Search

Introduction: Radiolucent lesions with gingival swelling found in the premolar and intercanine region can elicit a different clinical diagnosis than one confirmed by histologic findings. The purpose of the study is to identify and present the frequency of the unexpected microscopic diagnosis of odontogenic keratocyst (OKC) in a location preoperatively favoring a lateral periodontal cyst (LPC) with similar clinical and radiographic appearance., Methods: A retrospective analysis of biopsies received from 2011 and 2019 was performed, and the number of LPC and OKC cases was assessed. The alignment of clinical and radiographic diagnosis to histologic findings and anatomic location was analyzed, and the number of OKC cases preoperatively misdiagnosed as LPCs was identified., Results: A total of 79,257 biopsies were received. Of those, 184 were diagnosed as LPCs and 742 as OKCs. For all preoperatively diagnosed LPCs, the clinical and histologic diagnosis aligned; however, 182 of 742 OKCs were submitted with a clinical misdiagnosis of LPCs. The location of these lesions with the unanticipated diagnosis overlapped with those for LPCs, specifically the maxillary and mandibular anterior and premolar regions., Conclusions: Radiolucent lesions with gingival swelling in the premolar and intercanine region are frequently clinically and radiographically misdiagnosed. A biopsy should be considered in all cases to establish the correct pathologic diagnosis and treatment course., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background: Lateral periodontal cyst (LPC) is an uncommon form of developmental odontogenic cyst. LPC can be suspected when there is a round, well-circumscribed radiolucency, usually of small diameter, along the lateral surface of vital erupted teeth, predominantly in the mandibular premolar region. Histopathological analysis allows LPC to be diagnosed based on its characteristic features such as a thin cuboidal to stratified squamous non-keratinizing epithelium containing epithelial plaques and glycogen-rich clear cells. The aim of this article was to report two cases of atypical LPC associated either with an impacted lower left canine (tooth #33) or with a lower right third molar (tooth #48)., Case Presentation: Case 1: A 56-year-old man was referred to us for an oro-dental assessment. Panoramic radiography revealed an impacted lower left permanent canine (tooth #33) with well-defined radiolucency on its upper cervical margin. A CT scan revealed a pericoronal radiolucency of 5 mm at its widest diameter around the impacted tooth #33. The pericoronal tissue was removed and sent for histopathological examination. The results revealed a lateral periodontal cyst. Satisfactory postoperative healing was achieved at the site. Follow-up at 12 months indicated no recurrence of the lesion. Case 2: A 54-year-old woman consulted with the main issue being pain on the lower right side of the face. Intra-oral examination revealed a vestibular swelling involving the region of the second molar (tooth #47), with obliteration of buccal sulcus. Pocket depth was determined to be 9 mm at the distal of #47. A diagnosis of gingival abscess resulting from chronic periodontitis was made. Panoramic radiography revealed a radiolucent cystic lesion associated with an impacted horizontal lower right third molar (tooth #48), suggestive of a dentigerous cyst. X-rays also revealed alveolar bone resorption on the molar (tooth #47). The cyst was removed along with the third molar and submitted for histopathological diagnosis. The diagnosis was LPC. Follow-up at 18 months indicated no recurrence of the lesion., Conclusion: These cases represent atypical presentations of LPC. They provide examples of the differential diagnosis of pericoronal radiolucencies involving an impacted tooth and our observations provide insights regarding the pathogenesis of LPC.

Buccal bifurcation cyst (BBC) is an uncommon inflammatory odontogenic cyst that generally occurs at the buccal region of the permanent mandibular first molars in children aged 6-8 years. The diagnosis of BBC cannot be made from the histopathologic features; therefore, diagnosis is primarily based on specific clinical and radiographic findings. In this case report, we present the clinical and radiological findings, including ultrasonography (USG) and cone-beam computed tomography (CBCT) images, of a 10-year-old boy who was referred with a complaint of swelling on the lower right jaw. According to the radiographic and clinical findings, the differential diagnosis of this lesion included lateral radicular cyst, lateral periodontal cyst, dentigerous cyst, eruption cyst, and others. Recently, in addition to classical radiographies and CBCT, USG has been considered important for diagnosis. In particular, if a cyst produces a perforation in the cortical bone, it is helpful to make a pre-diagnosis with USG.

