Oral Surgery Treatment of Radicular Cyst

Abstract

Cysts are pathological formations that develop in the bone tissue or in the soft tissues of the upper and lower jaw. Reasons for their formation are many and varying, depending on the type. Cysts are usually caused due to root infection involving tooth decay. Untreated dental caries then allow bacteria to reach the level of the pulp, causing infection. The bacteria gains access to the periapical region of the tooth through deeper infection of the pulp, traveling through the roots. The resulting pulpal necrosis causes proliferation of epithelial rests of Malassez which release toxins at the apex of the tooth. The body's inflammatory response will attack the source of the toxins, leading to periapical inflammation. The main condition for their formation is presence of epithelial tissue on the place where the new cyst will be developed. Radicular cyst treatment and the access to them can be very variable and it depends on many different factors. The most important of them are the patient’s condition, the therapy opportunities and the intraoperative parameters.The methods of treatment and the type of surgical procedure that will be chosen depend on the size of the cyst, its location and also the pathological formation. Radicular cysts and other bone lesions in many cases cause huge bone loss therefore risk of bone fracture. Also some of the bone lessions are biologically active and they can cause bone destruction if they are not removed correctly and on time. That's why these days bone grafts are used when the defect is big. About the oral surgery treatment, a survey was conducted to define the modern surgical techniques for radicular cysts remove. This study was conducted to evaluate the contemporary oral surgical treatments that are used for treating radicular bone cysts. The study has taken place in a specialized dental office for oral surgery, using questionnaire, clinical examinations and paraclinical examination techniques. The results have shown that radicular cysts are mostly developed in the older adults and more often on the teeth in the transcanine sector. About the symptoms found in the patients, they had experienced mostly pain and swell, rarely fistula and tooth discoloring. The analyze of the data has shown that most often treatment options for radicular cysts are cystectomy with apicotomy and cystectomy with extraction. In the cases treated with apicotomy, intraoperative canal filling was also used. Bone grafting was used rarely, dependently on the patients’ requests. Postoperative, patients have experienced pain and swelling in the first 24 hours after the treatment. The survey and the results collected from it can be used to makea better evaluation and better therapy planning for the radical cysts. Firstly to achieve better results in the tissue consolidation, also to have bigger satisfaction of the treated patients that depends on the postoperative parameters such as pain, swelling or some others consequences of the treatment.