Guided Bone Regeneration in the Treatment of a Lateral Periodontal Cyst: 2-Year Clinical and Radiologic Follow-up

Lateral periodontal cysts (LPCs) are rare odontogenic cysts of developmental origin. A 52-year-old man presented with an asymptomatic gingival swelling located between the mandibular left canine and first premolar, both of which were vital. Radiography showed a well-circumscribed radiolucent area and loss of the lamina dura around the tooth socket in contact with the lesion and of the interproximal buccal bone. The lesion was enucleated. The defect was immediately grafted with a 1:1 mixed autologous and heterologous bone graft covered with a collagen membrane. Histology confirmed the diagnosis of LPC. At 12- and 24-month clinical and radiologic follow-up, complete bone and periodontal healing was found, with no sign of recurrence.

A New Approach for the Treatment of Lateral Periodontal Cysts with an 810-nm Diode Laser

The aim of this study was to test whether the combination of diode laser therapy and surgical treatment for a lateral periodontal cyst (LPC) would result in greater clinical improvement compared with surgery alone. A total of 18 patients with LPCs were assessed for eligibility for this study. At baseline, each patient was randomly allocated to one of two regimens: diode laser plus surgery (test group) or traditional surgical treatment alone (control group). Healing parameters were assessed at 7 to 21 days to monitor short-term complications, and periodontal parameters were assessed at 3, 6, and 12 months to evaluate long-term healing. The test group demonstrated highly significant differences in both the short-term and long-term parameters compared with the control group. This study showed that diode laser treatment results in a shorter wound-healing period and could be considered valuable for the surgical treatment of LPCs.

Managing a Lateral Periodontal Cyst With Bone Graft: A Computed Tomography Assessment 18 Months Postoperatively

The lateral periodontal cyst is a rare benign lesion that is generally asymptomatic and commonly discovered by routine intraoral radiography. Reports on proper management of this lesion are readily available. However, the literature is sparse regarding the long-term outcomes following surgery. A traditional radiographic technique does not provide an adequate image of the healing, and a patient may resist the prospect of a reentry procedure. The current report is the first to utilize a cone-beam computed tomography scan to evaluate the healing potential of a freeze-dried bone allograft approximately 18 months postoperatively.

Inflammatory collateral cyst associated with a palatoradicular groove: report of a case and discussion of nomenclature

The aims of this article are to present a case demonstrating the connection between palatoradicular grooves and inflammatory collateral cysts and to discuss the related nomenclature. Radiographs in a 21-year-old man revealed a radiolucent, unilocular, well-defined area near the vital maxillary right lateral incisor and canine. Palatal swelling was present, and a 6-mm-deep periodontal pocket was found at the palatal surface of the right lateral incisor. The differential diagnoses were keratocystic odontogenic tumor, developmental lateral periodontal cyst, and inflammatory lateral periodontal cyst. The area was explored surgically, and the lesion was excised. Surgical exploration revealed a palatoradicular groove, which was scaled and planed with the aid of manual curettes with the intention of creating a flat surface to promote insertion of the periodontal fibers. Histopathologic analysis revealed that the lesion was an inflammatory cyst. The presence of a palatoradicular groove can put the periodontium at risk because a resulting lack of fiber insertion makes oral hygiene difficult. This established inflammatory process can initiate development of an inflammatory collateral cyst that may be misdiagnosed, hindering successful management. In this case, bone grafting and placement of a resorbable membrane were used to promote bone formation and subsequent sealing of the periodontal space.

[Juvenile paradental cysts in children after mandible distraction: case-control study and clinical cases presentation]

Seventy-five children aged 6-17 years (mean age 9.8±4.1 years) that received mandible distraction (MD) at the age of 0-17 years (mean age at MD 6.1±4.3) were included in the study. Indication for MD were hemifacial microsomia (n=41), Goldenhar syndrome (n=4), Robin sequence (n=10), Treacher, Collins syndrome (n=7) or acquired mandible underdevelopment (n=13). Control groups consisted of 22 children aged 5-14 years (mean age 7.0±3.7 years) with mandible underdevelopment of similar origin (hemifacial microsomia (n=15), Goldenhar syndrome (n=2), Robin sequence (n=4), Treacher, Collins syndrome (n=1)) with no history of MD and 80 healthy children aged 6-10 years (mean age 7.1±2.2 years). Case-control study results proved MD to be the risk factor for juvenile paradental cysts (JPCs) with the risk more prominent in early MD cases. JPCs often do not manifest clinically and may resolve spontaneously but in refractory cases lesion curettage without endodontic treatment is an adequate approach, as JPCs are usually not associated with pulp necrosis.