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.

Lateral periodontal cysts (LPCs) are odontogenic epithelial cysts composed of nonkeratinized epithelial cells that are in the category of developmental cysts, rather than inflammatory cysts. Lateral periodontal cysts are rare both in people and domestic animals; they are associated with vital teeth and located lateral to a tooth root. Lateral periodontal cysts are typically asymptomatic lesions that are characterized radiographically as a unilocular lucency with well-defined corticated borders. Canine acanthomatous ameloblastoma (CAA) is the most common odontogenic neoplasm in dogs and rarely presents as a cystic lesion. This case report describes the diagnosis and treatment of a cyst that occurred as a swelling apical to a gingival mass that was diagnosed histologically as CAA. Surgical management by conservative gingivectomy, cyst enucleation, and bone grafting was an effective treatment in this patient.

Gingival cysts, which are more frequently reported as gingival cysts of adults (GCA), are soft tissue cystic lesions of odontogenic origin that are infrequently seen, especially in children. These lesions usually appear as localized firm elevations on the facial gingiva in the anterior segment of the mandible. The purpose of this paper is to present a rare case of a gingival cyst discovered on the palatal aspect of the posterior maxilla in a four-year-old child. The lesion was treated with excisional biopsy.

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.

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 two additional cases of a paradental cyst in the buccal and mesial aspects of a mandibular first molar involving the apical area. The difficulty of diagnosis, treatment, and controversies regarding terminology are also discussed.

Proteus syndrome (PS) is a sporadic and rare congenital disorder characterized by a patchy or mosaic postnatal overgrowth, sometimes involving the face. The onset of overgrowth typically occurs in infancy and can commonly involve skin, connective tissue, central nervous system, eyes and viscera. The progressive overgrowth causes severe complications, such as skeletal deformities, cystic lung disease, invasive lipomas, connective tissue hyperplasia, benign and malignant tumours and deep venous thrombosis with pulmonary embolism, which can cause premature death. This disorder is caused by somatic mosaicism for a specific activating AKT1 mutation that would be lethal in a non-mosaic state. In this report, current knowledge of the aetiology, the diagnosis and the craniofacial manifestations of the disorder are reviewed. The short-term management of a 7-year-old patient with unusual oral manifestations is described. For the first time mutation of AKT1 (c.49G > A) gene was detected both in cranial exostosis and in central odontogenic fibroma of the lower jaw., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Introduction: Bone grafts are frequently used in the treatment of bone defects. Bone harvesting can cause postoperative complications and sometimes does not provide a sufficient quantity of bone. Therefore, synthetic biomaterials have been investigated as an alternative to autogenous bone grafts., Aim and Objectives: The aim of this study was to evaluate and compare bovine derived hydroxyapatite (BHA) and synthetic hydroxyapatite (SHA) graft material as bone graft substitute in maxillary cystic bony defects. Patients were analyzed by computerized densitometric study and digital radiography., Materials and Methods: In this study, 12 patients in each group were included randomly after clinical and radiological evaluation. The integration of hydroxyapatite was assessed with mean bone density, surgical site margin, and radiological bone formation characteristics, of the successful graft cases using computer densitometry and radio-visiograph. Statistical analysis was carried out using Mann-Whitney U-test, Wilcoxon matched pairs test and paired t-test., Results: By the end of 24 th week, the grafted defects radiologically and statistically showed similar volumes of bone formation. However, the significant changes observed in the formation of bone and merging of material and surgical site margin at 1 st week to 1 st month. The results were significant and correlating with all the parameters showing the necessity of the grafting for early bone formation. However, the bone formation pattern is different in both BHA and SHA group at 3 rd month interval with significant P value., Conclusion: Both BHA and SHA graft materials are biocompatible for filling bone defects, showing less resorption and enhanced bone formation with similar efficacy. Our study showed maximum bone healing within 12 weeks of grafting of defects. The BHA is economical; however, price difference between the two is very nominal.

