Luca Vigano ¹*, Pudylyk Diana ², Peroni Giona ², Antuono Dalila², Tregambi Federica², Di Felice Silvia² and Cinzia Casu³

¹DDS, Department of Oral Radiology, San Paolo Dental Building, University of Milano, Italy
²Dentistry Student, ASST Santi Paolo e Carlo, San Paolo Dental Building, University of Milan, Italy
³DDS, Department of Surgical Science, Oral Biotechnology Laboratory (OBL), University of Cagliari, Italy

*Corresponding Author:Luca Viganò, DDS, Department of Oral Radiology, San Paolo Dental Building, University of Milano, Italy.

Received: March 21, 2022; Published: April 11, 2022

Abstract

Background: Radicular cysts are common odontogenic entities, accounting for about 50% of all odontogenic cysts. They are associated with non-vital dental elements in which deep caries or inadequate endodontic treatments allow bacteria to migrate and infect peri-apical areas. Subsequent phlogistic processes trigger embryological epithelial rests potentially present in periodontal ligament, making them proliferate and form a cystic lesion.

Materials and Methods:We reported 2 cases of patients with maxillary radicular cysts associated with non-vital elements. Both patients showed up for routine visit and had no symptoms related to their lesions. Only intra-oral examination and especially radiological investigation could assess the presence of the lesions, allowing further histological investigation to reach a final diagnosis. Treatment included a surgical approach in both patients: cyst was removed and affected teeth or radicular residues were extracted.

Results: A few months later, a post-surgery OPG x-ray was performed and the bone structure appeared completely regenerated as no osteolytic lesions could be detected.

Conclusion: Radicular cysts often affect patients that aren’t aware of their presence, as clinically these entities show no symptoms until very late stages or if infective complications arise. An accurate intra-oral examination and more importantly routinary basic radiographic imaging, e.g., OPG, can identify early maxillary lesions and guide clinicians in their diagnostic approach.

