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Pediatric dental procedures are carried out largely to prevent the adverse effects of primary teeth infection on succedaneous teeth (ST). The existing literature on how and when periapical infection (PI) from primary teeth affect ST is conflicted. A series of seven case reports on PI (abscesses and radicular cysts) from primary molars, until the eruption of the premolars, have been illustrated. The resistance of ST to PI based on their developmental stages is also discussed.

Background Odontogenic cysts (OCs) constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations. Aims The aim was to determine the prevalence and factors associated with the cases of histopathologically diagnosed OCs that report to our institution and to analyze the factors associated with the presence of OCs and to study the biologic behavior of different types of cysts. Materials and methods A cross-sectional study was performed on 596 oral and maxillofacial specimens during 2013-2017. Out of these, the cases which were histopathologically proven as OCs were separated and data were collected and analyzed regarding the age, gender, primary symptom, site, radiographic feature, histopathologic diagnosis, treatment given, recurrences and associated conditions if any. Results Of the 596 cases included in the study, 67 (11.2%) had a histopathological diagnosis of OCs. 41 cases were inflammatory cysts and 26 developmental cysts. 28 cases (41.8%) were reported as periapical cysts, 10 cases (14.9%) were odontogenic keratocysts (OKCs), 9 cases (13.4%) were dentigerous cysts, 8 cases (11.9%) were inflamed cyst wall, 5 cases (7.5%) each of residual cyst and developmental OCs and one case (1.5%) each of orthokeratinized OC and calcifying OC. Conclusion This study showed that the prevalence of OCs was similar to other reported studies. Periapical cysts were the most common cysts reported, followed by OKCs showing that the latter were more frequent than dentigerous cysts.

Objective: This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects. Materials and Methods: This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively. Results: PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing. Conclusion: Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.

Aim: The present study was conducted to determine the podoplanin expression in odontogenic tumors and cysts. Materials and Methods: It consisted of 12 cases of the keratocystic odontogenic tumor (KCOT), 10 cases of ameloblastoma, 8 cases of dentigerous cysts (DC), 8 cases of radicular cysts (RC) and 8 dental follicles (DF) as controls which were immunohistochemically evaluated using an antibody against podoplanin. Results: Immunostaining intensity, % of PPC and total score of ameloblastoma was higher than DC and DF but less than KCOT (t- 1.48). When DC was compared with KCOT and RC, the podoplanin expression was significantly higher with DC (P < 0.05). The podoplanin expression was comparatively higher with KCOT as compared to RC and DC. OT (t-4.40) revealed higher podoplanin expression as compared to OC and DF (t-5.54). Conclusion: There was significantly higher expression of podoplanin in cases of ameloblastoma and KCOT as compared to the RC, DC and DF. Podoplanin may be considered as a useful marker to delineate the aggressiveness of ameloblastoma and KCOT.

The radicular cyst arises from proliferated epithelial cell rests of malassez when they get stimulated by an inflammatory process originating from pulpal necrosis of a nonvital tooth. The associated tooth is usually asymptomatic and may result in swelling of the soft tissues and mobility of the teeth involved. The typical radiographic description of the lesion is a round or oval, well-circumscribed radiolucency involving the apex of the tooth. Radicular cysts can be managed either surgically or nonsurgically. The nonvital, discolored anterior tooth associated with the lesion is a common esthetic concern for patients. It can effect their self-confidence and employability. Discolored nonvital teeth are frequently compromised due to root canal treatment, previous trauma, or caries. Invasive treatment options like crowns or veneers further weaken the tooth structure. This case report presents the successful surgical management of a radicular cyst associated with a nonvital discolored anterior tooth. This will also include the technicalities involved in the inside/outside nonvital bleaching technique.

The maintenance of a tooth with periapical lesion is more often managed by periradicular surgery when the efforts using conventional endodontic (re) treatment prove insufficient to achieve desired outcome. The most critical elements of successful bone regeneration involve the production hermetic seal of the endodontic canal after the root end resection and promotion of early uneventful wound healing using desirable biomaterials, particularly in large-sized intraosseous periapical defects. Yet even after the use of different biomaterials available, the wide varieties of such defects have shown suboptimal outcomes and also took longer healing period. The simple procurement method, ready bioavailability, cost-effectiveness, ease of handling, and remarkable healing potential of platelet-rich fibrin (PRF) in filling the large-sized periapical intrabony defects is presented in this article, with the aim of providing optimal and most elusive environment for wound healing in regenerative procedure. The entire intrabony defects were condensed with autologous PRF as the only grafting material in all four different cases for regeneration. The same surgical technique successfully applied to all four selected cases resulted in an uneventful healing post surgically and almost complete defect fill over 6 months' follow-up. The use of autologous PRF can be recommended for further research in view of its therapeutic use in large-sized intraosseous defects even in different health disciplines; to support the successful outcome identified in this case series.

