An apical periodontal cyst, also called a radicular cyst, is a mass of soft tissue that is characterized by having a fluid-filled central cavity (called a lumen) that develops around the lower 1/3 of a tooth root, either at the bottom or along the side of the root. They often form as a result of a dental granuloma, a proliferating mass of infected tissue and bacteria that forms in response to dead tissue within the pulp chamber of the tooth. The death of the pulp may be due to extensive decay, deep restorations, or trauma to the tooth.

Radicular cysts usually present no symptoms unless a secondary infection develops. They range in size from two millimeters to three centimeters, and may have either well defined or ill-defined borders. The larger lesions tend to be better defined and may overlap the root tips of several teeth. Radicular cysts of this type tend to be long-standing.

Radicular cysts usually enlarge slowly, and rarely displace teeth or expand bone as they grow. They can occur at any age in response to a non-vital (dead) tooth, but are most common among those in their 30's and 40's.

* We will first perform tests to determine whether the cyst is related to gum disease or a non-vital tooth (dead pulp). Once this has been

determined, we will proceed with the appropriate treatment.

* We can attempt to save the tooth by removing the infected material in the dental pulp by performing a root canal procedure.

* If the tooth is heavily decayed, or if there is a lack of supporting bone tissue, we will need to extract the tooth.

* Radicular cysts require surgical removal; if they are not removed, they will continue to grow slowly and are subject to infection. This

applies to either form of treatment mentioned above.