In principle, any radicular cyst should be surgically removed and submitted to histologic (fine tissue) examination. 1. dental surgery Root apex resection (surgical procedure in which the root apex and the inflamed area surrounding the root apex are removed) with cystectomy (complete cyst removal). For small apical (“tooth rootward”) or lateral (“lateral”) cysts. If necessary, … Radicular Cyst: Surgical Therapy
To prevent radicular cysts, attention must be paid to reducing individual risk factors. Behavioral risk factors Because a devitalized (root-dead) tooth is a prerequisite for the development of a radicular cyst, poor dietary habits and inadequate oral hygiene increase the risk of caries and, therefore, the risk of potentially developing a radicular cyst as a … Radicular Cyst: Prevention
The following symptoms and complaints may indicate a radicular cyst: Main symptoms Often asymptomatic – radiographic incidental finding. Avital tooth (” dead tooth”) If necessary, percussion dolence (sensitivity to tapping). If necessary, tooth loosening Pain usually only with infected cyst “Parchment crackling” on palpation of a thin layer of bone over the cyst lumen. Large … Radicular Cyst: Symptoms, Complaints, Signs
Pathogenesis (disease development) Radicular cysts result from the inflammatory stimulus of chronic apical periodontitis (inflammation of the periodontium (tooth-supporting apparatus) just below the root of the tooth; apical = “tooth rootward”). Lateral radicular cysts: in the presence of an endodontic lateral canal, the cyst is localized laterally to the root contour. Inter-radicular/radicular deciduous tooth cysts: … Radicular Cyst: Causes
The following curative measures can be used for radicular cysts: Counseling/education. The patient should be educated about the symptoms of a radicular cyst and motivated to practice active dental hygiene.
Conventional nonsurgical therapeutic procedures Trepanation (opening of the pulpal tooth). Endodontic treatment (root canal treatment or revision). In case of apical osteolysis up to 10 mm: Subsequently wait-and-see therapy, since the differential diagnosis between root granuloma and small radicular cyst is only possible histologically (fine tissue). In case of persistence or increase of periapical whitening … Radicular Cyst: Dental Therapy
Classification of odontogenic (“originating from the teeth”) cysts. Cyst shape Localization Radicular (“affecting the root”) cysts At the root of the tooth Follicular (“belonging to a follicle”) cysts On impacted wisdom teeth, canines (and premolars). Residual cysts (“cyst left behind after extraction (tooth removal) of a tooth affected with a radicular cyst”) Like radicular and … Radicular Cyst: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic and therapeutic steps. Extraoral examination Inspection Facial asymmetries Soft tissue swelling Fistulas Skin florescences Abnormal findings on the eye Palpation Bimanual (symmetry comparison) Bony facial skull [fracture/bone fracture due to very large cysts]. Mandibular rim Jaw angle Pine branch Pine cavity wall Lymph nodes … Radicular Cyst: Examination
The diagnosis of a radicular cyst is usually made on the basis of history and clinical examination and radiographs alone. Up to a size of approximately 0.5 cm, radicular cysts can be distinguished from root granulomas only by histology (fine tissue examination). To confirm the tentative diagnosis in case of uncertainty in the diagnosis or … Radicular Cyst: Test and Diagnosis
The diagnosis of a radicular cyst is usually made on the basis of the patient’s history, clinical course, and physical examination. Further medical device diagnosis may be required for differential diagnosis. Obligatory medical device diagnostics. Radiographs Panoramic radiograph [larger cysts] Tooth film [smaller cysts] Bite recording lower jaw (for 3rd dimension). Computed tomography (CT) axial … Radicular Cyst: Diagnostic Tests
The medical history represents an important component in the diagnosis of radicular cysts, in addition to the diagnostic findings. Family history Are there any common diseases in your family? [If there is evidence of predisposition based on multiple radicular cysts] Current medical history / systemic history (somatic and psychological complaints). What complaints do you have? … Radicular Cyst: Medical History
Respiratory System (J00-J99) Retention cyst (cyst due to outflow obstruction of a gland) of the maxillary sinus [DD: Missing compactal lamella as cyst boundary]. Musculoskeletal system and connective tissue (M00-M99). Focal osteoporotic (focal bone loss) bone marrow defect [DD: absent bone trabeculae]. Well demarcated bone marrow island (physiological findings). Mouth, esophagus (esophagus), stomach, and intestines … Radicular Cyst: Or something else? Differential Diagnosis
