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While common in adult teeth, radicular cysts are uncommon in deciduous teeth. When they do occur, they are associated with non-vital teeth and typically present 6 months to 5 years after vitality is lost. They cause swelling, bone-loss and permanent tooth bud displacement. Often, they are incidental findings. A case involving radicular cysts on the left and right sides of the mandible is presented. If non-vital deciduous teeth receive pulp therapy, regular post- operative reviews are recommended.

Introduction: The preliminary diagnosis of chronic periapical lesions is made on the basis of clinical symptoms and radiographs, which is a reliable diagnostic tool, but it has only a subsidiary role since histopathological verification is essential for the definitive diagnosis. This study was aimed at diagnosing removed chronic periapical lesions and classifying them by size as well as at comparing the clinical diagnoses with histipathological results., Material and Methods: The study included 34 patients diagnosed with chronic periapical process by applying clinical examination and radiography. The removed chronic periapical lesions were processed according to classical histological technique and analyzed by hematoxylin and eosin staining protocol., Results: According to histopathological analysis 53% of chronic periapical lesions were periapical granulomas and 47% were radicular cysts. The size of the lesions ranged from <9 mm (70% of lesions), 9 to 20 mm (18% of lesions) and >20 mm (12% of lesions).The histopathological examination revealed that clinical diagnosis was wrong in 26% of cases., Conclusion: A statistically significant difference between clinical and histopathological diagnosis has been found. The histopathological findings strongly suggest the necessity of complete curettage of lesions sizing >20 mm in order to prevent recurrences.

Radicular cysts (RCs) are the most common inflammatory jaw cystic lesions that occur infected and necrotic in teeth pulps. They account for more than 50% of all odontogenic cysts. Radicular cysts cause slowly progressive painless swelling. There are no symptoms until they become large. Enucleating the cyst is recommended with primary treatment. Here we describe a patient with a large RC with maxillary sinus involvement who underwent an endonasal endoscopic approach for complete resection. In conclusion, the endonasal endoscopic approach should be kept in mind for the resection of RC with maxillary sinus involvement because of its minimally invasive characteristics.

Aim:   The purpose of the present study was to evaluate the correlation between clinical and histopathological diagnoses of periapical inflammatory lesions, focusing mainly on cystic conditions., Methods:   Files dating from 1998 to 2006 at the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, Brazil, were reviewed to identify cases with histopathological diagnoses of periapical inflammatory lesions. A total of 1788 files were analyzed, and 255 cases were identified with clinical diagnoses of periapical inflammatory lesions., Results:   The most prevalent clinical diagnosis was apical periodontal cyst (59%), followed by periapical granuloma (20%), and dentoalveolar abscess (2%). After histopathological analysis, 53% of the cases represented apical periodontal cyst, 42% periapical granuloma, and 5% dentoalveolar abscess., Conclusions:   The outcomes of the present study show a high prevalence of periapical cysts among periapical inflammatory lesions. Moreover, this study highlights the importance of histopathological evaluation for the correct diagnosis of periapical inflammatory lesions., (© 2011 Blackwell Publishing Asia Pty Ltd.)

The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of periapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases.

Objective: Dentists play an important role in the early diagnosis and treatment of oral lesions. However, treatment based solely on a clinical impression of the diagnosis, without histologic confirmation, can result in serious consequences, particularly when the lesion is precancerous or cancerous. The purpose of this study was to determine the overall accuracy of clinical diagnoses made by dentists as well as to compare the diagnostic ability of general practitioners with members of various dental specialties., Method and Materials: The biopsy reports of 976 specimens submitted to the Department of Oral and Maxillofacial Pathology, Virginia Commonwealth University School of Dentistry, between January 2009 and January 2010 were reviewed. The presumptive clinical diagnosis made by the practitioner and the final histologic diagnosis on each specimen were recorded in addition to whether the submitting dentist was a general practitioner or a specialist., Results: Of the clinical diagnoses made by the submitting dentists, 43% were incorrect. General dentists misdiagnosed 45.9%, oral and maxillofacial surgeons 42.8%, endodontists 42.2%, and periodontists 41.2% of the time. The most commonly missed clinical diagnoses were hyperkeratosis (16%), focal inflammatory fibrous hyperplasia (10%), fibroma (8%), periapical granuloma (7%), and radicular cyst (6%). Cancerous lesions were misdiagnosed 5.6% of the time., Conclusions: The high rates of clinical misdiagnosis by dental practitioners indicate that all excised lesions should to be submitted for histologic diagnosis.

