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Objectives Cysts of the mandible are common and are often found clinically in oral surgery. Marsupialization for relatively large cystic lesions may be performed to reduce the size of the lesion and to obtain a histopathological diagnosis. For cystic lesions of the mandible, the effect of marsupialization has many advantages, such as a reduction in lesion size, the avoidance of mental nerve palsy, and preservation of the teeth. It is still unclear whether there is a difference in the reduction rate based on patient age and pathology (dentigerous cyst, odontogenic keratocyst, radicular cyst, ameloblastoma (unicystic type)) and initial size of the lesion. Methods The subjects included 55 patients with cystic lesions with a major axis of 3 cm or greater (16 dentigerous cysts, 20 odontogenic keratocysts, 7 radicular cysts, and 12 ameloblastoma) who underwent treatment at our department. Using simulation software (ProPlanCMF®), the volume of the lesion was extracted from the CT data before and after the marsupialization, and the three-dimensional reduction rate before and after marsupialization was calculated. Results No significant difference was observed between the subgroups in terms of histopathological diagnosis, patient age or size of lesion. Although the effect of marsupialization on cystic lesions with a major axis of 3 cm or more showed a significant difference between 3.0 months and 4.5 months, the difference was not significant between 4.5 months and 6.0 months. Conclusions An indication for the enucleation timing after marsupialization is 4.5 months when the rate of decrease after fenestration slows down.

Objective This study aimed to analyze claudin-1, -4, and -7 expression in different types of odontogenic cysts (odontogenic keratocysts [OKCs], dentigerous cysts [DCs], calcifying odontogenic cysts [COCs], and radicular cysts [RCs]) as well as its association with OKC recurrence. Materials and Methods Seventy samples of odontogenic cysts samples were immunohistochemically stained to detect claudin-1, -4, and -7 expression. Patient information and OKC recurrence data were recorded. The staining was analyzed semiquantitatively and categorized based on the pattern and percentage of positively stained cystic epithelial cells. Statistical Analysis Expression of different claudins between groups was analyzed using the Kruskal–Wallis test with Dunn's test, followed by post hoc pairwise comparison. The association between claudin expression and OKC recurrence was analyzed by the Mann–Whitney U test. Correlations among claudin expression were examined with Spearman's correlation coefficient. Level of significance was at p Results Claudin-1 was widely expressed in every odontogenic cyst. Most DCs (50%) expressed claudin-1 in more than 75% of cells, as did RCs (65%), while most OKCs (50%) expressed claudin-1 in 26 to 50% of cells. Most COCs (50%) expressed claudin-1 in 51 to 75% of cells. Every sample of OKC and RC was positive for claudin-4, but no sample showed staining in more than 51% of cells. Every odontogenic cyst was positive for claudin-7. DCs (35%), OKCs (55%), and RCs (40%) mostly showed staining in 26 to 50% of cells. High claudin-1 expression was shown in COCs, DCs, and RCs, while low expression of claudin-4 was shown in every odontogenic cyst. For claudin-7, the expression is high only in COCs. Claudin-1 and -4 was significantly different among each odontogenic cyst. High expression of claudin-1 was correlated with OKC recurrence. The correlations of claudin-1 with claudin-7 expression and claudin-4 with claudin-7 expression were significant in DCs. In COCs, claudin-1 and claudin-7 expression was significantly correlated. Conclusions The expression of claudin-1, -4, and -7 was present in every odontogenic cyst, but the proportion of positive staining cells was different. Expression of claudin-1 is associated with OKC recurrence. Dysregulation of claudin expression may play a pathogenic role in cyst pathogenesis.

