Akademik Veri Yönetim Sistemi
MIDD 2025 – Mediterranean International Dental Days, Antalya, Türkiye, 6 - 08 Kasım 2025, sa.2, ss.11-12, (Özet Bildiri)
"Onion-skin" periosteal reaction and cortical bone expansion are rare and concerning radiographic findings, frequently associated with severe pathologies such as malignancy or aggressive bone infections. This case reports the conservative management of an endodontically-driven lesion in the mandibular anterior region exhibiting these dramatic radiographic characteristics. An eighteen-year-old male patient presented with an asymptomatic swelling in the mandibular region. Diagnostic tests revealed the devitalization of tooth #31, leading to a diagnosis of pulp necrosis and chronic apical periodontitis. Radiographic examination showed a large periapical lesion associated with the apex of the involved tooth. The lesion caused dramatic expansion, and even partial perforation, of the buccal cortical plate, resulting in an "onion-skin" appearance on the buccal surface. Root canal treatment (RCT) was initiated. After intracanal medication, the root canal was obturated using conventional techniques. Immediately post-treatment, the swelling subsided, and the patient's symptoms resolved. Clinical and radiographic followups at 1, 3, and 6 months showed significant regression of the cortical expansion and periosteal reaction, along with complete periapical bone healing. This case emphasizes that an endodontic etiology must always be considered in the differential diagnosis and management of lesions presenting with malignancy-mimicking radiographic features. Keywords: Periapical lesion, root canal treatment, Onion skin view