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.

Introduction: An accurate differential diagnosis of apical periodontitis (AP) and nasopalatine duct cyst (NPDC) should be established to define the best treatment for endodontically treated maxillary anterior teeth with apical periodontitis. Three-dimensional cone beam computed tomography (CBCT) images help to plan treatment and to define an initial diagnostic hypothesis. However, endodontic treatment or retreatment may be unnecessarily prescribed when radiographs show a superimposition of the incisor foramen over the apex of maxillary central incisors, mimicking AP. Diseases of nonendodontic origin that affect the tooth apex, such as NPDC, should be included in the differential diagnosis., Methods and Results: Four clinical cases of patients with large periapical radiolucencies and similar radiographic features are described. AP is usually a consequence of endodontic infection; in cases of NPDC, however, spontaneous epithelial proliferation, in addition to bacterial infection and trauma, may also contribute to cyst formation. The frequency and recurrence rates of NPDC are low, and its behavior is less aggressive. Surgical enucleation of the periapical lesion is recommended after nonsurgical treatment does not heal AP., Conclusions: The use of new diagnostic tools, such as CBCT imaging, may provide detailed high-resolution images of oral structures, which help to make an initial diagnostic hypothesis and to plan surgery. Histopathology is mandatory for the differential diagnosis., (Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

This case report describes the diagnosis and surgical treatment of a cyst-like periradicular lesion in an alpaca.

A large maxillary cyst was treated for 3 months with marsupialization and decompression, followed by surgical endodontic therapy of the affected teeth and cystectomy. Although small cystic lesions will typically heal with nonsurgical endodontic therapy, larger lesions may need additional treatment. Surgical enucleation of a large cystic lesion may lead to damage of other teeth or anatomic structures. Therefore, treatment should begin with the more conservative approach of decompression, to reduce the size of the lesion, followed by apicoectomy and cystectomy.

The purpose of this report is to document a case of unsuspected ameloblastoma involving the right man dibular subpontic region in a 38-year-old Cambodian female patient. This lesion was purportedly preceded by multiple radiolucencies which were diagnosed as radicular cysts and treated a few times in the past years by enucleation followed by endodontic therapy of the affected teeth. Bridgework restoration of the partially edentulous area was performed. This case report demonstrates radiographic changes that occurred in the periods before and after the diagnosis of ameloblastoma. The case may represent an example of radicular cysts and ameloblastoma occurring as a collision phenomenon, or the ameloblastoma may have arisen as a result of neoplastic transformation of the lining epithelium in an inflammatory odontogenic epithelial cyst.

Introduction: This study investigated the differentiation of radicular cysts from granulomas. Cone beam computed tomography (CBCT) imaging was compared with the existing standard, biopsy and histopathology., Methods: Forty-five patients scheduled for an apicoectomy received a CBCT scan of the involved arch. Two oral and maxillofacial radiologists, working independently and using the same criteria, categorized the CBCT images as one of the following: cyst, likely cyst, likely granuloma, granuloma, or other. After apicoectomies, two oral pathologists, working independently and using the same criteria, diagnosed the surgical specimens as one of the following: radicular cyst, granuloma, or other. We examined the following: (1) interrater agreement between pathologists as to the biopsy diagnosis, (2) interrater agreement between radiologists as to the CBCT diagnosis, and (3) accuracy of radiologists' diagnostic assessments using histopathology as the standard., Results: Findings showed strong interrater reliability between pathologists (kappa=0.79, z=5.46, p<0.0001) and weak interrater reliability between radiologists (kappa=0.14, p=not significant). Accuracy (true-positives plus true-negatives) for the two radiologists was 51% and 63%., Conclusion: Under the conditions of this study, based on the inconsistency of the radiologists' reports as evidenced by statistical analyses, it was concluded that CBCT imaging is not a reliable diagnostic method for differentiating radicular cysts from granulomas. Surgical biopsy and histopathological evaluation remain the standard procedure for differentiating radicular cysts from granulomas., (Copyright (c) 2010. Published by Elsevier Inc.)