A radicular cyst is the most common odontogenic cyst that arises from the epithelial residues in the periodontal ligament due to periapical periodontitis following death and necrosis of the pulp. A fistula may form a cyst with a pulp infection that produces pus and seeks its way out to the gingival surface to create a canal. The purpose of this case report is to report the management of a patient with a chronically infected radicular cyst with fistula while retaining the involved tooth. A case report was a 13-year-old female patient who came to Department Oral Surgery of a hospital with a complaint of a lump in the front gum and palate that didn't heal for two years ago and often discharged pus. Intraoral examination showed a lump in the gingiva and palate with fistula in the interdental gingiva of teeth 11-12 with soft consistency and pain with palpation. Panoramic results showed characteristics of the radicular cyst at the 13-11 tooth region. The lesion is diagnosed as a chronic infection of a radicular cyst due to pulp necrosis in teeth 12-11 with interdental fistulas. Biopsy enucleation of the cyst was performed with teeth preservation. The patient was advised to have regular check-ups. On the sixth month of control, the surgical wound was good, without any complaints and signs of recurrence. The result is that a radicular cyst can become chronically infected and form a fistula that oozes pus into the oral cavity. The cyst can be treated with enucleation biopsy and fistulectomy with the preservation, without any recurrences.

BACKGROUND Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its classification of maxillofacial bone pathology in 2017. Using these updated guidelines, a systematic review of common maxillofacial bone lesions in the pediatric population was performed. METHODS A PubMed search was conducted capturing English language articles from inception to July 2020. Thirty-one articles were identified that described the frequency of maxillofacial bone pathology. Data were extracted and organized using the WHO 2017 classification of odontogenic and maxillofacial bone tumors. Prevalence data were analyzed among diagnostic categories and geographical regions. The SAS version 9.4 was used to complete statistical analyses. RESULTS The articles included patients from birth to a maximum age of 14 to 19 years. The most common odontogenic cysts included radicular cyst (42.7%) and dentigerous cyst (39.0%) followed by odontogenic keratocyst (15.0%). Among odontogenic bone tumors, odontoma (49.3%) was most common followed by ameloblastoma (29.1%). The most common nonodontogenic bone tumor was fibrous dysplasia (42.4%), and the most common malignant bone tumor was osteosarcoma (75.0%). Significant variations were found by geographic region, with dentigerous cyst more common than radicular cyst, and ameloblastoma more common than odontoma in African and Asian countries (P

Context: Odontogenic cysts are among the most common lesions to affect the oral and maxillofacial region. Cysts are capable of causing significant bony disfigurement, tooth displacement and pathological fractures. Several surgical approaches exist for the management of larger cysts of the jaws. These include enucleation, marsupialization and decompression. Aims: 1. Analysis of histopathologic findings in odontogenic cysts before and after decompression 2. Analysis of Ki-67 expression in odontogenic jaw cysts before and after decompression. Settings and Design: Decompression technique was used for the treatment of 10 cases of odontogenic cysts in the study. Incisional biopsies of cystic lining (pretreatment) and corresponding excisional biopsies (posttreatment) were received for histopathologic and immunohistochemical examination. Subjects and Methods: Hematoxylin and eosin stain was used for histopathologic findings, and Ki-67 was used for immunohistochemical findings using antibody Ki-67 in fresh tissue samples. Results: Overall, radicular cysts, dentigerous cysts, and sialo-odontogenic cyst contained fewer Ki-67 + cells than odontogenic keratocysts. The average scores were found to be 2.2 and 1 for before and after decompression, respectively. A statistically significant difference was observed between the two groups. The two-tailed P value was found to be

Background Radicular cysts may enlarge considerably, cause extensive bone destruction, and jeopardize the integrity of the associated vital teeth. The different treatment approaches are aimed mainly at eliminating the cystic epithelial membrane while reducing the risk of injury to vital structures. Contrary to other treatment modalities, preapical surgery offers an unequivocal single occasion resolution for the patient. However, it has been associated with higher risk of collateral damages. Case presentation A patient presented with a large radicular cyst originating from a maxillary lateral incisor. The adjacent central and canine teeth initially failed to exhibit responses to sensibility tests but showed signs of vitality. Microsurgical management was aimed at enucleating the cystic membrane while maintaining adjacent teeth vitality. Upon careful and controlled cyst enucleation under the dental operating microscope, the neurovascular bundle of one of the involved teeth was visualized and its integrity was maintained throughout the procedure. Results The procedure was successful and follow up recalls revealed recovery of normal sensibility of tooth 11 and 13 with complete bone regeneration around their apices. Conclusion Within the limitation of the present case report, we demonstrated that complete excision of large periapical cyst can be performed without sacrificing the vitality of the adjacent teeth, by preserving the integrity of their neurovascular supply through controlled microsurgical enucleation, and by a potential apical vascular repair ensuing unintended injury. Diagnosing the pulp vitality of non-offending teeth whose apices protrude into the cystic lumen is a complex process and can be misleading. Pressure from the growing cyst can inhibit vital teeth responses to neural-based sensibility tests leading to false negative results. Thus, in such cases, the use of blood perfusion-based vitality testing is recommended for correct initial diagnosis.

