Definition, Characteristics, and Diagnosis of Lateral Periodontal Cyst
- Lateral periodontal cyst is a type of cyst found in the oral and maxillofacial region.
- It is a developmental odontogenic cyst.
- The cyst is usually asymptomatic and discovered incidentally during routine dental examinations.
- It is most commonly found in the mandibular premolar and canine region.
- Histologically, the cyst is lined by nonkeratinized stratified squamous epithelium.
- Lateral periodontal cysts are often small and have well-defined borders.
- They may cause expansion of the cortical bone in the affected area.
- Radiographically, the cyst appears as a unilocular radiolucency with a thin radiopaque border.
- Differential diagnosis includes other odontogenic cysts and periapical lesions.
- Definitive diagnosis is made through histopathological examination of the cyst lining.
Treatment and Management of Lateral Periodontal Cyst
- Enucleation, or complete surgical removal of the cyst, is the most common treatment approach.
- In some cases, marsupialization may be performed.
- Adjunctive measures such as guided bone regeneration may be used to promote bone regeneration.
- Regular follow-up and monitoring is necessary to detect any recurrence of the cyst.
- Prognosis is generally favorable, with a low recurrence rate reported.
Complications and Associated Conditions of Lateral Periodontal Cyst
- Squamous-cell carcinoma can rarely arise within a lateral periodontal cyst.
- Pigmented lateral periodontal cysts and other pigmented odontogenic lesions have been reported.
- The lateral periodontal cyst has been associated with the botryoid odontogenic cyst.
- The cyst may cause displacement or resorption of adjacent teeth.
- In rare cases, the cyst may be associated with root resorption.
Research and Literature on Lateral Periodontal Cyst
- Several studies have been conducted to analyze the clinical significance, etiology, and diagnosis of lateral periodontal cyst.
- A case report and review of pertinent literature have been published, highlighting a successful treatment approach using enucleation and guided bone regeneration.
- The lateral periodontal cyst has been discussed in dental association journals and oral pathology textbooks.
- Multifactorial analysis of a series of lateral periodontal cyst cases has been conducted.
- Research has been conducted on the pigmented lateral periodontal cyst and other pigmented odontogenic lesions.
Formation, Pathophysiology, Classification, Diagnosis, Prognosis, and Predictive Factors of Lateral Periodontal Cyst
- Controversial origin with three etiopathological hypotheses.
- Hypothesis suggests cyst is lined by nonkeratinized epithelium reminiscent of reduced enamel epithelium.
- Histopathologically presents glycogen-rich clear cells, similar to dental lamina remnants.
- Epithelial cell rests of Malassez in roots surface play a role in cyst formation.
- Other theories propose pulpal infection or chronic periodontal disease as possible causes.
- Two morphological types: Unicystic and Multicystic.
- Botryoid odontogenic cyst was once classified as a variant but opposed by some researchers.
- Cells of origin for both cysts may be the same.
- Asymptomatic and usually detected in routine radiography.
- Insidious onset with a yearly growth rate of 0.7mm.
- Adjacent teeth vitality important for differential diagnosis.
- Radiographically presents as a rounded, teardrop-shaped radiolucency.
- Surgical removal required, with bone regeneration occurring within 6 months to 1 year.
“Lateral periodontal cysts (LPCs) are defined as non-keratinised and non-inflammatory developmental cysts located adjacent or lateral to the root of a vital tooth.” LPCs are a rare form of jaw cysts, with the same histopathological characteristics as gingival cysts of adults (GCA). Hence LPCs are regarded as the intraosseous form of the extraosseous GCA. They are commonly found along the lateral periodontium or within the bone between the roots of vital teeth, around mandibular canines and premolars. Standish and Shafer reported the first well-documented case of LPCs in 1958, followed by Holder and Kunkel in the same year although it was called a periodontal cyst. Since then, there has been more than 270 well-documented cases of LPCs in literature.