Epithelial cells derive their nutrients by diffusion from adjacent c. Dentigerous cyst, also known as follicular cyst is an epitheliallined developmental cyst formed by accumulation of fluid between the reduced enamel epithelium and crown of an unerupted tooth. The periapical cyst exhibits the same clinical and radiographic features as the periapical granuloma i. Radicular cysts arise from the epithelial residues in the periodontal ligament as a result of inflammation. Radicular cyst at the apex of a dead tooth with necrotic pulp. The radicular cyst is the model pathogenesis of an inflammation. Pdf radicular cysts are the most common cystic lesions affecting the jaws. The pathogenesis of the true cyst has been described in three phases 14.
Radicular or periapical cyst, is the most common inflammatory cyst arising due to the proliferation of the epithelial rests in the periodontal ligament. Periapical cyst treatment dental solutions bangalore. Initially, the cyst swells to a round hard protrusion, but later on the body resorbs some of the cyst wall, leaving a softer accumulation of fluid underneath the mucous membrane. Radicular cyst is believed to be derived from the epithelial cell rests of malassez. Radicular cysts on maxillary lateral incisor, often cause an expansion of palatal bone and mucosa.
Pathogenesis of radicular cyst is conveniently considered in 3 phases, which are as follows. Periapical cysts begin as asymptomatic and progress slowly. The periapical cyst also termed radicular cyst, and to publishing standards pdf a lesser extent dental cyst is the most common odontogenic. Radiographically, they appear as a round or oval unilocular radiolucency but, in contrast to a radicular cyst, there is no obvious tooth involvement figure 4. The pathogenesis of dentigerous cyst is still controversial. Nov 22, 2014 the frequency of dentigerous cyst formation has been calculated as 1. Radicular cyst is the most common odonto genic cyst that occurs at the apex or lateral to the root of a nonvital tooth. Radicular cysts are always associated with a nonvital tooth, and this is an important diagnostic criterion for radiolucent lesions at the apex of the teeth.
A radicular cyst presupposes physical, chemical or bacterial injury resulting in death of pulp followed by stimulation of epithelial cell rests of malaseez which are present normally in periodontal ligament pathogenesis. Radicular cyst definition of radicular cyst by medical. This article covers odontogenic tumours and cysts, which is a subset of oral pathology and can be grouped under the heading of head and neck pathology. The cyst is believed to be originated from the epithelial cell rests of malassez. Radicular cysts are the most common of all jaw cysts and comprise about 52% to 68% of all the cysts affecting the human jaws.
Oral pathology periapical cyst pathogenesis phase 1 phase of initiation. These cysts are therefore centered on the apex of the tooth and tend to be small, most radicular periapical cyst. It is concluded that the dental cyst arises from proliferation of the epithelial rests of malassez in a focus of inflammation stimulated by pulpal necrosis of the associated tooth. Objective of the study was to investigate the effect of il1 on epithelial cell proliferation which is an important factor in the pathogenesis of radicular cyst. Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin affecting the jaws. Three feasible mechanisms have been proposed for histogenesis of the cyst by benn and altini. Cysts are frequent lesions occurring in the oral cavity and are of much significance because they may be destructive and cause significant signs and symptoms. An apical cyst is considered to be a direct sequel to apical granuloma, although a granuloma need not always develop into a cyst. This leads to apical periodontitis, granuloma formation and eventual cyst formation. Due to still unknown reasons only a small fraction o10% of the periapical lesions advance into true radicular cysts 16, 26. Review article endodontic management of a periapical cyst a. Periapical cysts are typically seen in middle to older age 3 rd to 6 th decades 2 pathology.
It enlarges by unicentric expansion from the hydrostatis pressure of its contents. Oral pathology periapical cyst pathogenesisrecall epithelial cell rests of malassez ermare part of the periodontal ligament cells. Surgical and supportive management of radicular cyst with. Radicular cyst a case report and overview on pathogenesis. Pathogenesis of radicular cyst has comprised of three distinct. Oct 07, 2017 the periapical cyst also termed radicular cyst or dental cyst is the most common odontogenic cyst. The cyst may cause the neighboring structures to be displaced, especially in the maxillary sinus and the mandibular canal. Interestingly the reported cases of large radicular cyst involve maxilla and very often extended to occupy large portions of the maxillary sinus. Periapical cysts result from infection of the tooth, which spreads to the apex and into the adjacent bone. The vast majority of oral malignancies are squamous cell carcinoma. The definitive diagnosis of the type of periapical lesion can only be made by a histological examination. The radicular cyst is the most common inflammatory cyst in the jaw that is of odontogenic origin. Intricate pathogenesis of radicular cyst international.
Apr 08, 2012 nonodontogenic cyst defination the epithelial lining is derived from sources other than the toothforming organ 5. It is caused by pulpal necrosis secondary to dental caries or trauma. Radicular cyst or periapical cyst linkedin slideshare. Proliferation of epithelial rest cells of malassez is an essential event in the pathogenesis of radicular cyst. Radicular periapical cysts are pathological cavities, lined with epithelium, and contain fluid or semi. Pdf radicular cyst a case report and overview on pathogenesis. Histopathological features are consistent with that of a radicular cyst, however, as the source of infection the tooth has been removed, they appear less inflammatory. They are found mostly at the apices of the tooth periapical. Dec 22, 2016 cysts are frequent lesions occurring in the oral cavity and are of much significance because they may be destructive and cause significant signs and symptoms.