Background Odontogenic keratocyst (OKC) is one of the odontogenic lesions that have been recently classified as a developmental cyst in the last WHO odontogenic classification in 2017, despite its clinical aggressiveness and relative rate of recurrence. Aim The aim of the current work was to assess and compare OKC with both ameloblastoma (AM) and radicular cyst (RC) in relation to immunohistochemical expression of Bcl-2 and CD138. Materials and methods This is a retrospective study that included 15 cases of OKC, 20 cases of AM, and 15 cases of RC. Immunohistochemical technique was applied to detect and compare Bcl-2 and CD138 expressions in these lesions. Results For Bcl-2, 86.6% of the OKC cases and all studied AM cases (100%) were positive for Bcl-2, without significant statistically correlation (P>0.05). At the same time, OKCs were significantly correlated with RC, which were completely negative to Bcl-2 (P 0.05). Conclusion The results of the current study registered (a) positive Bcl-2 expression in OKC and AM compared with negativity of RC; (b) increased CD138 epithelial expression in OKC and RC than in AM; and (c) increased stromal CD138 expression in both OKC and AM than RC. These results reflect difference in their growth profile and invasive behavior. At the same time, it elucidates that molecular defect in Bcl-2 and CD138 protein is critical for biology of studied odontogenic lesions with consequently effect on their diagnosis and treatment. However, the localization of Bcl-2 expression supports the classification of OKC as a neoplastic one rather than a developmental cyst, in contrary to the new WHO classification. So, further studies with markers panel are recommended for more understanding of the biological nature of OKC.

Odontogenic keratocyst (OKC), a rare, locally aggressive developmental cyst, is found incidentally on dental radiographs, most commonly in the posterior mandible. When it occurs in the periapical region in association with nonresponding teeth to pulp sensibility tests, it is often misdiagnosed as other endodontic lesions such as radicular cyst, lateral periodontal cyst and dentigerous cyst. This case report describes the rare occurrence of OKC in the anterior mandibular region managed successfully with endodontic treatment and re-interventional surgery in a conservative approach. This case report also emphasizes on the importance of histopathological examination of the surgically excised tissue specimens as the clinical, radiographic and histopathological correlations are essential for successful treatment.

Radicular or periapical cysts are one of the most commonly occurring odontogenic cysts of the jaws. The present article reported a case of a 12-year-old female with the chief complaint of swelling and pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border with respect to the right mandibular 1st, 2nd and 3rd molar. The case was managed by complete enucleation under general extraction with the extraction of right mandibular 1st, 2nd and 3rd molar. The success of the surgery was apparent by the uneventful healing during the follow-up period and evidence of complete healing after 1-month follow-up. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.

Radicular cysts are considered to be rare in the primary dentition comprising 0.5%–3.3% of the total number of radicular cysts in both primary and permanent dentition. Ectopic eruption is an eruption disturbance with the prevalence of 5.6% with majority being permanent central incisors. Etiology for eruption disturbance commonly includes odontoma, cysts, supernumerary teeth, and crown-root malformation. Ectopic eruption of permanent incisor due to radicular cyst associated with traumatized primary incisor is a very rare clinical entity that requires timely interception. The present case illustrates the clinical feature and multi-disciplinary management of ectopic eruption of permanent central incisor in a 9-year-old girl child.

Chronic inflammatory hyperplasia is a reactive soft-tissue lesion. These lesions represent a reaction to some kind of irritation or low-grade injuries such as chewing, trapped food, calculus, fractured teeth, and iatrogenic factors, including overextended flanges of dentures and overhanging dental restorations. Treatment includes surgical excision of lesion and regular follow-up for the recurrence. Radicular cysts are the most common of all jaw cysts and comprise about 52%–68% of all the cysts affecting the human jaws. Radicular cysts arise from the epithelial residues in the periodontal ligament as a result of inflammation. They generally result due to pulpal infection following dental caries. Treatment comprises enucleation of cyst and endodontic treatment of tooth. These are two entities were irrelevant, and occurrence of these two entities in a single individual was an averment of patients' negligence and lack of oral hygiene awareness among patients of lower social economy. A complete case report accompanied with emphasis on hygiene awareness was depicted in this present case report.