Introduction: This report of 2 cases describes the diagnostic procedures used to identify 2 Stafne's bone cavities (SBC) found in unusually anterior locations in the mandible, both mimicking periapical lesions of endodontic origin., Methods: In the first patient, a 47-year-old man, an SBC was diagnosed in the area of teeth #27, 28, and 29. In the second patient, a 62-year-old man, the SBC was a fortuitous finding, because this patient was referred for dental implant therapy., Results: In both cases, the final diagnosis was achieved by using limited cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). In both patients, the lingual bone cavity was found to be occupied by accessory salivary gland tissue., Conclusions: The combination of CBCT and MRI as noninvasive diagnostic techniques seems ideal to avoid surgical explorations, incisional biopsies, or enucleations of the lesion for diagnostic purposes.

Introduction: The inability to distinguish periapical cysts from granulomas before performing root canal treatment leads to uncertainty in treatment outcomes because cysts have lower healing rates. Searching for differential expression of molecules within cysts or granulomas could provide information with regard to the identity of the lesion or suggest mechanistic differences that may form the basis for future therapeutic intervention. Thus, we investigated whether granulomas and cysts exhibit differential expression of extracellular matrix (ECM) molecules., Methods: Human periapical granulomas, periapical cysts, and healthy periodontal ligament tissues were used to investigate the differential expression of ECM molecules by microarray analysis. Because matrix metalloproteinases (MMP) showed the highest differential expression in the microarray analysis, MMPs were further examined by in situ zymography and immunohistochemistry. Data were analyzed by using one-way analysis of variance followed by the Tukey test., Results: We observed that cysts and granulomas differentially expressed several ECM molecules, especially those from the MMP family. Compared with cysts, granulomas exhibited higher MMP enzymatic activity in areas stained for MMP-9. These areas were composed of polymorphonuclear cells (PMNs) in contrast to cysts. Similarly, MMP-13 was expressed by a greater number of cells in granulomas compared with cysts., Conclusion: Our findings indicate that high enzymatic MMP activity in PMNs together with MMP-9 and MMP-13 stained cells could be a molecular signature of granulomas unlike periapical cysts.

This report describes a case of orthokeratinized odontogenic cyst arising in the mandibular molar region of a 39-year-old man. Under the initial clinical diagnosis of radicular cyst, root canal treatment was performed on the mandibular right second molar. The treatment that continued for six months did not achieve healing. Subsequently surgical intervention was selected since the tooth fracture was found, and the prognosis was judged to be poor. After atraumatic tooth extraction, the apical cystic lesion was enucleated, and the tooth was replanted. A definite diagnosis of orthokeratinized odontogenic cyst was made by histopathological examination of the biopsy specimen. The radiograph taken seven months after the operation showed an improvement in the radiolucent lesion. No clinical signs of tooth mobility, pain, and swelling were present. The tooth was then successfully retained with the final restoration. Careful follow-up is needed in order to detect any signs of recurrence.

The article is a case report of an unusual manifestation of primary hyperparathyroidism seen in the mandible. Primary hyperparathyroidism is a rare disorder that can present its first symptoms in the jaws. The pre- and post-treatment radiographic features of such cases have only rarely been reported in dental literature. This case report highlights the importance of careful clinical and radiographic examination before commencing root canal treatment.

This article describes a case of persistent apical periodontitis that required several nonsurgical and surgical approaches for resolution. A 28-year-old woman presented with a large symptomatic apical periodontitis lesion associated with the maxillary left lateral incisor that persisted in spite of previous nonsurgical and surgical endodontic treatment. Root canal retreatment was accomplished, but the lesion only showed a slight decrease in size after 18 months. Forty-six months after retreatment, the patient returned because of reemergence of symptoms. Radiographically, the lesion remained relatively unaltered. Periradicular resurgery was performed, and a biopsy specimen consisting of the lesion and the apical part of the root was collected for analysis. Radiographic and clinical reevaluation after 4 years revealed complete healing. Histopathologic and histobacteriologic observations demonstrated that the lesion was a cyst, and that the probable reason for failure was the occurrence of bacteria within dentinal tubules and in a lateral canal slightly coronal to the amalgam root-end filling. This case report clearly illustrates the difficulties imposed by anatomic complexities in attaining a disinfection level that is compatible with periradicular tissue healing.

