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: Infection of interradicular (” located between the tooth roots”) root canals leads to cyst localization between the roots in deciduous teeth.
Pathophysiology: Malassez epithelial remnants (epithelial cell nests remaining from the embryonic period) are activated by mediators of an ongoing inflammation and proliferate. Endotoxins [from endo, Greek ἔνδον endon “inside”, Greek toxikon = poison] and fibroblasts stimulate growth. Although the diseased tooth as the focus of infection and the cyst are immediately adjacent, the cyst contents remain free of microorganisms for a long time.
Etiology (Causes)
Biographic causes
- Genetic burden – predisposition is discussed (possibly multiple radicular cysts).
Behavioral causes
- Nutrition
- Inadequate fluoride intake (e.g., through fluoridated table salt).
- Frequent sugary or carbohydrate-rich snacks or meals.
- Oral hygiene
- Insufficient
- Lack of fluoride intake (from dental care products).
- Visit to the dentist
- Insufficient use of dental checkups.
Causes related to disease
- Apical (“tooth root“) granuloma (inflammation-related, nodular tissue formation).
- Caries profunda (lat. deep dental caries).
- Avital tooth (“dead tooth”)
Other causes
- Root filling, insufficient (insufficient).
- Tooth restoration, insufficient
