Oral dirofilariasis mimicking endodontic failure: a case report.

BACKGROUND: Oral dirofilariasis is a rare parasitic infection that can mimic common dental pathologies. This report presents a unique case where dirofilariasis was mistaken for an acute apical abscess, highlighting diagnostic challenges and the importance of interdisciplinary collaboration. CASE PRESENTATION: A 47-year-old male presented with a persistent, painless swelling in the maxillary anterior region (tooth 11). Initial history and radiographic examinations suggested an acute apical abscess following inadequate root canal treatment. However, during surgical exploration, a live nematode was discovered in the periapical lesion. The parasite was extracted, and histopathological analysis confirmed Dirofilaria spp. The patient underwent endodontic retreatment and achieved full recovery. CONCLUSIONS: This case underscores the need for clinicians to consider parasitic infections in atypical presentations of periapical pathology. Advanced imaging, thorough surgical assessment, and histopathological confirmation are essential in distinguishing rare infections from common dental diseases.