Large radicular cyst compressing the mandibular canal: a case report
Abstract
Objectives: To describe radicular cysts and differentiate them from radiographically similar cysts such as odontogenic keratocysts.Case Report: A 21-year-old female patient presented to the Dental and Oral Hospital with a primary complaint of residual root fragments in the left mandibular region, for which she requested extraction. Extraoral clinical examination revealed no facial asymmetry, swelling, or tenderness, and the region was asymptomatic upon palpation. The patient reported no relevant systemic medical history. Panoramic radiographic examination demonstrated a well-defined unilocular radiolucent lesion extending from the apical third of tooth 36 to the periapical areas of teeth 35, 37, and 38. Given the limitations in diagnostic detail offered by conventional periapical radiography, a Cone-Beam Computed Tomography (CBCT) scan was subsequently performed. Multiplanar reconstruction images from the CBCT revealed a radiolucent lesion extending from the periapical area of tooth 35, with evidence of compression on the mandibular canal.
Conclusion: Radicular cysts are the most common type of odontogenic cyst and are associated with dental inflammation. Radicular cysts and OKCs have a similar radiographic appearance, leading to confusion between the two. Cone Beam Computed Tomography (CBCT) offers three-dimensional imaging that allows a comprehensive assessment of the lesion's size, extent, and relationship to adjacent anatomic structures, allowing the characteristics of both radicular lesions and OKCs to be clearly demonstrated. The characteristics of each lesion can be clearly described, making CBCT a very helpful modality in these cases.
Keywords: Cone Beam Computed Tomography, odontogenic cyst, radicular cyst
References
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2. Essaket, Soukaina, Laila Benjelloun, Saliha Chbicheb. Odontogenic Keratocyst Mimicking a Radicular Cyst. Integrative Journal of Medical Sciences. 2021;8(1):1-4
3. Althaf, S., et al. "The role of cone-beam computed tomography in evaluation of an extensive radicular cyst of the maxilla." J Restor Dent Endod. 2021; 1(1): 30-3
4. Aparna PV, Ramasamy S, Sankari SL, Massillamani F, Priyadharshini A. Bilateral radicular cyst of the mandible: A rare case report. SRM J Res Dent Sci 2018;9:37-9
5. Damayanti, et al. Imaging Analysis 3d Cone-Beam Computed Tomography Of A Suspected Infected Radicular Cyst In The Mandible. Jurnal Radiologi Dentomaksilofasial Indonesia. 2022;6(3):119-24
6. Prashanth BR, Vidhya MS, Karale R, Kumar GV. Is odontogenic keratocyst an endodontic enigma? A rare case report of management of odontogenic keratocyst in anterior mandible. J Oral Maxillofac Pathol. 2020 Feb;24(1):S7-S10
7. Kuźniarski A, Kiryk J, Kiryk S, Kijak E, Dubowik MA, Matys J, Dobrzyński M. Development and Treatment of Radicular Cyst in Pediatric Patient—Case Report. Journal of Clinical Medicine. 2025; 14(2):452. https://doi.org/10.3390/jcm14020452
8. Kumaravelu, Raghu, Nithin J Jude, R Sathyanarayanan. Radicular Cyst : A Case Report. Journal of Scientific Dentistry. 2021;11(1): 23-5
9. Savithri V, Suresh R, Janardhanan M, Aravind T, Mohan M. Prevalence of odontogenic cysts and its associated factors in South Indian population. J Oral Maxillofac Pathol. 2020;24(3):585. doi: 10.4103/jomfp.JOMFP_171_20
10. Shivhare, Peeyush, et al. Multilocular Radicular Cyst – A Common Pathology with Uncommon Radiological Appearance. Journal of Clinical and Diagnostic Research. 2016; 10(3): 13-5
11. Karjodkar F.R. Textbook of dental and Maxillofacial Radiology. 2nd Edition. New Delhi; Jaypee Brother: 2009. p. 256-86
12. Kushnerev E, Yates JM. Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review. J Oral Rehabil. 2015 Oct;42(10):786-802
13. Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018 Oct;9(5):883-897
14. Oren N, Vaysberg A Ginat DT. Updated WHO nomenclature of head and neck lesions and associated imaging findings. Insights Imaging 2019; 10:72
15. M, Pavithra, Arvind M. Radicular cyst mimicking a Keratocyst – a case report. Innovations. 2022;69(6):630-36
16. Cho, Bong-Hae, Yun-Hoa Jung, Jae-Joon Hwang. Aggressive central odontogenic fibroma in the maxilla: A case report. Imaging Science in Dentistry. 2022; 52(4):415-9
17. Benzeer, Lifam Fathima, Anu Babu, Prashanth Shenoy, Laxmikanth Chatra. Dentigerous cyst mimicking a radicular cyst: A case report. Medical Reports. 2024; 6(1): 1-3
18. Pociask, Elzbieta et al. Differential Diagnosis of Cysts and Granulomas Supported by Texture Analysis of Intraoral Radiographs. Sensors. 2021;21(1): 1-13
19. White SC, Pharoah, MJ. Oral Radiology Principles and Interpretation. 7th edition. St. Louis: Mosby Co; 2014. p. 334-59
20. Elhakim A, Kim S, Kim E, Elshazli AH. Preserving the vitality of teeth adjacent to a large radicular cyst in periapical microsurgery: a case report with 4-year follow-up. BMC Oral Health. 2021;21(1):382
Published
2025-08-31
How to Cite
ANDIKA, Steve Yosua et al.
Large radicular cyst compressing the mandibular canal: a case report.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 9, n. 2, p. 105-109, aug. 2025.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/1388>. Date accessed: 29 nov. 2025.
doi: https://doi.org/10.32793/jrdi.v9i2.1388.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
