Radicular cysts are among the most common odontogenic cystic lesions in the maxillofacial region. This case report details the management of a large radicular cyst in the anterior maxillary region of a 32-year-old female patient and includes a literature review on such cysts. The patient underwent cyst decompression, surgical enucleation, tooth extractions, root canal treatments, periapical curettage, and prosthetic rehabilitation. This study underscores the effectiveness of conservative approaches, such as decompression, in reducing cyst size and highlights the importance of individualized treatment plans for achieving optimal outcomes and preventing recurrence. Collaborative efforts between clinicians and multidisciplinary teams are crucial for managing radicular cysts and ensuring long-term oral health for patients.

Periapical cysts of primary teeth are pathologic entities which are seldom encountered in the clinical practice. Most frequently, these lesions arise in correspondence with primary teeth presenting previous pulp therapy, severe carious lesions, or a history of previous trauma. The aim of the present study is to systematically review the treatment modalities of periapical cysts of the deciduous, along with the reporting of a clinical case.
A case of periapical cyst treated with marsupialization occurring in an 11-year-old patient is described. A literature search was devised to retrieve studies reporting the treatment of periapical cysts, and involved papers published in the Cochrane Oral Health Group specialist trials, MEDLINE via PubMed, and EMBASE up to March 2023. A total of 39 articles were retrieved. Following title and abstract analysis, 27 articles were selected for full-text analysis, with the final inclusion of 24 articles.
Periapical cysts of primary teeth present an overall good prognosis irrespective of the treatment option adopted. The performance of a prompt diagnosis appears of utmost importance, as the extraction of the primary teeth involved implies the management of the residual space for the correct positioning of the corresponding permanent teeth.

Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.
畸形舌侧沟是上颌切牙尤其是侧切牙常见的发育畸形，常引起牙周组织的破坏。本文报告1例畸形舌侧沟引发的牙周-牙髓联合病变误诊为单纯的根尖周囊肿的病例，经完善根管治疗及根尖周囊肿刮除术后病程迁延不愈，造成患牙区域颊、颚侧骨板缺如，后通过拔除患牙同期行位点保存术，后期配合种植修复，得到临床治愈。畸形舌侧沟隐匿性强、临床表现往往不典型，如有上颌侧切牙脓包反复发作或深牙周袋持续存在，应完善影像学检查，必要时行牙周翻瓣术探查牙根面形态。.

In endodontics, accurate diagnoses are important for the selection of appropriate and successful therapy. Several nonendodontic entities in periapical location may resemble those of inflammatory endodontic origin and impact therapeutic approaches. The aim of this study was to review noninflammatory entities mimicking dentoalveolar abscesses or apical periodontitis and to discuss clinical and pathological features. In this review study, the authenticated search engine in PubMed (MEDLINE) database was used to find articles by using \"Nonvital Pulp Dentoalveolar Abscess\", \"Nonvital Pulp And Apical Periodontitis\", \"Periapical Abscess\", \"Chronic Dentoalveolar Abscess\", \"Chronic Apical Periodontitis\", \"Periapical Granuloma\", And \"Radicular Cyst\". Each of these predefined keywords were combined with the terms \"Misdiagnosed\", \"Mimicking\", \"Masquerading\", or \"Simulating\" to search for reported cases indexed from 1978 to 2020. All case reports fulfilling the selection criteria were reviewed to identify radiolucent nonendodontic periapical lesions focused on the questions: \"Which pathological entities mimick radiolucent endodontic lesions in periapical location? Based on endodontic clinical parameters, what are the contrasting features?\" Out of 426 articles, 111 were relevant to the subject, including a series of cases and case reports. Only well-documented English and recent papers were considered. A total of 30 noninflammatory entities appeared clinically as radiolucent endodontic lesion in periapical location. Lesions simulating chronic apical periodontitis represented 83.3% and dentoalveolar abscess 16.7%. Interestingly, primary malignancies and metastasis counted 43.3% and pain was a typical symptom. Swelling was a noncontributory clinical feature in distinguishing periapical lesions. Lack of pulp response was registered in 68.4% of nonedodontic lesions. A flowchart was generated to summarize clinicopathological aspects of radiolucent nonendodontic entities appearing as dentoalveolar abscesses or apical periodontitis In relation to clinical practice, it is very important for us to note that, a group of pathological entities may simulate radiolucencies of endodontic origin in periapical location, especially malignancies and non-inflammatory odontogenic lesions.

Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding to IPL increasingly deepened, IPL classification based on different elements was proposed although there still lacks an overall classification system. This study, aiming to systematically integrate the available data published in the literature on IPL associated with histopathology, proposed a comprehensive classification framework and treatment decision tree for IPL.
English articles on the topic of \"implant periapical lesion\", \"retrograde peri-implantitis\" and \"apical peri-implantitis\" were searched on PubMed, Embase and Web of Science from 1992 to 2021, and citation retrieval was performed for critical articles. Definite histopathology and radiology of IPL are indispensable criteria for including the article in the literature. The protocol was registered in PROSPERO (CRD42022378001). A total of 509 papers identified, 28 studies were included in this review. In only one retrospective study, 37 of 39 IPL were reported to be at the inflammatory or abscess stage. 27 cases (37 implants) were reported, including acute non-suppurative (1/37, developed to chronic granuloma), chronic granuloma (5/37), acute suppurated (2/37), chronic suppurated-fistulized (6/37), implant periapical cyst (21/37), poor bone healing (2/37), foreign body reaction (1/37). Antibiotics alone did not appear to be effective, and the consequence of surgical debridement required cautious interpretation because of the heterogeneity of lesion course and operation. Implant apicoectomy and marsupialization were predictable approaches in some cases.
The diversiform nature of IPL in the case reports confirms the need for such histopathological classification, which may enhance the comparison and management of different category.

The aim of this study was to report a rare case of nasopalatine duct cyst with sebaceous differentiation. Further, a systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation.
A 55-year-old Korean man was referred to our hospital because of a cystic lesion of the anterior maxilla. Radiologic examination revealed a well-circumscribed radiolucent lesion in the anterior maxilla. Histology showed a respiratory columnar and cuboidal epithelium-lined cyst. Transition from the ciliated columnar epithelium to stratified squamous epithelium with sebaceous differentiation was observed. Based on these findings, the final diagnosis was nasopalatine duct cyst with sebaceous differentiation. A systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation. There were 24 cases of sebaceous differentiation in the epithelium of the cysts including 2 odontogenic keratocysts, 8 orthokeratinized odontogenic cysts, 8 dentigerous cysts, 1 radicular cyst, and 2 glandular odontogenic cysts. However, no case reports describing the occurrence of nasopalatine duct cysts with sebaceous differentiation have been reported.
This first case report of nasopalatine duct cysts with sebaceous differentiation could provide insight into the diagnostic process of cystic lesions with sebaceous differentiation.

The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson\'s chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

BACKGROUND: This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts.
METHODS: A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD [Blinding]). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool.
RESULTS: Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates.
CONCLUSIONS: The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible.

OBJECTIVE: To assess epidemiological, clinical, and radiographic characteristics of odontogenic cysts (OCs) in a South Brazilian sample and to compare the results with international literature.
METHODS: For the main study purposes, biopsy and histopathological records were retrospectively analyzed from December 2006 to December 2018, OC cases were selected, and data about clinical characteristics were evaluated. Further, a literature review was performed for similar studies.
RESULTS: In the main study, the prevalence of OCs was 11.26% (n = 406), the majority of patients was male (56.73%), and the mean age was 39 ± 17.33 years. Radicular cyst was the most common OC (46.06%), followed by the odontogenic keratocyst (15.02%), dentigerous cyst (14.04%), and paradental cyst (13.55%). Inflammatory OCs were more prevalent in the maxilla (54.84%) and developmental cysts in the mandible (69.92%) (p < 0.05). Individuals with inflammatory OCs were usually older (41.0 ± 15.34 years) than the ones with developmental OC (28.0 ± 19.68 years) (p < 0.05). Regarding the literature review, 22 articles were included. Analysis of pooled data showed that global prevalence of OCs was 11.62% (95%CI = 9.97-13.37), from which radicular cyst was the most common (54.26%; 95%CI = 49.30-59.18), followed by dentigerous cyst (22.94%; 95%CI = 19.22-26.89) and odontogenic keratocyst (11.99%; 95%CI = 8.88-15.49). Furthermore, studies from Asia (72.40%; 95%CI = 70.30-74.40) and South America (68.48%; 95%CI = 64.07-72.72) presented the highest frequencies of inflammatory OCs.
CONCLUSIONS: The main study showed that the prevalence of OCs was 11.26%, which corroborates with international literature. Considering geographic variability of OC distribution, public health authorities and researchers could use these data for the development of focused prevention interventions, especially with regard to inflammatory OCs.

The purpose of this study was to report the clinical efficacy of decompression for 3 cases with large periapical lesions and to review technique details. Three cases with large periapical cystic lesions were treated with decompression after root canal treatment. A traditional decompression technique was used for the first case. After aspiration, mucogingival incision, irrigation, and incisional biopsy, a pediatric endotracheal tube was sutured in place and kept for 3 weeks for lesion debridement. An aspiration/irrigation technique was adopted for the second case. An 18-G needle with a syringe was used to aspirate the cystic lesion. Two needles were then inserted into the lesion; copious saline irrigation was delivered from 1 needle and until clear saline was expressed from the other. For the third case, decompression was accomplished with a surgical catheter that was subsequently replaced with a gutta-percha plug after 1 month. None of the 3 cases underwent complete enucleation and root-end surgery. Healed lesions or lesions in healing were observed after 1 to 2 years. Based on the presented cases and published case reports on decompression, a literature review was provided covering indications, technique details, modification, and prognosis of decompression in endodontics. For large periapical cystic lesions, conservative decompression may be used for certain cases before or in lieu of apical surgery. Decompression enables healing of large, persistent periapical lesions after root canal treatment.