Methods: A 49 year-old woman with non-contributory medical history was referred from a private practitioner to the Department of Endodontology. On clinical examination, #11 & #12 gave no response neither percussion nor electric pulp tests. Preoperative radiograph revealed a large radiolucent lesion around the periapices of #11, #12 and #14. The teeth had closed apices. In view of the clinical symptoms and periapical pathology, it was diagnosed as chronic apical periodontitis and a nonsurgical endodontic treatment of #11 & #12 was planned. When the cavities were opened, there was drainage from the access. Two large needles which were tightly wedged 3 mm beyond the apices were inserted inside the root canals and luted to the access with composite resin material. At 1 month follow up, no pus drainage was observed. The teeth were asymptomatic and root canals obturated.
Results: The patient was followed up at regular interval of 1, 3, 6 and 12 months respectively. At one-year follow up, complete resolution of the periapical pathology was observed and the patient was completely asymptomatic.
Conclusions: The result of this case demonstrates that drainage in conjunction with intracanal medicamentation may possibly be used in managing large periapical lesions.