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Li P, Zhao Y, You Y, Lin L, Yu D, Zhao W. Current Perspectives on Paradental Cyst: A Literature Review. Dent J (Basel) 2023; 11:281. [PMID: 38132419 PMCID: PMC10742593 DOI: 10.3390/dj11120281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.
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Affiliation(s)
- Pei Li
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (P.L.); (L.L.)
| | - Yifan Zhao
- School of Stomatology, Department of Medicine, Changsha Medical University, Changsha 410219, China;
| | - Yuehua You
- Department of Stomatology, Longhua People’s Hospital Affiliated to Southern Medical University, Shenzhen 518109, China;
| | - Ling Lin
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (P.L.); (L.L.)
| | - Dongsheng Yu
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (P.L.); (L.L.)
| | - Wei Zhao
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (P.L.); (L.L.)
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Rodrigues PA, Subramanya AP, Prabhuji MLV, Vardhan KB. Incidental finding of paradental cyst in the maxillary anterior teeth during immediate implant placement. J Indian Soc Periodontol 2022; 26:614-618. [PMID: 36582954 PMCID: PMC9793931 DOI: 10.4103/jisp.jisp_625_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/03/2022] [Accepted: 04/09/2022] [Indexed: 12/12/2022] Open
Abstract
Paradental cyst is classified as an inflammatory cyst, and its occurrence in the anterior maxillary region is very rare. Several hypotheses have been put forward on the etiopathogenesis among which the formation of cyst secondary to inflammatory destruction of the periodontium and alveolar bone can be attributed to the present case. A 26-year-old male patient reported with loosened maxillary anterior teeth. After clinical and radiological examination, extraction of teeth #12, #11, #21, and #22 followed with immediate implant placement was planned. During extraction of #21, incidentally, a cyst was noted to be attached to the apices of #21 tooth. Implants were placed at #12, #11, and #22 sites, and socket of #21 was debrided thoroughly, followed by the placement of graft. A histopathological study of the cyst revealed it to be a paradental cyst. The patient was followed up for 6 months, and no recurrence of cystic lesion was noted. When immediate implant placement is being planned, considerations to the periodontal and periapical disease status of the teeth being extracted are crucial to achieve better treatment outcomes.
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Affiliation(s)
- Phebie Asta Rodrigues
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Ashwin Parakkaje Subramanya
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India,Address for correspondence: Dr. Ashwin Parakkaje Subramanya, Department of Periodontics, Krishnadevaraya College of Dental Sciences, Hunsemaranhalli, New Airport Road, Bengaluru - 562 157, Karnataka, India. E-mail:
| | - MLV Prabhuji
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
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Menditti D, Laino L, DI Domenico M, Troiano G, Guglielmotti M, Sava S, Mezzogiorno A, Baldi A. Cysts and Pseudocysts of the Oral Cavity: Revision of the Literature and a New Proposed Classification. In Vivo 2018; 32:999-1007. [PMID: 30150421 DOI: 10.21873/invivo.11340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 06/16/2018] [Accepted: 06/21/2018] [Indexed: 01/19/2023]
Abstract
This article includes a comprehensive and up-to-date review on the cysts of the oral cavity. Several classifications of odontogenic (OC) and non-odontogenic (non-OC) oral cysts and the surrounding regions have been proposed. We suggest a new critical classification based on an established relationship between anatomical area, histological origin and clinical behavior (frequency, rate of recurrence, malignant potential). Moreover, the differential cytokeratin (CKs) expression of the various cysts is reported as epithelium-specific markers of differential diagnosis. Finally, issues related to differential diagnosis and therapeutic approaches of the cysts included in the two groups are described.
