Radicular Cyst

Definition:
Periapical cyst. Common non-neoplastic cyst caused by dental inflammation characterized by stratified squamous lining and inflammation.

Clinical Features:

Most frequently encountered cyst of jaws.
All age groups (most commonly third and fourth decades)

Pathogenesis:
Odontogenic (arises from odontogenic epithelium)
Sequel of dental inflammatory disease

Histopathology:
- Lined by stratified squamous epithelium:
- Thickness varies according to degree of inflammation
- Difficult to identify
- Ulceration common
- Metaplasia
- Calcification
- Hyaline bodies
- Inflammatory infiltrate in wall: (acute, chronic and mixed)
- Aggregates of cholesterol crystals
- Foamy macrophages
- Multinucleated giant cells
- Plasma cells

Diagnosis:
- Called residual cyst when observed after tooth extraction
- Two proposed categories depending on relation to tooth canal.
A- Apical true cyst
B- Apical pocket cyst

Other Investigations:
well-circumscribed radiolucency at apex of affected tooth in Radiograph.

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