The paradigm of the inflammatory radicular cyst: biological aspects to be considered

Abstract

Inflammatory radicular cysts (IRCs) are chronic lesions that follow the development of periapical granulomas (PGs). IRCs result from multiple inflammatory reactions led initially by several pro-inflammatory interleukins and growth factors that provoke the proliferation of epithelial cells derived from epithelial cell rests of Malassez present in the granulomatous tissue, followed by cyst formation and growth processes. Multiple theories have been proposed to help explain the molecular process involved in the development of the IRC from a PG. However, although multiple studies have demonstrated the presence of epithelial cells in most PGs, it is still not fully understood why not all PGs turn into IRCs, even though both are stages of the same inflammatory phenomenon and receive the same antigenic stimulus. Histopathological examination is currently the diagnostic gold standard for differentiating IRCs from PGs. Although multiple studies have evaluated the accuracy of non-invasive or minimally invasive methods in assessing the histopathological nature of the AP before the intervention, these studies' results are still controversial. This narrative review addresses the biological insights into the complex molecular mechanisms of IRC formation and its histopathological features. In addition, the relevant inflammatory molecular mediators for IRC development and the accuracy of non-invasive or minimally invasive diagnostic approaches are summarised.

Microsurgical management of radicular cyst using guided tissue regeneration technique: A case report

“…The radicular cyst represents 55% of odontogenic cysts, and 52%-68% of all cysts of the jaws[ 7 ]. This chronic entity is the result of multiple inflammatory reactions initially guided by various proinflammatory interleukins and growth factors which cause proliferation of epithelial cells derived from epithelial rests of Malassezz in granulomatous tissue, followed cyst formation and growth[ 2 , 8 ]. However, since events associated with the molecular biology of the radicular cyst are still unclear, there is need for more research in this area[ 2 ].…”

“…Radicular cysts, also known as apical periodontal cysts, are the most common inflammatory odontogenic cysts of the jaw[ 1 ]. They are chronic lesions arising from pre-existing periapical granulomas triggered by inflammatory reactions generated in the apex of the affected teeth due to infected or necrotic pulps, although they may also be located on the lateral surfaces of roots associated with accessory canals[ 2 ]. Generally, radicular cysts have a predilection for the male gender, and they occur between the third and sixth decades of life[ 1 ].…”

Extraction Management of Gangrene Radix with Radicular Cyst

“…Continuous activation of inflammatory mediators has resulted in the expansion of the lesion to enlargement. 11,12 Nearly all radicular cysts are lined by non-keratinized squamous depithelial cells. The epithelial lining can develop with severe inflammation and consists of polymorphonuclear lymphocytes.…”

“…Bay cyst formation begins with bubbles, then a capsule collar forms around the roots. 12 The choice of treatment in cases of radicular cysts is influenced by several factors such as the location of the cyst, the integrity of the cyst wall that forms, the size of the cyst, and the distance of the cyst to vital tissue in the body. 10 Treatment that can be done for radicular cysts consists of surgical treatment (surgical) and without surgery (non-surgical).…”

About a Possible Impact of Endodontic Infections by Fusobacterium nucleatum or Porphyromonas gingivalis on Oral Carcinogenesis: A Literature Overview

“…In radicular cysts, ERMs proliferate because they are stimulated by inflammatory cytokines secreted by the various cytotypes that populate the cyst [144,[147][148][149][150][151] (Figure 2). Specifically, in addition to epithelial cells, the cyst contains fibroblasts, lymphocytes, monocytes/macrophages, and Langerhans cells [149,150,152,153].…”