Noninvasive Endodontic Periapical Biopsy of a Periapical Fibrous Scar: Case Report

Postendodontic periapical fibrous scars (PFScs) comprise a type of radiolucent healing that is frequently misinterpreted as a pathological lesion. A combined clinical, radiologic, and histologic correlation is essential for a reliable diagnosis. This report presents a case of a patient with a long-term persistent asymptomatic postendodontic radiolucency that was misdiagnosed as endodontic failure and referred for endodontic retreatment and periapical surgery. To reach a definitive diagnosis, a core bone biopsy needle (CBBn) technique was performed on the area of the radiolucency. The material obtained was processed for histologic analysis and the lesion was determined to be a PFSc. In conclusion, the use of a CBBn before any invasive treatment allowed the clinician to distinguish between PFSc and other persisting pathosis, such as periapical granuloma or cystic lesions. (J Endod 2022;48:375-378.)

Automated summary

This case report highlights the misdiagnosis of a long-term persistent postendodontic radiolucency as endodontic failure. The use of a core bone biopsy needle technique allowed for a definitive diagnosis of postendodontic periapical fibrous scars.