Radicular Cyst

Radicular Cysts . Cysts are fluid-filled cavity pathological semi-liquid or gaseous materials are usually walled connective tissue and contains fluid or semi-viscous liquid, it can be in soft or hard tissue like bone. Cyst cavity in the oral cavity is always limited by the epithelial layer and the outside covered with connective tissue and blood vessels.
Radicular cyst is also called periapical cyst. These cysts are the most common type of cyst was found. Radicular cyst is formed by the chronic irritation that is not vital teeth. These cysts grow from the epithelial rest of Malassez proliferation experiencing due to the inflammatory response triggered by bacterial infection due to pulp necrosis
Periapical cyst is a cyst that forms on the tip apex (root) of the teeth which had nonvital tissue pulpanya / off. Cyst is a continuation of pulpitis (inflammation of the pulp). Can occur in any tooth tip, and can occur at any age. Its size ranges from 0.5-2 cm, but can also more. When the cysts reach a large diameter, it can cause the face to be no symmetry because of the lump and may even cause paresthesias due to suppression of nerve by the cyst. In X-ray examinations radicular cyst will appear radiolucent bounded clear picture.
The general pattern of growth of a cyst is due to stimulation (cytokinase) on the remnants of epithelial cell growth and proliferation which then experienced in its growth does not invade surrounding tissue. The remaining epithelium will then proliferate to form a solid mass. Then the masses will be getting bigger so that the epithelial cells in the center of mass will lose blood flow, so that the flow of nutrients that occurs through a diffusion process will be interrupted. Death of cells in the center of mass will cause the cyst to form a fluid-filled cavity that is hipertonis. Hipertonis circumstances will cause the transudation of fluid from the extra lumen toward the lumen. The result is the hydrostatic pressure resulting in the growing mass of cysts. The process of enlargement of the mass of cysts can continue berlangsuung, sometimes until it can occur due to the expansion of mass parastesia mild nerve to suppress the onset of pain.
These cysts do not cause complaints or pain, except for an infected cyst. On radiographic examination, the cyst periapical dental granulomas show a picture like that is clearly bounded radiolucent lesion around the apex of the tooth in question and the edges like a thin layer of a compact such as the lamina dura.
Almost all radicular cysts derived from periapical granuloma that occurred previously. These cysts are also caused by continuing inflammation that occurs initially in the pulp, which then extends beneath the periapical tissues.
Pathophysiology of radicular cyst that is initiated from the pulp tissue inflammation that over time cause periapical inflammation. This inflammation stimulates the epithelial-rest malassez contained in the periodontal ligament resulting in periapical granuloma formation that can be infected or sterile. Finally, the epithelium had necrosis due to loss of blood supply and granuloma turn into cysts.
Residual cyst is a cyst caused by inflammation at the root fragments left behind when the revocation or the presence of residual granulomas that are not picked up during retraction. On clinical examination toothless jaws obtained by extraction and history had ever done in the radiology images found radiolucent image. In histopathological characterized by the presence of a cavity is covered with epithelium that did not experience keratinization squamosa and have varying thickness. Typically the process of inflammation can be seen by the discovery of many neutrophil cells in the cyst wall. Care is to do a residual cyst enucleation and generally does not occur recurrences.
Treatment consisted of root canal treatment or tooth extraction and cysts curettaged concerned. Can also be treated by means Marsupialisasi and enucleation.