Introduction: The botryoid odontogenic cyst (BOC) is a developmental cyst of odontogenic epithelial origin considered as a rare multilocular variety of lateral periodontal cyst (WHO 1992). This cystic lesion site is in the periodontal space of vital teeth., Observation: A 21-year-old woman consulted for a swelling of the anterior maxillary region. The clinical examination revealed bucal swelling extending from the left central incisor to the first left premolar. The mucosa was normal. The adjacent teeth were vital. X-ray revealed a bilocular radiolucency extending between the roots of teeth 21 and 24. The lesion was enucleated, under local anaesthesia via a vestibular approach. Histology was typical of a BOC with cystic spaces lined by squamous epithelium with thickening and clear cells. Forty-eight months after surgery, there was sign of recurrence., Discussion: BOC is known to be a recurrent odontogenic cyst. Several cases of multiple recurrences have been reported up to nine years after the initial surgery. Long-term follow-up is thus mandatory.

Background: A radicular cyst in a 9-year old girl is reported., Case Report: A 9-year-old child was referred from her General Dental Practitioner because of the need for obtaining expert care, assessment and treatment with regards to a radiolucency associated with her lower right second primary molar (85)., Treatment: This included surgical intervention for the removal of the affected tooth, enucleation of the cyst and primary closure of the surgical area., Follow-Up: This was satisfactory and 12 months post-operative the patient reported no further problems or symptoms. It could be seen that the area previously occupied by the cyst had undergone bony infill.

The radicular cysts are result of inflammatory process in the periapical tissues associated with necrotic and infected pulps. Humoral and cellular immune responses play a central role in the pathogenesis of these lesions. The most important role in the growth of these lesion have proinflammatore cytokine TNF-alpha, IL-1 and IL-6. Cytokine can be secreted by macrophages, monocytes and other cells of the immune system and can participate in skeletal homeostasis including osteoclastic formation, and bone resorption in maxillofacial region. The aim of this study is to give a consise rewiew for mechanism of growth of maxilofacial radicular cysts, indicated of clinical aspect, as well as expalined role of cytokine in this pathophysiology process.

Unicystic ameloblastoma is believed to be less aggressive and responds more favorably to conservative surgery than the solid or multicystic ameloblastomas. This report is a rare case of unicystic ameloblastoma of the maxilla that was treated by enucleation under suspicion of a radicular cyst related to a dens in dente. The neoplastic nature of the lesion became evident only when the enucleated material was available for histologic examination. With this report, the authors illustrate the importance and complexity of a differential diagnosis of lesions with a cystic aspect in the anterior region of the maxilla, among them - inflammatory radicular cysts, odontogenic keratocysts, adenomatoid odontogenic and unicystic ameloblastoma. Relevant diagnostic problems and choice of treatment of unicystic ameloblastoma are presented along with a review of the literature.

Aim: To present the clinicopathological features of a series of four periapically located central giant cell granulomas (CGCGs) that were misdiagnosed and treated as being of endodontic origin., Summary: Four cases of periapical CGCGs were submitted with a clinical diagnosis of either radicular or residual cyst. In two cases, root canal treatment had been performed previously. The patients were two women and two men whose age ranged from 31 to 85 years. Two cases were located in the mandibular premolar-molar region, and two in the anterolateral region of the maxilla. Two lesions were submitted for histological examination with a diagnosis of radicular cyst whereas the remaining two were submitted with a diagnosis of residual cyst., Key Learning Points: Periapical giant cell lesions may be unilocular and therefore misdiagnosed as an endodontic lesion because of their radiographic similarity to an inflammatory periradicular lesion, especially if the teeth have been root filled or if the vitality is negative or doubtful. It is important to follow up the healing process of a periapical radiolucency related to a root filled tooth and, in case of persistence, to perform surgery and to submit the specimen for histological examination.

