Radicular cysts occur as a result of untreated periapical periodontitis (granuloma).
A radicular cyst represents a central cavity located around the tooth apex (the top of the root) filled with fluid and lined with epithelium (layer of tissue similar to the surface of the oral mucosa). Cyst fluid is light yellow, viscous and rich in cholesterol. Cysts occur without symptoms (no pain) but in very large cysts there might be discomfort in the area of the cyst. They are usually detected on X-ray pictures by chance. Radicular cysts have a specific image of X-ray pictures. They represent a dark, circular or elliptical “bubble” around the tooth root, which has pushed the roots of the adjacent teeth. Furthermore, the boundary between the wall of the cyst and the bone appears as a thin white stripe (sclerotic shaft).

This constitutes a protective process of the bone, which resists the growth of cyst. The first sign of development of radicular cyst could be swelling in the jaw. The growth of the cyst leads to movement of the teeth sideways, resulting in their crowns tilting together and the roots separating from one another. The mobility of the teeth can be increased. The pulp (nerve) of the affected teeth is not responding to any irritating factors (because the tooth is dead). A cyst can form pus and progress to fistula (bone opening) in the area of the tooth root. The fistula is flat, slightly hollowed inward and barely visible. Under pressure yellowish liquid is released. The treatment is done depending on the size of the cyst and the symptoms that the patient experiences. It can be removed surgically through apical osteotomy for small cysts. The operations of large cysts are more complicated and depend on the size and the location of the cyst.

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