Unusual management problems in the treatment of a long-standing destructive periapical cyst. Report of a case.

A case report is presented in which an orthognathically compromised patient presented with a destructive periapical lesion that caused resorption of first and second molar roots and buccal and palatal cortical plates. The initial diagnosis and treatment were influenced by the absence of pre-existing dental records and an unrecountable dental history. Unusual endodontic management problems were encountered when copious intracoronal fluid, determined to be saliva, continually flowed through the open canals via a periodontal defect. The pathology report described the rare finding of large portions of fibrous scar tissue, indicating that some healing had occurred prior to treatment.