• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.137-142
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• 2016

We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.275-280
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• 2009

Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

• Restorative Dentistry and Endodontics
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• v.47 no.4
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• pp.35.1-35.9
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• 2022

Although the success rates of microsurgery and micro-resurgery are very high, the influence of a recurrent perforation combined with radicular cyst remains unclear. A 21-year-old white female patient had a history of root perforation in a previously treated right maxillary lateral incisor. Analysis using cone-beam computed tomography (CBCT) revealed an extensive and well-defined periapical radiolucency, involving the buccal and palatal bone plate. The perforation was sealed with bioceramic material (Biodentine) in the pre-surgical phase. In the surgical phase, guided tissue regeneration (GTR) was performed by combining xenograft (lyophilized bovine bone) and autologous platelet-rich fibrin applied to the bone defect. The root-end preparation was done using an ultrasonic tip. The retrograde filling was performed using a bioceramic material (Biodentine). Histopathological analysis confirmed a radicular cyst. The patient returned to her referring practitioner to continue the restorative procedures. CBCT analysis after 1-year recall revealed another perforation in the same place as the first intervention, ultimately treated by micro-resurgery using the same protocol with GTR, and a bioceramic material (MTA Angelus). The 2-year recall showed healing and bone neoformation. In conclusion, endodontic micro-resurgery with GTR showed long-term favorable results when a radicular cyst and a recurrent perforation compromised the success.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.166-173
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• 1999

A clinical study of selected patients with cyst which were managed in the Department of oral and maxillofacial sugery from March 1994 to February 1998 was done. An following results were obtained 1. Male were involved more than females by cyst in a ratio of 1.95:1 and most of the cases occurred in the secondary decades 2. The primary site of radicular cysts were the anterior incisor area, dentigerous cysts were anterior incisor area and canine area, incisive canal cysts were maxillary anterior area, odontogenic keratocyst were the mandibular ramus area. 3. The common symptoms were swelling(65 cases), pain(12 cases) and the mean duration of syptomatic period was 10 days. 4. The rates of histopathologic classification were radicular cyst(58%), dentigerous cyst(22%), incisive canal cyst(9%), odontogenic keratocyst(11%). 5. Average of Alk. phosphatase was 235(IU/L) at pre-twenty age and 102(IU/L) at post-twenty age. 6. In treatment modalities, enucleation was most common, odontogenic keratocyst was treated by enucleation and curettage for prevention of recurrence.

• Restorative Dentistry and Endodontics
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• v.2 no.1
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• pp.20-26
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• 1976

Cellulose acetate electrophoresis was used for differential diagnosis of radicular cysts and granulomas. Sixteen periapical lesions were excised from sixteen teeth with radiographic evidence of periapical pathosis, and two normal periodontal tissues were surgically removed from two wisdom teeth. The tissue samples were separated into two parts. Half was prepared for cellulose acetate electrophoresis, and the electrophoretic patterns were scanned with Helena densitometer. The other half was examined histologically, and the histologic diagnoses were then compared with the electrophoretic patterns and with the x-ray findings. The results were the following: 1. The histopathologic results showed the presence of 13 granulomas (81.8%) and 3 cysts (18.3%). 2. An albumin pattern, alpha-globulin pattern, beta-globulin pattern, fibrinogen pattern and gamma-globulin pattern were found in all eighteen cases. 3. All eighteen cases were divided into normal periodontal tissue group, dental granuloma group, and radicular cyst group by the histopathologic diagnosis. The electrophoretic pattern of dental granuloma group and that of normal periodontal tissue group resembled each other. The two groups showed the highest percentage in beta-globulin fraction, and the beta-globulin of dental granuloma group(47.17%) was higher than that of normal periodontal tissue group (40.54%) by 6.63%. On the contrary, beta-globulin fraction of radicular cyst group (28.00%) was much lower than those of the granuloma group (47.17%) and normal periodontal tissue group (40.54%), and alpha-globulin of radicular cyst group (34.16%) was much higher than those of the granuloma group (20.04%) and normal group (19.58%). 4. Five cases (31.3%) of the sixteen periodontal lesions showed different results between histopathologic diagnoses and radiographic findings.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.49-54
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• 1999