An apical cyst is a direct sequeltoapicalgranuloma,althoughagranulomaneed not always develop into a cyst. T, progressive growthof an epithelial island moves the innermost cells of that island away from their nutrients. Radicular cysts are formed in the area of apical periodontitis of endodontic ally involved teeth. This proliferation is a result of the inflammation induced by bacteria and necrotic products seeping into the periapex through the infected pulp. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. Oral pathology periapical cyst radicular cyst apical periodontal cyst types of radicular cyst periapical cyst1. Pathogenesis from epithelial cell rests of mallasez 3 phases, phase of intiation phase of cyst formation growth and enlargement of the the radicular. Cyst development requires the presence of epithelium in deep tissues and a proliferative stimulus. Stimulation of cell rests of malassez in response to inflammation elicited by baterial infection of pulp direct response to necrotic pulp tissue. A radicular cyst is a cyst which has developed from embryonic tissue remains, usually due to a dentogenous inflammational stimulus. Nonodontogenic cyst defination the epithelial lining is derived from sources other than the toothforming organ 5. Sep 15, 2010 the pathogenesis of dentigerous cyst is still controversial.
The lesion is seen mostly in the males during their third and fifth decades of life. An insight into the most common inflammatory cyst of the jaws sushmit koju 1, nitesh kumar chaurasia 2, vinay marla 3, deepa niroula 1, pratibha poudel 4 1 department of oral medicine and radiology, dhulikhel hospital, nepal 2 department of oral and maxillofacial surgery, dhulikhel hospital, nepal 3 department of oral pathology, penang international. In the litera ture a number of terms are used to describe periodontal cysts, such as periapical cyst alt et al. Jun 18, 2019 radicular pain or radiculopathy is spread along the nerve in neck, upper extremity, thorax, abdomen, lower back, or lower leg. Comparable changes do not occur in any other region of the body. These cysts are therefore centered on the apex of the tooth and tend to be small, most pathogenesis. Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin.
Pathogenesis of odontogenic cysts cyst formation in the jaws requires three elements. The pathogenesis of the three common forms of odontogenic cyst is discussed. Only few cases of radicular cysts involving large part of maxilla have been previously reported in literature 1619. A cyst is a cavity in tissue enclosed within the skin epithelium which may consist of several chambers and which is usually filled with fluid or pulp. Radicular cyst international journal of applied dental sciences. The pathogenesis of dental cysts can usually be described as a consequence of and as originating from remnants of the complicated process of embryonal tooth and jaw development.
Dental caries or trauma cause chronic inflammation which eventually forms a periapical inflammation. The radicular cyst is the most common odontogenic cyst 52. Most are harmless, but they should be removed when possible because they occasionally may change into malignant growths, become infected, or obstruct a gland. Pdf radicular cysts are the most common inflammatory odontogenic cysts of jaws.
Oral pathology periapical cyst radicular cyst apical periodontal cyst types of radicular cyst periapical cyst 1. Pathogenesis of radicular cysts has been described as. Some investigators have noted a greater tendency for periapical cysts to be larger, to cause root. Commonly known as a dental cyst, the periapical cyst is the most common odontogenic cyst. Subsequent infection of the cyst causes swelling and pain.
Radicular cyst also known as periapical cyst, periodontal cyst, root end cyst or dental cyst, originates from epithelial cell rests of malassez in periodontal ligament as a result of inflammation due to pulp necrosis or trauma. Radiology of cysts of the jaws columbia university. Radicular cyst an update with emphasis on pathogenesis. The periapical cyst also termed radicular cyst or dental cyst is the most common odontogenic cyst. A radicular cyst presupposes physical, chemical or bacterial injury resulting in death of pulp followed by stimulation of epithelial cell rests of malaseez which are present normally in periodontal ligament. The associated tooth is nonvital, usually asymptomatic, and may result in swelling, tenderness, tooth mobility. It may develop rapidly from a periapical granuloma, as a consequence of untreated chronic periapical periodontitis periapical is defined as the tissues surrounding the apex of the root of a tooth and a cyst is a pathological cavity lined by epithelium, having fluid or gaseous content that is not. A radicular cyst is an odontogenic cyst of inflammatory origin i abstract. Apical or periapical cyst, or radicular cyst radicular cyst. The origin of the cyst epithelium lies with rests of malassez, which are epithelial remnants of hertwig epithelial root sheath that lie dormant within the periodontal ligament. It is usually associated with a tooth having a necrozed pulp. The general topic of head and neck pathology is covered in the head and neck pathology and head and neck cytopathology articles. A massive dentigerous cyst of the mandible in a young patient.
1253 1191 353 915 1495 609 1050 835 15 83 356 531 1308 1315 1001 1027 1390 882 85 1291 225 1339 551 939 1241 1329 1146 343