AÇBİD- 10th International Congress- 2016, Antalya, Türkiye, 11 - 15 Mayıs 2016, ss.200
Radicular cysts are the most common type of cystic lesions occurring in jaws. They originate from epithelial remnants of the periodontal ligament as a result of inflammation that is generally a consequence of pulp necrosis. Caries is the most frequent aetiological factor of radicular cysts in the primary dentition. They may also be a result of traumatic injuries to primary teeth. Most radicular cysts develop slowly and do not reach very large borders. Patients do not experience pain unless acute inflammatory exacerbation is present and the lesions are often detected only during routine radiographic examination. If the cyst becomes larger, symptoms including swelling, mild sensitivity, tooth mobility, paresthesia and displacement may be observed. The affected tooth does not respond to pulpal, thermal or electrical vitality tests. The radiographic pattern of radicular cysts are observed with generally loss of the lamina dura along the adjacent root, and a round or oval radiolucent lesion circumscribed by a well-defined radiopaque line involving the tooth. This radiopaque line sometimes can not be seen in infected or rapidly growing cysts. In our case, a small radicular lesion between mandibular canines (2.3 x 1.3 cm) was observed at the anterior mandible and the patient was consulted to endodontics department. But patient neglected the endodontic treatment. After 4 years, he referred to our clinic again with pain and paresthesia at anterior mandible. Radiographic examinations were performed and very large (8,3 x 2,3 cm) bilaterally mandibular cyst between mandibular second molars, was seen. A large surgical enucleation and multiply apical resections were performed while preventing mental and inferior alveolar nerves bilaterally.After reposing the mental nerve and surgical enucleation, all symptoms including paresthesia has disappeared. As a conclusion, while the treatments of the small radicular cystic lesions could be treated with only endodontic treatment or conservative surgery, neglection of the treatment would make the surgery more complex and that may give rise serious complications such as neurosensorial disturbances and fractures of jaws.