RADICULAR

CYST
Sayyed Jani
BDS
INTRODUCTION:
 Most common odontogenic cyst
 Around 60% of all jaw cysts and 15% of all periapical lesions are Radicular cyst.
 It is an inflammatory odontogenic cyst surrounding the periapical region of tooth.
ETIOPATHOGENESIS:
 It occurs as a result of

(a) Bacterial infections

(b) Necrosis of Dental pulp
(c) Dental caries
DEMOGRAPHS:
Gender prediction: Males > Females
Age prediction: 20 to 60 years
Site of occurance: Commonly maxillary anteriors followed by mandibular premolars and
molars .
Origin: odontogenic
CLINICAL FEATURES:
 Asymptomatic mostly
 painless slow growing swelling
 associated teeth shows sensitive to percussion
 Rarely causes expansion of cortical plates
 Long standing of cyst may undergo an acute exacerbation

of inflammatory process and develop rapidly into abscess

and then may proceed to cellulitis or form a draining fistula.
 On aspiration we can see straw coloured fluid with

cholesterol crystals.
RADIOGRAPHIC FEATURES:
 Radiographic features are similar to Periapical Granuloma.
 We can’t differentiate between Radicular cyst and

Periapical Granuloma.
 Unicystic radiolucent areas are seen which are

surrounded by thin radiopaque line which indicates

reaction of bone to the slowly expanding mass.
HISTOLOGICAL FEATURES:
 Lining epithelium is Non keratinized stratified squamous epithelium.
 Epithelium shows spongiosis and inflammatory cell infiltration.
 Epithelium shows arcading pattern
 Epithelium shows Rushton bodies .
 Rushton bodies - arc shaped ; eosinophilic ; hyaline bodies. They are refractile ; amorphous
in structure; Brittle in nature . There is no clinical significance and their origin is unknown.
They are also seen in residual cyst .
 Connective tissue – delicate with dense inflammatory cell infiltration.
 Deeper portion of connective tissue is more fibrous.
 Cystic lumen contains straw coloured fluid with cholesterol crystals.
TREATMENT AND PROGNOSIS:
 Root canal therapy of the involved teeth along with periapical surgery or extraction of
involved tooth followed by periapical curettage .
 If the cyst is incompletly removed then the remnant cells may develop into Residual cyst.