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PubMed1990

Distribution of factor XIIIa-containing cells and collagenous components in radicular cysts: histochemic and immunohistochemic studies.

The distribution of subunit A of Factor XIII (FXIIIa) and of collagenous components was investigated by the avidin-biotin-peroxidase complex (ABC) method for FXIIIa and by the Sirius red F3BA method, respectively, in 43 cases of radicular cysts. Besides the covering epithelial layer, the radicular cyst wall was composed of the following three layers: an inner granulomatous layer, an outer fibrous connective tissue layer, and an intermediate layer. In each layer, a positive reaction for FXIIIa was observed in certain connective tissue cells. These FXIIIa-containing cells were few in number in the inner layer where collagenous components were also sparse. In the slightly to moderately fibrous intermediate layer, these cells markedly increased in number and were dendritic or stellate in shape. In the outer densely fibrous connective tissue layer, they decreased slightly in number and were slender and spindle-shaped. The results obtained in the present study indicate the close relationship between the distribution of FXIIIa-containing cells and of collagenous components. Such a relationship suggests that these cells play an important role in the process of fibrosis occurring in the radicular cyst wall.

Collagen↗
PubMed2001

Radicular cyst associated with a primary molar following pulp therapy: a case report.

A radicular cyst arising from the primary second molar and causing displacement of the permanent successor to the lower border of the mandible, with accompanying buccal expansion, was examined clinically and radiographically. Extraction of the primary molar and extirpation of the cyst led to uneventful healing. The primary molar had received pulp treatment with therapeutic agents approximately 1.5 years prior to the patient's first visit. The relationship between pulp treatment and rapid growth of the radicular cyst is discussed.

Anti-Infective Agents, Local↗
PubMed2005

Apoptosis in epithelial cells of apical radicular cysts.

AIM: To investigate the occurrence of apoptotic cell death in the epithelium of radicular cysts and to compare its frequency in lesions presenting a distinct functional state. METHODOLOGY: Twenty radicular cysts were selected and arranged into two groups with 10 lesions in each group: atrophic (quiescent) and hyperplastic (active) epithelium. Morphologic investigations of apoptosis were conducted by means of optic microscopy in haematoxylin and eosin slides. Immunohistochemical techniques to detect the bcl-2 protein were carried out by streptavidin-biotin-peroxidase assay. In both instances, 30 sequential high-power microscopic fields were observed to determine apoptotic (AI) and bcl-2 immunostaining (bcl-2I) indexes. The presence of AI and bcl-2I within the two groups was compared using the t-test. Correlation between the AI and the bcl-2I was investigated using the Spearman test. RESULTS: Apoptosis was detected in the epithelium of all cysts. Higher AI levels were found in lesions with an atrophic (0.17 +/- 0.19) rather than a hyperplastic (0.10 +/- 0.10) epithelium. The same was found for the bcl-2I levels (0.06 +/- 0.03 vs. 0.04 +/- 0.01, respectively). However, these differences were not statistically significant. A positive and significant correlation was found between AI and bcl-2I. CONCLUSIONS: Apoptosis was always present in the epithelium of the lesions and was more frequent in lesions with atrophic (quiescent) epithelium.

Apoptosis↗
PubMed1996

In situ determination of different dehydrogenase activity profiles in the linings of odontogenic keratocysts and radicular cysts.

The levels of succinate, lactate, glutamate, glycerophosphate and glucose-6-phosphate dehydrogenases within the linings of keratinizing and non-keratinizing odontogenic cysts were investigated using static end-point and continuously monitored Nitroblue Tetrazolium-based histochemical methods. The use of TV image analysis for quantification of formazan final reaction products was validated by demonstrating significant relationships between the integrated absorbance at 585 nm and the amount of formazan in, and thickness of, gelatin films containing reduced tetrazolium salt (r = 1.0, p < 0.001). Absorbance readings of stained sections gave mean coefficients of variation of 1.8 +/- 0.9% between day of measurement, and of 5.65 +/- 1.32% between serial sections. End-point assays indicated that the linings of odontogenic keratocysts contained higher levels of glucose-6-phosphate dehydrogenases (p < 0.0002) and lower levels of lactate dehydrogenase (p < 0.002) than those of radicular cysts. Succinate, glutamate and glycerophosphate dehydrogenase activities were similar in both cyst types. Results from continuously monitored assays, performed for glucose-6-phosphate and succinate dehydrogenases, demonstrated linear reaction rates over the first 2.75 min of reaction. The calculated enzyme activities from continuous assays were between 1.49 and 3.49 times higher than those determined from end-point assays and confirmed that levels of glucose-6-phosphate dehydrogenase were significantly higher in the linings of odontogenic keratocysts than those of radicular cysts (p < 0.004). By contrast, succinate dehydrogenase activity was significantly higher in radicular cyst linings (p < 0.03). These results highlight the benefits of an approach to in situ determination of enzyme activity using image analysis and continuous monitoring methodologies. Overall, the high level of glucose-6-phosphate dehydrogenase found in keratocyst linings is consistent with their clinical behaviour and higher level of proliferation and synthetic activity whereas the level of lactate dehydrogenase in radicular cysts probably reflects the presence of local tissue damage within these inflammatory lesions.