Background: Fine-needle aspiration cytology (FNAC) involves puncturing a lesion for microscopic analysis. Smears are prepared using aspirated material for cytology and for cell block (CB) preparation. FNAC is a preoperative technique and does not provide sufficient information for precise diagnosis, and the risk of false diagnosis or intermittent diagnosis always exists. To overcome the deficiencies of FNAC, the CB technique (CBT) is considered a novel innovative technique for odontogenic lesions. The present study is carried out to evaluate the efficacy of CBT in diagnosing odontogenic cystic lesions and ameloblastoma of the jaw and comparing it with aspiration cytology and histopathology. Methods: In this prospective study, 17 patients with clinical diagnosis of odontogenic cysts and ameloblastoma are obtained. FNAC smears and CBs are prepared and compared with cytology and histopathology. Results: A total of 17 cases of odontogenic cysts and ameloblastoma are divided into seven odontogenic keratocyst (OKC), three dentigerous cysts, three radicular cysts and four ameloblastoma. In seven cases of OKC, five cases (71.4%) are showing positive features and two cases (28.6%) are showing negative features. Three dentigerous and three radicular cysts are showing three positive CB features (66.7%) and three negative features (33.3%). Among four cases of ameloblastoma, two cases (50%) are showing positive CB features and two cases (50%) are showing negative features. Conclusion: CB is a novel diagnostic technique in oral pathology for odontogenic cysts, tumors, metastatic tumors and bony lesions. Compared to FNAC, it gives accurate diagnostic architecture and apparent histopathological features. This technique can be used alternative to FNAC.

Cholesterol granuloma is an inflammatory reaction to cholesterol crystals deposition which may develop in a variety of sites including the middle ear, mastoid process or even paranasal sinuses. A dentigerous cyst is the one that encloses the crown of unerupted tooth by expansion of its follicle & is attached to the neck of the tooth. Histopathological examination usually shows a thin fibrous cyst wall which, being derived from dental follicle, consists of young fibroblast widely separated by stroma and ground substance rich in mucopolysaccharide. cholesterol crystals which presents as longitudinal clefts in histologic sections, are frequent feature in the inflammatory lesions like radicular cyst but are very rare in dentigerous cyst. This case study presents an unusual case of cholesterol granuloma occurring in dentigerous cyst wall.

Dentigerous cyst is known to be caused by the accumulation of fluid between the epithelium and the crown of an unerupted tooth. Its size increases by the expansion of the follicle, and it is attached to the neck of the tooth. These cysts are often associated with impacted third molars and maxillary canines and rarely with supernumerary teeth. In the present paper, we report a case of a dentigerous cyst associated with an impacted ectopic supernumerary tooth. This cyst was missed initially due to a failed root canal treatment associated with the nonvital maxillary central incisor. This case of a cystic lesion can create a dilemma between radicular and dentigerous cyst. The pathogenesis of the ectopic tooth, differential diagnosis, and management are also discussed.

Radicular cysts are the most commonly occurring cystic lesions in the oral cavity. The management of periapical localized cysts requires conventional nonsurgical root canal therapy. However, a multidisciplinary approach involving Endodontist and Oral surgeon holds the key to treat a large radicular cyst. This article aims to report a successful multidisciplinary management of a large-infected cyst, which was associated with maxillary central incisor with open apex.

Radicular cysts associated with primary teeth are rare. This case report describes radicular cyst associated with carious primary mandibular second molar in a 5-year-old patient and discusses its surgical intervention, space management, and follow-up for 3½ years.

Background and aim Periapical lesions are considered as the most common lesions that associated with necrotic teeth. Histopathologically, these lesions are accompanied with variable amount of inflammatory cells; among them, macrophages are present in a significant number. This study was planned to assess the role of macrophage subpopulations in the pathogenesis of periapical lesions through the presence of M1 and M2 macrophages. Materials and method Twenty cases of periapical lesions including radicular cysts and periapical granuloma (10 cases each) were selected. Immunohistochemical expressions of CD68, CD163, CD204 and pancytokeratin were evaluated. Results M1 macrophages (CD68+ and CD204+) were strongly associated with periapical granuloma. In radicular cyst, the total number of macrophages was lower than that in periapical granuloma and they were M2 macrophages (CD163+). Conclusion Macrophages contributed to the inflammatory response of periapical lesions. M1 macrophages were associated with periapical granuloma while M2 macrophages were associated with radicular cyst. Transformation of periapical granuloma to radicular cysts requires M2 macrophage polarization.