This article presents a clinical case of the treatment of a mandibular radicular cyst from 3.6 teeth by creating a decompression "window", which allows the cyst volume to be reduced up to complete restoration of the bone structure as well as ensuring the integrity of the surrounding anatomical structures. The subsequent filling of the cavity with newly formed bone is due to secondary osteogenesis. This operation can be performed on an outpatient basis in a dental surgery room under local anesthesia

OBJECTIVES: The current study was conducted to analyze immunohistochemical appearance of P53 protein in odontogenic cysts. METHODOLOGY: Thirty paraffin blocks of confirmed case were prepared to investigate the immunohistochemical appearance of P53 protein. RESULTS: Sixteen out of thirty odontogenic cysts (53.3%) showed P53, four out of ten dentigerous cyst (40%) had P53, twelve out of fifteen odontogenic keratocysts (80%) expressed P53 while none of the five radicular cysts (0%) showed P53 protein. CONCLUSION: Reclassification of OKC as keratocystic odontogenic tumor was supported by the present study and its findings.

Background/purpose Actinomycosis is sometimes associated with a radicular cyst (RC). This retrospective study evaluated the clinical and histopathological features of 6 RCs with actinomycosis (AM/RCs). Materials and methods The demographic data and clinicopathological features of 6 AM/RCs were collected and analyzed. Results The 6 AM/RCs were taken from 2 male and 4 female patients, and 3 were found in the maxilla and the other 3 in the mandible. The involved teeth included maxillary or mandibular incisors (2 cases) and maxillary or mandibular first and second molars (4 cases). The most common symptom was pain (5 cases) and the more frequent signs were sinus tract and pus discharge (4 cases). Microscopically, the actinomycotic colony presented as a mass with filamentous bacteria arranging in a sun-ray pattern at the periphery. The mean actinomycotic colony number was 7.7 ± 6.6 colonies per slide. Due to the severe inflammation in all 6 AM/RCs, the stratified squamous epithelial lining was completely abolished in 2 cases and partially destroyed in 4 cases with the residual epithelial lining varying from approximately 10%–50%. Conclusion Our results indicate that pain is the most common symptom and sinus tract and pus discharge are the two frequent signs of our 6 AM/RCs. The stratified squamous epithelial lining was either completely abolished (2 cases) or partially destroyed (4 cases) in 6 AM/RCs. Thus, if the endodontically-treated tooth shows a recurrent sinus tract and poor response to repeated conventional root canal treatments, periradicular actinomycotic infection should be highly suspected.

The removal of an odontogenic jaw cyst usually requires at least elevation of the mucoperiosteal flap for adequate access to the cystic lesion and its complete enucleation. In this report, we present a simple intra-socket flapless cystic removal technique for a radicular cystic lesion related to the mandibular first molar. This technique produces an optimal outcome and gives the patient the most comfortable surgical experience.

Non vital teeth with periapical cysts do not respond to routine root canal therapy alone. Conventional RCT (root canal therapy) should be combined with conservative management of cysts or surgical management. Contemporary options for non-surgical management are repeated intra canal dressing with Ca (OH)2, aspiration and decompression techniques. Repeated intra canal dressing with Ca(OH)2 and Iodoform (Metapex) was advocated in 15 of our patients for a period of eight years from 2011-2019. The healing of the lesions was excellent with respect to bone formation, reestablishment of periodontal ligament and reduction in tooth mobility on follow up of six months to one and a half years. This case series gives insight of successful non-surgical management of periapical cysts. We reiterate the effectiveness of non-surgical management of periapical cysts as it was well observed in our case series. The promising prognosis of non-surgical management of periapical cysts can render the surgical options antediluvian.