Histocytochemistry↗
PubMed1999

Inducible nitric oxide synthase activity by interferon-gamma-producing cells in human radicular cysts.

AIM: In this study, the interaction of interferon-gamma-(IFN-gamma) and inducible nitric oxide synthase (iNOS)-producing cells in human radicular cysts were investigated. METHODOLOGY: Inflamed periapical tissues were obtained from patients at the time of endodontic surgical treatments and were cut into two pieces. After fixing with acetone or 4% paraformaldehyde in phosphate-buffered saline, 5-m-thick paraffin and cryostat sections were prepared. The paraffin sections of the inflamed tissues were evaluated histologically with haematoxylineosin stains. The specimens diagnosed as radicular cysts were then examined by immunostaining. Immunohistochemistry for iNOS and fluoresence microscopy for IFN-gamma using the cryostat sections were performed with a mixture of affinity purified human iNOS antiserum and human IFN-gamma monoclonal antibodies. RESULTS: The results revealed that iNOS-gamma producing cells localized adjacent to IFN-gamma-producing cells. In addition, some of iNOS-producing cells exhibited immunoreactive IFN-gamma. On the other hand, epithelial cells showed significant levels of iNOS production, but not IFN-gamma. CONCLUSIONS: The data would suggest the possibility that iNOS production could be precisely controlled by autocrine or paracrine effects of IFN-gamma producing cells in radicular cysts and might play a pivotal role in periapical lesions. These findings are consistent with a hypothesis suggesting that NO inhibitors could be used through the root canals as a pharmacological treatment for periapical lesions.

Adult↗
PubMed2002

Expression of cytokeratins (CKs) 8, 13 and 18 and their mRNA in epithelial linings of radicular cysts: implication for the same CK profiles as nasal columnar epithelium in squamous epithelial lining.

OBJECTIVE: Our objective was to specify cytokeratin (CK) patterns in lining epithelia of radicular cysts which are sometime lined with ciliated columnar epithelia as seen in the nasal epithelia. MATERIALS AND METHODS: We examined the CK expression in 52 radicular cysts obtained from 32 maxillary and 20 mandibular lesions and investigated CK-mRNA expression using in situ hybridization in 24 maxillary and 13 mandibular cysts and reverse transcription-polymerase chain reaction (RT-PCR) in 24 maxillary cysts. RESULTS: Of the maxillary cysts, 20, 29 and 19 squamous epithelial linings were positive for CK8, CK13 and CK18, respectively; of the mandibular cysts, 10, 20 and 11 linings were positive for these CKs, respectively. The expression patterns of CK18(+)-CK13(-), CK18(+)-CK13(+) and CK18(-)-CK13(+) were observed in 3, 16 and 13 linings of the maxillary cysts and 0, 11 and 9 linings of the mandibular cysts, respectively. In situ hybridization revealed the expression of CK18-mRNA in 9 and 4 linings of 24 maxillary and 13 mandibular cysts examined, respectively. With RT-PCR, we explored that both CK18- and CK13-mRNA were expressed not only in the normal nasal and gingival epithelia but also in the examined maxillary cyst linings although their expression levels differed correlating with the difference in CK staining. CONCLUSION: It is concluded that CK13- and CK18-mRNA are constitutively expressed in columnar and squamous epithelial cells, respectively, and that the variant CK expression patterns with CK18-mRNA expression in maxillary radicular cysts are indicative of the possibility of phenotypic transformation in the cyst linings.

Adult↗
PubMed1998

[Incidence of radicular cysts in a series of 125 chronic periapical lesions. Histopathologic study].

The incidence of radicular cysts in 125 chronic periapical lesions was studied in 36 cases of periapical surgery (28.8%), and to 89 tooth extractions (71.2%). Histopathology revealed 18 radicular cysts (14.4%) and 107 lesions corresponding to chronic apical periodontitis (C.A.P.) or granulomas (85.6%). Cholesterol clefts, a fibrous capsule and presence of a cavity were more common in the cysts, significant differences being observed with respect to chronic apical periodontitis.

