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exhibit “egg shell crackling”. The associated teeth are always non-vital and may show discolouration. Al- thoughtheassociatedteethusuallyshownorootre- sorption, there may be smooth resorption of root apices. When cysts are intact, cyst cavities may be filled with brown- or straw-coloured fluid, giving them a shimmering gold appearance.4 Radicular cysts are inflammatory lesions leading to bone re- sorptionandcanreachgreatdimensionsandbecome symptomaticwheninfectedorwithgreatsizedueto nerve compression. The main cause of failure of en- dodontic treatment is generally accepted to be the continuing presence of microorganisms in the root canal system that have either resisted treatment or havereinfectedtherootcanalsystem.E.faecaliswas the most frequently found microbe in such cases.5 Chlorhexidine gluconate has been proposed for use bothasanirrigantandasamedicamentespeciallyin endodonticretreatment.Asamedicament,itismore effective than calcium hydroxide in eliminating E. faecalis infection inside dentinal tubules.6 As an irri- gant, it appears as effective or superior to sodium hypochlorite in the elimination of E. faecalis.7 The adult human periosteum is highly vascular and is known to contain fibroblasts, osteoblasts, and stem cells. Skoog8 subsequently introduced the use of pe- riosteal flaps for closure of maxillary cleft defects in humans; he reported the presence of new bone in cleft defects within 3–6 months following surgery. Furthermore, animal studies have reported hetero- topic ossification in different organs after implanta- tion of free periosteal grafts.9, 10 In all age groups, the cells of the periosteum retain the ability to differen- tiate into various cells.11 On the basis of these obser- vations, it can be hypothesised that the periosteal membrane can contribute to the stimulation of new boneformationandhasanimmensepotentialforre- generation. PRF belongs to the new generation of platelet concentrates with simplified processing. PRF con- tains a variety of growth factors, which enhance healing by increasing angiogenesis and matrix biosynthesis.12 Theimmenseosteoinductivecapabil- ity of DFDBA is well-described in the periodontal lit- erature.13 The treatments of these cysts are still under dis- cussion, and many professionals opt for a conserva- tive treatment by means of endodontic technique.14 However, in large or non-healing lesions, the en- dodontic treatment alone is not efficient and surgi- cal treatments like marsupialisation or enucleation should be considered.15 In this case, surgical enucle- ationwaspreferredandwasperformeduneventfully. _Conclusion To conclude, a radicular cyst is a common condi- tionfoundintheoralcavity.However,itusuallygoes unnoticed and rarely exceeds the palpable dimen- sion. This case report illustrates the successful man- agementofaradicularcystwithenucleationanden- dodontic treatment. The use of autologous perios- teum and PRF has a promising future in periodontal regeneration._ Editorial notes: A list of references is available at the publishers. Theauthorsdeclarethattheyhavenoconflictofinterest. Thisarticlewasfirstpublishedin:CaseReportsinDentistry, vol. 2013, Article ID 893791, 5 pages, 2013. doi:10.1155/ 2013/893791 I case report Fig. 5_Harvested autologous periosteum. Fig. 6_Autologous periosteum placed as a barrier membrane. Fig. 7_PRF placed as a barrier membrane. Fig. 8_Sutured flap with 3-0 silk suture. Fig. 9_Histopathology of excised cyst. Fig. 10_Six months postoperative radiograph. Fig. 11_Nine months postoperative radiograph. Fig. 12_Healing at nine months after operation. 20 I implants2_2015 contact Dr Manthan Desai MDS Consultant Periodontist and Implantologist Mumbai,India manthandesai.md@gmail.com Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 5 Fig. 6 Fig. 7 Fig. 8