Aim: To report a clinical case of unicystic ameloblastoma previously misdiagnosed as radicular cyst., Summary: A 49-year-old white male was referred to a private practitioner complaining of an asymptomatic bony hard swelling of the left posterior mandible. The patient's dental history indicated that his left mandibular first molar had been extracted approximately 10 years previously. At that time, preoperative radiographic examination demonstrated a radiolucent area of 1.5 cm diameter with well-defined margins involving the distal root of tooth 36. The lesion was diagnosed as cystic and surgery for its removal was advised, but not performed. At presentation, radiography demonstrated a well-defined 3 cm diameter radiolucency extending from the second premolar to the second molar. The lesion was enucleated and histopathological examination confirmed a diagnosis of unicystic ameloblastoma., Key Learning Points: *Despite a clinical diagnosis of periapical disease of endodontic origin, a nonendodontic lesion may be present. *Unicystic ameloblastoma located on the periapical area of a tooth can lead to a pulp-periapical misdiagnosis, and should be considered in differential diagnosis. *All tissue specimens recovered in apical surgery should be submitted to histopathological analysis.

Malignant mesothelioma is a rare tumor arising from the pleura or peritoneum. Distant hematogenous metastasis is seen in more than half of cases, preferentially to the brain, lung, bone and soft tissues [Br. J. Dis. Chest 70 (1976) 246]. There has been only one previous report of this tumor metastasizing to the jaw bone [Pathologica 92 (2000) 273].

Inflammatory odontogenic cysts include radicular cysts and its etiological variance, residual cysts. Among these lesions, the radicular cyst is the most frequent. It is caused by the growth of remnants of Malassez cells involved in the development of the dental organ. Clinically, radicular cysts are difficult to diagnose. Histologic diagnosis is of primary importance in order to definitely discriminate the different kinds of periapical lesions. In this paper, the clinical, radiographic, etio-physio-pathological and microscopic features of these pathological formations are described. A case of a large radicular cyst and a case of residual cyst are reported and the surgical treatment and histologic differential diagnosis are presented.

Aim: To present a clinical case of a giant cell lesion located in an unusual site, initially misdiagnosed and treated as an odontogenic cyst., Summary: Periapical radiolucencies often suggest the presence of odontogenic pathosis, usually inflammatory granulomas or cysts. The high frequency of such lesions tends to lead clinicians to arrive at a diagnosis without completing a comprehensive assessment of the patient or carrying out the full range of available diagnostic tests. A case report of a giant cell lesion, which was misdiagnosed and treated initially as an odontogenic lesion because of its unusual location, is presented., Key Learning Points: Clinical signs and radiographic appearance are usually sufficient to reach a diagnosis of periapical pathosis. When traditional treatment does not lead to success, a biopsy should be considered to ascertain the diagnosis and allow the correct treatment to be provided. Histological examination of soft tissue removed during endodontic surgery is essential.

Diseases of the mandible affect the soft tissues aside from the osseous manifestation. This can be shown clearly and in great detail by magnetic resonance imaging (MRI). MRI is the gold standard in the diagnostic evaluation of any internal derangement of the temporomandibular joint. Dental MRI requires high resolution techniques and in some cases also intravenous administration of contrast material. These techniques allow delineation of the neurovascular bundle. In the past few years new indications were formulated, for example, the evaluation of the integrity of the inferior alveolar nerve in trauma and in radicular cysts. New quantitative methods now enable insights into the pathophysiology. The objective of this review is to communicate accepted indications for MRI of the mandible and to present innovative applications.

A 13-year-old, male/neutered Border Collie dog was diagnosed with a radicular cyst of the left premaxilla. Tooth extraction and curettage of the lesion resulted in a positive clinical outcome 6-months following treatment.

