Abstract
AIM: This study aimed to compare the healing outcomes of periapical lesions with different histopathological features, focusing on the effectiveness of nonsurgical endodontic therapy versus surgical management. METHODOLOGY: This observational study compared the healing of histologically confirmed periapical lesions after nonsurgical or surgical treatment. Patients were followed for ≥12 months. Healing was assessed clinically and radiographically at 6 and 12 months and classified as complete, incomplete, or no healing. Chi-square tests compared outcomes between treatment groups (P < 0.05). RESULTS: Analysis revealed that nonsurgical management showed high success in periapical granulomas and pocket cysts, whereas surgical approaches provided superior outcomes in true cysts and persistent lesions. A comparative table demonstrated that complete healing was significantly more predictable when treatment modality was tailored to the lesion's histopathology. CONCLUSION: Histopathological differentiation of periapical lesions plays a critical role in guiding treatment strategy. While nonsurgical therapy remains effective for most inflammatory lesions, surgical intervention is more beneficial for true cysts, underscoring the importance of lesion-specific management.