Clinical case description: A 31 year old male patient, with no relevant medical history, was fowarded by a colleague showing in a panoramic radiography, a lesion in the second quadrante. The CT scan confirmed the existence of a cyst in the area, also affecting the teeth 21 and 22. After doing the endodontic treatment of 23 the patient was medicated with amoxicilin 875 mg + clavulanic acid 125 mg, aceclofenac 100 mg and chlorhexidine 0.2%, to perfom the surgery. Discussion: Periapical injuries are amongst the most common pathological lesions of the alveolar bone. They are most often found in the anterior maxillary portion. This is related with the presence of epitelial waste and the high incidence of trauma in anterior teeth. Its location and morfology results in a higher probability of pulp necrosis. The removal of these lesions, is a sensitive work because, if they reach a considerable size, it may affect the oro-nasal communication, existing reported cases of bone destruction of the nasal cavity. Conclusion: Periapical lesions should initialy be treated with a nonsurgical endodontic treatment. If this treatment dows not result in success, the next step would be a surgical approach. A correct planning of the surgery accompanied by appropiate imaging exams, incresse the predictability of the intervention, reducing the postoperative inconveniences and the probability injury relapse. Keywords: Jaw, apical lesions, surgery, apicectomy, endodontics, anterior