Large buccal bifurcation cyst in a child: a case report and literature review

BACKGROUND

WHO defines the mandibular buccal bifurcation cyst as a cyst occurring near the cervical margin of the lateral aspect of a root as a consequence of inflammatory process in a periodontal pocket. The pathogenesis of these cysts is still debated, but they are most likely originated from reduced enamel epithelium or from inflammatory proliferation of epithelial cell rests of Malassez that come from the superficial mucosa of a tooth in eruption. The aim of this article was to describe a case of large buccal bifurcation cyst of a permanent mandibular first molar.

CASE REPORT

A 6-year-old boy was referred to Department of Oral Riabilitation of the Istituto Stomatologico Italiano, University of Milan, Italy, with the complaint of hard swelling over the buccal gingiva and a deep probing depth located on the buccal aspect. Radiograph revealed a well-defined semilunar-shaped radiolucency, marked by a fine radiopaque line on the buccal aspect of the partially-erupted lower right first molar and it was large enough to include a small part of the crown of the second right molar. As reported in the literature the treatment of choice is enucleation and curettage of the lesion without extraction of the vital involved tooth. This procedure has shown excellent results in both the short- and long-term. The definitive diagnosis of paradental cysts can be assessed by histopathologic analysis.

Gingival cyst of the adult: a case report and immunohistochemical investigation

A 42-year-old woman had a sessile swelling that involved the maxillary gingiva corresponding to the right canine and premolar area. Clinical examination showed a painless small nodule (10 mm in diameter) located between the right maxillary canine and premolar. The lesion was vesicular, sessile, and slightly compressible on palpation. Microscopic examination of the lesion (following an excisional biopsy) showed cystic spaces covered by an epithelium lining that consisted of cuboidal and squamoid cells intermingled with clear cells. These morphologic findings were consistent with gingival cyst of the adult. Immunohistochemical technique against cytokeratins revealed that the epithelial cells were positive for cytokeratins No. 7, 8, 13, 14, and 19. Two years after removal, no recurrence was reported.

Use of guided tissue regeneration in the treatment of a lateral periodontal cyst with a 7-month reentry

BACKGROUND

The lateral periodontal cyst (LPC) is an unusual cyst of odontogenic origin, most frequently encountered in the mandible between the roots of canines and premolars. The most common treatment for LPC is surgical enucleation. This article reports a case of an LPC treated with guided tissue regeneration (GTR) and bone allograft.

METHODS

A 74-year-old woman presented for periodontal examination. Radiographs revealed a cystic lesion with LPC characteristics. After surgical incisions and flap reflection, the cyst was removed and sent for biopsy. Because of the anatomy of the resulting intrabony defect, GTR was considered the ideal treatment.

RESULTS

The biopsy revealed the histologic features of an LPC. Radiographs at 7 months post-treatment indicated bone fill of the initial defect. Although some attachment loss occurred, the reentry demonstrated a high percentage of bone fill of the defect after 7 months.

CONCLUSION

Depending on the anatomy of the defect left after the removal of an LPC, GTR, along with bone grafting, can be a very useful tool for its treatment by reducing the attachment loss observed after simple enucleation of the cyst.

Epithelial inclusion cyst after free gingival graft: a case report

There have been few case reports of cystic lesions occurring after gingival grafting. There are three reports of this type of sequela after connective tissue grafting, but this is the first known case of a cystlike lesion developing secondarily to a free gingival graft procedure. The bulky tissue, which had developed under the previously grafted area, was properly excised under local anesthesia. The small specimen removed was sent for histologic analysis. A new gingival graft was performed immediately after the lesion enucleation, as the cystic lesion had dislocated the earlier graft. The surgical wound healed uneventfully, and no recurrence was seen 18 months later The microscopic sections showed a cystic cavity lined with an orthokeratinized, hyperplastic, stratified squamous epithelium covered with fibrous connective tissue. The development of a cystlike lesion following a free gingival graft is, to date, an unpublished event. The fact that most cystic lesions appear in the mandibular lateral incisor-canine-first premolar area deserves further consideration.

[A radiolucency between the roots of 2 vital teeth]

An asymptomatic radiolucency between a vital 44 and 45 was detected in a 64-year-old woman. Treatment consisted of enucleation. Histopathologically, the features of a lateral periodontal cyst were observed. The lateral periodontal cyst is a rather rare developmental odontogenic cyst that has a tendency to recur after incomplete removal.

Infected paradental cysts in children: A clinicopathological study of 15 cases

We report the clinical, radiographic and histological features of 15 paradental cysts of the first and second molars and recommend conservative surgical treatment. Twelve young patients were operated on for 15 paradental cysts of the first and second molars, and had conservative operations with partial preservation of the mandibular cortical bone. After 2 years there had been no recurrences. The differential diagnosis of paradental cyst was fundamental to allow the correct treatment and the early diagnosis of lesions on the opposite side. The maintenance of periodontal hygiene in the immediate and late postoperative periods was an aid to ensure complete remission of the lesions.

Cutaneous draining sinus tract of odontogenic origin: unusual presentation of a challenging diagnosis

A 44-year-old woman presented with a chronically draining lesion on her cheek just lateral to the nasofacial sulcus. The lesion was refractory to treatment with oral antibiotics. Physical examination revealed poor dentition, and a panoramic radiograph demonstrated periapical abscesses in the maxillary right lateral incisor and canine. A diagnosis of cutaneous fistula of odontogenic origin was made, and the patient was treated with tooth extraction. The cutaneous fistula subsequently resolved. Intraoral examinations and radiographs are critical for making the diagnosis of cutaneous draining sinus tract of odontogenic origin. Many patients undergo unnecessary surgical therapies before having the correct diagnosis made, but root canal therapy or surgical extraction is the treatment of choice. A dental origin must be considered for any chronically draining sinus of the face or neck.

[Tooth bud fixation by the material LitAr]

The results of the biotransformation investigation of the material LitAr after replacing through it the cystectomy area for the fixation of the permanent tooth rudiment are given here. The conversion process of the material LitAr into the bone tissue was checked roentgenologically and with the use of magnetic resonance image (MRI). In accordance with the MRI data all the bone tissue formation marks have been stated in 2 months after implanting the material LitAr into the rudiment fixation area. All the further observations (up to 10 months) have shown the bone tissue formation which was accompanied by cutting the tooth in the correct position and on time.

Paradental cyst: case report and review of the literature

The origin of paradental cysts is related to inflammatory processes, especially pericoronaritis involving impacted or semi-impacted teeth. The authors present a case of paradental cyst related to lower second molar that did not show clinical evidence of inflammatory process. The main aspects related to its classification, diagnosis and clinical characteristics are also discussed.

DDAVP normalized the bleeding time in patients with congenital platelet TxA2 receptor abnormality

BACKGROUND

An Arg60-to-Leu mutation was found in the first cytoplasmic loop of the PLT TxA2 receptor as a new congenital PLT disorder characterized by impaired responsiveness to TxA2. However, it has not been clarified whether DDAVP is effective in correcting the bleeding time (BT) in this PLT disorder.

STUDY DESIGN AND METHODS

DDAVP (0.4 microg/kg) was intravenously administered over 20 minutes in five patients with this PLT disorder, and template BT, PLT retention to glass beads, PLT aggregation, and a coagulation study were performed before and after the infusion of DDAVP. PLT TxA2 synthesis defects (cyclo-oxygenase deficiency, volunteers taking aspirin), thrombasthenia, and Bernard-Soulier syndrome were also included in this study.

RESULTS

The normalization of BT was found in all patients with this PLT disorder, and one of the patients successfully underwent oral surgical procedures with DDAVP as the only hemostatic agent. DDAVP was also efficacious in the TxA2 synthesis defect but not in other disorders. FVIII coagulation activity, vWF antigen, and ristocetin cofactor significantly increased in all patients after DDAVP, but no changes were seen in the PLT retention rate and PLT aggregation study after DDAVP infusion.

CONCLUSION

DDAVP was effective in correcting BT in patients with impaired responsiveness to TxA2 as well as impaired production of TxA2.

