Radicular Cyst

Radicular cysts are located at the root tips of the teeth (Fig. 4.3). They arise from the epithelial rests of Malas-sez and are the cysts most frequently seen [34, 146].

They are lined by non-keratinising squamous epithelium. This epithelial lining may be thin and atro-phic or show elongated rete processes. In many cysts, cholesterol clefts with adjacent giant cells occur. With-

Fig. 4.3. Schematic drawing showing a bisected mandible. Left to right: examples of a dentigerous cyst, a lateral periodontal cyst and a radicular cyst (drawing by John de Groot)

in the cyst epithelium, hyaline bodies of various size and shape may be present (Fig. 4.4). The specific nature of these so-called Rushton bodies is unclear [95]. Occasionally, the lining squamous cells are admixed with mucous cells or ciliated cells (Fig. 4.5). Sometimes, the histologic pattern of the radicular cyst is complicated by extensive intramural proliferation of squamous epithelial nests of varying size, thus mimicking a squa-mous odontogenic tumour (see Sect. 4.4.1.4) [187]. The same histology may be shown by other jaw cysts, in particular when there are extensive inflammatory changes. When a radicular cyst is retained in the jaws after removal of the associated tooth, the lesion is called a residual cyst.

When complicated by inflammation, radicular cysts may cause pain and swelling. However, they may also be asymptomatic and fortuitously detected by radiographic examination of the dentition.

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