Читать книгу Shear's Cysts of the Oral and Maxillofacial Regions - Paul M. Speight - Страница 60

Radicular cysts may be removed by conservative surgery involving simple curettage of the lesion. Often this is carried out by an apicectomy procedure involving removal of the cyst and the root apex and sealing of the apical portion of the root canal. Occasionally the offending tooth may be removed, but if the cyst is not curetted, then a residual cyst may arise.

Many periapical radiolucencies are treated non‐surgically by endodontic procedures that remove the necrotic pulp and disinfect and seal the root canal. In this way, about 95% or more of apical lesions heal or do not progress. In this case, however, the lesion is not removed for histological examination and, as discussed above, the majority will be periapical granulomas. In this respect, the lesion heals because the causative root canal infection has been removed and it is not necessary to make any distinction between periapical granulomas and cysts, nor between true cysts and pocket cysts (Ricucci et al. 2020 ).

Useful analyses or reviews on the non‐surgical treatment of periapical lesions have been presented by Natkin et al. (1984 ), Nair (2003 , 2004 , 2006 ), Santos‐Junior et al. (2019 ), and Ricucci et al. (2020 ), and in systematic reviews by Sathorn et al. (2005 ), Torabinejad et al. (2005 ), and Glynis et al. (2021 ).