Authors:

Abdulaziz M. Alshahrani^1,2*, Larissa Marcia Martins Alves ^1,3

1. Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
2. Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
3. Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil.

DOI: 10.52338/cicasrep.2024.4146

Abstract:

Background: A radicular cyst (RC), also known as a periapical cyst, is the most common type of odontogenic cyst. It typically develops at the apex of a tooth’s root due to chronic inflammation following pulp necrosis, often resulting from untreated dental caries or trauma. A radicular cyst is commonly found in anterior maxilla, not commonly seen in the mandible. The bilateral symmetrical presentation of this cyst is quite rare. This case report emphasizes the surgical role in the early diagnosis and treatment of such lesions and the overall oral rehabilitation of such mutilated dentition.

Case Report: This report describes the case of a 60-year old healthy African male who presented with a rare case of bilateral symmetrical radicular cyst in the mandibular premolar region along with advanced periodontal disease and hopeless remaining dentition. The patient management comprised surgical enucleation of the cystic sac for histopathologic examination, extraction of associated remaining roots, and total mouth extraction under local anesthesia followed by bone augmentation and implant supported overdenture prosthesis. This case was followed up at 6, 12, 24 and 36 months. Radiographic analyses revealed complete healing at the sites of the cyst’s enucleation with no signs of recurrence or preapical pathology.

Conclusions: This case presented a common condition in an uncommon age group, sex, location, and presentation. It highlights the importance of clinical and radiographic diagnosis and reinforces the role of histopathologic examination. This case also demonstrates the scope of dental management and comprehensive care of a dental patient with a hopeless dentition.

Keywords:

Case report; Bilateral mandibular radicular cysts; Periapical cysts; Premolar radicular cysts; Surgical enucleation; Implant overdenture prosthesis.

Citation:

Abdulaziz M. Alshahrani. Bilateral symmetrical radicular cyst in the mandibular premolar regions: A case report with 3-year follow-up. Clinical Imaging and Case Reports 2024.