[Microcystic lateral parodontal cyst. Report of a case]

The lateral periodontal cyst (LPC) is an odontogenetic lesion of the maxillary bone representing about 0.8% of maxillary cystic lesions. It starts in the lateral periodontal area of a vital erupted tooth. Clinical symptoms are generally absent. Its diagnosis usually can be made on the basis of an occasional radiographic examination which shows an osteolytic monoloculate lesion with defined outlines. The botryoid cyst is a variation of LPC and is radiographically different and more aggressive than the common LPC. A clinical case of LPC which allows to make histopathological and clinical considerations on these cystic lesions is described.

Gingival cysts in the adult

BACKGROUND

Gingival cysts in the adult are unusual cysts of odontogenic origin with less than 100 reported, including this series. Even rarer are cases of multiple gingival cysts. This paper reports the second largest retrospective study of biopsy cases of adult gingival cysts with a spectrum of their features and another case of multiple gingival cysts.

METHODS

The files of a biopsy service were reviewed for the most recent 10-year period. Data collected included location, age, gender, clinical features, clinical diagnosis, and histologic features. These were compared to previous reports. There was also a case report of multiple cysts.

RESULTS

Twenty-two adult gingival cysts were retrieved, 2 of which were multiple. They are uncommon cysts of odontogenic origin, noted primarily in the fifth and sixth decades with only a slight predilection for females. They occur more in the mandible on the labial attached gingiva of the anterior teeth. Histology shows a very thin, uninflamed wall lined by a very thin squamoid or cuboidal epithelium. Multiple cysts are very rare.

CONCLUSIONS

Gingival cysts in the adult are uncommon cysts that are diagnosed at the clinical level about 50% of the time, with others being confused with a mucocele. They may be bluish due to the fluid and may cause pressure resorption of the labial bone, yielding a radiolucency sometimes confused with a lateral periodontal cyst. Treatment consists of an excisional biopsy.

Unusual surgical approach in a bilateral case of mandibular buccal infected cyst

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.

Formation of a cyst-like area after a connective tissue graft for root coverage

BACKGROUND

Many techniques have been developed to obtain root coverage. There have been few complications reported with these techniques. This case report chronicles the development of a cyst-like area after a connective tissue partial-thickness double pedicle graft was used to obtain root coverage.

METHODS

The root coverage procedure was performed as previously reported. Postoperatively, in the surgical area, the patient developed occasional swelling. It was possible to express a white material from the area. A biopsy was taken to determine the cause of the clinical findings.

RESULTS

Histological evaluation revealed the development of a cyst-like area.

CONCLUSION

The development of cysts does not seem to be a common event. However, this case report demonstrates that they are a possible complication of root coverage procedures.

Long-term follow-up on keratocysts treated according to a defined protocol

A prospective study was conducted on 82 odontogenic keratocysts (OKCs) diagnosed in 80 patients over a 25 year period. The clinical and radiographic data were correlated, which resulted in an accurate picture of the clinical presentation, relationship with teeth and incidence of lingual perforations in mandibular OKCs. In 40% of the cysts no suspicion had arisen before surgery, in 60% the diagnosis was secured before surgery. This last group of patients was treated according to a defined protocol, with the exception of the maxillary OKCs, which entailed excision of the attached, overlying mucosa and enucleation of the cyst after which the defect was treated with Carnoy's solution. The other patients underwent just enucleation of the cysts. For the first 5 years the patients were seen every year, thereafter every 2 years if possible. Recurrences (9/82) were mainly found in the patients in which the cyst had just been enucleated. Only three cysts recurred in the group treated according to the above mentioned protocol. Most recurrences presented within 5 years, but late recurrences did occur even after 25 years. The aetiology and pathogenesis of OKCs is briefly discussed in the light of the present findings. It is concluded that the suggested treatment protocol and follow-up schedule provides a safe means to manage a lesion that is known to recur and may even give rise to life threatening situations.

Surgical exposure and orthodontic extrusion of an impacted canine tooth in a cat: a case report

A 7 month-old, male domestic shorthaired cat was referred because of facial swelling, an operculated cystic oral mass, and impaction of the associated maxillary left canine tooth. Surgical exposure and realignment failed to result in eruption. Surgical reexposure and orthodontic extrusion resulted in a functional alignment of the tooth within the dental arch. Follow up evaluations over the 5 ensuing years indicated persistence of the facial deformation, no evidence of ameloblastic biotransformation, and a healthy tooth.

Using absorbable collagen membranes for guided tissue regeneration, guided bone regeneration, and to treat gingival recession

This article reviews the role of barrier membranes in guided tissue regeneration (GTR) and guided bone regeneration (GBR), including the advantages of using absorbable barrier membranes in GTR and GBR and the unique properties of collagen membranes. The indications and contraindications for using collagen membranes for these procedures are examined, and successful cases are presented. Finally, the role of collagen membranes in the future of regenerative therapy is considered.

Lateral periodontal cyst: report of a case with 1-year reentry

The lateral periodontal cyst is a relatively rare cyst of the jaw (0.8%) of unproven origin. It is most commonly found in the mandible between the roots of canines and premolars. This article reports a case of a lateral periodontal cyst in a 73-year-old woman, documents its diagnosis and treatment, and also presents a 1-year reentry. No grafting or barrier techniques were used. The result was complete bony regeneration of the defect after 1 year.

[Advantages of the relaxed mucoperiosteal flap in the treatment of alveolar extension cyst]

Postoperative symptoms, pain and swelling, confirmed the justification of relaxed mucoperiosteal flap application, because they proved to be more alleviated than in previously applied routine operative treatments. Clinical researches completely confirmed the experimental results. Postoperative infection, dehiscence and hematoma formation entirely corresponded to the experimental results and were less marked upon use of relaxed mucoperiosteal flap. Extraordinary advantage was observed in application of this flap in those cases when, upon removal of great cysts, there was necessary to perform resection of greater number of teeth. The mucoperiosteal flap covers resected surfaces and makes blood clot evenly distributed, and in that way, what has been experimentally confirmed, the preconditions for quicker regeneration and reparation of the operative area have been achieved.

[The relaxed mucoperiosteal flap in treatment of alveolar extension cyst]

Justification of the relaxed mucoperiosteous flap application is proved by clinical investigation. Faster creation of a somewhat more significant layer of the newly created bone as well as the shortening of the post-operational clinical in relation to the open and closed operational method are due to the fact that this method was carried out by the principle of closed operations which ensure the healing of the wound per primam intentionem. Equally distributed, not too voluminous blood clot, enabled its faster resorption and organization, acting stimulatively on quickened osteogens, regenerational and reparational post-operation processes.

Lateral periodontal cyst: a case report and review of the literature

A polycystic lateral periodontal cyst was observed over a period of 25 months. The case history, a description of the natural history of this lesion and its diagnostic characteristics, and a review of the literature are presented.

Osseous repair of a lateral periodontal cyst

THE LATERAL PERIODONTAL CYSTS is a slow-growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through-and-through perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze-dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months.

The buccal bifurcation cyst: a prospective study of treatment outcomes in 44 sites

OBJECTIVE

The clinical, radiographic, and histologic features of the mandibular buccal bifurcation cyst were studied to further define this lesion. The treatment and outcomes were also analyzed.

STUDY DESIGN

This prospective study, which spanned 3 years, included 32 patients. Their ages ranged from 5.5 to 11 years (mean of 7.5). A total of 44 buccal bifurcation cysts were treated solely with enucleation, and patients were followed up for 2.5 to 3 years.

RESULTS

All lesions were located at the buccal bifurcation of the mandibular first molar. Tilting of the buccal cusps, causing prominence of the lingual cusps, occurred in 75% of the cases. The lesion extended from the buccal bifurcation to the tooth apex in 81.2%, and a periosteal reaction on the lateral surface of the mandible adjacent to the cyst was noted in 68.8% of the cases. All of the 44 histologic reports were nonspecific, but showed a cyst lining of stratified squamous epithelium with chronic inflammation. Microbiology consisted of mixed oral flora. Complete radiographic healing in all sites without recurrence was noted in 2.5-year follow-up. The periodontal pocket depth around all the involved teeth was normalized. No loss of the mandibular first molars occurred.

CONCLUSIONS

The mandibular buccal bifurcation cyst is a distinct site-specific and age-specific clinical entity treatable by enucleation without tooth extraction.

