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Endo tips    Better Endo    Endo abstracts    Endo discussions

Cyst removal
The opinions within this web page are not ours. Authors have been credited
for the individual posts and images where they are.

From: Marcela
On 21st Feb 2007, Marcela wrote in ROOTS:

Hi folks, Yesterday I did the extractions of the unrestored rest of 
roots and removed  this cyst in the 23 years old boy patient. I am 
very happy because I know that the cyst  was completely extracted. 
I send all the pictures attached.

Although I had stuff (bone), I "couldnīt" fill the cavity with anything 
because the patient couldnīt affort that (the surgery was done under 
the NHS). Which what should exactly fill this hole??? All comments are 
very welcome - Marcela



hi Marcela. good work. HI Marcela,
thanks for the radiographs.. however i am unable to make out what cyst 
it is...what du think.? well, i should say tat his oral hygiene s very 
poor indeed !! see those adjacent teeth !!!  - Joseph

Are you serious? ;-) Canīt you see the cyst in ULQ? Between UL1-UL2
Look in this OPG - Marcela

Sorry Marcela, you cannot diagnose a "cyst" reliably via radiograph.  
The only way  that you can confirm the cystic nature of the tissue 
removed is by having it biopsied.  You DID have it biopsied, did you not?

References:

"It is impossible to diagnose periapical lesions with any degree of 
accuracy unless  a biopsy is taken and the tissue is examined under 
the microscope, even though the  incidence of cysts is greater for 
larger lesions." ( Weine:  Endodontic Therapy 4th Ed.)

"apical periodontitis cannot be differentially diagnosed into cystic  
and noncystic  lesions based on radiographs alone". Pathways of the 
pulp  8th Ed. p. 492

Biopsy analysis should be standard protocol for all tissue removed 
from the body -  especially when a lesion like that can be easily 
enucleated. - Rob K

Dear Rob, I already knew that but in this case I diagnosed the cyst 
via "my own eyes".  I would have like to send it to a pathologist but 
we havenīt got any availabe. - Marcela

Pre-op cyst removal

Surgery 1

Surgery 2

Surgery 3 Sutures placed

UL2 cyst

Nice curves in mesial canal

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