Non‐microbial etiology: periapical cysts sustain post‐treatment apical periodontitis

Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection following pulpal necrosis. This condition is typically asymptomatic and mostly affects the tooth's apices. It primarily affects non-vital teeth and is characterized by inflammation. Cyst development is the final stage of the inflammatory process after a periapical infection; hence, it often occurs later in life. A cyst in the maxilla can occasionally spread across the maxillary sinus. Radicular cysts can be treated with surgical endodontics, the removal of the problematic tooth, enucleation with primary closure, or marsupialization and enucleation. This case report discusses a successful surgical therapy for an infected radicular cyst.

“…Apical cysts have full epithelialization but do not open into the apical foramen or root canal. Currently, it is known as a radicular cyst or a true cyst [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

The Surgical Management of a Radicular Cyst in the Maxillary Anterior Region - A Case Report

Gurav,

Sontakke,

Thakare

et al. 2024

“…Consequently, enucleation and marsupialization are frequently used in surgical treatment to eliminate these cysts. If traumatically injured teeth are left untreated, they may develop cyst-%like apical periodontitis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Radicular Cyst With the Use of Advanced Platelet-Rich Fibrin and Bone Graft: A Case Report

Kriplani,

Sedani,

Patel

et al. 2024

In addition to helping with wound healing, periapical surgery is performed to remove periapical disease. Concentrates of platelets have been applied extensively in endodontics and other fields of regenerative medicine. A periapical inflammatory lesion was found in a 35-year-old male patient who complained of pain in the maxillary anterior region and displayed slight edema in the same area. The lesion was treated with periapical surgery utilizing advanced platelet-rich fibrin (A-PRF). Mesenchymal stem cell processes of proliferation and differentiation can be induced by several types of platelet concentrates. Growth factors are released at the application site by platelet-rich fibrin (PRF) for a minimum of seven days. The activity of osteoblasts is stimulated by growth factors and secreted cytokines. Furthermore, the release of growth factors promotes fibroblast migration, which quickens tissue regeneration. In addition to helping with wound healing, periapical surgery is performed to remove periapical disease. The synthesis of fibrin networks laden with platelets and growth factors is made possible by PRF, which is subsequently used to accelerate bone regeneration and, consequently, to improve bone formation. In this instance, the best possible bone regeneration and repair were accomplished. After 12 weeks, 24 weeks, and 36 weeks, the patient was brought back for follow-ups. He was found to be asymptomatic, and the radiograph showed considerable periapical healing with nearly enough bone production.

“…Untreated dental caries and other conditions that cause infection or swelling of the dental pulp may also have a detrimental effect on the prevalence [ 8 ]. The relative frequency of occurrence in all intraoral cysts is 52-68% [ 9 ]. The more frequently involved parts of the jaw bone are the anterior region of the maxilla and the premolar region of the mandible.…”

Section: Introductionmentioning

confidence: 99%

Non-surgical Management of a Large Periapical Lesion: A Case Study of the Successful Application of a Modified Triple Antibacterial Paste

Awghad,

Mahapatra,

Reche

et al. 2024

Infection of the dental pulp involves mainly Gram-negative, anaerobic bacterial flora and due to this infection, the periapical area experiences an immunological response, which is termed a periapical lesion. This lesion may appear as a radiolucent (dark) area on X-rays, which indicates periapical inflammation and infection. Its prevalence depends on factors such as age, oral health maintenance, and dental care. Men are more likely to be affected by this infection than women. There are two modalities for the treatment of periapical lesions: surgical or non-surgical endodontic therapy. The modified triple antibiotic paste (TAP) comprising ciprofloxacin, metronidazole, and clindamycin in the ratio of 1:1:1 was first prepared expressly to treat the teeth with necrotic pulp and to support the protocol for revitalization and regrowth. The treatment was very successful in eliminating germs from the root canal system. It provides broad-spectrum antimicrobial activity against a wide range of bacteria commonly associated with endodontic infections. The modified TAP is usually inserted into the canal for a predetermined amount of time and then removed followed by the irrigation of root canal, which helps to eliminate the microorganisms from the root canal. The non-surgical treatment should always be the first choice over the surgical approach so as to avoid a more invasive procedure.