“Management of radicular cyst in the aesthetic zone mimicking periapical pathology: a diagnostic challenge"
Keywords:
Radicular cyst, Periapical cyst, Root end cyst, Inflammatory odontogenic cyst, Anterior maxilla, Periapical pathology, Endodontic surgery, Apicoectomy, Cyst enucleationAbstract
Background:Radicular cysts are the most common inflammatory odontogenic cysts, typically arising from non-vital teeth. Though frequently asymptomatic and discovered incidentally, their presentation in the anterior maxilla — an aesthetically sensitive region — may mimic other periapical pathologies, posing diagnostic and therapeutic challenges.
Case Presentation:A 46-year-old male presented with pus discharge and swelling in the anterior maxillary region. Clinical examination revealed a non-fluctuant, non-tender lesion with a sinus tract in relation to teeth 21–23, which were non-vital. Fine Needle Aspiration yielded yellowish, blood-tinged fluid, suggestive of a secondary infection. Radiographic and CBCT imaging revealed an ill-defined periapical radiolucency with cortical perforation extending from tooth 21 to 23. Root canal treatment of the affected teeth was performed, followed by surgical enucleation of the lesion and apicoectomy under local anaesthesia. Histopathologic analysis confirmed the diagnosis of a radicular cyst.
Conclusion:This case highlights the importance of integrating clinical, radiographic, and histopathological findings in diagnosing periapical lesions, especially in cosmetically sensitive zones. A combined endodontic and surgical approach proved to be effective in achieving complete resolution with minimal morbidity and optimal aesthetic preservation..
Keywords: Radicular cyst, Periapical cyst, Root end cyst, Inflammatory odontogenic cyst, Anterior maxilla, Periapical
Downloads
References
Khetan RR, Reche A, Basra AS, Awghad SS, Awghad S. Radicular cyst: The sequelae of untreated caries. Cureus. 2024 May 14;16(5).
Sahore M. Management of a Radicular Cyst Encroaching the Maxillary Sinus in a Thrombocytopenic Patient: The Crucial Role of Oral Physicians in Careful Planning and Intervention.
Raval RD, Nyklesh V, Patel HM, Naik PS, Patel PP. Management of infected radicular cyst in maxillary anterior region: a case report. Int J of Adv Health Sci. 2015;1:8-11.
Sharma P, Singh S, Mandlik J, Handa A, Khan N, Chaubey S. Management of radicular cyst by surgical enucleation: case report. Eur Chem Bull. 2023;12:2331-7.
Travassos, R.M.C., Martins, W.W.R., Martins, L.G., de Almeida, G.M., Chaves, A.T.D., Cardoso, M.D.S.O., da Paz, E.S.L., Alves, J., dos Santos Ferreira, G., de Queiroz Marques Filho, E. And Dos Santos, P.G.S.T., 2024. Tratamento de cisto radicular em maxila anterior com uso de agregado trióxido mineral (MTA) e enxerto ósseo: relato de caso. Brazilian Journal of Implantology and Health Sciences, 6(11), pp.472-482.
Kadam M, Sharma A, Majumder H, Ganesh sv. Surgical management of radicular cyst associated with open apex and apicectomy with maxillary anterior teeth-a case report.
Kaur J, Sroa RB, Kaur A, Kaur M, Kumar B, Kaur G. Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report. Journal of Pharmacy and Bioallied Sciences. 2024 Feb 1;16(Suppl 1):S987-9.
Kadam NS, De Ataide ID, Raghava P, Fernandes M, Hede R. Management of large radicular cyst by conservative surgical approach: a case report. Journal of clinical and diagnostic research: JCDR. 2014 Feb 3;8(2):239.
Ali GH, Ajili F, Hammami C, Blouza I. Interdisciplinary Management of Radicular Cyst in Anterior Maxilla-A Case Report.
Doumari b, dhoum s, el hajjioui z, jabri m. Post-Traumatic Radicular Cyst Involving Multiple Anterior Teeth: Open Apex Management and Surgical Enucleation–A Case Report. Advances in Oral and Maxillofacial Surgery. 2025 Jun 24:100558.
Prasada KL, Bhagawati B, Chawla G. Management of Radicular Cyst: A Case Report. Indian Journal of Public Health Research & Development. 2019;10(11):1207–9.
Vigneshwar S, Ishwarya P, Priyadharsana PS. Case Report of Two Giant Radicular Cysts. International Journal of Scientific Research. 2021;10(6):1–2.
Mukherjee D. An insight into the pathogenesis of odontogenic hamartomas involving oral cavity. Oral Maxillofac Pathol J. 2020 Jul 1;11(2):64
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