Radicular cyst is the second most common odontogenic cyst. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. When asymptomatic, a cyst can acquire a large size, even extending into anatomic cavities. The present case reports an extensive radicular cyst extending into the maxillary sinus that could have been easily mistaken for just a displaced tooth. Conventional radiographs show two-dimensional images of three-dimensional objects. Cone-beam computed tomography provides undistorted three-dimensional information of hard tissues, gives adequate spatial resolution, and recently seen as an expansion in diagnosis and management of periapical lesions. Prompt diagnosis and treatment of radicular cyst were successful with endodontic treatment and surgical management.

Background Buccal Fat Pad (BFP) excision has become an aesthetic surgical procedure. Although this procedure is quite common, it is important to bear in mind that the scientific evidence supporting the efficacy of this treatment is scarce and of low quality. The purpose of this systematic review was to analyse all relevant data to assess the efficacy and safety of BFP excision for improving midface aesthetics. Material and Methods A thorough search of MEDLINE (PubMed), Scopus and Cochrane Library databases was conducted. The PICO approach was used where healthy patients seeking cheek slimming and facial silhouette refining undergo BFP excision and were compared before and after surgery in terms of BFP volume reduction, adverse effects and patient satisfaction. Results Of the 1,413 references identified, 4 were included in the qualitative synthesis. Only one study reported BFP volume reduction, which was 3.10 mL (95%CI: 2.38 to 3.80; P < 0.001), and the mean volume of the excised tissue was 2.74 ± 0.69 mL (range, 1.8-4.9 mL). 84.6% of the patients stated that their facial contour was much better and the remaining 15.4% noticed that the appearance of their cheeks following BFP excision was better. Seven complications were reported in the 134 cheek refinement procedures. Conclusions BFP removal has an initially favorable outcome for facial aesthetics and a low postoperative complication rate, however, there are many procedures being performed with poor quality methodology and there is also a lack of published data on its long-term follow-up results. Key words:Buccal fat pad, buccal fat pad excision, surgery, plastic, aesthetics, cheek refinement, facial silhouette refining.

Radicular cysts are the most common inflammatory cysts of the jaws. Surgical intervention aims to eliminate periapical pathology in order to allow bone regeneration and healing of periapical tissues. Autologous platelet-rich fibrin is a healing biomaterial in oral surgical defects with the new perspective of accelerated healing. Titanium-prepared platelet rich fibrin (T-PRF) is a third-generation platelet concentrate developed to overcome the harmful effects of silica in glass tubes and also has a longer resorption rate. The purpose of this case report is to present the effects of T-PRF applied to the bone defect that occurs after the enucleation of the radicular cyst. A significant increase in bone density was observed after eight months of follow-up. T-PRF has been shown to be effective in the treatment of bone defects. Therefore, it is thought that it can be used as the only regenerative material in the treatment of bone defects.

Made available in DSpace on 2021-06-25T10:48:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-05-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Aim: To characterize plasma cell subsets in chronic periapical lesions affecting permanent and primary teeth. Methodology: Only chronic periapical lesions without root canal treatment were selected. Twenty-one radicular cysts and 7 periapical granulomas affecting permanent teeth and 19 radicular cysts and 4 periapical granulomas affecting primary teeth were assessed for immunoglobulin (Ig) light chain (kappa and lambda), Ig heavy chain (IgG, IgG4, IgA, IgM and IgD) and plasma cell immunohistochemical markers (MUM1/IRF4, EMA and CD138). The data acquired were analysed by Student’s t test, Mann–Whitney U, Friedman test followed by Dunn's multiple comparison test and Spearman’s rank correlation. Results: All cases were polyclonal (having similar kappa/lambda light chain ratios). IgG was most abundant compared to other Ig heavy chains (all, P

