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BMC Oral Health Dec 2022Radicular cysts arising from primary teeth are rare. Enucleation and marsupialization or decompression are treatment approach to odontogenic cysts. Decompression known...
BACKGROUND
Radicular cysts arising from primary teeth are rare. Enucleation and marsupialization or decompression are treatment approach to odontogenic cysts. Decompression known to achieve good results in various cysts is widely used in clinic. This study aims to evaluate the efficiency of decompression in reducing radicular cysts associated with primary teeth in children.
METHODS
Cases of radicular cysts associated with primary teeth treated by decompression were reviewed in the present study. Clinical information and radiologic data of pre and post decompression were measured and analyzed.
RESULTS
Twenty-three patients treated for 25 cysts were included. All lesions with mean initial area 3.66 ± 2.00 cm were reduced after decompression time ranging 2 to 10 months. Mean rate of reduction was 0.77 ± 0.44 cm/mo and large lesions (> 3.5 cm) had a significantly higher reduction rate compared to smaller ones (< 3.5 cm) (P < 0.00). All effected succedaneous teeth erupted after treatment at follow-up while 12 (46%) of them had root development problems.
CONCLUSIONS
Decompression represents superiority as an effective and less invasive treatment in radicular cysts associated with primary teeth.
TRIAL REGISTRATION
This study was retrospectively registered in the Ethics Committee of Ninth People's Hospital Affiliated with Shanghai JiaoTong University School of Medicine (No.SH9H-2022-T158-1).
Topics: Child; Humans; Radicular Cyst; Retrospective Studies; China; Odontogenic Cysts; Decompression; Tooth, Deciduous
PubMed: 36457003
DOI: 10.1186/s12903-022-02572-w -
Journal of Oral and Maxillofacial... 2020The aim of this study is to compare the proliferative capacity and antiapoptotic capacity of unicystic ameloblastoma (UA), odontogenic keratocyst (OKC), dentigerous cyst...
OBJECTIVE
The aim of this study is to compare the proliferative capacity and antiapoptotic capacity of unicystic ameloblastoma (UA), odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) by assessing the Ki-67 labeling index (LI) and Bcl-2 LI, respectively.
MATERIALS AND METHODS
Formalin-fixed, paraffin-embedded tissue blocks of twenty-three histopathologically diagnosed UAs, 6 OKCs, 8 DCs and 10 RCs were selected from the archival specimens. Five micrometer thick sections of tissue blocks of the lesions were processed for immunohistochemical staining with Ki-67 and Bcl-2. The Ki-67 LI and Bcl-2 LI were determined for the cases with a positive reaction.
RESULTS
Ki-67 expression was seen in 6 (26.1%) cases of UA, 4 (66.7%) OKC, 1 (12.5%) DC and 1 (10.0%) RC. There was a statistically significant difference between the mean Ki-67 LI of UA and OKC ( = 0.024). Bcl-2 expression was seen in 16 (69.6%) UA, 5 (83.3%) OKC, 5 (62.5%) DC and 5 (50.0%) RC. The mean Bcl-2 LI of UA was significantly higher than that of DC ( = 0.048). Furthermore, cases of OKC had significantly higher mean Bcl-2 LI compared to DC ( = 0.026) and RC ( = 0.049).
CONCLUSION
This study suggests that the Ki-67 LI may help in differentiating OKC from UA. The Bcl-2 LI may be useful in differentiating UA from DCs, and differentiating OKC from DC and RC.
PubMed: 33456257
DOI: 10.4103/jomfp.JOMFP_289_19 -
Archives of Oral Biology Nov 2013In this study the potential presence of bacteria in radicular cyst (RC) and keratocystic odontogenic tumour(KCOT) fluids from clinically asymptomatic patients was...
OBJECTIVE
In this study the potential presence of bacteria in radicular cyst (RC) and keratocystic odontogenic tumour(KCOT) fluids from clinically asymptomatic patients was investigated.
MATERIALS AND METHODS
Cyst fluids were collected by needle aspiration from 16 patients with asymptomatic osteolytic lesions (10 RCs and 6 KCOTs) undergoing surgery. All samples were transferred into tubes containing pre-reduced transport medium, delivered to the microbiology laboratory and processed within 1h. The cysts, surgically enucleated, were sent for standard histopathological examination. Cyst fluid samples were cultured on selective and differential media in anaerobic (for about 2 weeks) and aerobic (for 24-48 h) conditions to detect viable microorganisms. After incubation, the colonies were counted, Gram-stained and identified by biochemical tests.