The lateral periodontal cyst (LPC) is a harmless developmental aberration derived from odontogenic epithelia lying between the roots of vital teeth. The exact histogenesis of LPC is a matter of debate but therapy is usually only required to maintain stable periodontal conditions and in case of evidence for growth of the cyst. We report on a case of LPC where successful surgical therapy had initialized osseous restoration. We further discuss the value of histological findings to substantiate a clinical and radiological diagnosis., (Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

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.

Background: Third molar surgery is considered the most frequently performed procedure in oral surgery. Although there are some indications for the removal of this tooth, such as the possibility of cystic degeneration or a tumor of the adjacent pericoronal follicle, there is no consensus in the literature about their prophylactic removal., Objectives: The aims of this study were to investigate the pathological alterations related to mandibular third molar dental follicles and to perform a narrative literature review., Methods: A prospective clinical, radiographic, and histopathologic study was conducted with pericoronal follicles of third molars. After histopathologic evaluation and establishment of diagnosis, 2 groups were defined: G1 (pericoronal tissues with pathological alterations based on histopathologic analysis) and G2 (pericoronal tissues without pathological alterations based on histopathologic analysis). In addition, a systematic review of the literature was performed., Results: One hundred thirteen specimens were analyzed. G1 was the most prevalent (P = 0.0004). Lesions were found in patients between 20 and 25 years of age (P < 0.004). The most prevalent histological diagnosis was the paradental cyst (47.7%; P < 0.0001). The narrative literature review showed that the majority of cases were mainly dentigerous cysts (P < 0.05)., Conclusions: The mandibular third molars in young adults showed a direct relationship with age and a statistical propensity for the development of these cystic alterations, notably paradental cysts.

The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without extraction of the adjacent tooth was performed. Lesion samples were sent for histopathological analysis. The histopathological analysis revealed a thin, non keratinised stratified squamous epithelium resembling reduced enamel epithelium. Epithelial plaques were also seen. A clinicopathological correlation incorporating the surgical, radiographical and gold standard histopathological findings was obtained to suggest the final diagnosis of the bilateral lateral periodontal cyst.

Aim: The aim is to radiographically quantify the bone density and relate the same with observer strategy in the bone healing., Objectives: To assess pattern of bone regeneration following grafting of defects with hydroxyapatite after apicoectomy/cystic enucleation., Materials and Methods: An observer strategy involving trained and experienced examiners used in large series of cases, evaluated radiographically over a period of 1 year with intervals. The cases were grouped into different categories depending on (1) surgical site outline merging with material margin, (2) internal portion of surgical site (i.e. bone formation characteristics) and (3) density of surgical site. The radiographs examined by blind process and the findings were tabulated. Operating surgeon (oral surgeon) has done the interpretation of data to create observer strategy of grafting cases., Observations and Results: The outline of the defect was changed, partly reduced and completely absent along with remodeling, which showed ground glass, specular or trabecular pattern of bone over a time with increasing density correlating bone regeneration within a short duration. The applied strategy and classification are recommended for follow-up studies. In this study the characteristics of the new bone formation were also delineated. This strategy is helpful for follow-up studies; implant procedures and so; to know quality and condition of bone after treatment.

The aim of the present study was to investigate the reasons for the persistence of primary teeth and also use panoramic radiography to determine the characteristics of persistence teeth. Four-hundred and twenty-six panoramic radiographies, which diagnosed one or more retained primary teeth, were selected from 100,577 panoramic radiographic image files from nine clinics and six different cities in Turkey. The selected radiographies were evaluated to determine the reasons for the persistence of primary teeth; furthermore, this study analyzed the characteristics of the retained primary teeth including tooth type, number, location, and root resorption, and whether, or not, the primary teeth showed evidence of pathological conditions, such as periodontal problems, caries, ankylosis, infra-occlusions, or tipping of the adjacent permanent teeth. Six hundred and seventy-seven retained primary teeth were determined in 426 patients (148 males and 278 females). Retained primary teeth were found most frequently in the mandible rather than the maxilla and the left side was more frequently affected than the right side. Level 1 was found as a most frequently encountered root resorption level. Within the limitation of the present study, the most common type of persistent primary teeth seen on the dental arch were mandibular primary second molars, followed by maxillary primary canines. The most frequent reason for the persistence was the congenital absence of successors to the primary teeth, followed by impaction of the successor teeth.

