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International Journal of Clinical... 2022To present the treatment of radicular cysts with marsupialization in children and help reduce morbidity.
AIM
To present the treatment of radicular cysts with marsupialization in children and help reduce morbidity.
BACKGROUND
Radicular cyst is a cyst with an odontogenic origin seen more frequently in permanent dentition and seldom in primary dentition. Radicular cysts can develop due to apical infection caused by caries or can also occur as a consequence of pulp therapy in primary teeth. It may adversely affect the normal development and eruption of the permanent succedaneous teeth.
CASE DESCRIPTION
We report two cases of radicular cysts in association with primary teeth with different etiologies and their conservative management with marsupialization and decompression techniques.
CONCLUSION
Marsupialization has shown to be effective in treating radicular cysts in primary teeth. Good bone healing and normal continued development of the succedaneous permanent tooth bud were observed. Marsupialization helps in preserving vital structures and reduces morbidity. It should be a preferred treatment modality for the management of large-sized radicular cysts.
HOW TO CITE THIS ARTICLE
Ahmed T, Kaushal N. Treatment of Radicular Cyst with Marsupialization in Children: Report of Two Rare Cases. Int J Clin Pediatr Dent 2022;15(4):462-467.
PubMed: 36875979
DOI: 10.5005/jp-journals-10005-2416 -
Journal of Conservative Dentistry : JCD 2021Periapical granuloma and periapical cysts develop as a sequela of inflammation of dental pulp, usually a consequence of an infected root canal. Mast cells (MCs) have...
BACKGROUND
Periapical granuloma and periapical cysts develop as a sequela of inflammation of dental pulp, usually a consequence of an infected root canal. Mast cells (MCs) have most frequently been implicated in the pathophysiology of periapical lesions such as periapical granulomas and cysts.
AIMS
The present study was undertaken to emphasize the presence and quantification of MCs in periapical lesions (granulomas and cysts) using toluidine blue stain, with an aim to elucidate their role in the pathogenesis of these lesions.
MATERIALS AND METHODS
The study comprised a total of 55 previously diagnosed cases (30 cases of radicular cyst and 25 cases of periapical granuloma) selected from the departmental archives. The MCs were quantified in all the sections in the three zones, namely the epithelial, subepithelial, and deeper connective tissue zones. The results were sent for statistical analysis.
STATISTICAL ANALYSIS
Wilcoxon paired -test and Mann-Whitney U test were applied for intra- and intergroup comparison MCs in different zones of periapical granulomas and radicular cyst, respectively.
RESULTS
A statistically significant difference was observed between the two lesions in all the three zones, i.e., epithelial, subepithelial, and in deeper connective tissue zone with = 0.001.
CONCLUSION
Although MCs were present in all the three zones of both periapical cysts and granuloma, they were predominantly observed in radicular cysts than in periapical granuloma. This suggests a significant role of MC in initiation, development, and progression of these periapical lesions.
PubMed: 35558681
DOI: 10.4103/jcd.jcd_505_21 -
Scientific Reports Aug 2020Clinical differentiation between cystic lesions of endodontic and non-endodontic origin is of importance because correct diagnosis may affect treatment decision making....
Clinical differentiation between cystic lesions of endodontic and non-endodontic origin is of importance because correct diagnosis may affect treatment decision making. Most radicular cysts are treated with conservative approaches and, therefore, are not surgically removed. The objective of this study was to determine the accuracy of clinical diagnosis of periapical lesions as compared to the histological findings, and to evaluate various associated factors. All biopsy specimens submitted for histological evaluation from 2002 to 2009 were assessed. Only cases of periapical lesions with complete patient data and clinical diagnosis were included. Sensitivity, specificity and accuracy of the clinical diagnosis were calculated and various patient-related factors were evaluated. Of the 4,908 cases, 183 met inclusion criteria. Histologically, there were 171 lesions of radicular cysts and 12 cases of non-endodontic cysts, including OKC and Incisive Canal Cyst. The diagnostic accuracy for clinical diagnosis for radicular cysts was 91.84% and 91.84% for non-endodontic cysts. There was a high accuracy of clinical differentiation between cystic lesions of endodontic and non-endodontic origin. However, some non-endodontic lesions may be incorrectly diagnosed clinically as lesions of endodontic origin. Histological evaluation may be necessary for the correct diagnosis. Further clinical studies are needed to evaluate clinical examination and histological diagnosis of periapical lesions.
Topics: Adult; Biopsy; Diagnosis, Differential; Female; Humans; Jaw Cysts; Male; Middle Aged; ROC Curve; Radicular Cyst; Retrospective Studies; Sensitivity and Specificity
PubMed: 32843680
DOI: 10.1038/s41598-020-71029-3 -
International Journal of Clinical... 2022Radicular cyst involving the deciduous dentition is rare. Most of the cases reported it with primary molar teeth with apical infection. But very rare literature is...
UNLABELLED
Radicular cyst involving the deciduous dentition is rare. Most of the cases reported it with primary molar teeth with apical infection. But very rare literature is available regarding radicular cysts associated with primary incisors.
CASE REPORT
A case of 9-year-old boy, who had bilaterally impacted supernumerary teeth, had developed a radicular cyst associated with a previously traumatized and intruded right upper primary lateral incisor is reported. Supernumerary teeth and intruded primary lateral incisor were removed along with enucleation of a radicular cyst.
CONCLUSION
The importance of correct diagnosis and management of radicular cyst in pediatric patients is important as most of the radicular cysts of primary teeth go undiagnosed, which can affect the developing succedaneous tooth bud.
HOW TO CITE THIS ARTICLE
Bhosale AN, Desai S, Patil S, Radicular Cyst Involving Deciduous Maxillary Incisor along with Bilateral Supernumerary Teeth: A Case Report. Int J Clin Pediatr Dent 2022;15(2):218-221.
PubMed: 37457217
DOI: 10.5005/jp-journals-10005-2358 -
Ghana Medical Journal Jun 2015To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a...
OBJECTIVE
To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population.
METHOD
A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.
RESULTS
From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3(rd) decade (n=23, 42.6%) with a mean age of 31 ± 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3(rd) and 4(th) decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%).
CONCLUSION
This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous-like change from cystic ameloblastoma arising from radicular cyst.
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Ameloblastoma; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Jaw Cysts; Male; Middle Aged; Nigeria; Radicular Cyst; Retrospective Studies; Sex Distribution; Young Adult
PubMed: 26339095
DOI: 10.4314/gmj.v49i2.8 -
JPMA. the Journal of the Pakistan... May 2022Radicular cyst is the most common type of odontogenic cyst associated with the apex of non-vital teeth. The lining of the radicular cyst usually arises from the...
Radicular cyst is the most common type of odontogenic cyst associated with the apex of non-vital teeth. The lining of the radicular cyst usually arises from the epithelial rests of Malassez. These cyst usually persists even after the elimination of microbial load from the root canals. Surgical removal is deemed necessary for the management. For larger lesions extending to the facial or palatal cortical plates, additional regenerative procedures such as bone grafting along with collagen membrane are warranted. This case report describes the surgical and prosthetic management of a giant radicular cyst that was perforating the cortical plates in the anterior maxilla.
Topics: Humans; Maxilla; Prosthodontics; Radicular Cyst
PubMed: 35713066
DOI: 10.47391/JPMA.2111 -
Medicina (Kaunas, Lithuania) Sep 2021: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and...
: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. : All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012-2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. : A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. : the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.
Topics: Adult; Female; Humans; Incisor; Male; Maxilla; Radicular Cyst; Root Canal Therapy; Tooth, Nonvital
PubMed: 34577915
DOI: 10.3390/medicina57090991 -
Clinical Oral Investigations Nov 2021With only limited information available on dimensional changes after jaw cyst surgery, postoperative cyst shrinkage remains largely unpredictable. We aimed to propose a...
OBJECTIVES
With only limited information available on dimensional changes after jaw cyst surgery, postoperative cyst shrinkage remains largely unpredictable. We aimed to propose a model for volumetric shrinkage based on time elapsed since cyst surgery.
MATERIAL AND METHODS
We used data from patients that underwent cyst enucleation or decompression between 2007 and 2017 and had at least three computed tomography (CT) scans per patient. We fitted one simple exponential decay model [V(t) = V · e] and one model with a patient-specific decay rate [V(t) = V · e].
RESULTS
Based on 108 CT scans from 36 patients (median age at surgery: 45.5 years, IQR: 32.3-55.3, 44% female), our simple exponential decay model is V(t) = V · e where V(t) is the residual cyst volume after time t elapsed since surgery, V is the initial cyst volume, and e is the base of the natural logarithm. Considering a patient-specific decay rate, the model is V(t) = V · e where γ is normally distributed, with expectation 0 and standard deviation 0.0041.
CONCLUSIONS
Using an exponential regression model, we were able to reliably estimate volumetric shrinkage after jaw cyst surgery. The patient-specific decay rate substantially improved the fit of the model, whereas adding specific covariates as interaction effects to model the decay rate did not provide any significant improvement.
