Radicular cysts are the most prevalent odontogenic cysts, making up around 60% of jaw cysts and 15% of periapical lesions, typically resulting from dental infections or pulp necrosis. Generally asymptomatic and slow-growing, radicular cysts may lead to complications like abscess formation; they exhibit specific radiographic features that resemble periapical granulomas and contain straw-colored fluid with cholesterol crystals. Treatment often involves root canal therapy or tooth extraction to prevent recurrence or the development of residual cysts.

1. Sayyed Jani
BDS

2.  Most common odontogenic cyst
 Around 60% of all jaw cysts and 15% of all periapical lesions are Radicular cyst.
 It is an inflammatory odontogenic cyst surrounding the periapical region of tooth.

3.  It occurs as a result of
(a) Bacterial infections
(b) Necrosis of Dental pulp
(c) Dental caries

4. Gender prediction: Males > Females
Age prediction: 20 to 60 years
Site of occurance: Commonly maxillary anteriors followed by mandibular
premolars and molars .
Origin: odontogenic

5.  Asymptomatic mostly
 painless slow growing swelling
 associated teeth shows sensitive to percussion
 Rarely causes expansion of cortical plates
 Long standing of cyst may undergo an acute exacerbation
of inflammatory process and develop rapidly into abscess
and then may proceed to cellulitis or form a draining fistula.
 On aspiration we can see straw coloured fluid with
cholesterol crystals.

6.  Radiographic features are similar to Periapical Granuloma.
 We can’t differentiate between Radicular cyst and
Periapical Granuloma.
 Unicystic radiolucent areas are seen which are
surrounded by thin radiopaque line which indicates
reaction of bone to the slowly expanding mass.

7.  Lining epithelium is Non keratinized stratified squamous epithelium.
 Epithelium shows spongiosis and inflammatory cell infiltration.
 Epithelium shows arcading pattern
 Epithelium shows Rushton bodies .
 Rushton bodies - arc shaped ; eosinophilic ; hyaline bodies. They are refractile ;
amorphous in structure; Brittle in nature . There is no clinical significance and
their origin is unknown. They are also seen in residual cyst .
 Connective tissue – delicate with dense inflammatory cell infiltration.
 Deeper portion of connective tissue is more fibrous.
 Cystic lumen contains straw coloured fluid with cholesterol crystals.

9.  Root canal therapy of the involved teeth along with periapical surgery or
extraction of involved tooth followed by periapical curettage .
 If the cyst is incompletly removed then the remnant cells may develop into
Residual cyst.