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Pathogenesis of Odontogenic Cysts
Published in Roger M. Browne, Investigative Pathology of the Odontogenic Cysts, 2019
Radicular cysts arises as a consequence of pulpal necrosis of the associated tooth. Recent studies have demonstrated that necrotic pulps are almost invariably infected, and that substantial numbers of anaerobic bacteria are present.95–99 These include species of Barteroides, Fusobacteria, Actinomyces, Campylobacter, Eubacteria, Arachnia, Propionibacteria, Peptostreptococci, Veillonella, and Lactobacilli. Such bacteria contain lipopoly-saccharide endotoxins and these have been found in necrotic pulps using the limulus assay.100–103 The escape of tissue breakdown products, bacteria and their products (including endotoxins) through the apical foramen initiates the formation of a periapical granuloma. Indeed a similar range of anaerobic bacteria has been found in the lumens of clinically uninfected radicular and residual cysts.
Bacterial Infections of the Oral Cavity
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
P. S. Manoharan, Praveen Rajesh
Caries risk-assessment analysis can be performed using a systematic charting that includes dietary history, genetic factors, and other local presentations (Hillman, 2002). Salivary buffer capacity by analyzing the pH of saliva can tell the risk range from high to low. Such analysis can help the clinician understand the nature of the disease and its severity and to develop preventive measures to preserve, prevent, and restore the tooth. Dental caries can progress to pulp and result in pulpal inflammation, which can be either acute or chronic and is based on the symptoms. It can be classified as reversible or irreversible pulpitis based on the nature of symptoms. Irreversible pulpitis needs a root canal. Irreversible pulpitis can progress to spread the infection beyond the tooth to the surrounding bone where it results in periapical abscess. The abscess can consolidate to a granuloma or spread to the surrounding areas and into potential spaces of the face and oral cavity, resulting in serious infection. Sometimes, the abscess can divert its course to the path of least resistance and drain to the oral cavity in the form of a sinus opening. Granuloma can be a chronic presentation or can progress to a cyst with breakdown of the cells and development of lining of the cavity filled with fluid. The cyst related to the tooth is termed a radicular cyst and can either progressively increase in size, expanding to the bone, or can present as a symptomatic painful swelling if it is infected.
Cysts and Tumours of the Bony Facial Skeleton
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Julia A. Woolgar, Gillian L. Hall
A radicular cyst may present with acute symptoms of pain and swelling but many are asymptomatic and seen as a radiolucency at the root apex on routine dental radiological examination (Figure 25.7). The associated tooth is, by definition, non-vital. Some teeth have additional communications between the root pulp canal and the periodontal ligament—one or more lateral canals—and these are the origin of lateral radicular (lateral dental) cysts.
Is tooth conservation possible in odontogenic sinusitis? Prospective evaluation of affected teeth condition-based protocol
Published in Acta Oto-Laryngologica, 2023
Akiko Ito, Muneo Nakaya, Kazuhiro Tada, Junko Kumada, Wataru Kida, Yasuhiro Inayoshi
If a periapical abscess or radicular cyst is found at the bottom of the maxillary sinus, removal of the infectious granulation tissue and cysts was performed using a 70° endoscope. Although tooth extraction is often preferred for large radicular cysts, the tooth can be preserved by resecting via the transmaxillary approach. Figure 4(a) shows CT findings before and six months after ESS and a postoperative, endoscopic photo. CT and endoscopy revealed periapical alveolar bone regrowth and scar healing. Our procedure for treating periapical lesions is not a substitute for root canal treatment but may help reduce residual lesions at the root apex of previously canalized teeth. Figure 4(b) shows the CT and endoscopic images of the sinus floor of the patient with periapical pathosis six months after ESS.
Relevance of periodic evaluation of endodontically treated primary teeth
Published in Libyan Journal of Medicine, 2019
Sally Kamal El-Din Mohamed, Huda Abutayyem, Said Abdelnabi, Juma Alkhabuli
DC is commonly associated with mandibular 3rd mandibular molar [5]. However, in the current case, the cyst was associated with unerupted mandibular 2nd premolar. Although such cases are relatively uncommon, a few cases have been reported [6]. Shibata et al. [7] studied the occurrence of DC in association with succedaneous teeth during the transitional dentition phase and reported a prevalence of 77.1% in the premolar region. There have been several explanations for the development of inflammatory and non-inflammatory DC. Benn and Altini [8] suggested three pathways for histogenesis of DC. In the first scenario, the developmental DC arises from the dental follicle and becomes secondarily infected as a result of a non-vital tooth. The second form occurs when a permanent successor erupts into radicular cyst that forms at apex of a non-vital deciduous resulting into a DC that is extra follicular in origin. Nevertheless, a radicular cyst developing at apex of primary tooth is extremely rare. The third possible cause is due to spread of peri-apical inflammation from a non-vital deciduous tooth to a follicle of permanent successor.