Histopathology of Radicular Cysts
Histopathology of Radicular Cysts
Objectives
By the end of these revision notes, you should be able to:
What are Radicular Cysts?
Radicular cysts are the most common type of odontogenic cyst. They arise from the epithelial remnants of the periodontal ligament (rest cells of Malassez), following chronic pulpal infection. It is an inflammatory cyst associated with the apex of a non-vital tooth.
Radicular cysts can also be found when a tooth has already been extracted and the cyst has persisted – this is referred to as a residual cyst.
Pathogenesis of Radicular Cysts
The development of a radicular cyst can be broadly divided in to three key stages:
- Initiation – chronic inflammation occurs due to long-standing pulpal necrosis. This stimulates proliferation of the epithelial rests of Malassez (typically around the apical third)
- Cyst development – as the cells proliferate, larger islands begin to form and breakdown (cavitation). This leads to a cyst cavity forming
- Cyst enlargement – the cyst gradually then begins to enlarge due to osmotic pressure. Bone resorption also occurs as expansion occurs – this may be due to the action of prostagladins
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