Adolescent↗
PubMed1985

Radicular cysts arising from deciduous teeth. Review of the literature and report of 23 cases.

Radicular cysts arising from deciduous teeth are rare. 28 such cases have been recorded in the literature since 1898. In this study, we present 23 personally-observed cases of radicular cysts arising from deciduous teeth. The patients' ages ranged from 4 to 12 years with one exceptional case aged 19 years. The M:F ratio was 1.6:1. The mandible was affected more frequently than the maxilla and the deciduous molars were the teeth most commonly involved. 2 of the cysts presented multi-locular radiolucency; in 9 cases, buccal expansion was noticed and in 8 cases, permanent buds were displaced. Caries was the most common etiologic factor in the formation of the cysts. Histologically, cysts in varying stages of development were lined by proliferating non-keratinized stratified squamous epithelium.

Child↗
PubMed1999

Two radicular cysts associated with endodontically treated primary teeth: rationale for long-term follow-up.

Although radicular cysts are relatively rare, they do occur. In addition, it appears that these lesions present in association with endodontically treated primary teeth. As shown in this paper and previous reports, cysts can be associated with a variety of pulp therapies. These lesions can lead to bony expansion and resorption. Radicular cysts may also cause displacement and damage to the developing permanent dentition. Given the severity of these sequelae it is prudent to recommend regular radiographic examination of primary teeth that have undergone pulp therapy.

Child↗
PubMed1990

Studies on cholesterol accumulation in radicular cyst fluid--origin of heat-stable cholesterol-binding protein.

1. The amount of apolipoprotein B (apo B) was measured using slit-immunoblotting in 20 specimens of radicular cyst fluids. Apo B was detected in all the cyst fluids with varying amounts. 2. Relationship between the amounts of apo B and free cholesterol or activity of heat-stable cholesterol-binding protein (HCBP) were examined. The amount of apo B was correlated well with the activity of HCBP (n = 20, r = 0.72, P less than 0.01) and with the amount of free cholesterol (n = 20, r = 0.45, P less than 0.05). 3. Anti-human apo B antibody inhibited cholesterol-binding activity in radicular cyst fluid. 4. When human-serum was chromatographed on a HPLC ion-exchange column, both cholesterol-binding activity and apo B had exactly the same retention time. 5. These results suggest that HCBP originates from beta-lipoprotein, and beta-lipoprotein may have an important role in cholesterol accumulation on radicular cysts.

Apolipoproteins B↗
PubMed1990

[Investigation of immunoglobulin presence and localisation in epithelial lining of radicular cyst walls by ABC immunoperoxidase technique].

Immunoglobulin classes A, G and M in the epithelial lining of radicular cysts are analysed by a new method: ABC immunoperoxidase technique. The obtained results show a high degree of all immunoglobulin classes present in the cyst walls, as well as in the epithelial lining. The findings suggest the important role of immunoglobulin in the processes occurring in the radicular cyst walls.

Humans↗
PubMed1977

Incidence of epithelial atypia in radicular cysts: a preliminary investigation.

Histologic sections of 100 radicular cysts were scored for epithelial atypia, inflammation, and presence of other histologic features. No atypia was found in 32 cases. In 34 cases, atypia occurred in epithelium that was heavily infiltrated with chronic inflammatory cells. There were 26 cases of slight atypia, six cases of moderate atypia, one case of severe atypia, and one case that appeared to be carcinoma arising in a cyst wall. There was no evidence that inflammation in the connective tissues occurred more frequently or was more severe in cases that exhibited greater degrees of atypia.

Aged↗
PubMed2006

Radicular cyst: a case report treated with conservative therapy.

This case reports on the treatment of a radicular cyst in a child. The patient presented a periapical radiolucent area associated to a root from the maxillary left primary second molar. After the extraction of the root, marsupilization of the lesion was done and a fixed resin tube was placed in the alveolar hole. After twenty-five months the lesion was healing. This technique has proved to be effective and conservative for the treatment of radicular cysts in primary teeth.

Child↗
PubMed2003

Radicular cyst associated with endodontically treated deciduous tooth: a case report.

This article presents a case report of radicular cyst associated with an endodontically treated deciduous second molar causing displacement of the permanent successor, with accompanying buccal expansion. Cystic sac was removed surgically along with the involved tooth under general anesthesia. Healing was uneventful. Histopathologically the cystic sac was consistent with the features of radicular cyst. Unusual amorphous, eosinophilic, atubular material incorporated within the cystic epithelium was observed.