Objective The aim: To provide clinical evaluation of the effectiveness of anesthesia for cystectomy of radicular cysts that have grown into the maxillary si-nus or nasal cavity using different techniques of endonasal block-ade of the nasopalatine nerve. Patients and methods Materials and methods: Clinical observations were conducted on 52 patients of different age and sex. These patients were diagnosed with large radicular cysts (more than 3.0 cm in diameter) that had grown into the maxillary sinus (33 cases) or into the nasal cavity (19 cases). The surgical excisions of cysts (oroantral cystectomies) were performed un-der local potentiated anesthesia. Patients were divided into two clinical groups, depending on the methods used for endonasal blockade of the nasopalatine nerve: the main and the control group. Patients in the main group underwent endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion. In the control group, the neural blockade was performed at the entry of this nerve into the incisive canal. Pain sensitivity and perception in patients were studied using subjective and objective methods. The data was analyzed by means of the Pearson's chi - square tests. Results Results: During the enucleation of radicular cysts that grew into the inferior nasal meatus and maxillary sinus in patients of the main group there was no pain observed. There were no manifestations of pain-induced stress neither from the side of autonomic system, nor physical or emotional manifestations of pain, which confirmed the effectiveness of nasopalatine nerve anesthesia. In patients of the control group during similar operation the full effect of local anesthesia was achieved in 56.0% of cases (χ2 - 9,270, р = 0,003). The rest of the patients during cystectomies showed some signs of pain-induced stress from the side of autonomic system or in the form of physical or emotional manifestations. Conclusion Conclusions: Endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion invariably provided a complete analgesia during enucleation of radicular cysts that have grown into the maxillary sinus or nasal cavity. Anesthesia of the nasopalatine nerve at its entry into the incisive canal allows pain-less cystectomy of radicular cysts that have spread to the front of the inferior nasal meatus from the front teeth.

Objectives: To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. Method: The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2–3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. Results: On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. Conclusion: In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.

Background Odontogenic cysts and tumours of the jaws represent one of the most prevalent groups of oral-maxillofacial lesions. We aimed to evaluate the clinical and pathological characteristics of a cohort of odontogenic cysts (OC) and odontogenic tumours (OT) of the jaws in a Portuguese population. Material and Methods This observational retrospective study analysed patients diagnosed with either an OC or OT of the jaws at a central hospital of Oporto, Portugal, between 1988 and 2006. Data collected from patients’ files included demographic, clinical, radiological and histopathological information. Recurrence was evaluated using univariate and multivariate analysis. Results The sample consisted of 397 patients, 231 males (58.2%) and 166 females (41.8%), with a mean-age of 36.7±17 years. Twenty-seven patients (6.8%) presented with more than one lesion providing a total of 433 lesions. There were 396 (91.5%) OC, mostly represented by radicular cysts (n=257;59.4%), dentigerous cysts (n=79;18.2%), or odontogenic keratocysts (n=50;11.5%). There were 37 (8.5%) OT, mostly represented by ameloblastomas (n=16;3.7%), and odontomas (n=9;2.1%). The most common initial clinical manifestation was swelling (n=224;51.7%). Recurrence was observed in 30 cases (6.9%), mostly in ameloblastomas (n=6;37.5%) and odontogenic keratocysts (n=12;24%). In the multivariate analysis the diagnosis classification of the lesion was the only independent and significant variable related with the recurrence (P=0.04). Conclusions Radicular cysts were the most commonly occurring type of OC and ameloblastomas the most commonly occurring OT. Amelobastomas and odontogenic keratocysts were the lesions with the highest rates of recurrence. This large sample provides useful information about the frequency profile and characteristics of OC and OT over a period of 18 years, allowing valuable comparison with data from other countries. Key words:Odontogenic cysts and tumours, radicular cyst, dentigerous cyst, odontogenic keratocyst, ameloblastoma, recurrence.

Radicular cysts are the most common cystic lesions in the oral cavity. Radicular cysts have a rare occurrence in the primary dentition. Radicular cysts arising from deciduous teeth are reported to occur in the age range of 3–19 years with a male predominance. The etiological factor is long-standing dental caries and dental trauma. The present case report describes the inflammatory radicular cyst involving the deciduous mandibular second molar. Surgical management includes enucleation of the cyst along with mandibular second premolar in a 5-year-old female patient. The surgical cavity was closed by an obturator appliance to maintain the patency. Eventful healing was seen after 3 months of follow-up. How to cite this article: Kajjari S, Gowtham A, Meharwade P, et al. Infected Radicular Cyst of Deciduous Second Molar Mimicking Dentigerous Cyst of Second Premolar in a Young Child: A Rare Entity. Int J Clin Pediatr Dent 2021;14(3):434–437.

