Periapical cyst

Periapical cysts, also known as radicular cysts, are the most frequent cystic lesion related to teeth (see mandibular lesions) and result from infection of the tooth.

On imaging, they generally present as round or pear-shaped, unilocular, lucent lesions in the periapical region, measuring less than 1 cm. 

Epidemiology

These are typically seen in middle to older age (3rd to 6th decades 2).

Pathology

Periapical cysts result from infection of the tooth, which spreads to the apex and into the adjacent bone. This leads to apical periodontitis, granuloma formation and eventual cyst formation. These cysts are therefore centered on the apex of the tooth and tend to be small, most <1 cm. There is also unsurprisingly usually overt evidence of caries.

Radiographic features

Plain radiograph, OPG and CT

At radiography, most radicular cysts appear as round or pear-shaped, unilocular, lucent lesions in the periapical region 3.

They are usually <1 cm in diameter and are bordered by a thin rim of cortical bone. The associated tooth usually has a deep restoration or large carious lesion.

Differential diagnosis


Lucent lesions of the jaw
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Article Information

rID: 1857
System: Head & Neck
Section: Pathology
Synonyms or Alternate Spellings:
  • Radicular cyst
  • Periapical cysts
  • Apical cyst
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    Figure 1: tooth anatomy
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    Case 2
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    Case 4
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    Case 5
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