When talking about teeth-related issues or diseases, people usually lament about tooth sensitivity, cavities, gum disease, and cracked teeth. However, there are a lot of other problems a person can encounter when it comes to oral health.
One of those rare or “obscure” conditions is Lateral Periodontal Cyst (LPC). In this post, we explore what an LPC is, its causes, and how to get rid of it.
What is Lateral Periodontal Cyst?
LPCs are non-inflammatory and non-keratinized cysts of developmental origin found lateral to the root of a vital tooth. Usually, it is asymptomatic and might be spotted on a routine radiographic examination.
Standish and Shafer reported the first case of Lateral Periodontal Cyst in 1958, and later in the same years, Holder and Kunkel followed suit. Since then, there have been hundreds of well-documented LPC cases in the dental literature.
Causes of LPC
So why do they arise? The exact cause of the lateral periodontal cyst is still unknown. However, some theories suggest that it may develop as a result of an inflammatory process or an odontogenic epithelial rest that is present in the periodontal ligament.
Here are some other possible causes or factors that may contribute to the development of LPC:
- Trauma: Trauma to the affected area may cause a focal inflammatory response that could lead to the development of the cyst.
- Infection: An infection in the periodontal ligament may also trigger the formation of an LPC.
- Developmental defect: LPCs may also result from a developmental defect in the dental tissues. LPC can occur accidentally as a tooth erupts due to flaws in tooth formation.
- Accumulation of pus: LPC can also develop due to the buildup of pus in the gums.
- Genetic factors: Some genetic factors may make some people more susceptible to developing LPCs.
- Age: LPCs tend to occur more frequently in adults over the age of 52.
Signs and symptoms of LPC
LPCs are usually painless but can cause tenderness and swelling in the affected area.
Observable clinical signs of a lateral periodontal cyst include soft-tissue swelling within or just below the interdental papilla.
On radiographs, the LPC comes out as a well-defined oval, round, or somewhat tear-drop shape. In rare instances, possible implications include loss of lamina dura, loss of enamel and dentine of bordering teeth, and enlargement of the periodontal ligament space.
Under the microscope, the Lateral Periodontal Cyst appears as a cystic activity with an extremely thin layer of epithelium around its margin and supported by connective tissue. Mostly, no inflammatory cells are present; however, in some rare cases, the fibrous capsule may exhibit slight inflammation. Lastly, numerous transparent cells rich in glycogen might be present in plaques or the epithelium layers.
Diagnosis of LPC
The diagnosis of an LPC is necessary when the cyst location is confined to the anterior maxillary tooth roots, the periodontal segment of the tooth, or around mandibular premolar roots.
The diagnosis is predominantly based on radiographic findings. Histopathological studies and analysis are employed to differentiate between LPC and other cysts resulting from inflammatory causes or potential keratocystic odontogenic tumours. Once a confirmed diagnosis is established, treatment is carefully planned and administered to prevent the recurrence of the lesion.
Treatment: Getting rid of it
Fortunately, in most cases, LPC is relatively harmless. However, if the cyst grows to the extent that it makes life uncomfortable for you or begins threatening the adjacent tissues, then treatment is necessary.
This is where oral surgeons in Palo Alto come in handy as the cyst is removed surgically.
The surgical removal of a lateral periodontal cyst (LPC) involves the following steps:
- Anesthesia: The first step is to administer local anesthesia to numb the area around the cyst and the affected tooth.
- Incision: Once the area is numb, your oral surgeon will make an incision in the gum tissue overlying the cyst. The size and shape of the incision will depend on the size and location of the cyst.
- Accessing the cyst: The surgeon will then use a small surgical instrument to carefully separate the surrounding gum tissue from the cyst to gain access.
- Removal of the cyst: Your surgeon will use a surgical instrument to remove the entire LPC and any associated inflamed tissue. The cyst will be sent for histopathological examination to confirm the diagnosis and rule out any malignancy.
- Closure: Once the cyst has been removed, the surgeon will carefully clean the area and close the incision using sutures. Sometimes, a small drain may be placed to allow any excess fluid to drain from the surgical site.
- Post-operative care: You will be given instructions on how to care for the surgical site, including how to keep the area clean and avoid irritating the incision. Antibiotics and pain medication may also be prescribed as needed.
Follow-up: Lastly, you will be scheduled for follow-up appointments to monitor healing and ensure that the cyst does not recur. The follow-up frequency may vary depending on the individual case.
Prevention of LPC
Observing oral hygiene and seeing the best periodontists in Palo Alto at least bi-annually are significant steps in preventing LPC and other common dental diseases. Teeth that remain healthy rarely ever have cysts developing near or around them.