Objective: To compare the histopathologic types of periapical lesions obtained during apicectomy of maxillary anterior teeth, with the clinico-radiological findings and treatment outcome of the lesions.

Methods: A prospective study was carried out over a 3-year period, during which periapical tissues obtained after apicectomy of maxillary anterior teeth were routinely examined histologically. Post-apicectomy radiological assessment of the patients was performed over a period of 2 weeks to 1 year.

Results: Thirteen patients with clinically diagnosed periapical lesions had apicectomy performed on their maxillary anterior teeth during the study period. There was a male to female ratio of 2.3:1 and the peak age group for the patients was 21 to 25 years (n=6, 46.2%). The mean duration of presentation of the lesions was 5.4 years + 4.6. The lesions were diagnosed histologically as periapical granuloma (n=9, 69.2%) and periapical cyst (n=4, 30.8%). A significant association of periapical granuloma with upper central incisor tooth and the clinical diagnosis of acute apical periodontitis was observed (p