Introduction: The three common odontogenic cysts include radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs). Among these 3 cysts, OKC is recently been classified as benign keratocystic odontogenic tumor attributing to its aggressive behavior, recurrence rate, and malignant potential. The present study involved qualitative and quantitative analysis of inducible nitric oxide synthase (iNOS) expression in epithelial lining of RCs, DCs, and OKCs, compare iNOS expression in epithelial linings of all the 3 cysts and determined overexpression of iNOS in OKCs which might contribute to its aggressive behavior and malignant potential. Aims: The present study is to investigate the role of iNOS in the pathogenesis of OKCs, DCs, and RCs by evaluating the iNOS expression in the epithelial lining of these cysts. Subjects and Methods: Analysis of iNOS expression in epithelial lining cells of 20 RCs, 20 DCs, and 20 OKCs using immunohistochemistry done. Statistical Analysis Used: The percentage of positive cells and intensity of stain was assessed and compared among all the 3 cysts using contingency coefficient. Kappa statistics for the two observers were computed for finding interobserver agreement. Results: The percentage of iNOS-positive cells was found to be remarkably high in OKCs (12/20) –57.1% as compared to RCs (6/20) – 28.6% and DCs (3/20) – 14.3%. The interobserver agreement for iNOS-positive percentage cells was arrived with kappa values with OKCs → Statistically significant (P > 0.000), RCs → statistically significant (P > 0.001) with no significant values for DCs. No statistical difference exists among 3 study samples in regard to the intensity of staining with iNOS. Conclusions: Increased iNOS expression in OKCs may contribute to bone resorption and accumulation of wild-type p53, hence, making OKCs more aggressive.

Context: The most common and important odontogenic cyst involving jaws is the odontogenic keratocyst (OKC) or primordial cyst, the dentigerous cyst and the radicular cyst. These cysts all though do not show similar behavior, they all have the potentiality to recur. Silver nitrate staining of the nucleolar organizer regions (AgNORs) of the benign and malignant lesions is becoming very useful as a diagnostic indicator. Thus, the aim of this study is to assess the diagnostic potential of AgNORs in the cystic epithelium of common odontogenic cysts. Materials and Methods: Archived specimens of odontogenic cysts were stained with hematoxylin and eosin stain and AgNOR stain. Results: The comparative evaluation of the AgNOR counts was done among the three varieties of odontogenic cysts, i.e., radicular cysts, dentigerous cysts and OKC and were observed that the mean for OKC was significantly higher than that of radicular cyst. Conclusion: Therefore, AgNor could be used as an efficient tool for comparative evaluation of microscopic features such as epithelial thickness, surface keratinization and mural proliferation in dentigerous cyst to that of the AgNOR count.

Aim and Objectives: The aim of the study was to analyze glucose content of cyst fluid to assess the cellular metabolism. Objectives were to analyze glucose level in cyst aspirates of dentigerous, odontogenic keratocysts, radicular, and residual cysts to analyze pathophysiological differences. Materials and Methods: Cyst fluid aspirates obtained from radicular cysts (n = 5), dentigerous cysts (n = 6), odontogenic keratocysts (n = 2), and residual cyst (n = 1) were assessed for glucose levels using Trinder's method. Statistical analysis was done by calculating mean ± standard deviation (SD) values for glucose levels. Analysis of variance test was employed to obtain P value. Results: No significant correlation was obtained among the various cysts studied. Mean ± SD values suggested highest metabolic glucose metabolism in radicular and odontogenic keratocysts. Dentigerous cyst showed intermediate values while residual cysts had least glucose content due to its quiescent nature. Conclusion: Cellular activity is similar in all the studied cysts but their expansile properties can be attributed to multiple other factors such as albumin, immunoglobulins, and keratin

Glandular odontogenic cyst (GOC) is a rare developmental cystic lesion of the jaws accounting for 0.012%–0.3% of all the odontogenic cysts. It occurs most commonly in middle-aged men, especially in the anterior mandible. It clinically presents as a slow-growing intraosseous lesion. Small cysts may be asymptomatic while larger ones may cause expansion with pain or paresthesia. Radiographically, it frequently presents as a multilocular radiolucency. Microscopic features are characterized by nonkeratinized stratified squamous epithelium of variable thickness with many microcystic or pseudoglandular spaces and plaque-like extensions. Although its microscopic features are characteristic, few situations may arise where this entity may be confused with dentigerous, botryoid odontogenic, radicular cyst, and central mucoepidermoid carcinoma. The importance of GOC relates to its high rate of recurrence making its diagnosis important. The purpose of this study is to present the clinicopathological features of five cases of GOC which have been reported in our institution.

Periapical infection in the primary tooth may lead to periapical abscess, granuloma, radicular cyst and even osteomyelitis. The infection in primary teeth can also affect the developing successor teeth leading to hypomineralization, hypoplasia, arrest of tooth development, regional odontodysplasia, delayed eruption etc. The purpose of this article is to report a case of malformed permanent tooth in relation to overlying infected deciduous teeth. The probable role of inflammation in pathogenesis of the present condition is also being discussed.

