Radicular cysts. Some aspects of the problem with a case description

Bulgarian Medical Journal, 2025, 19(1), 66-71.

Kh. Fakih

Department of Oral and Maxillofacial Surgery at FDM – MU – Sofia

Abstract. Radicular cysts (RC) are the most common odontogenic lesions in the jaw bones. Differential diagnosis is made with lateral RC originating from an accessory canal, with keratocyst, with periodontal cyst and with ameloblastoma, as well as with odontogenic tumors. When RCs are smaller in size, diff erentiation between them and granuloma is diffi cult. There are diff erent methods of treatment of RCs in terms of eff ectiveness. Their application depends on the size of the cystic lesion and the tooth(s) involved in it, stability and perspective of the tooth in function with one or another treatment, size of the bone lesion around it and cooperation of the patient. These individual features of each individual case divide the treatment approaches into the following groups: conservative; surgical-conservative; surgical. A case of a patient with a RK measuring 9.90 mm x 9.62 mm in the area of teeth 26 and 27, which protrudes into the sinus cavity, is presented. This necessitated the treatment strategy to foresee the behavior in the event of a possible complication (perforation of the sinus mucosa) with plasty of the adjacent tissues to close the sinus. Nine months after the surgical intervention for the extraction of 26, 27 with extirpation of the cyst, healing of the bone structure in the area of the extracted teeth and intact sinus mucosa were observed.

Key words: radicular cysts, incidence, treatment, complications

Address for correspondence: Assoc. Prof. Khodor Fakih, e-mail: