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Radicular cyst

#oceanofdentistry#OCEANOFDENTISTRY oral pathology radicular cyst periapical cyst periodontal cyst root end cyst. Infective carious teethInflammatory odontogenic cyst Lined by epithelial cells derived from rests of Malassez Also called radicular cyst, apical periodontal cyst, root end cyst, or dental cyst Terminology Epithelial rest of Malassez: Derived from Hertwig epithelial root sheath Small spherules of 6 - 8 epithelial cells with high nuclear to cytoplasmic ratio Little or no reverse polarity of cells Periapical cyst: present at root apex Lateral radicular cyst: present at the opening of lateral accessory root canals Residual cyst: remains even after extraction of offending tooth Periapical granuloma: chronic granulomatous inflammation of periapical tissues Epidemiology Most common odontogenic cyst (52% of jaw cystic lesions) Most common in 4th & 5th decades, but occurs over wide age range Sites 60% in maxilla (vs. mandible) Most commonly in apex of lateral incisors, but also along lateral accessory root canals Pathophysiology Dental caries or trauma cause chronic inflammation which eventually forms a periapical inflammation; continued inflammation stimulates cells of the rests of Malassez, the epithelial cells undergo necrosis to form the cyst which may be sterile or become secondarily infected While most are lined by epithelium derived from rests of Malassez, epithelial lining may be respiratory type derived from the maxillary sinus, in the setting of a periapical lesion communicating with the sinus wallMay be oral epithelium from a fistula or oral epithelium proliferating down a periodontal pocketClinical feature May be asymptomatic and incidentally found with radiographsPossible swelling (occurs slowly)May be painful if infectedRadiology descriptioRound to oal radiolucency, often with well definedortical border (this border can be lost when infectedCan displace or reabsorb roots of adjacent teeth if largeDependent on tooth affected, size of cyst / extent of bone destruction and accessibility for treatmentadult teeth, can treat necrotic pulp (infection source) via pulpectomy ("root canal") with sparing of the tooth; this induces involution of the cyst; can also extract tooth In some very large cysts, after above treatment, additional surgical management (enucleation or marsupialization) is required for the osseous cyst Rare complications: Squamous cell carcinoma and epidermoid carcinoma may arise from the epithelial lining of periapical cysts Pathologic bone fracture (occurs with large cysts that erode nearly completely through the jaw) Insta gram :ocean of dentistry Fb:. Pharmacology adda Whatsapp for notes :https://chat.whatsapp.com/E4sX2QPn29S...