CASE

PRESENTATION

PRESENTED BY
D. K.VISHNU PRIYATHAM
POST GRADUATE FIRST YEAR
DEPARTMENT OF OMFS
DEMOGRAPHIC DATA
NAME :T.RAMADEVI

AGE :48years

GENDER :FEMALE

ADDRESS:MOHANNAGAR,KOTHAPET

EMRNO. :202304250030
CHIEF COMPLAINT: Patient complains of pain in upper
right back tooth region since 1 month.

HISTORY OF PRESNT ILLNESS:

 PAST MEDICAL
No relevant history FAMILY HISTORY
• No relevant history

PAST DENTAL HISTORY

HISTORY
This is patient’s first dental PERSONAL HISTORY
visit. • Patient brushes once daily
• Mixed diet
• No deleterious habits
GENERAL EXAMINATION

Patient is conscious coherent well oriented with date and time.

Gait : No abnormality detected.
Height : 5 feet 1 inch.
Weight :50 kgs.
Built : Moderately built .
EXTRA ORAL EXAMINATION

Patient’s face is apparently symmetrical

Mouth opening :40 mm

TMJ :No abnormality detected

Lymphadenopathy :Not detected

NTRAORAL EXAMINATION
Oral hygiene status : Fair
Stains +; calculus +.
On soft tissue examination : no abnormality
detected.
On hard tissue examination:
Missing 21
Angle’s class i malocclusion
CBCT
PROVISIONAL DIAGNOSIS
Radicular cyst

DIFFERENTIAL DIANOSIS
Traumatic cyst
Surgical defect
Peri apical granuloma
Periapical pocket cyst
TREATMENT PLAN
• Patient is referred to department of endodontics for pulp vitality
testing of
• Advised minor surgical profile
• Enucleation of the cystic lesion under LA
• Followed by tooth replacement of after adequate bone formation
SURGICAL PROFILE RESULTS
VITALS AS MEASURED ON OPERATIVE DAY

PULSE : 78 Beats /minute

TEMPERATURE : Afebrile
RESPIRATORY RATE: 16 cycles /minute
BLOOD PRESSURE : 135 /70 mm of Hg
ARMAMENTARIUM
EXICISIONAL BIOPSY
• Under sterile aseptic conditions draping is done and 3
ml of 2%lignocaine Hcl solution with 1:80,000 dilution
of adrenaline containing 75 mg of lignocaine given as
local infiltration .
• A full thickness mucoperiosteal flap is raised by giving
a crevicular incision from 23 to distal papilla of 11
• And a vertical incision is given distal to 23.
• A window is created at the site of enlargement
using No. 6 round bur under copious saline
irrigation.
• Enucleation is carried out through this window
• After retrograde filling of root canal of 22 the flap
closure is done by sling suturing using 3-0 silk .
POST OPERATIVELY

Patient is given postoperative instructions and prescribed the

following medications
1. Cap. AMOXICILLIN -500Mg TID for 3 days
8AM --------4PM ------------11 PM
2. TAB. ZERODOL SP BID for 3 days
8AM -------------8PM
3. TAB . PANTOP OD for 3 days
7AM
Patient is recalled after one week for suture removal.
BIOPSY REPORT
FINAL DIAGNOSIS
Infected periapical cyst
DISCUSSION
• Radicular cyst is of inflammatory origin and believed to be formed by inflammatory
proliferation of epithelial cell rests of Malassez in the area of apical periodontitis of a tooth
having an infected necrotic pulp.

• Radicular cysts are the most common type of all jawbone

cysts and comprise about 52-68% of all the cysts affecting
the jawbone
• only about 15% of all periapical osteolytic lesions associated
with endodontically involved teeth . Approximately, 9% are
true cysts and 6% pocket cysts .

• The anterior region of the maxilla and premolar region of the

mandible are more frequently involved than other parts of
the jaw bone by radicular cysts
SEQUALAE OF
CYST

•Secondary infection
•Perforation of cortical plates
•Remain dormant
THANK
YOU
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