Radicular Cysts

Classify cysts of the jaws. Describe the clinical and radiographic features of the radicular cyst.
Answer: Ameloblastoma

Radicular Cyst Clinical Features

Incidence: Radicular cyst constitutes about 50 % or more among all types of jaw cysts.
Age: Mostly the third, fourth, and fifth decades of life.
Sex: More common among males.
Site: The cyst can occur about any tooth of either jaw, but the maxilla (60%) is more commonly affected than the mandible (40%).
Origin: The cyst is believed to originate from the cell rests of Malassez.
The involved tooth is always non-vital and can be easily detected by the presence of caries, fractures, discolorations, etc. Moreover, the affected tooth does not respond to thermal electric pulp testing.
The cyst becomes more symptomatic as there is an acute exacerbation of the periapical inflammation.
Larger lesions on the other hand, often produce a slow enlarging, bony hard swelling, of the jaw with expansion and distortion of the cortical plates or disturbance in occlusion mostly of the regional teeth; maxillary lesions may cause either buccal or palatal cortical expansion, whereas the mandibular lesions often cause buccal or labial expansions and rarely the lingual expansions.
Severe bone destruction by the cystic lesion results in thinning of the cortical plates, and it may produce a “springiness” of the jawbone when digital pressure is applied.

Radicular cyst definition

There may be the presence of fluctuations in case the bone is completely eroded by a large cyst.
These lesions clinically appear blue as they lie close to the overlying epithelium since the bone has been completely resorbed.
Pain may be present in the cyst, if it is secondarily infected and it may result in the development of either intraoral or extraoral pus-discharging sinuses.
On rare occasions, there may be an occurrence of paresthesia or pathological fractures in the bone, etc.
Occasionally, radicular cysts can be multiple, affecting several teeth or several roots of a multirooted tooth.
A radicular cyst may persist in the jaw after the attached tooth has been extracted; such a cyst is often called a ’residual cyst’. These cysts frequently cause swelling in the dentulous jaws, and they regress slowly and spontaneously.
In some cases, radicular cysts may develop at the opening of a large accessory pulp canal on the lateral aspect of the tooth root, and these cysts are often termed ’ lateral radicular cysts’.
If the cyst is secondarily infected, then it leads to the formation of an abscess, which is called a “cyst abscess”.

Reader Interactions