Radicular cysts are the most common inflammatory odontogenic cyst of jaw that emanates from the epithelial cell rests of malassez in the periodontal ligament. 60% of cases are found in maxilla, most commonly around incisors and canines with male predilection. Most of the cases remain silent until secondarily infected. Treatment modalities of Radicular cyst according to their size and severity are extraction of the associated tooth, endodontic treatment, apical surgery, enucleation and/or marsupialization. Though, radicular cyst involving inferior alveolar nerve may cause paraesthesia due the neurosensory disturbance caused by mechanical compression or stress. Here, we report a case of neurapraxia occurred in an infected radicular cyst involving roof of the inferior alveolar nerve canal. Keywords: Radicular cyst, Inferior alveolar nerve, Paraesthesia, Neurosensory disturbance, Compression, Stress.

Aims and Objectives: The present study aims at evaluation of age, sex and site of occurrence related prevalence of Radicular cyst, Dentigerous cyst, Odontogenic keratocyst (OKC), Lateral Periodontal cyst, Residual cyst, Adult Gingival cyst, Calcifying odontogenic cysts. Materials and Methods: During 8 year period (From 2010 to 2017), 1000 patients with cystic lesions of the jaws were analysed. All patients underwent clinical examination and plain film radiography (panoramic, periapical, and occlusal views). Some of them were referred for CBCT or computed tomography (CT) with a multiplanar reconstruction program (MPR). Age, sex, type of cyst and location were recorded in designed performa. The treatment modalities used for the management of cysts are marsupialization, enucleation, enucleation with bone grafting or resection under local or general anaesthesia depending on the case. Results: Radicular cyst(45.2%) is most common cyst followed by dentigerous cyst(23.2%),Odontogenic keratocyst (13.4%), lateral periodontal cyst(8.9%), residual cyst(4.5%),Calcifying odontogenic cyst (4.4%) followed by the least common occurring adult gingival cyst (1.1%). The mandibular posterior region (41.3%) is most predilected site of occurrence of cysts in orofacial region however maxillary anterior region (17.7%) is least predilected site of occurrence. Conclusion: The radicular cyst is most common cyst of oral cavity while adult gingival cyst is least common cyst. Keywords: Cyst, Jaw bone, Prevalence, Odontogenic, Nonodontogenic.

Background This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts. Material and Methods A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD 42020189349). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool. Results Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates. Conclusions The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible. Key words:Computer-assisted diagnosis, computer-assisted image analysis, computer-assisted image processing, odontogenic cysts, keratocysts, radicular cysts.

Introduction. A radicular cyst is an odontogenic cyst originated from residual epithelial cells (remnants of Malassez cells) of periodontal ligaments with the previous history of chronic inflammation. The radicular cyst usually results from traumatized pulp or necrotic pulp that is left untreated. This study aimed to treat the maxillary lateral incisor with necrotic pulp and radicular cyst by apicoectomy, retrograde closure using mineral trioxide aggregate, followed by enucleation and bone graft application. Case Report. A 28-year-old female patient who suffered from recurrence pain and swelling in the right maxillary incisor area came to Gadjah Mada University Dental. The patient had a history of trauma on her maxillary right incisor 12 years ago. Vitality test, percussion test and palpation test showed negative results. Cone beam computed tomography radiograph showed circular radiolucent lesions with a firm radiopaque border surrounding the apical of tooth resulted in a cortical bone loss on the labial aspect. The lateral maxillary incisor was diagnosed as necrotic pulp with the radicular cyst. Conventional endodontic treatment was performed in two visits using calcium hydroxide as intracanal medicament followed by class I composite resin restoration. Apicoectomy procedure was performed on the third visit using mineral trioxide aggregate as retrograde filling material followed by enucleation of radicular cysts and application of bone graft as bone regeneration material. Three months of control after treatment showed good bone tissue regeneration. Post-operative control in the third month showed functional bone tissue regeneration. Conclusion. Apicoectomy and retrograde closure using aggregate mineral trioxide followed by enucleation and bone graft application is a treatment of choice for pulp necrosis with the radicular cyst.