Ko, Lim found some differences in the concentrations of bone resorptive cytokines, especially IL-$1{\alpha}$ and IL-$1{\beta}$ in periapical lesions and inflamed pulps. And they suppose that these differences may be due to the type of cells which produce each cytokine. The purpose of this study was to analyze the human odontogenic cysts & cystic fluid for their contents of IL-$1{\alpha}$, IL-$1{\beta}$ and TNF-$1{\alpha}$ and to compare the concentrations of each cytokine according to the cytokine producing cells. The cystic tissues used in this experiment, were obtained from periapical surgery or cyst enucleation surgery. Cystic fluid was obtained from root canal during routine endodontic therapy(n=5). Cystic tissues were subdivided into two groups, inflammatory radicular cyst group(n=15) and developmental odontogenic keratocyst group(n=3). Normal periapical tissues of extracted third molar(n=5) were also obtained to be used as control group. Each specimen was incubated in 0.5ml homogenizing buffer (0.1mol/L potassium chloride, 0.02mol/L TRIS;pH=7.6) for two hours and then homogenized with glass homogenizer. Each specimen was centrifuged in a microcentrifuge for 3 minutes, and supernatants were extracted. The concentrations of cytokines were measured with R&D ELISA kit. The data were analyzed by Mann-Whitney U test for the differences among the diseases and t test for the correlations among each cytokine. Following results were obtained ; 1. For IL-$1{\alpha}$ and IL-$1{\beta}$, all experimental groups showed significantly higher concentrations of each cytokine than the control group (p<0.05). 2. In radicular cysts, the concentrations of IL-$1{\alpha}$ were higher than IL-$1{\beta}$, but not stastically significant (p>0.05). In odontogenic keratocysts, the concentrations of IL-$1{\alpha}$ were significantly higher than IL-$1{\beta}$ (p<0.05). In cystic fluid, the concentration of IL-$1{\beta}$ was significantly higher than IL-$1{\alpha}$ (p<0.05). 3. Between odontogenic keratocysts and radicular cysts, the concentrations of IL-$1{\alpha}$ were significantly higher in odontogenic keratocysts than in radicular cysts (p<0.05). 4. For TNF-${\alpha}$, only cystic fluid group showed significantly higher concentrations than the control group (p<0.05).

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.111-120
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• 1984

The author analyzed clinically and radiologically 319 radicular cysts which were proven histologically in Infirmary College of Dentistry Yonsei University and Seoul National University Hospital from 1965 to 1983, and which occurred in 167 males and 139 females between the ages of 6 and 70. This analysis was undertaken to discover the frequency and distribution of the radicular cysts with regard to the age and sex, the chief complaints of the patients, the regions, the radiographical appearances, the tooth changes, and the anatomical structures involved by the lesions. The obtained results were as follows: 1. The most frequently involved age group for the radicular cysts was the third decade of the patients, and the greatest number 69.9 per cent occurred between the ages of 11 and 40 years. The statistical analysis did not show any significant difference between male and female (P>0.05) 2. The frequently involved region for the radicular cysts was orderly the maxillary anterior region (44.9 per cent), the mandibular anterior region (15.9 per cent), the maxillary premolar region (14.8 per cent), and the mandibular premolar region (11.0 per cent). The maxillo-mandibular ratio of the radicular cysts was about 7:3. The statistical analysis did not show any significant difference between right and left sides (P>0.05). 3. The greatest number was 92.2 per cent, which were involved in apical portions of the radicular cysts, 88.7 per cent of the radicular cysts were found in the round shapes which were oval and elliptical, and 66.8 per cent of the radicular cysts were observed with the completely hyperostotic borders. 4. The radicular cysts caused the root resorption in 55.2 per cent and the migration of the involved tooth or teeth in 23.5 per cent respectively.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.239-247
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• 1994

20 radicular cysts of primary teeth mimicking dentigerous cyst were reviewed. The following results were obtained. 1. The patients' age ranged from 7 to 14 years. Males(60%) were more involved than females(40%). 2. The mandible(85%) was affected more frequently than the maxilla(15%) The mandibular deciduous molar area(80%) was the most frequently involved. 3. The diameter of the cyst varied from 10 to 30㎜. 55% of permanent successors showed underdeveloped roots less than one-third. 4. The etiologic factors were pulp-treated teeth(65%), severe caries (20%), trauma(10%), deep amalgam filling(5%).

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.185-187
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• 2009

Although most of sacral perineural cysts are asymptomatic, some may produce symptoms. Specific radicular pain may be due to distortion, compression, or stretching of nerve root by a space occupying cyst. We report a rare case of S1 radiculopathy caused by sacral perineural cyst accompanying disc herniation. The patient underwent a microscopic discectomy at L5-S1 level. However, the patient's symptoms did not improved. The hypesthesia persisted, as did the right leg pain. Cyst-subarachnoid shunt was set to decompress nerve root and to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and cyst. Immediately after surgery, the patient had no leg pain. After 6 months, the patient still remained free of leg pain.