Background: Cyst and tumors arise from tissue remains of odontogenesis, these interactions have been considered to play an important role in the tumorigenesis of odontogenic lesions. The connective tissue stroma has an essential role in the preservation of epithelial tissues and minor alterations in the epithelium are followed by corresponding changes in the stroma, such as angiogenesis. Vascular endothelial growth factor (VEGF) is considered the first factor which maintains its position as the most critical driver of vascular formation and is required to initiate the formation of immature vessels, with this aim, present study was executed to evaluate VEGF expression in kertocystic odontogenic tumor, dentigerous cyst and radicular cyst (RC). Materials and Methods: A retrospective study was carried out comprising a total of 31 cases; 13 cases of keratocystic odontogenic tumor (KCOT), nine cases of dentigerous cyst (DC) and nine cases of RC. The sections were stained immunohistochemically with VEGF antibody and were evaluated for the presence and intensity of the immuno reactive cells. Statistical analysis was carried out using Chi-square test to inter-compare the VEGF expression between KCOT, DC, and RC. Results: VEGF expression in the epithelium and connective tissue was significantly higher in KCOT compared to dentigerous and RC. One case of KCOT with carcinomatous change also revealed positive results for the VEGF expression in the dysplastic epithelium, tumor islands, and connective tissue. The significant difference was observed on inter-comparison of the VEGF expression in the connective tissue of KCOT and DC, whereas no significant difference was observed in the VEGF expression in the connective tissue of KCOT and DC. Conclusion: The present study data supports the literature finding that angiogenesis can be important in the progression and enlargement of odontogenic cysts similarly to what occurs in neoplastic conditions and further it can be concluded that the higher positivity for VEGF of KCOT could help to explain in part the aggressive biological behavior of the lesion. The stroma of KCOT could be regarded not only as a structural support of the cyst wall but also as playing a part in the neoplastic behavior of cyst.

The failure of amalgam retrofilling and presence of an associated cystic lesion makes surgical endodontic intervention inevitable. Amalgam retrofilling can also give rise to mucoperiosteal tattoo formation and allow incorporation of amalgam particles in the cystic lining. Such a finding has not yet been reported in the endodontic literature. This case report describes the successful endodontic management of a large radicular cyst associated with failed amalgam retrofilling, mucoperiosteal tattoo and amalgam particles dispersed in the epithelial cystic lining. All four mandibular incisors associated with the lesion presented with Weine Type II canal anatomy. The follow-up revealed clinical and radiographic signs of healing.

This paper describes the importance of accurate diagnosis in the management of complex endodontic cases and highlights the usefulness of cone beam computed tomography (CBCT) in the effective management of challenging cases. This paper discusses seven patients managed for different Endodontic related conditions. The conditions include large radicular cyst, coronoradicular groove, open apex, impacted tooth in an inverted position, mandibular lateral incisor with unusual anatomy (two canals and root concavity), extensive external cervical resorption, and root fractures. In all these cases, CBCT revealed the three-dimensional nature of anatomic and pathologic structures and aided us in following appropriate treatment strategies. CBCT appears to be more reliable than radiographs in the diagnosis and management of complex cases. Since structures can be visualized in different planes, three-dimensional nature of any given object can be studied without any superimposition and distortion. Appropriate utilization of this technology could help in effective patient management. Clinical Relevance To Interdisciplinary Dentistry This article discusses several cases with conditions like large radicular cyst, extensive root resorption, open apex, corono-radicular groove, root fractures were managed using cone beam computed tomography with an interdisciplinary approach. The usefulness of CBCT in various dental specialties like endodontics, oral surgery, periodontics were discussed.

Radicular cyst is a most common type of odontogenic cyst that develops mostly as sequel of untreated dental caries. It is classified as inflammatory type originated mostly from cell rests of Malassez. Radicular cyst arising from deciduous teeth is rare, accounting for just 0.3% to 5% of the total number. Residual kind of radicular cyst in deciduous teeth are still very sparse in literature. Most of the residual cysts are asymptomatic and are found only on routine radiographic examination. We are presenting an interesting and rare case of symptomatic residual radicular cyst of left primary first molar extraction socket with secondary infection in a 5-year-old child. Our aim is to emphasize on investigations, recognition, and treatment of such inflammatory residual radicular lesions associated with deciduous teeth, which has been an unreported clinical entity.

