Residual cysts masquerading as periapical lesions: three case reports

Area of Science:

• Oral pathology
• Odontogenic cysts
• Dental radiology

Background:

• Residual cysts are inflammatory odontogenic cysts that develop from the remnants of the Hertwig's epithelial root sheath after tooth extraction.
• These lesions can remain asymptomatic and undetected for prolonged periods.
• Their radiographic appearance can be challenging to differentiate from other periapical pathologies.

Observation:

• Three cases are presented where residual cysts were found adjacent to a remaining tooth.
• The radiographic presentation of these residual cysts mimicked periapical lesions associated with the adjacent vital teeth.
• Clinical and radiographic examination alone was insufficient for definitive diagnosis in these instances.

Findings:

• The study highlights the diagnostic challenge posed by residual cysts when located near vital teeth.
• Histopathological examination confirmed the diagnosis of residual cyst in all reported cases.
• Misinterpretation of radiographic findings can lead to inappropriate treatment planning.

Implications:

• Accurate diagnosis of residual cysts adjacent to remaining teeth is crucial for appropriate management.
• Awareness of this diagnostic pitfall can prevent unnecessary endodontic or surgical interventions on vital teeth.
• Further research into advanced imaging techniques may aid in differentiating these lesions.