Abstract
Large periapical lesions present a clinical challenge and may not always respond to nonsurgical root canal therapy alone. This case report describes the management of a large periapical lesion in a young patient who presented with palatal swelling in the anterior maxilla. Radiographic examination, including cone-beam computed tomography (CBCT), revealed an extensive periapical radiolucency associated with the maxillary central incisor. Root canal therapy was completed, followed by surgical intervention without apicoectomy or the use of regenerative materials. The surgical approach was conservative, aimed solely at removing the periapical pathology. The access cavity was restored using composite resin. Clinical and radiographic follow-up over 18 months demonstrated complete resolution of symptoms and progressive bone healing. This case highlights the effectiveness of conservative surgical management in achieving successful long-term healing of large periapical lesions without the need for adjunctive regenerative techniques.