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 "couldn´t" fill the cavity with anything because the patient couldn´t 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, thnaks 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? ;-) Can´t 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 haven´t got any availabe. - Marcela