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Affiliation(s)
- Dardo Menditti
- Department of Dentistry, Orthodontics and Oral Surgery, University of Campania, Naples, Italy
| | - Luigi Laino
- Department of Clinical and Experimental Medicine, University of Campania, Naples, Italy
| | - Marina DI Domenico
- Department of General Pathology and Biochemistry, University of Campania, Naples, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Campania, Naples, Italy
| | - Mario Guglielmotti
- Department of Dentistry, Orthodontics and Oral Surgery, University of Campania, Naples, Italy
| | - Sara Sava
- Department of Dentistry, Orthodontics and Oral Surgery, University of Campania, Naples, Italy
| | - Antonio Mezzogiorno
- Department of Mental Health and Physics, Preventive Medicine, University of Campania, Naples, Italy
| | - Alfonso Baldi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania, Naples, Italy
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Odontogenic keratocyst mimicking paradental cyst. Case Rep Dent 2014; 2014:974241. [PMID: 25114809 PMCID: PMC4119640 DOI: 10.1155/2014/974241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 06/04/2014] [Accepted: 06/23/2014] [Indexed: 01/10/2023] Open
Abstract
Objective. The aim of this paper is to present an uncommon clinical and radiographic aspect of odontogenic keratocyst (OKC) mimicking paradental cyst. Methods. A 32-year-old female patient showed a well-delimited radiolucent lesion connected with the root of the left third molar with close anatomical relationship with the mandibular canal. The clinical, radiographic, and anamnestic features lead us to diagnose a paradental cyst that was treated by enucleation after extraction of the partially impacted tooth. Results. Histological analysis showed typical histological features of PKC such as the presence of a lining of stratified squamous epithelium with a well-defined basal layer of palisading columnar of cuboidal cells. Conclusion. Initial X-ray analysis and the position of the lesion related to the third mandibular tooth caused us to mistakenly diagnose a paradental cyst. We were only able to identify the cyst as an PKC rather than a paradental cyst after histological analysis.
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Pierse JE, Stern A. Benign cysts and tumors of the paranasal sinuses. Oral Maxillofac Surg Clin North Am 2012; 24:249-64, ix. [PMID: 22341510 DOI: 10.1016/j.coms.2012.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To thoroughly understand the biology of any lesion and render the appropriate management, clear and accurate definitions are paramount. For benign cysts and tumors of the oral maxillofacial region, an accurate depiction of these lesions needs to be elucidated to provide both the treating surgeon and the patient with a clear understanding of the course of treatment and the outcome.
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Affiliation(s)
- Joseph E Pierse
- Department of Dentistry/Oral Maxillofacial Surgery, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA.
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Abstract
The paradental cyst is commonly misinterpreted when associated with atypical clinical and radiographic characteristics, in turn causing diagnostic problems. For this reason, the study of the differential diagnosis of this lesion has become extremely important. In addition, the correlation of clinical, histologic, and radiographic findings are also of great value in obtaining accurate diagnoses. The minor variations in the clinical appearance of paradental cysts make it feasible to consider the two main groups of cysts separately: those associated with 1st and 2nd permanent molars of the mandible and those associated with the 3rd mandibular molar. Moreover, this distinction in localization may well dictate the necessary treatment. Bearing in mind the minor clinical variations, the present article aims to discuss the differential diagnosis of this lesion and its different possible treatments by presenting a case report to illustrate the findings.
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Kanno CM, Gulinelli JL, Nagata MJH, Soubhia AMP, Crivelini MM. Paradental cyst: report of two cases. J Periodontol 2006; 77:1602-6. [PMID: 16945040 DOI: 10.1902/jop.2006.050380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The paradental cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space. METHODS In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis. RESULTS In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst. CONCLUSIONS The presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.
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Affiliation(s)
- Cláudia M Kanno
- Post-Graduation Program, Dental School of Araçatuba, São Paulo State University, São Paulo, Brazil.
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Hisatomi M, Asaumi J, Konouchi H, Yanagi Y, Matsuzaki H, Kishi K. Comparison of radiographic and MRI features of a root-diverging odontogenic myxoma, with discussion of the differential diagnosis of lesions likely to move roots. Oral Dis 2003; 9:152-7. [PMID: 12945597 DOI: 10.1034/j.1601-0825.2003.01802.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Lesions that can produce divergence of the roots of teeth in the mandible include odontogenic cysts (odontogenic keratocysts, lateral periodontal cysts and radicular cysts), ameloblastomas, odontogenic myxomas, central giant cell granulomas, adenomatoid odontogenic tumors and aneurismal bone cysts, and other tumors. Moreover most benign jaw lesions can do this occasionally. However, when lesions--which show interradicular tear-shaped radiolucencies--are small it is often difficult to interpret them radiographically, because they do not show characteristic radiographic features. We describe a comparison of radiographic and magnetic resonance (MR) features of a root-diverging odontogenic myxoma, with discussion of the differential diagnosis of lesions likely to move roots. In addition, we discuss radiographic and MR features of possible lesions, which show similar radiographic findings to odontogenic myxoma.
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Affiliation(s)
- M Hisatomi
- Department of Oral and Maxillofacial Radiology, Field of Tumor Biology, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan.
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Reichart PA, Philipsen HP. [Inflammatory paradental cyst. Report of 6 cases]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 2003; 7:171-4. [PMID: 12764684 DOI: 10.1007/s10006-003-0473-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The inflammatory paradental cyst has been described as an entity in the WHO classification of odontogenic tumors and cysts (1992). It is mainly located at mandibular molars, in particular third molars of the lower jaw. Radiologically, involved molars show a circumscribed, mostly half-moon shaped translucency distal or distobuccal to the involved tooth. Patients frequently report episodes of infection (pericoronitis). The histological findings are identical to those of inflammatory radicular cysts. The inflammatory paradental cyst has been described infrequently in the international literature. There are no reports available in German. AIM OF THE STUDY AND CASES The aim of the present study was to present six of our own cases of inflammatory paradental cysts. Five men and one woman with an average age of 29.5 years were affected. In two cases paradental cysts occurred bilaterally. Three patients reported recurrent previous infections (pericoronitis). Radiologically, the typical translucency with clear demarcation distal to the third molars was observed. All of the third molars were vertically retained. Histologically, the inflammatory paradental cysts showed features identical to those of radicular cysts. The inflammatory paradental cyst is a clear indication for osteotomy of lower wisdom teeth. Postoperative complications or recurrences of the inflammatory paradental cysts have not been described. DISCUSSION A correct clinical, radiological, and histopathological diagnosis of paradental cysts is mandatory, and more reports are needed in order to compile more information about relative frequency and pathogenesis of this cyst variant.
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Affiliation(s)
- P A Reichart
- Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Universitätsklinikum Charité, Humboldt-Universität, Berlin.
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Colgan CM, Henry J, Napier SS, Cowan CG. Paradental cysts: a role for food impaction in the pathogenesis? A review of cases from Northern Ireland. Br J Oral Maxillofac Surg 2002; 40:163-8. [PMID: 12180213 DOI: 10.1054/bjom.2001.0750] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We present the clinical, radiographic and histological findings of 15 paradental cysts. These were the second most common type of cyst associated with mandibular third molars, comprising 25% of all lesions at this site. Ten patients were aged 30 years or younger and 13 gave a history of pericoronitis. There was a close relationship between the site of the cyst and the angle of the impacted tooth; the cyst lay mesially to two mesioangularly impacted teeth, buccal to two vertically impacted teeth and distal/distobuccal to the remainder, all but one of which were distoangular in impaction. The pericoronal follicular space was preserved in nine cases, a useful diagnostic sign. Most cysts were lined with epithelium that resembled that seen in radicular cysts, although the lining of three cysts resembled that of unicystic ameloblastoma, a potential diagnostic pitfall. We propose that the relation between location of cyst and angle of impaction points to a role for food impaction in the pathogenesis of paradental cysts.
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Affiliation(s)
- C M Colgan
- Division of Oral Surgery, Oral Medicine and Oral Pathology, School of Dentistry, Queen's University, Belfast UK
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Wolf J, Hietanen J. The mandibular infected buccal cyst (paradental cyst). A radiographic and histological study. Br J Oral Maxillofac Surg 1990; 28:322-5. [PMID: 2248940 DOI: 10.1016/0266-4356(90)90107-v] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mandibular infected buccal cysts occur on the buccal and distal aspects of the roots of partly or fully erupted mandibular molars with vital pulps. In the present investigation six cases associated with mandibular first and second molars were studied. The cysts were lined with a non-keratinised squamous epithelium with a mixed inflammatory cell infiltrate in the connective tissue. The clinical and microscopic features were similar to those of previously reported paradental cysts. The inflammation always present in these cysts may have an important role in their pathogenesis. It may induce periodontal pocketing, which may lead to hyperplasia and cyst formation in adjacent odontogenic epithelium, which may be either remnants of the reduced enamel epithelium or cell rests of Malassez.
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Affiliation(s)
- J Wolf
- Department of Dental Radiology, University of Helsinki, Finland
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