Radicular cysts are inflammatory jaw cysts confined to the apices of teeth with infected and necrotic pulp. They arise from the epithelial residues in the periodontal ligament as a result of inflammation, following the death of pulp. The treatment of such lesions vary with regard to their sizes; the small cystic lesions heal after an endodontic therapy, but larger lesions, may require additional treatment. Apical surgery for radicular cysts generally involves apical root resection and sealing with endodontic material. This case report, describes the treatment of a cyst related to the maxillary central and lateral incisors using platelet rich fibrin along with synthetic nanocrystalline hydroxyapatite granules for the regeneration of lost tissues. A follow‑up evaluation at 6 months and 1‑year revealed a significant radiographic bone fill with satisfactory healing at the surgical site.Keywords: Hydroxyapatite granules, platelet rich fibrin, radicular lesion

Keratocystic odontogenic tumor was previously considered as a common cyst of developmental origin but now it is considered as a tumor of the oral cavity with high recurrence rate and it has an ability to mimic other jaw cysts. Present study is a case report of a 19 year old male presenting with apainful swelling in right lower face region. On clinical and radiographic examination, a provisional diagnosis of Radicular cyst was given. Histopathological examination revealed Keratocystic Odontogenic Tumor. KOT may look similar to endodontic lesion. The lesion was successfully treated by complete enucleation. The aim of the study is to report and distinguish a case of keratocystic odontogenic tumor simulating Radicular cyst because of its aggressive behavior and high recurrence rate.

Background: Odontogenic cysts are distinct entities and a quite common occurrence in the jaw bones. These are individual lesions which arise from the same odontogenic apparatus but with varying pathogenesis. Various molecules have been implicated to play a role in the pathogenesis of these lesions ranging from cell cycle perturbations to mutations in oncogenes and tumor suppressor genes. Materials and Methods: The role of cytokeratin (CK) 10 and 14, epidermal growth factor receptor (EGFR), tenascin and Ki-67 was studied in 5 cases of dentigerous cysts, 3 cases of odontogenic keratocysts (OKCs) (keratocystic odontogenic tumor), 3 cases of radicular cyst, 2 cases of orthokeratinized odontogenic cyst (OOC), and 2 cases of calcifying odontogenic cyst. Results: The study revealed that CK10 was significantly higher in OOC, CK14 expressed mild to intense positivity in all the odontogenic cysts. EGFR showed significant expression in OKC and tenascin expression was significantly higher in OKC. Conclusion: The study has observed the behavioral differences in the most commonly occurring odontogenic cysts. Further molecular characterization would help in better understanding.

Treacher Collins syndrome (TCS, OMIM 154500) [1] is a rare autosomal dominant disorder of the craniofacial region and structures derived from first and second branchial arches such as the ears, eyelids, maxilla and mandible are affected in this syndrome. An 18 year old female presented with the dysmorphic features of the face, partial anodontia, macroglossia, malocclusion, cleft palate, coloboma, limbal dermoid, deformity of the pinna, partial hearing loss (absence of right ear canal), malar hypoplasia and radicular cyst in the left body of mandible as well as in the maxillary posterior region. In this case, though radicular cysts are incidental findings, the limbal dermoid reported here is a rare manifestation in TCS.

Radicular cyst is the most common odontogenic cyst occurring in the jaws. The cyst is commonly found in relation to the maxillary anterior teeth in the third and fifth decade of life. It arises from epithelial remnants and has been classified as inflammatory cyst, as a consequence of pulpal necrosis following caries, with an associated periapical inflammatory response. Hereditary defects like amelogenesis imperfecta can also lead to early loss of enamel, causing pulp exposure and necrosis, which ultimately may lead to radicular cyst. Radiographically, radicular cyst appears as a round or oval, well-circumscribed radiolucent image involving the apex of the tooth. This paper presents a case of multiple radicular cyst and amelogenesis imperfecta.

Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin. Large radicular cyst is comparatively less frequently associated with primary teeth. They represent only 0.5-3.3% of the total number of cysts in primary dentition. Radicular cysts arising from deciduous teeth are reported to occur in age range of 3-19 years with a male predominance. Although large radicular cysts are treated by enucleation with extensive removal of bone and vital teeth, marsupialization can be preferred as a conservative approach to reduce the morbidity. The purpose of this article is to report a case series of large radicular cysts associated with badly mutilated and traumatized primary teeth and to demonstrate how best they can be conservatively treated during mixed dentition period.

Radicular cysts arising from deciduous teeth are remarkably rare. This article presents a case report of radicular cyst associated with an endodontically treated deciduous second molar. Clinical and radiographic features were consistent with the dentigerous cyst. The cystic lesion was surgically enucleated under local anesthesia. But, histopathologically findings confirmed a final diagnosis of the radicular cyst. The case report highlights the unusual presentation of a radicular cyst associated with deciduous teeth, which clinically and radiographically mimicked a dentigerous cyst.

