Читать книгу Shear's Cysts of the Oral and Maxillofacial Regions - Paul M. Speight - Страница 77

Inflammatory collateral cysts are simple cysts and there is no evidence to suggest that recurrence is a problem. Paradental cysts associated with third molars are usually enucleated along with the offending tooth. However, if the tooth is not impacted or angulated and appears to be erupting, it may be preserved and should continue to erupt into a normal occlusion.

Mandibular buccal bifurcation cysts are often enucleated without removal of the associated tooth, which then erupts normally. Nevertheless, removal of the cyst may not be necessary, since there is good evidence that it may resolve after more conservative treatment. Marsupialisation of the cyst has been found to be effective and has resulted in compete regression, with normal eruption of the associated tooth and restoration of a normal gingival profile (Lizio et al. 2011 ). Cysts have also been shown to resolve after simple probing and irrigation, or even to heal spontaneously as the tooth erupts (David et al. 1998 ; Gomez et al. 2001 ; Zadik et al. 2011 ). That these cysts are self‐limiting and may resolve spontaneously is supported by the fact that they rarely reach a large size and they do not occur in adults.

Figure 4.7 Paradental cyst adjacent to the root of an impacted mandibular third molar. The cyst is lined by non‐keratinised stratified squamous epithelium of variable thickness and showing areas of proliferation and inflammation in the wall.

Source: Courtesy of Prof G.T. Craig.