RESULTS
Cultures were positive for the presence of bacteria in 15 (9 RCs, 6 KCOTs) out of 16 cases. RCs and KCOTs generally yielded low bacterial counts (10(2)-10(4) CFU/ml) and were predominantly colonized by obligate anaerobes (64%), whereas less commonly by facultative anaerobes (36%). No significant differences in the detection frequencies of obligate and facultative anaerobes were evidenced between RCs and KCOTs. Propionibacterium acnes was the most common obligate anaerobe recovered both in RC and KCOT fluids. Among facultative anaerobes, Gemella morbillorum was more frequently isolated in KCOTs, whereas Staphylococcus spp. in RCs.
CONCLUSIONS
Bacteria may be present and persist within fluids of clinically asymptomatic jaw cystic lesions. The influence of bacteria and latent bacterial infection within cystic jaw lesions should be reconsidered in odontogenic cyst progression.
Topics: Adult; Aged; Aged, 80 and over; Asymptomatic Diseases; Cell Culture Techniques; Colony Count, Microbial; Female; Gemella; Humans; Jaw Neoplasms; Male; Middle Aged; Odontogenic Tumors; Propionibacterium acnes; Radicular Cyst; Staphylococcus
PubMed: 24112722
DOI: 10.1016/j.archoralbio.2013.07.009 -
Iranian Endodontic Journal 2021In endodontics, accurate diagnoses are important for the selection of appropriate and successful therapy. Several nonendodontic entities in periapical location may... (Review)
Review
In endodontics, accurate diagnoses are important for the selection of appropriate and successful therapy. Several nonendodontic entities in periapical location may resemble those of inflammatory endodontic origin and impact therapeutic approaches. The aim of this study was to review noninflammatory entities mimicking dentoalveolar abscesses or apical periodontitis and to discuss clinical and pathological features. In this review study, the authenticated search engine in PubMed (MEDLINE) database was used to find articles by using "Nonvital Pulp Dentoalveolar Abscess", "Nonvital Pulp And Apical Periodontitis", "Periapical Abscess", "Chronic Dentoalveolar Abscess", "Chronic Apical Periodontitis", "Periapical Granuloma", And "Radicular Cyst". Each of these predefined keywords were combined with the terms "Misdiagnosed", "Mimicking", "Masquerading", or "Simulating" to search for reported cases indexed from 1978 to 2020. All case reports fulfilling the selection criteria were reviewed to identify radiolucent nonendodontic periapical lesions focused on the questions: "Which pathological entities mimick radiolucent endodontic lesions in periapical location? Based on endodontic clinical parameters, what are the contrasting features?" Out of 426 articles, 111 were relevant to the subject, including a series of cases and case reports. Only well-documented English and recent papers were considered. A total of 30 noninflammatory entities appeared clinically as radiolucent endodontic lesion in periapical location. Lesions simulating chronic apical periodontitis represented 83.3% and dentoalveolar abscess 16.7%. Interestingly, primary malignancies and metastasis counted 43.3% and pain was a typical symptom. Swelling was a noncontributory clinical feature in distinguishing periapical lesions. Lack of pulp response was registered in 68.4% of nonedodontic lesions. A flowchart was generated to summarize clinicopathological aspects of radiolucent nonendodontic entities appearing as dentoalveolar abscesses or apical periodontitis In relation to clinical practice, it is very important for us to note that, a group of pathological entities may simulate radiolucencies of endodontic origin in periapical location, especially malignancies and non-inflammatory odontogenic lesions.
PubMed: 36704403
DOI: 10.22037/iej.v16i3.32572 -
Head and Neck Pathology Dec 2021Dentigerous cysts, also known as follicular cysts, are among the most common developmental cysts of the gnathic bones. The majority of cases are clinically asymptomatic...
Dentigerous cysts, also known as follicular cysts, are among the most common developmental cysts of the gnathic bones. The majority of cases are clinically asymptomatic and discovered incidentally on panographic radiographs during routine dental care. The cyst appears as a radiolucency, classically unilocular, associated with the crown of an unerupted or impacted tooth. Usually diagnosed in the 2nd-3rd decade, third molars of the mandible are the most commonly affected teeth. Histologically, dentigerous cysts demonstrate a fibrous or fibromyxoid connective tissue wall lined by squamous epithelium, classically lacking rete ridges. Inflammation may introduce histologic changes, however. The differential diagnosis includes hyperplastic dental follicle, periapical or radicular cyst, unicystic ameloblastoma, odontogenic keratocyst, and other odontogenic cysts and tumors. While the findings are generally classic and pose no diagnostic dilemma, the diagnosis is best made in the context of the appropriate clinical and radiographic setting. Submitted tissue with a lack of history, to include a detailed relationship with the affected tooth, may result in misdiagnosis and subsequent confusion for the clinician. So, despite its simple features, dentigerous cysts are not uncommonly mischaracterized. Therefore a review of a classic case of dentigerous cyst is presented.