Objective: Cytokeratins (CKs) are integral components in the formation of enamel, dentin and/or cemental matrix and their subsequent mineralization. K8 and K19 are known to be chemically homologous during the formation of tooth structures. This feature is rather unique and is expressed across the milieu of odontogenic tissues in the physiological and pathological states. The present study was designed to evaluate the expressions of K8 and K19 in odontogenic lesions immunohistochemically and to test the hypothesis that they can be used to identify the odontogenic epithelium. Study Design: K8 and K19 were assessed in 60 cases of odontogenic lesions retrieved from the archival files, which included ameloblastoma (18), ameloblastic carcinoma (2), adenomatoid odontogenic tumor (AOT) (9), squamous odontogenic tumor (SOT) (1), odontogenic keratocyst (OKC) (10), dentigerous cyst (10), and radicular cyst (10), including two cases of normal gingiva and follicular tissue. Results: K8 was expressed in 53/60 (88.3%) and K19 in 56/60 (93.3%) odontogenic lesions. The labeling for K19 was found to be more intense compared to that for K8. Further, K8 and K19 were found to be positive in all the gingival and follicular tissues. Conclusions: Positive expressions of K8 and K19 in all the odontogenic lesions studied suggest that these can be used as definitive markers for identifying the odontogenic epithelium. However, the intense and consistent expression of K19 suggests that this CK is extremely sensitive in identifying the odontogenic epithelium.

Background: Periapical lesions occur in response to chronic irritation in periapical tissue, generally resulting from an infected root canal. Specific etiological agents of induction, participating cell population and growth factors associated with maintenance and resolution of periapical lesions are incompletely understood. Among the cells found in periapical lesions, mast cells have been implicated in the inflammatory mechanism. Aim: Quantifications and the possible role played by mast cells in the periapical granuloma and radicular cyst. Hence, this study is to emphasize the presence (localization) and quantification of mast cells in periapical granuloma and radicular cyst. Materials and Methods: A total of 30 cases and out of which 15 of periapical granuloma and 15 radicular cyst, each along with the case details from the previously diagnosed cases in the department of oral pathology were selected for the study. The gender distribution showed male 8 (53.3%) and females 7 (46.7%) in periapical granuloma cases and male 10 (66.7%) and females 5 (33.3%) in radicular cyst cases. The statistical analysis used was unpaired t‑test.Results: Mean mast cell count in periapical granuloma subepithelial and deeper connective tissue, was 12.40 (0.99%) and 7.13 (0.83%), respectively. The mean mast cell counts in subepithelial and deeper connective tissue of radicular cyst were 17.64 (1.59%) and 12.06 (1.33%) respectively, which was statistically significant. No statistical significant difference was noted among males and females.Conclusion: Mast cells were more in number in radicular cyst. Based on the concept that mast cells play a critical role in the induction of inflammation, it is logical to use therapeutic agents to alter mast cell function and secretion, to thwart inflammation at its earliest phases. These findings may suggest the possible role of mast cells in the pathogenesis of periapical lesions. Keywords: Mast cells, Periapical granuloma, Radicular cyst, Toluidine blue

Lateral periodontal cyst (LPC) is a relatively uncommon type of odontogenic developmental cyst often detected on routine radiological examination. The purpose of this article is to report a case of unilocular radiolucent cystic lesion of the mandible in the region of premolars with clinical and radiological features of radicular cyst. LPC is characterized by thin cuboidal or stratified squamous nonkeratinizing epithelium ranging from 1 to 5 cell layers and presence of one or more epithelial thickening or plaques. Glycogen rich clear cells are also encountered either in the epithelial plaque or in the superficial layer of the lining epithelium.

Objective: The present study aimed to investigate the probable differences in cell proliferation index of odontogenic cysts and tumors by means of a comparative silver stained nucleolar organizing region (AgNOR) quantification. Study Design: This descriptive cross-sectional study was done on archival paraffin blocks (n = 62), consisting of 10 odontogenic keratocysts, 10 dentigerous cysts, 10 radicular cysts, 10 conventional ameloblastomas, 10 adenomatoid odontogenic tumors, 10 calcifying epithelial odontogenic tumors and 2 ameloblasic carcinomas. Results: The mean AgNOR count of odontogenic cysts was 1.709 and the benign odontogenic tumors was 1.862. Highest AgNOR count was recorded in odontogenic keratocyst and lowest was seen in radicular cyst. Statistically significant difference in AgNOR counts of ameloblastoma and adenomatoid odontogenic tumor, amelobalastoma and calcifying epithelial odontogenic tumor, benign odontogenic tumors and ameloblastic carcinoma were seen. AgNORs in ameloblastic carcinoma were more in number and more widely spread. Conclusion: AgNOR technique may be considered a good indicator of cell proliferation in odontogenic cysts and tumors.

