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Differentiation of periapical granulomas and radicular cysts by digital radiometric analysis.

It is generally accepted that two of the most commonly seen radiolucencies, the periapical granuloma and the radicular cyst, cannot be differentiated radiographically. The purpose of this investigation was to determine the feasibility of identifying radiometric differences in these two pathologic conditions by analyzing the patterns of the gray-level distributions of digitized radiographic images. Radiographs used in the study had been sent by practitioners to the School of Dentistry with tissue specimens. Radiographs of lesions identified as periapical granulomas and radicular cysts in the mandibular posterior quadrant were included in the study. The radiographs were digitized and regions of interest were drawn to include the lesions. Frequency distributions (histogram) with 256 gray-scale intervals and a cumulative percent histogram were computed. The typical histograms of the dental granulomas had narrower ranges and lower gray-scale values than did cysts. The results of this study indicate that it is feasible to radiometrically differentiate between lesions that are visually indistinguishable on radiographs.

Diagnosis, Differential↗

Central neurilemmoma of the jaw in concurrence with radicular cyst: a case report.

We report the features of a central neurilemmoma in the mandible of a patient having an inflammatory apical dental (radicular) cyst in the same region. A 29-year-old woman complained of numbness on the right side of the lower lip of 3 months duration and noted following endodontic therapy to the right mandibular first molar tooth. Panoramic radiography revealed a bilocular radiolucency in the right body of the mandible. Excisional biopsy was performed. The histopathology revealed neurilemmoma of the mandible in concurrence with inflammatory apical dental (radicular) cyst. No recurrence was detected during a 1-year follow-up.

Adult↗

Gyrate erythema in a patient with dental radicular cyst.

Nonspecific gyrate erythemas (NGE) are commonly associated with hypersensitivity reactions to exogenous or endogenous antigens. A case of NGE with clinical resemblance to tinea corporis in a patient with a dental radicular cyst is reported. Cutaneous lesions disappeared after surgical excision of the dental cyst. The clinical and pathological details are described and the relationship between radicular cyst and cutaneous lesions discussed. Earlier reports are reviewed and the possibility of a focal origin is emphasized.

Erythema↗

Production of human-inducible nitric oxide synthase in radicular cysts.

To examine if nitric oxide (NO) is produced in radicular cysts, NO synthase (NOS) production was analyzed. Periapical tissues were removed from patients at the time of endodontic surgery. Frozen tissue sections were histologically evaluated with hematoxylin-eosin staining. Production of human-inducible NOS (iNOS) in apical cysts was then immunohistochemically examined. Immunoreactive human iNOS was widely distributed in epithelial cells, endothelial cells, fibroblasts, macrophages, or polymorphonuclear leukocytes. Remarkably, iNOS-positive cells were significantly present around blood vessels, and cells residing apart from the blood vessels showed weak or no iNOS production, suggesting that only cells around blood vessels could be stimulated for iNOS synthesis. These data demonstrated the possibility that several, but not all, cells could be stimulated to synthesize iNOS in inflamed tissues. In the presence of iNOS, NO can be produced spontaneously in periapical lesions and may play a crucial role in the regulation of chronic infection.

Enzyme Induction↗

Ossification in the wall of a radicular cyst: report of a case.

An unusual case of a maxillary radicular cyst that contained bone in the wall is presented. In our opinion, this finding was the result of a reparative process that started after the extraction of the tooth responsible for the original formation of the cyst.

Female↗

Symptomatic residual radicular cysts.

The clinical, radiological and histological characteristics of 31 symptomatic residual radicular cysts are compared and contrasted with 39 asymptomatic residual cysts. Differences in size and site incidence are demonstrated along with an inversely proportional relationship between radiographic cortication and degree of acute inflammation in the cyst wall. A number of possible aetiological factors, to account for initiation of active inflammation in deeply placed residual cysts have been examined and excluded, but explanation, in most cases, remains paradoxical.

Epithelium↗

[Radicular cysts. Apropos of a clinical case].

We report a clinic case of radicular cyst, that were growing progressively, since seven years ago, and destroying the floor of the maxillary sinus. We made the diagnosis, treatment and discussion of this case.