Keywords:Asymptomatic; Maxillary Radicular; Odontogenic; Radiographic

References

1. El-Naggar AK., et al. “World Health Organization classification of head and neck tumours”. 4^th Lyon: IARC (2017): 232-240.
2. Tamiolakis P., et al. “Demographic and Clinical Characteristics of 5294 Jaw Cysts: A Retrospective Study of 38 Years”. Head and Neck Pathology 4 (2019): 587-596.
3. Bilodeau EA and Collins BM. “Odontogenic Cysts and Neoplasms”. Surgical Pathology Clinics 1 (2017): 177-222.
4. Ciulli E., et al. “Maxillary cyst: description of a clinical case”. Journal of Oral Implantology (Rome)2 (2009): 28-33.
5. Manuale illustrato di chirurgia orale. M. Chiapasco. - Italia: Masson Elsevier (2017): 261-291.
6. Kramer I., et al. “WHO international histological classification of tumours. Histological typing of odontogenic tumours”. 2^nd Berlin: Springer-Verlag (1992).
7. Aquilanti L., et al. “Non-neoplastic jaw cysts: a 30-year epidemiological study of 2150 cases in the Italian population”. British Journal of Oral and Maxillofacial Surgery 2 (2021): 168-173.
8. Robinson RA. “Diagnosing the most common odontogenic cystic and osseous lesions of the jaws for the practicing pathologist”. Modern Pathology s1 (2017): S96-S103.
9. Chen JH., et al. “Clinicopathological analysis of 232 radicular cysts of the jawbone in a population of southern Taiwanese patients”. The Kaohsiung Journal of Medical Sciences 4 (2018): 249-254.
10. Schvartzman Cohen R., et al. “The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth”. Medicina (Kaunas)9 (2021): 991.
11. Rajendra Santosh AB. “Odontogenic Cysts”. Dental Clinics of North America 1 (2017): 105-119.
12. Çalışkan MK., et al. “Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery”. International Endodontic Journal 11 (2016): 1011-1019.
13. Deshmukh J., et al. “Giant radicular cyst of the maxilla”. BMJ Case Reports (2014): bcr2014203678.
14. Casu Cinzia and Luca Viganò et coll. “Central Giant Cell Granuloma: A Narrative Review of Radiological Features and Differential Diagnosis”. General medicine and Clinical Practice 3 (2020): 01-05.
15. Eryilmaz T., et al. “Odontogenic keratocyst: an unusual location and review of the literature”. Annals of Plastic Surgery 2 (2009): 210-212.
16. Regezi JA., et al. “Oral pathology clinical pathologic correlations”. 7^th St. Louis: Elsevier (2017): 253-257.
17. Lunawat SD., et al. “Odontogenic Keratocyst: A Rare Presentation in Anterior Maxilla”. Journal of College of Physicians and Surgeons Pakistan 11 (2020): 1226-1229.
18. Kerr JT., et al. “Midline maxillary odontogenic keratocyst”. Annals of Otology, Rhinology and Laryngology 9 (2004): 688-690.
19. Kitisubkanchana J., et al. “Odontogenic keratocyst and ameloblastoma: radiographic evaluation”. Oral Radiology 1 (2021): 55-65.
20. Pazdera J., et al. “Gorlin-Goltz syndrome with familial manifestation”. Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czech Republic (2021): 4.
21. Hingst V and Weber MA. “[Dental X-ray diagnostics with the orthopantomography - Technique and typical imaging results]”. Radiologe1 (2020): 77-92.
22. Mao WY., et al. “Comparison of radiographical characteristics and diagnostic accuracy of intraosseous jaw lesions on panoramic radiographs and CBCT”. Dentomaxillofacial Radiology 2 (2021): 20200165.
23. Avril L., et al. “Radiolucent lesions of the mandible: a pattern-based approach to diagnosis”. Insights Imaging1 (2014): 85-101.
24. Tsesis I., et al. “Accuracy for diagnosis of periapical cystic lesions”. Scientific Reports 1 (2020): 14155.
25. Consolo U., et al. “Analysis of Marsupialization of Mandibular Cysts in Improving the Healing of Related Bone Defects”. Journal of Oral and Maxillofacial Surgery 8 (2020): 1355.e1-1355.e11.
26. D Sorrentino., et al. “Marsupialization in the treatment of cysts of the jaw bones: Applicability and advantages”. Dental Cadmos2 (2021): 140-146.
27. Oliveros-Lopez L., et al. “Reduction rate by decompression as a treatment of odontogenic cysts”. Medicina Oral, Patologia Oral y Cirugia Bucal 5 (2017): e643-e650.
28. Pogrel MA. “Treatment of keratocysts: the case for decompression and marsupialization”. Journal of Oral and Maxillofacial Surgery 11 (2005): 1667-1673.
29. Abdelwahab M., et al. “Endoscopic enucleation of large jaw cysts: Promising outcomes”. Auris Nasus Larynx3 (2018): 578-584.
30. Laino L., et al. “Surgical Strategies for Multicystic Ameloblastoma”. Journal of Craniofacial Surgery 2 (2020): e116-e119.
31. Wagdargi SS., et al. “Evaluation of Spontaneous Bone Regeneration after Enucleation of Large Cysts of the Jaws using Radiographic Computed Software”. The Journal of Contemporary Dental Practice 6 (2016): 489-495.
32. Chiapasco M., et al. “Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases”. Journal of Oral and Maxillofacial Surgery 9 (2000): 942-949.
33.  

Citation

Citation: Luca Vigano., et al. “Large Asymptomatic Maxillary Radicular Cysts Simulating Odontogenic Keratocysts or Bone Tumor Lesions: Importance of Radiographic Investigation". Acta Scientific Dental Sciences 6.5 (2022): 47-54.

Copyright

Copyright: © 2022 Luca Vigano., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.