Cysta Radicularis Magna Maxillae: A Case Report and 5-Year Follow-Up

Abstract

BACKGROUND: An odontogenic cyst is a pathological, epithelial-lined cavity containing fluid or semi-fluid which arises from the epithelial remnants of tooth formation. These cysts may become increasingly obvious clinically as they increase in size, initially creating a bony hard swelling. As this gradually and slowly enlarges, the bony covering becomes increasingly thin, which clinically may be  demonstrated on palpation. Management of jaw cysts as a pathology requires a serious and thorough approach, and it begins at the first examination of the patient. The most important starting point is to analyze and find out the cause of the change, the duration of development, and the presence or absence of clinical symptoms. The use of 3D CBCT analysis of the jawbones provides an answer for the modality of surgical treatment, the proximity to certain anatomical structures, and the way to resolve postoperative bone defects.

CASE PRESENTATION: Twenty-three-year-old male, came with swelling on the left anterior side of the face, and above tooth 22. The swelling began 7 days earlier, and the patient had no other medical conditions and diseases. The radiographic examination shows radiopaque mass  between and above the root of tooth 22 in the anterior maxilla, confluent with other large radiopaque mass to the other teeth of this zone. A radical surgical approach was considered for cyst removal, and bone regeneration techniques for replenishment of the bony defect.

CONCLUSION: A radical surgical approach is the only treatment in most cases of large radicular cysts. It should be noted that the preoperative 3D analysis is also a key factor that dictates this radical approach. Bone augmentation techniques are a reliable and predictable method for filling in bone defects, and should always be combined and included in this treatment.