Dentogenous inflammatory diseases can lead to typical dermatological facial symptoms with formation of cutaneous sinuses. Partsch's chronic granulomatous inflammation can result from conducted inflammation of a nonvital tooth via a chronic apical inflammation. In this rare disease, the granulomatous tissue perforates the bone, channels through the overlying skin, and drains via cutaneous or oral sinuses. A frequent localization of the cutaneous sinus is the skin inferior to the body of the mandible, and it is caused by an inflammation of the lower molars. Treatment consists of identifying the responsible teeth and eliminating the focus of infection. Chronically progressive periradicular granuloma and/or radicular cysts can be present with impressive dermatological symptoms. Therefore, X-ray examinations are necessary to exclude possible dentogenic causes in cases of badly healing processes of the face or neck.

Objective: To investigate the nuclear morphometric features of epithelial cells lining keratocysts and some other odontogenic cysts., Study Design: All cases were selected from the archives of the Department of Pathology, Gülhane Military Medical Academy, as follows: 20 keratocysts and 10 dentigerous and 10 radicular cysts. Nuclear morphometric variables were measured on hematoxylin and eosin-stained histologic slides. Basal and intermediate cells of the epithelium were evaluated separately. Nuclei of the cells were outlined interactively and measured using a specially written macro program. Area, feret ratio (ratio of the longest nuclear axis to the shortest one) and circularity (F circle) of the nuclei were calculated. Additionally, nuclear densitometric analysis was performed on the keratocyst cases., Results: The number of cells in the basal layer (cell density) was higher in keratocysts than in other cysts. The mean nuclear area of basal cells was smaller than of intermediate cells in both keratocysts and other cysts (P < .001). The feret ratio values revealed that basal cell nuclei of keratocysts were more ovoid as compared to those of other cysts (P < .001). Nuclear densitometric findings showed that the DNA indices of all keratocyst cases were close to 1.0, and the cells were considered diploid., Conclusion: Increased cell density, a more ovoid nuclear shape and more variation in the size of basal layer cell nuclei in keratocysts were helpful in differentiating these lesions from other odontogenic cysts.

A distinctive form of paradental cyst can occur on the buccal and apical aspects of erupted mandibular molars. This cyst has peculiar clinical and radiographic features, although the microscopic findings are the same as those of odontogenic inflammatory cysts. Diagnostic and therapeutic problems can occur when this lesion is misinterpreted as a radicular cyst. The purpose of this paper is to present an additional case of a paradental cyst in the buccal and mesial aspects of a mandibular second molar involving the apical area of a mandibular first molar. The difficulty of diagnosis, treatment, and controversies regarding terminology are also discussed.

The adenomatoid odontogenic tumor (AOT) is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. A rare subvariant of the extrafollicular type of AOT may mimic periapical disease radiographically. We report on a 15-year-old girl with a periapical radiolucent lesion affecting teeth 7 and 8 initially suspicious of periapical disease, although clinical findings seemed to indicate a nonendodontic lesion. An exploratory surgical approach was chosen, and the final diagnosis of the removed noncystic tissue mass was microscopically confirmed to be an AOT.

The diagnosis and therapeutic approach to periapical cysts is an extremely controversial concern for dentists. Furthermore, as this complaint represents the most frequent cystic lesion of the maxilla, together with the fact that its differential diagnosis with chronic apical periodontitis presents special difficulty, the question takes on even greater importance. The purpose of this article is to assess the validity of the various diagnostic techniques used to differentiate between both pathologies and make a critical analysis of the controversy surrounding the therapeutic approach to suspected periapical cysts through non-surgical and follow-up treatment, or surgical enucleation and histopathological analysis.

Cysts of the maxillary sinus of odontogenic origin have been well-documented in the literature. Most of these lesions involve the apex of the offending tooth and appear as a well-defined periapical radiolucency. Presented here is a case of an unusually large lesion, which involved the entire maxillary sinus and extended into the floor of the nose. The lesion also caused paresthesia on the affected side. The lesion was removed with conservative treatment without any postoperative complications.

Root perforation repair has historically been an unpredictable treatment modality with an unacceptably high rate of clinical failure. Recent developments in the techniques and materials utilized in root perforation repair have dramatically enhanced the prognosis of both surgical and nonsurgical procedures. This article presents a review of the literature pertaining to root perforation repair and illustrates, through clinical case presentations, the principles of extraradicular surgical repair and non-surgical internal repair of root perforation using mineral trioxide aggregate (MTA).