Lateral periodontal cyst (LPC) is a developmental jaw cyst of odontogenic origin. It has characteristic histopathologic features that are identical to those seen in the peripherally occurring gingival cyst of adults (GCA). The polycystic variant of LPC is termed the botryoid odontogenic cyst (BOC). The histogenetic origin of LPC is probably the rests of dental lamina in the alveolar bone. In the case of BOC, it might be that several adjacent epithelial rests simultaneously undergo cystic change and eventually form a polycystic lesion. Few previous examples of multifocal occurrence of LPC can be found in the literature. We report an additional 4 patients with this rare presentation of multiple, separate LPCs, and review the literature on this topic., (Copyright © 2011 Mosby, Inc. All rights reserved.)

Introduction: The lateral periodontal cyst is an uncommon odontogenic developmental lesion and chiefly arises in the alveolar bone between the roots of a pair of erupted teeth or lateral to a tooth root. Two atypical cases of the lateral periodontal cyst occurring in periapical sites are reported., Methods: Both lesions presented as an incidental radiographic finding, appearing as an apical radiolucency with well-circumscribed sclerotic borders. One lesion, initially suspected to be of pulpal origin, persisted after endodontic therapy; the other case was first considered to be an odontogenic keratocyst. A biopsy was performed on each patient for lesional identity., Results: Histopathologic assessment of each lesion was consistent with a lateral periodontal cyst and revealed thin, nonkeratinized epithelial linings containing nodular plaques and clear cells. The cyst walls were thickened and had minimal inflammation., Conclusions: The featured cases show that the lateral periodontal cyst is not always confined to the interradicular region and can masquerade as a lesion of endodontic origin. Aberrant cases warrant long-term surveillance., (Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: The paradental cyst is an uncommon lesion associated with the permanent mandibular first or second molar in children just prior to tooth eruption. The purpose of this article is to present two cases of paradental cyst affecting the buccal aspect of permanent mandibular first molar of both young patients. We also discuss diagnosis, treatment and radiographic findings of the cases., Patients and Methods: In both cases was made only the enucleation of cyst without extraction of the adjacent tooth. Lesional samples were sent for histopathologic analysis., Results: The histopathologic analysis of both cases, revealed a lining of hyperplastic, nonkeratinized squamous epithelium with heavy, dense inflammatory cell infiltrate in the epithelium and connective tissue wall. The histopathology associated with macroscopic and radiographic examination permitted the definitive diagnosis of a paradental cyst on the mandibular left first molar. A follow-up of 1 year was carried out in both cases and no recurrences was noted; in the first case was observed the correct eruption of the mandibular permanent left first molar., Conclusions: A clinicopathologic correlation, incorporating the surgical, radiographic, and histological finding, is required to obtain the final diagnosis of paradental cyst. Today, the treatment of choice is simple enucleation and thorough curettage of the cyst without extraction of the involved tooth.

Background: The buccal bifurcation cyst (BBC) is a paradental cyst that typically presents on the buccal aspect of mandibular permanent first molars in children 6 to 11 years of age. Histopathologic features are non-specific and closely resemble other inflammatory odontogenic cysts. The aim of this article is to report a case of a BBC and to review the management of such lesions., Methods: A 7-year-old white male, complaining of lower right tooth pain and swelling, presented to the Nationwide Children's Hospital Dental Clinic. A clinical examination revealed no caries and swelling localized to the area approximating tooth #30 with a 15-mm probing depth on the buccal aspect. Radiographs revealed a radiolucency involving the bifurcation and root area of tooth #30, accompanied by the distal displacement of unerupted tooth #31. Therapy consisted of a simple surgical enucleation of the cyst., Results: A microscopic evaluation revealed a chronically inflamed cyst lined by a non-keratinized stratified squamous epithelium. The immediate postoperative course was uneventful. At 14 months postoperatively, the development of teeth #30 and #31 was noted as normal. Probing depths around tooth #30 were

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.

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.

