What is a Radicular Cyst?

Watch Dental Video about Radicular Cyst

A radicular cyst is a cyst which has developed from embryonic tissue remains, usually due to a dentogenous inflammational stimulus.

A cyst is a cavity in tissue enclosed within the skin (epithelium) which may consist of several chambers and which is usually filled with fluid or pulp.

Cysts grow in size more or less quickly, though their growth behaviour is, with a few exceptions, restrictive and not aggressive. By not aggressive we mean that the surrounding structures such as blood vessels and nerves are blocked but not damaged.

A radicular cyst develops from leftover tissue (epithelial remains) from tooth development. Usually the remains of cells from tooth development – what are called dental lamina – remain in our jawbone. These tissues can, when stimulated by inflammation, for example due to a dead dental nerve and/or a badly done root treatment, be excited into growth – the result may be the development of a cyst.

In the film "radicular cyst" you can see a removal of a radicular cyst. Years ago the patient fell and in doing so injured his front left incisor. He didn’t go to the dentist. Over the years his tooth migrated away from the centre line and became discoloured. The origin of this phenomenon can be seen in this x-ray. The dental nerve was injured in the accident and then died.

The putrescent tissue caused an inflammatory reaction in the bone. This inflammational stimulus gave the growth stimulus to the embryonic epithelial remains of the dental lamina. A radicular cyst developed – the dark spot in the x-ray. The cyst then pushed the tooth away from the middle.

Radicular Cyst in the Jaw

Radicular Cyst in the Jaw

The treatment for the removal of the cyst is as follows. The mucosa has already been carefully folded to one side. Now the bone above the cyst will be removed carefully – the entire cyst pod can now be seen.

Next, the cyst is spooned out by means of a specific instrument. It is very important that the entire contents are meticulously removed. If any parts of the cyst remain this could cause a new cyst to develop, even years later (a so-called relapse). Since the problem is very great, at the end of the operation replacement bone material will be used. This should only be done when there are no signs of inflammation and the area can be cleaned out completely. Finally the mucosa is stiched.

Twice-yearly x-ray checks will confirm if the treatment was successful or not. More about the removal of cysts can be found in the video "Cystectomy". An alternative to the planned operation could be the opening of the cyst first – more about this in the aforementioned video.

Left untreated, cysts in the mouth, jaw or facial area will grow in size over the years as a rule and this will lead to particular local complications sooner or later.

The operational risks are negligible when the surgeon is experienced. Nonetheless there could be complications occasionally which could then possibly make further measures necessary. With every further necessary measure further complications, which could even be life threatening, may once again crop up.

We’re only going to mention the special complications particular to the removal of radicular cysts and these are:

  • Injury to surrounding structures such as nerves, cheeks, blood vessels, tooth roots and teeth with the relevant consequences
  • incorrect cystectomy of malignant masses which should be properly removed along with added tissue for safety
  • Wound infection
  • Broken jaw
  • leaving cyst fragments behind, which could cause a recurrence of the cyst as a result

Fortunately due to improvements in medicine in the last decade such complications are very unlikely to occur.

Click here to see the video: Bone Cyst - Radicular Cyst

 

This post is also available in: German

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