TREATMENT APPROACHE FOR ODONTOGENIC CYSTS IN THE MAXILLA

  • Mirjana Markovska Arsovska Department for Oral Surgery, Universal Dental Clinical Centre St. Pantelejmon, Faculty of Dental Medicine , Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Goran Terzievski PHO Terzievski Dental Studio, Ohrid, North Macedonia
  • Ljuba Simjanovska Department for Oral Surgery, Universal Dental Clinical Centre St. Pantelejmon, Faculty of Dental Medicine , Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Sofijanka Gerasimova Pisevska Department for Oral Surgery, Universal Dental Clinical Centre St. Pantelejmon, Faculty of Dental Medicine , Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Irena Stojanova Department for Oral Surgery, Universal Dental Clinical Centre St. Pantelejmon, Faculty of Dental Medicine , Ss. Cyril and Methodius University in Skopje, North Macedonia

Abstract

A cyst is defined as a pathological cavity lined by epithelium. The epithelium itself is surrounded by fibrocollagenous connective tissue and may be derived from various sources. They are usually associated with carious, nonvital, discolored, or fractured teeth and are found mostly at the apices of the teeth. Radiologically, it arises from the apex of the root of a carious tooth and is bounded by a thin rim of cortical bone. They rarely become problematic and are incidentally found on routine dental radiographs. As they appear to reach a considerable size prior to medical attention due to their insidious and destructive growth characteristics during the intraosseous stage, treatment often requires extensive cystectomy and skeletal reconstruction. This case report shows the treatment of a big radicular cyst in the maxilla . After surgical enucleation and biopsy, histopathological picture revealed fragments of sections of a collagen cyst wall lined with multilayered squamous epithelium which were seen microscopically. Scarce inflammation is present. Immunohistochemically was found focal CD20+ lymphoid accumulations (up to 40%) with CD3+ T lymphocytes up to 60% of which a significant part is CD40+, and 10% CD8+, CD68 mark the reduced presence of resident histiocytes (up to 5%). The finding confirmed the presence of a chronically inflamed radicular cyst.


Keywords: radicular cyst, imunohistochemistery, cystectomy, cyst diagnosis, cyst biopsy


 


 

References

1.Mass E, Kaplan I, Hirshberg A. A clinical and histopathological study of radicular cysts associated with primary molars. J Oral Pathol Med. 1995;24:458.
2.Fonseca JR. Oral and maxillofacial surgery. Philadelphia: WB Saunders; 2002. p. 5.
3.Joshi NS, Sujan SG, Rachappa MM. An unusual case report of bilateral mandibular radicular cysts. Contemp Clin Dent. 2011;2:59.
4.Nilesh K, Dadhich A, Chandrappa P. Unusually large radicular cysts of maxilla: steps in diagnosis & review of management. J.Bio.Innov 2015;4:01–11.
5.Hahn HM, Lee YJ, Park DH. Huge Radicular Cyst of the Maxilla Treated with Complete Resection and Immediate Reconstruction by Rib Bone Graft J Maxillofac Oral Surg. 2019 Sep;18(3):378-381.
6.Uloopi KS, Shivaji RU, Vinay C; Pavitra, Shrutha SP, Chandrasekhar R.J Indian Soc Pedod Prev Dent. 2015 Jan-Mar;33(1):53-6.
7.Shear M. Cysts of the oral and maxillofacial regions. 3rd edn Boston: Wright, 1992.
8.Irfan M, Alauddin M, Roselinda A, et al. Big radicular cyst in a 12 year old girl: a case report. Int Med J 2007;6:C5.
9.Pekiner FZ, Borahan O, Ugurlu F, et al. Clinical and radiological features of a large radicular cyst involving the entire maxillary sinus. MUSBED 2012;2:31–6.
10.Krishnamurthy V, Haridas S, Garud M, et al. Radicular cyst masquerading as a multilocular radiolucency. Quintessence Int 2013;44:71–3.
11.Gibson GM. Case report: a large radicular cyst involving the entire maxillary sinus. Gen Dent 2001;50:80–1.
12.Jacob S. Rushton or hayline bodies in radicular cysts. A morphologic curiosity. Indian J Pathol Microbiol 2010;53:846–7.
13.Tandri SB. Management of infected radicular cyst by surgical decompression. J Cons Dent 2010;13:159–61.
14.Walton RE. The residual radicular cyst: does it exist? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:471.
15.Danin J. Outcomes of periradicular surgery in cases with apical pathosis and untreated canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:227–32.
16.Rees J. Conservative management of a large maxillary cyst. Int Endod J 1997;30:64–7.
17.Batista et al. Immunohistochemical analysis of ADAMTS-1, versican and pEGFR expressions in periapical granuloma and radicular cyst, BMC Oral Health (2021) 21:102.
18.Brito et al. Immunohistochemical Analysis of Galectins-1, -3, and -7 in Periapical Granulomas, Radicular Cysts, and Residual Radicular Cysts, J End Vol. 44, Issue 5, May 2018, Pages 728-733.
19.França, Glória M. Release of Matrix Metalloproteinases by Macrophages in Radicular Cysts and Residual Radicular Cysts, Applied Immunohistochemistry & Molecular Morphology: April 2022 - Volume 30 - Issue 4 - p 291-297.
Published
2022-12-29
How to Cite
MARKOVSKA ARSOVSKA, Mirjana et al. TREATMENT APPROACHE FOR ODONTOGENIC CYSTS IN THE MAXILLA. Journal of Morphological Sciences, [S.l.], v. 5, n. 3, p. 153-157, dec. 2022. ISSN 2545-4706. Available at: <http://www.jms.mk/jms/article/view/vol5no3-23>. Date accessed: 29 mar. 2024.
Section
Articles