The lateral periodontal cyst and the botryoid odontogenic cyst are two rare nosological entities, who, despite their radiological and clinical presentation can only be diagnosed by their rather typical histopathological characteristics. The purpose of this article is to report two cases of radiolucent cystic lesions of the mandible, located in the premolar area, with a clinical and radiographic diagnosis of residual cyst, which showed histological features of a lateral periodontal cyst. Histopathologically, the lateral periodontal cyst lining is characterized by a thin cuboidal to stratified squamous non-keratinizing epithelium, ranging from one to five cell layers and presence of one or more epithelial thickenings or plaques. Furthermore, glycogen-rich clear cells encountered either in the epithelial plaques or in the superficial layer of the lining epithelium.

The purpose of this study was to observe histologically the sequence of events leading to resolution of periradicular tissues, with a view to advancing the perception of periapical healing. Our material consisted of periapical specimens obtained from 15 single-rooted, endodontically treated teeth of patients aged 25-40 years. All the teeth required extraction because of complicated crown-root fracture following trauma, iatrogenic aetiology (cervical root resorption following bleaching) or extensive carious lesions. The patients were informed that, based on their clinical condition, surgical procedures should be performed under flap reflection in order to extract the fractured root. Informed consent, which was necessary for the surgery, was obtained in all cases. A small block section containing the apical root tip and surrounding periapical tissues was removed prior to root extraction. The results of histological examination revealed osteoblastic activty and osteoid bone formation six days after the root canal instrumentation. Periapical tissue healing was observed despite the presence of overfilled material. The lining epithelium was infiltrated with chronic inflammatory cells and surrounded by collagen bundles and newly formed bone.

Objectives: We investigated the occurrence of inflammatory paradental cysts (IPC) in the mandibular premolar, and demonstrated the points of difference with regard to diagnostic features between IPC and dentigerous cysts (DC)., Material and Methods: We analyzed the radiographs and histology of 60 cases with a cystic lesion associated with inflammation in the mandibular premolar region based on diagnostic criteria as IPC., Results: In 4 out of 60 cases, we diagnosed the 4 cysts as IPCs in the mandibular premolar region, and recognized that one form of IPC was similar to a mandibular infected buccal cyst. The other 56 non-IPC cases were diagnosed as DC. On the IPCs, the permanent tooth normally erupted in all 4 cases after treatment, but in one case, the IPC recurred., Conclusions: The present investigation suggested that we might have misdiagnosed IPCs in the mandibular premolar region as DC to date. It is important to consider the differences between IPC and DC with regard to the causes of recurrence during treatment of IPC.

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.

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 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.

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.

Objective: The aim of the study was to evaluate the clinicopathologic features of 54 paradental cysts., Method and Materials: The cases were retrieved from the files of the Department of Oral Pathology of the University of São Paulo, in Brazil. Only case files that included complete data, radiographs, and clinical history were used for the study., Results: Most of the cysts were adjacent to a partially erupted mandibular third molar; only two cysts were adjacent to mandibular second molars, and one cyst was adjacent to a first molar. Women were affected more often than were men (33:21), and most of the patients were in their second or third decades. In most cases, the affected tooth had a history of one or more episodes of pericoronitis. Histologically, these cysts presented the typical features of an inflammatory cyst, having a lining epithelium, which apparently resulted from a union between reduced enamel epithelium and oral epithelium., Conclusion: Development of the paradental cyst could be avoided if episodes of pericoronitis were properly treated, because the cyst is usually related to pericoronitis.

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.

The lateral periodontal cyst (LPC) is a relatively uncommon but widely recognized odontogenic cyst of developmental origin. It is found mostly in adults and has no sex predilection. LPC is usually discovered during routine radiographic examination, is located mainly between the roots of vital mandibular canines and premolars, and seldom causes pain or other clinical symptoms. The defect appears on radiographs as a round or teardrop-shaped, well circumscribed radiolucency. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. In this paper, two cases of lateral periodontal cysts are presented. In the first case, the patient (woman, 62 years old) complained of an asymptomatic gingival swelling in the region between the right maxillary canine and premolar. The radiographic examination revealed a well circumscribed radiolucency with a radiopaque margin between the roots of the canine and premolar. The adjacent teeth had vital pulp. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin". In the second case, the patient (women, 44 years old) complained of a swelling in the area of tooth 32. During radiographic examination a well circumscribed radiolucency between the roots of the lateral incisor and the canine was discovered. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin".

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.