Adult↗

[Demonstration of PGE2 by immunofluorescence in the wall of radicular cysts].

The present study gives the first evidence, through immunofluorescence, of the prostaglandins PGE2 in radicular cysts. The results are in agreement with literature. In addition, the immunofluorescence technique has also demonstrated the localization of prostaglandins inside the cyst cavity. In opposition to previous data, the present study also shows that epithelial cells seem to synthesize more PGE2 than fibroblasts and mononuclear components of the external connective tissue.

Dinoprostone↗

Conservative treatment of a radicular cyst in a 5-year-old child: a case report.

The present report describes the management of a radicular cyst in a 5-year-old child. The treatment comprised extraction of the primary teeth involved followed by marsupialization. A removable appliance with a resin extension penetrating into the cystic cavity was used to help decompress the lesion. This treatment allowed rapid healing of the lesion and eruption of the permanent incisors without the need for orthodontic treatment.

Child, Preschool↗

Radicular cyst of the premaxilla in a dog.

A 13-year-old, male/neutered Border Collie dog was diagnosed with a radicular cyst of the left premaxilla. Tooth extraction and curettage of the lesion resulted in a positive clinical outcome 6-months following treatment.

Animals↗

Osteolytic processes in human radicular cysts: morphological and biochemical results.

In an attempt to verify the nature of bone resorption processes on the bone surrounding radicular cysts, fragments of cysts with the adjacent bone tissue were studied by morphological, cytochemical and ultrastructural methods. Cyst fluid was analysed for its content of cytokines with osteolytic activity. The cyst wall exhibited several connective tissue extensions which penetrated the adjacent bone. Numerous multinucleated tartrate-resistant acid phosphatase (TRAP)-positive cells were seen at the tip of the intraosseous extensions of the cyst capsule and in direct contact with the bone tissue. Typical resorption lacunae were identified on the bone surface by scanning electron microscopy. Moreover, mononuclear TRAP-positive cells were seen within the cyst capsule. High levels of prostaglandin E2 (PGE2) and interleukin-6 (IL-6) were detected in the cyst fluids. In conclusion, active bone resorption may contribute significantly to the growth of these lesions within the jaws.

Acid Phosphatase↗

Concentrations of lomefloxacin in radicular cyst and oral tissues following single or multiple oral administration.

Concentrations of lomefloxacin in serum, the wall and fluid of radicular cyst, gingiva, and jawbone following single or multiple oral administration were measured. The highest concentrations of lomefloxacin in serum, cyst wall, cyst fluid, gingiva, and jawbone occurred at 3 h after multiple administration, and were 2.31 micrograms/ml, 4.06 micrograms/g, 1.54 micrograms/ml, 4.72 micrograms/g and 2.79 micrograms/g, respectively. The mean concentration ratios of wall/serum, fluid/serum, fluid/wall, gingiva/serum, and jawbone/serum at the highest concentrations were 1.74, 0.73, 0.47, 2.52 and 1.20, respectively. Although most lomefloxacin concentrations in cyst and oral tissues following single oral administration did not exceed the MICs for 80% of clinically isolated strains of alpha-hemolytic streptococci, Staphylococcus aureus and Niesseria spp., most of those obtained after multiple oral administration exceeded the MICs except in the case of fluid.

Adult↗

[A technic for performing tooth-preserving operations in treating radicular cysts and chronic periodontitis of the permanent teeth in children and adolescents].

A high incidence of complications developing during and after removal of teeth with chronic periodontitis and radicular cysts has made the dentists resort to conservative surgical methods of treatment of such conditions. These methods are replantation, resection of radical apex, hemisection, radicular amputation, granulectomy, crown-radicular separation, crown-radicular amputation, hemireplantation, and inter-radicular granulectomy. The technique of such treatment is described in detail. Conservative surgical methods of treatment include the following stages: (1) conservative therapy; (2) surgical treatment; (3) orthodontic treatment; (4) dynamic follow-up till complete recovery of osseous tissue. The recommended modalities are not difficult but rather effective and may be performed at pedodontic clinics.

Adolescent↗