Summary
  • Smooth well-defined margins / well-corticated.
  • Uniformly radiolucent.
  • Round or oval / usually small, less than 1 cm in diameter.
  • Lateral surface of roots of mandibular premolars and canines region, occasionally in the anterior region in the maxilla.
  • If large, it can cause displacement or expansion.
  • Wide age range with mean around 50 years old.
  • Rare / asymptomatic / developmental rather than inflammatory.


DDX

Lateral Periodontal Cyst


Definition

A lateral periodontal cyst appears to originate from epithelial rests in the periodontal ligament adjacent to the lateral side of the root of an erupted tooth. It is considered to be developmental and not as a result of inflammatory stimuli.


Clinical Features

A lateral periodontal cyst is often located in the mandibular premolars and canines region, and rarely can be found in the anterior region in the maxilla. It has wide age range with a mean age in fifth and sixth decades of life. Most lateral periodontal cysts are asymptomatic and found incidentally on routine dental examination. The involved teeth are vital unlike in a radicular cyst.


Radiographic Features

It appears as a well-defined round or oval uniform radiolucency with corticated borders. It is usually less than 1 cm in diameter. Larger cysts may cause expansion or displacement.


Differential Diagnosis

A lateral periodontal cyst has similar appearance to other conditions due to its location and radiographic appearance. The following should be considered in a differential diagnosis: a small KCOT, mental foramen, lateral radicular cyst.


Treatment

A lateral periodontal cyst doesn’t tend to recur. Excisional biopsy and enucleation is the treatment of choice.


Case Reports


CASE 1»

Cone Beam CT ReportHISTORY: A 18-year-old female patient was referred for a Cone Beam CT evaluation of a possible cyst in the #5-6 region.


FINDINGS: A well-defined radiolucent lesion is present in the area between tooth #5 and #6. The lesion margins are smooth and corticated. It extends between the roots of #5 and #6. The lesion measured 18 mm at its greatest dimension. There is thinning in the buccal cortical plate and it is expanded. There are no signs of root resorption or displacement.


IMPRESSION: The radiographic signs are most consistent with a cyst; however, benign lesions and reactive lesions can also be included in the differential diagnosis. The following lesions can be considered given the patient history and radiographic signs:

  • Lateral periodontal cyst
  • Keratocystic odontogenic tumor
  • Adenomatoid odontogenic tumor
  • Central giant cell granuloma

    • Biopsy is recommended.




Dentigerous Cyst
Simple Bone Cyst
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