CLINICAL RELEVANCE
Estimating postoperative cyst shrinkage is relevant for both treatment planning of jaw cyst surgery as well as evaluating the clinical success of the surgical approach.
Topics: Cysts; Female; Humans; Male; Orthognathic Surgical Procedures; Radicular Cyst; Tomography, X-Ray Computed
PubMed: 33876318
DOI: 10.1007/s00784-021-03907-7 -
Scientific Reports Jul 2023Recently, 1-nonadecene and L-lactic acid were identified as unique metabolites in radicular cysts and periapical granuloma, respectively. However, the biological roles...
Recently, 1-nonadecene and L-lactic acid were identified as unique metabolites in radicular cysts and periapical granuloma, respectively. However, the biological roles of these metabolites were unknown. Therefore, we aimed to investigate the inflammatory and mesenchymal-epithelial transition (MET) effects of 1-nonadecene, and the inflammatory and collagen precipitation effects of L-lactic acid on both periodontal ligament fibroblasts (PdLFs) and peripheral blood mononuclear cells (PBMCs). PdLFs and PBMCs were treated with 1-nonadecene and L-lactic acid. Cytokines' expression was measured using quantitative real-time polymerase chain reaction (qRT-PCR). E-cadherin, N-cadherin, and macrophage polarization markers were measured using flow cytometry. The collagen, matrix metalloproteinase (MMP)-1, and released cytokines were measured using collagen assay, western blot, and Luminex assay, respectively. In PdLFs, 1-nonadecene enhances inflammation through the upregulation of some inflammatory cytokines including IL-1β, IL-6, IL-12A, monocyte chemoattractant protein (MCP)-1, and platelet-derived growth factor (PDGF) α. 1-Nonadecene also induced MET through the upregulation of E-cadherin and the downregulation of N-cadherin in PdLFs. 1-Nonadecene polarized macrophages to a pro-inflammatory phenotype and suppressed their cytokines' release. L-lactic acid exerted a differential impact on the inflammation and proliferation markers. Intriguingly, L-lactic acid induced fibrosis-like effects by enhancing collagen synthesis, while inhibiting MMP-1 release in PdLFs. These results provide a deeper understanding of 1-nonadecene and L-lactic acid's roles in modulating the microenvironment of the periapical area. Consequently, further clinical investigation can be employed for target therapy.
Topics: Humans; Radicular Cyst; Periapical Granuloma; Leukocytes, Mononuclear; Virulence; Cytokines; Inflammation; Lactic Acid; Tumor Microenvironment
PubMed: 37400519
DOI: 10.1038/s41598-023-37945-w -
Acta Medica Academica Aug 2019In silico bioinformatical analysis suggested that the expression of two genes, CCL5 (C-C Motif Chemokine Receptor 5) and ep300 (Histone acetyltransferase p300), could be...
OBJECTIVES
In silico bioinformatical analysis suggested that the expression of two genes, CCL5 (C-C Motif Chemokine Receptor 5) and ep300 (Histone acetyltransferase p300), could be used as potential new biomarkers in differentiation between periapical granulomas and radicular cysts. Thus, we hypothesized that gene expression of CCL5 and ep300 in periapical lesions would classify the lesions as either granuloma or cyst.
MATERIALS
Patient samples (n=122) included 46 periapical granulomas, 38 radicular cysts and 38 healthy gingival samples as controls. Real-time PCR analysis of CCL5 and ep300 transcripts was compared to SDHA (Succinate dehydrogenase complex, subunit A) as the reference. Clinical parameters (e.g., intensity of inflammation and lesion size) were measured and correlated with CCL5 and ep300 expression. ROC (Receiver operating characteristic) and logistic regression analyses were used to establish the diagnostic character of ΔCt values.
RESULTS
Granulomas and radicular cysts had significantly higher expression of CCL5 and ep300 compared to controls (P<0.05). However, no differences were observed when comparing granulomas and radicular cysts. ROC analyses showed that CCL5 and ep300 have good diagnostic accuracy, but low accuracy for distinguishing between the lesions.
CONCLUSIONS
This study confirmed that expression of CCL5 and ep300 is relevant for the pathogenesis of periapical inflammatory lesions but cannot be used as a distinctive marker between these lesions.
Topics: Biomarkers; Chemokine CCL5; Diagnosis, Differential; E1A-Associated p300 Protein; Gingiva; Humans; Periapical Granuloma; Radicular Cyst
PubMed: 31718213
DOI: 10.5644/ama2006-124.251