Bava Fareed Ahmed, Umar Dilshad, Bahseer Bahija, Baroudi Kusai
Senior Lecturer, Department of Oral Surgery, Century Dental College, Kasaragod, Kerala, India.
Senior Lecturer, Department of Orthodontics, Al Farabi College of Dentistry, Riyadh, Saudi Arabia.
J Int Oral Health. 2015 Feb;7(2):61-3.
A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area.
根端囊肿是上颌前部最常见的牙源性囊肿之一,在青少年中并不常见。它们大多位于牙根尖(根尖囊肿)、牙根侧面(侧方根端囊肿),在拔除患牙后留在颌骨内(残余囊肿)。根端囊肿被归类为炎症性囊肿,是龋齿导致牙髓坏死后的结果,伴有根尖周炎症反应。它们发展缓慢,若无感染则无症状。因此,它们可能会发展到很大的尺寸。在影像学上,很多时候很难将根端囊肿与先前存在的慢性根尖周炎病变区分开来。在此,我们报告一例19岁患者双侧下颌第一磨牙相关根端囊肿的罕见病例。全景片显示左侧第一磨牙根尖区有一个大的单房性透射区,边界清晰,从第二前磨牙牙根延伸至第二磨牙近中根。相应地,在下颌右侧也可见到另一个边界清晰的单房性透射区。对于根端囊肿有几种治疗方法,如外科牙髓治疗、拔除患牙、摘除囊肿并一期缝合,以及袋形缝合后摘除囊肿。患者的治疗包括手术摘除囊肿囊袋,随后对同一区域进行修复。