Topics: Dentigerous Cyst; Humans; Male; Mandibular Diseases; Radiography, Panoramic; Young Adult
PubMed: 33881736
DOI: 10.1007/s12105-021-01327-3 -
Dento Maxillo Facial Radiology Feb 2023Limited studies have differentiated radicular cysts and granulomas with MRI. Therefore, we investigated the MRI characteristics of the two lesions and clarified features...
OBJECTIVES
Limited studies have differentiated radicular cysts and granulomas with MRI. Therefore, we investigated the MRI characteristics of the two lesions and clarified features for distinguishing between them.
METHODS
We collected data of 27 radicular cysts and 9 granulomas definitively diagnosed by histopathology and reviewed the fat-saturated weighted, weighted, and contrast-enhanced fat-saturated weighted images. We measured the maximum diameter and apparent diffusion coefficient values of the lesions. We employed Fisher's exact test, the Mann-Whitney test, and independent -tests to compare the two lesions and created a decision tree for discriminating between them.
RESULTS
There were significant differences between radicular cysts and granulomas with respect to five imaging characteristics-signal intensity of the lesion centre on fat-saturated weighted images; signal intensity, texture, and contrast enhancement of the lesion centre on contrast-enhanced fat-saturated weighted images; and maximum diameter of the lesion. The cut-off diameter for radicular cysts was 15.9 mm. The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.971, 85.2%, and 100%, respectively.
CONCLUSIONS
From the decision tree analysis, maximum diameter, lesion centre contrast enhancement on contrast-enhanced fat-saturated weighted images, and lesion centre signal intensity on fat-saturated weighted images were important for discriminating between radicular cysts and granulomas.
Topics: Humans; Radicular Cyst; Magnetic Resonance Imaging; Diffusion Magnetic Resonance Imaging; Granuloma; ROC Curve; Contrast Media
PubMed: 36688723
DOI: 10.1259/dmfr.20220336 -
Brazilian Oral Research 2021The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and... (Review)
Review
The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.
Topics: Adolescent; Adult; Brazil; Chronic Disease; Female; Humans; Multicenter Studies as Topic; Periapical Abscess; Periapical Diseases; Periapical Granuloma; Radicular Cyst; Young Adult
PubMed: 33729278
DOI: 10.1590/1807-3107bor-2021.vol35.0033 -
Cureus Oct 2023A radicular cyst, also known as a periapical cyst or root end cyst, is a type of odontogenic cyst that is typically associated with permanent teeth. The radicular cyst...
A radicular cyst, also known as a periapical cyst or root end cyst, is a type of odontogenic cyst that is typically associated with permanent teeth. The radicular cyst usually is associated with maxillary central incisors followed by mandibular first molars. It occurs as a result of bacterial infection and pulpal necrosis which leads to inflammatory stimulation of the epithelial cell rests of Malassez along the periodontal ligament area of the tooth. Most cases of the radicular cyst are asymptomatic and they are diagnosed accidentally during routine radiographic examination. This article presents a case report of a 42-year-old male with an apical periodontal cyst associated with the maxillary anterior region. Early diagnosis and treatment planning is necessary. This article signifies the role of the surgeon in the early diagnosis and treatment plan of the cyst.
PubMed: 37965401
DOI: 10.7759/cureus.47030 -
Journal of Dental Sciences Jul 2022
PubMed: 35784141
DOI: 10.1016/j.jds.2022.04.003 -
International Journal of Clinical... 2023This case report aims to describe the importance of early diagnosis, various clinical features, and management of radicular cyst with primary mandibular molar.
AIM
This case report aims to describe the importance of early diagnosis, various clinical features, and management of radicular cyst with primary mandibular molar.
BACKGROUND
Radicular cyst is an odontogenic inflammatory cyst in origin seen more frequently in permanent dentition and rarely in the primary dentition. It can develop due to pulp injuries or pulp necrosis caused by deep dental caries or dental trauma. It may adversely affect the normal development and eruption of the permanent succedaneous teeth.
CASE DESCRIPTION
We report a case of radicular cyst in association with the primary mandibular molar and its therapeutic management.
CONCLUSION
The efforts in diagnosing and managing radicular cyst when associated with primary teeth hold a good impact on a child's oral health status. Good amount of bone healing and development of the succedaneous permanent tooth bud in its normal position were observed when managed appropriately.
CLINICAL SIGNIFICANCE
Early diagnosis, proper treatment planning, appropriate management, and regular follow-ups of radicular cyst in primary dentition hold great importance for pediatric dentists as well as general dentists in routine dental practice.
PubMed: 38162247
DOI: 10.5005/jp-journals-10005-2679