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The terms botryoid odontogenic cyst and lateral periodontal cyst have both been used to describe a histologically distinct type of cyst characterized by a thin epithelial lining exhibiting focal thickenings or plaques. The cyst reported herein is a well-documented example of this type of cyst, which exhibited persistent and recurrent behavior.
Over a period of 4 years, 41 isolated, advanced periodontal defects were selected for histologic examination. The objective of this study was to establish the presence of cystic epithelium. Twenty of the biopsies fulfilled the criteria for lateral periodontal cyst (LPC). These results indicate that there is a distinct possibility that proliferation of epithelial elements other than crevicular could be implicated in isolated periodontal defects.
The lateral periodontal cyst is a rather infrequently reported odontogenic cyst. The cyst seems to develop in direct contact to the periodontal membrane of an erupted vital tooth. This type of cyst should not be confused with a radicular cyst in a lateral position developing as a consequence of inflammation from an infected or necrotic branch of the pulp canal. Several authors do not differentiate between the lateral periodontal cyst and the gingival cyst, but it seems justified to consider the lateral periodontal cysts as a separate entity of odontogenic cysts. In this origin of the lateral periodontal cyst is reviewed and several possibilities are discussed. It is concluded that the epithelial lining of this type of cysts most probably originates from the cell rests of Malassez. Case report of one lateral periodontal cyst is presented.
THE LATERAL PERIODONTAL CYSTS is a slow-growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through-and-through perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze-dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months.
The lateral periodontal cyst is of developmental odontogenic origin and must be differentiated from the gingival cyst of adults, a primordial cyst in a lateral periodontal position, and a cyst of inflammatory origin. This paper is based on a histologic study of five cases. Four were in the mandibular premolar region and one in the lateral incisor-canine region of the maxilla. The cysts are lined by a thin non-keratinized epithelium which resembles the reduced enamel epithelium. Many of them arecharacterized by the presence of localized plaque-like thickenings of their epithelial linings, consisting of fusiform or large swollen, edematous cells. These epithelial thickenings appear to result from a localized proiferation of basal cells. The lateral periodontal cyst may arise initially as a dentigerous cyst which develops by expansion of the follicle along the lateral surface of the crown and comes to lie on the lateral aspect of the root if tooth eruption is normal. Alternatively, it may arise from the cell rests of Malassez.
The lateral periodontal cyst is a developmental odontogenic cyst associated with the lateral root surfaces of teeth. It is treated by surgical enucleation and diagnosed on the basis of clinical, radiographic, and histologic findings. This article is a case report of the surgical treatment of a lateral periodontal cyst in a unique mandibular midline location. The preoperative history and postoperative recall examinations cover an 8-year period.
Lateral periodontal cysts account for 0.8% of all jaw cysts seen in our department. Published reports have indicated that they occur most frequently in the 5th to 7th decades, that there is a male preponderance and that they are located mainly in the mandibular canine-premolar region. In our own series of 20 cases, 10 were found in the anterior maxilla. We have distinguished unicystic and multicystic (including botryoid) varieties. They were lined predominantly or exclusively by thin reduced enamel epithelium-like tissue which contained many clear cells and epithelial thickenings referred to as plaques. Glycogen was present in the epithelium of two-thirds of our cases although not exclusively in the clear cells, many of which showed no positivity. Two of our examples of the botryoid variety were different histologically, being lined predominantly by non-keratinizing stratified squamous epithelium with crowded and pyknotic nuclei and no clear cells. One case contained melanin while another showed epithelial crypt formation and superficial palisaded low columnar cells as seen in the glandular odontogenic cyst. This raised the question of whether the latter may form part of the clinicopathologic spectrum of lateral periodontal cyst. The histogenesis of lateral periodontal cysts is uncertain but we favour origin from reduced enamel epithelium.
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We report a case of the calcifying odontogenic cyst occurring on the left anterior mandible of a 41-year-old male with clinical and radiographic features which made it initially to be a lateral periodontal cyst. This unusual presentation of a calcifying odontogenic cyst is discussed and its significance for the clinician is reviewed. A calcifying odontogenic cyst may present some problems for the differential diagnosis both clinically and histopathologically. The differential diagnosis of a lesion occurring in a lateral periodontal location should include the calcifying odontogenic cyst.
The lateral periodontal cyst and the botryoid odontogenic cyst are two rare nosological entities, who, despite their radiological and clinical presentation can only be diagnosed by their rather typical histopathological characteristics. The purpose of this article is to report two cases of radiolucent cystic lesions of the mandible, located in the premolar area, with a clinical and radiographic diagnosis of residual cyst, which showed histological features of a lateral periodontal cyst. Histopathologically, the lateral periodontal cyst lining is characterized by a thin cuboidal to stratified squamous non-keratinizing epithelium, ranging from one to five cell layers and presence of one or more epithelial thickenings or plaques. Furthermore, glycogen-rich clear cells encountered either in the epithelial plaques or in the superficial layer of the lining epithelium.
The lateral periodontal cyst (LPC) is a relatively uncommon but widely recognized odontogenic cyst of developmental origin. It is found mostly in adults and has no sex predilection. LPC is usually discovered during routine radiographic examination, is located mainly between the roots of vital mandibular canines and premolars, and seldom causes pain or other clinical symptoms. The defect appears on radiographs as a round or teardrop-shaped, well circumscribed radiolucency. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. In this paper, two cases of lateral periodontal cysts are presented. In the first case, the patient (woman, 62 years old) complained of an asymptomatic gingival swelling in the region between the right maxillary canine and premolar. The radiographic examination revealed a well circumscribed radiolucency with a radiopaque margin between the roots of the canine and premolar. The adjacent teeth had vital pulp. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin". In the second case, the patient (women, 44 years old) complained of a swelling in the area of tooth 32. During radiographic examination a well circumscribed radiolucency between the roots of the lateral incisor and the canine was discovered. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin".
The lateral periodontal cyst and gingival cyst of the adult are both developmental odontogenic cysts located predominantly in the mandibular premolar-canine region. In this paper, a case report is described of a lateral periodontal cyst and gingival cyst occurring in the same patient along with a discussion of clinical, radiographic, and histological features of these lesions.
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A series of six cases of botryoid odontogenic cyst (BOC) are presented, and their clinical, radiographic, histologic and follow-up data are analyzed. A review of the English language literature revealed an additional 60 cases of BOC, bringing the total number of cases to 66.