A Pronounced Apical Translucency With Endodontic Causation? – an Interdisciplinary Case-Report

Objectives: The present rare interdisciplinary case report presents an incidental finding of asymptomatic apical translucency on a mandibular first molar of a 70-year old male patient.
Methods: The diagnostic finding was detected through a routine dental examination including a panoramic radiography. The further detailed radiological examination revealed a circular, homogenous, solid translucency with a cross-sectional dimension of approximately 15 mm (Fig. 1). The translucency appears to have contact apical to the mesial root of the tooth 36. The clinical investigation in the field of interest showed neither swelling on palpation nor abnormalities on the teeth except for a delayed pulp sensitivity with CO₂ snow on tooth 36. Following to a thorough examination, the patient obtained a specialized endodontic treatment by using dental operating microscope (Fig. 2) and hereafter he was undergoing to a minimal-invasive surgical intervention.
Results: The pathological diagnosis was hemangioma.
Conclusions: This case illustrates not only a well-documented very rare example of a hemangioma with topographic association to the inferior alveolaris nerve with respect to its combined endodontic and surgical treatment. Moreover, its three years follow-up documentation also presents the importance of a concise preliminary examination in order to reduce possible risks and to achieve the most satisfactory results for the patient.