 years ago. Teeth #21 and #22 are fractured (coronal) but have remained asymptomatic until a swelling episode 3 months ago that drained naturally.
Clinical Findings (from CBCT):
Pathology: Large, well-defined, and well-corticated periapical lesion measuring 12.36 mm.
Bone Status: Significant erosion and perforation of both buccal and palatal cortical plates.
Bone Loss: Vertical bone loss extends toward the cervical third of the crown.
Tooth Status: Both #21 and #22 show Grade 0 Mobility (completely solid).
Root Anatomy: Simple Vertucci Type 1 (single straight canal).
The Dilemma:
I consulted with a government medical college today. The doctor recommended extraction of both teeth to "properly disinfect" the area and remove the cyst. However, because the teeth feel solid and I have a straight-forward root anatomy, I am strongly considering a private MDS Endodontist for a save without extraction.
Looking for insights from Endodontists or Oral Surgeons. I want to keep my natural teeth if at all possible.
CBCT scan report: CBCT Scan Report