Radicular cysts are the most common cysts of the jaws. They are localized on the apex of the teeth with necrotic pulp. They are classified as inflammatory cysts. Radiographically, they appear as an oval radiolucent lesion with well-defined radiopaque border. They develop slowly, and asymptomatic unless infected. Because of this they can reach big dimensions. Intraoral examination of an 21-year-old man revealed a fluctant swelling on the palatinal and vestibular mucosa of the incisor-canine region. Radiographic examination revealed well defined and uniformly radiolucent lesion present between the left and right molar regions. The lesion was extending to nasal cavity and left and right maxillary sinus regions. The result of the histopathological examination was reported as radicular cyst. In this report it was aimed to present a giant radicular cyst case.

Introduction: Desmosomes together with adherens junctions represent the major adhesive cell–cell junctions of epithelial cells. Any damage to these junctions leads to loss of structural balance. Aim: The present study was designed to analyze the desmosomal junctions in different odontogenic cysts and compare them with their corresponding hematoxylin and eosin (H and E) stained sections. Materials and Methods: Ten cases each of odontogenic keratocyst (OKC), dentigerous cysts (DCs), radicular cysts (RCs) and normal mucosa were stained with hematoxylin and eosin. Scanning electron microscopy (SEM) analysis of the sections was then carried out of all the sections. The area of interest on H and E stained section was marked and this marking was later superimposed onto the corresponding unstained sections and were subjected to SEM analysis. Results and Observations: OKC at ×1000 magnification showed many prominent desmosomes. However, an increase in the intercellular space was also noted. SEM analysis demonstrated similar findings with the presence of many desmosomes, though they were seen to be damaged and fragile. H and E stained DC under oil immersion did not show any prominent desmosomes. SEM analysis of the same confirmed the observation and very minimal number were seen with a very condense arrangement of the epithelial cells. RC at ×1000 magnification revealed plenty of desmosomes, which were again confirmed by SEM. Conclusion: The number and quality of desmosomal junctions in all the cysts has a role in the clinical behavior of the cyst.

Radicular cyst is one of the most common odontogenic cysts of the jaws, but those arising from primary teeth are very rare. This article reports two such rare cases incidentally affecting deciduous maxillary teeth.

Background: Odontogenic cysts and tumors are most common benign destructive lesions in the oral cavity. These cystic lesions with its central fluid, reservoir of non-physiological composition, is in itself likely to provoke an inflammatory response in the surrounding host tissues, which may result in its formation and enlargement. Aims and Objectives: 1. To evaluate the number of mast cells and eosinophils in radicular cyst, keratocystic odontogenic tumor and dentigerous cyst and to intercompare it with the degree of inflammation. 2. To evaluate and intercompare the staining quality of toluidine blue and thionin for mast cells identification and Carbol Chromotrope and Congo red for eosinophils evaluation. Study Design: The study comprised of total 47 cases of which 20 were of radicular cyst, 15 were keratocystic odontogenic tumor and 12 were dentigerous cyst. Sections of 4μm thick were cut and stained with gold standard hematoxylin and eosin staining procedure for routine diagnosis. The amount of inflammation in each cyst was graded. They were further stained with toluidine blue and thionin for mast cells identification and Carbol Chromotrope and Congo red for eosinophils identification. The statistical analysis used was one way ANOVA (Analysis of Variance) and Pearson's Correlation Coefficient. Results: The mean number of cell count per high power field of mast cells was higher than the eosinophils. On correlating with degree of inflammation the results came out to be statistically significant. The staining quality for mast cells was equally good with toluidine blue and thionin, whereas Carbol Chromotrope had a significantly better staining quality than Congo red in case of eosinophils. Conclusion: The higher number of mast cells detected in odontogenic cysts could contribute in the release of inflammatory mediators involved in the pathogenesis of odontogenic cysts formation and enlargement. The histochemistry using various stains has proved to be promising in identification of mast cells and eosinophils.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm. Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Here, we report a case of a UA in a 55-year-old female. This case report also emphasizes the use of cone beam computed tomography to locate the lesion boundaries to adjacent vital structures, which further benefits the surgeon in treating such lesion.

Cemento-osseous dysplasia is a non-neoplastic process usually confined to the tooth bearing areas of jaws or edentulous alveolar process. Cemento-osseous dysplasias are categorized into three types on basis of the clinical and radiographic features: Periapical, focal and florid. Focal cemento-osseous dysplasia is benign fibrous osseous condition that can be seen in dentulous and edentulous patient. The lesion is detected only on radiographic examination with variation comprising a combination of radiolucent and radiopaque pattern. It is asymptomatic and needs no treatment. We report an unusual case of concomitant occurrence of infected focal cemento-osseous dysplasia in mandible with atypical clinical presentation of two sinus openings and a radicular cyst in maxilla.