Oral and Maxillofacial Surgery Expert Forum
Long Standing Dental Cyst
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Long Standing Dental Cyst

I underwent partial root canal treatment 12 years ago. I did not return for the conclusion of this treatment. Consequently Oct 2010 a dentist taking a routine x-ray identified a cyst eminating from the root of this tooth which had filled the gap left by a tooth which had been extracted several years previously (around 2 cm). I am asymptomatic and have not suffered and pian, swelling and loss of sensation in that area. The cyst could have been there for anything between 12 and 2 years although there are signs that it has been slow growing over a long period. The radiography shows a translucent oval lesion with well defined unform radio-opaque borders. The maxillo-facial surgeon booked me for removal of the offending root and cyst but suggested it was not of any concern and so the appointment was booked for 10 weeks hence (due February 2011). I am however concerned that due to the potentially long standing nature of this lesion that the lining may have undergone, or begun, malignant transformation. I have scoured Google and see some examples of this which have served only to re-enforce my concern. Am I right to be concerned?
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Although it is difficult to be certain without seeing you clinically and evaluating the radiographs, I would probably agree with your oral & maxillofacial surgeon and not lose any sleep over this. Particularly because you did not complete endodontic treatment for that tooth and the lesion or infection that was there in the first place probably never resolved.
All the best,
DrT

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.  
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I have an appt to remove a piece of tooth heading south in my mandible, surrounded by large cyst.  In addition, I have a piece of mercury amalgam lodged in the maxillary bone following incomplete removal.  During this terrifying ordeal, a huge amount of maxillary bone was simply drilled away, unbeknown to me.  Several dentists have said the foreign body is not a problem, but I do have an unresolved facial lesion directly above the area, spreading almost 2cm in dia. on my cheek.  This has been biopsied and results are "inconclusive".  I have spent 4 years begging doctors and dentists to PLEASE associate the facial red spot with the dental pathology.  They cannot lose face, so NO ONE IS WILLING TO ADMIT IT.  I have had to book myself an expensive Cavitat treatment to get yet another opinion.   Please can you tell me if an MRI will BE MORE DEFINITIVE THAN A CAVITAT?  I just cannot lose any more money.    Incidentally, the facial redness appeared the morning after the UL6 erupted and my face swelled up for 48hrs.  This was 4 yrs ago and I am STILL trying to get resolution on the facial redness.  The patch erupts in small red pinpricks in different positions on the patch, every couple of weeks, with regularity.  These do not produce any exudate, and the patch has not repsonded to anti-fungal, Metronidazole etc., anti-biotics.  WHY ISN'T ANYONE SMELLING THE COFFEE?  I suspect fear and trepidation!
Desperate I am not any more;  disappointed and resigned now, yes.!!
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
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