Child↗
PubMed1998

Bone regeneration after radicular cyst removal with and without guided bone regeneration.

In order to determine the degree of bone regeneration after removal of radicular cysts using guided bone regeneration (GBR), a prospective, controlled and randomized clinical study was performed. Thirty patients with radicular cysts were divided into three groups. One group, the control group (n=10 patients), was treated by enucleation and primary closure. The other two groups were treated by enucleation and primary closure but GBR was used in addition, using a resorbable membrane (n=10) and a nonresorbable membrane (n=10). The membranes were fixed with nonresorbable Memfix System screws. The residual volume and the density of the newly formed tissue was measured by computer-assisted tomography and computer-assisted digital image analysis before enucleation and three and six months postoperatively. No statistical significance was found in density and residual volume between the three treatment groups after six months. These results suggest that GBR using membranes does not contribute to increased bone regeneration.

Adult↗
PubMed1998

Histologic difference in epithelial linings between follicular and radicular cysts.

The purpose of this study was to identify histologic differences in epithelial linings between follicular and radicular cysts in relation of their development. Linings and surrounding tissues of 25 radicular and 20 follicular cysts from archival paraffin embedded tissues were obtained and stained with haematoxylin and eosin. Radicular cysts showed orthokeratotic 9-14 cell-layer-thick non-keratinized squamous epithelium and unspecific chronic inflammatory reaction in connective tissue. Follicular cysts showed 2-4 cell-layer-thick of non-keratinized stratified squamous or flattened-low cuboidal epithelium and connective tissue capsule free from inflammatory cell infiltration.

Adolescent↗
PubMed2005

Radicular cyst arising from a traumatized primary incisor: a case report of a rare complication that emphasizes the need for regular follow up.

Radicular cysts associated with the deciduous dentition are rare. The literature is sparse regarding cysts associated with primary incisor teeth, which is surprising given the frequency with which these teeth are traumatized. Most cases reported involve molar teeth associated with apical infection following on from caries. A case of a 3-year-old boy who developed a large radicular cyst associated with a previously traumatized upper primary incisor is reported.

Child, Preschool↗
PubMed2005

Immunohistochemical analysis of apoptosis-related factors in lining epithelium of radicular cysts.

BACKGROUND: Some studies suggest that apoptosis-related factors are involved in the inflammatory processes of marginal periodontal lesions. However, the role of apoptosis in periapical inflammatory lesions remains unclear. We investigated the possible role of apoptotic cell death in periapical inflammatory lesions by means of immunohistochemical analysis of apoptosis-related factors and use of a cell proliferation marker. METHODS: Paraffin-embedded sections of 19 radicular cysts (RCs), and five residual radicular cysts (RRCs) and control specimens of normal gingivae excised from seven cadavers were prepared and examined immunohistochemically with the use of monoclonal antibodies or polyclonal antisera against single-stranded DNA (ssDNA), p53, Bax, Bcl-2, caspase-3, Fas, Fas ligand (Fas-L), and Ki-67 antigen. RESULTS: Epithelium of gingiva, RCs, and RRCs showed expression of ssDNA in suprabasal and superficial epithelial cells and Ki-67 reactivity in basal and parabasal cells. Expression of Ki-67 and ssDNA in RCs and RRCs was slightly higher than that in gingiva. Both Ki-67 and ssDNA reactivity in RCs with intense inflammatory reactions or with thick lining epithelium were significantly stronger than those in RCs with less inflammatory reactions or with thin lining epithelium. Reactivity for p53 was noted sporadically in epithelium of gingiva, RCs, and RRCs, and p53 expression in RCs was significantly greater than that in gingiva. Ki-67 and ssDNA reactivity in RCs increased parallel to the degree of p53 expression. Bax and Bcl-2 were detected in some basal epithelial cells in RCs and RRCs as well as in gingiva. The ssDNA reactivity significantly increased parallel to Bax expression and slightly decreased parallel to Bcl-2 expression in lining epithelium of RCs. Caspase-3 was detected in superficial epithelial cells of both gingiva and lining epithelium of RCs and RRCs, and the distribution of these cells was compatible with the expression of ssDNA. Expression of Ki-67 and ssDNA in caspase-3-positive fields was significantly higher than that in caspase-3-negative fields in RCs. There was very limited expression of Fas and Fas-L in lining epithelium of RCs and RRCs as well as in gingiva. CONCLUSIONS: These data suggest that apoptosis-related factors are involved in the pathophysiologic activity of periapical inflammatory lesions. Such factors may be affected by the structure of lining epithelium and the degree of inflammatory change.

Adult↗