Periapical lesion results from serious inflammatory response to microorganisms around the tooth root and the root canal [1]. Periapical lesions could perforate into the oral cavity affecting hard tissue or maxillary sinus. The infection around the root and tooth leads to bone resorption caused by local osteomyelitis [2]. Furthermore, cellulitis in soft tissue causing swelling in the face is a common symptom of severe local jawbone osteomyelitis. Traumatic injuries of teeth can cause granuloma or cysts associated with periapical lesions. Granulomas are composed usually of solid soft tissue, while cysts are semisolid tissue surrounded by epithelium [3]. Radiographs show lesions structure as unilocular, lucent, round, or pear shaped contoured by a thin rim of cortical bone [4]. The incidence of cysts formation is between 6 and 55% in small lesions and a 100% with lesions larger than 20 mm [2]. On the other hand, granulomas occurrence ranges between 9.3 and 87.1%, where abscesses formation rate is between 28.7 and 70.07% [4]. Epithelial proliferation and other molecular mechanisms can cause lesion formation. Nonetheless, by-products of microorganisms, which lead to osmotic fluid accumulation in the lumen, are the most common cause of periapical lesions [5]. Therefore, eliminating microorganisms can release the hydrostatic pressure resulting from osmotic fluid and minimize the effect of periapical lesions on the tooth. Management of infection-caused periapical lesions is a two-step process. Firstly, antibacterial treatment is performed using antibiotics (e.g., metronidazole, ciprofloxacin, and minocycline), chemical irrigation, and disinfectants (i.e., calcium hydroxide). Despite its wide use as disinfectant of the root canal system, calcium hydroxide is not effective as root canal dressing [2, 6, 7]. Secondly, releasing the hydrostatic pressure is detrimental and can be achieved by decompression, aspiration, and aspiration irrigation [8–۱۰].