Effect of decalcified freeze-dried bone allograft on the healing of jaw defects after cyst enucleation

PURPOSE

This study radiographically evaluated the changes that occur in jaw defects after enucleation of cysts and either grafting with demineralized freeze-dried bone allograft (DFDBA) or packing with absorbable gelatine sponge (Gelfoam).

PATIENTS AND METHODS

Thirty-two patients (14 males, 18 females) with cystic lesions of the jaws were divided into two groups. Group A underwent enucleation and bone grafting with DFDBA. Group B underwent enucleation and packing with Gelfoam. Both groups were evaluated radiographically before surgery, immediately postoperatively, and 6, 12, 24, and 36 months postoperatively. The density of the area was measured with a digital densitometer.

RESULTS

The density in group A was significantly (P < .05 to .01) greater than in group B at 6 and 12 months postoperatively. The difference at 24 months was not significant. Group A reached density levels at 6 months that were reached by group B at 12 months.

CONCLUSION

The findings demonstrate that decalcified freeze-dried bone allograft enhances bone healing in jaw defects after cyst removal.

Report of a lateral periodontal cyst and gingival cyst occurring in the same patient

The lateral periodontal cyst and gingival cyst of the adult are both developmental odontogenic cysts located predominantly in the mandibular premolar-canine region. In this paper, a case report is described of a lateral periodontal cyst and gingival cyst occurring in the same patient along with a discussion of clinical, radiographic, and histological features of these lesions.

[Paradental cyst]

The paradental cyst is an odontogenic inflammatory cyst (WHO classification, 1992). It has been rarely described in the french literature and includes: The inflammatory paradental cyst which occurs on the buccal or distal aspects of an erupted third mandibular molar or of a canine (first description by Main in 1970); the mandibular infected buccal cyst which occurs on the buccal surface of the mandibular second or first molar in children around 6-8 years of age with an associated history of inflammatory signs (Stoneman and North, 1993). The histological features are the same as those of the radicular cyst. Prognosis is excellent after enucleation. This paper present an additional case report of a paradental cyst located on a second mandibular molar.

Surgical excision of a congenital lateral fistula of the upper lip. An intra-oral approach

A new technique for removal of a congenital lateral upper lip fistula is described, using an intra-oral approach. Previous reports of removal of such a congenital malformation have used an extra-oral approach. The technique described allows for excellent visualization of the fistula without cutaneous lip incision. Using this approach, good aesthetic results and complete removal of the fistula and associated mucous glands can be obtained.

Periodontal repair of periapical lesions: the borderland between pulpal and periodontal disease

A series of cases demonstrating the destruction of periapical periodontal structures, without pulpal involvement has been presented. Treatment using both surgery and antibiotics resulted in extensive healing without any concommitant endodontic therapy. The results suggest that lesions affecting the apical periodontium are either periodontal or pulpal in origin. Careful diagnosis allows the maintenance of pulp vitality in cases where apical destruction has a source other than an infected pulp. The commonly held belief that lateral and accessory canals are a significant source of pulpal contamination from deep periodontal pockets has been questioned.

Median mandibular lateral periodontal cyst

The lateral periodontal cyst is a developmental odontogenic cyst associated with the lateral root surfaces of teeth. It is treated by surgical enucleation and diagnosed on the basis of clinical, radiographic, and histologic findings. This article is a case report of the surgical treatment of a lateral periodontal cyst in a unique mandibular midline location. The preoperative history and postoperative recall examinations cover an 8-year period.

[Lateral periodontal cysts]

The lateral periodontal cyst is a rather infrequently reported odontogenic cyst. The cyst seems to develop in direct contact to the periodontal membrane of an erupted vital tooth. This type of cyst should not be confused with a radicular cyst in a lateral position developing as a consequence of inflammation from an infected or necrotic branch of the pulp canal. Several authors do not differentiate between the lateral periodontal cyst and the gingival cyst, but it seems justified to consider the lateral periodontal cysts as a separate entity of odontogenic cysts. In this origin of the lateral periodontal cyst is reviewed and several possibilities are discussed. It is concluded that the epithelial lining of this type of cysts most probably originates from the cell rests of Malassez. Case report of one lateral periodontal cyst is presented.