Abstract
The follicular dental cyst (FDC) was defined as “a cyst arising by separation of the follicle from around the crown of an unerupted tooth within the jaws”. But, what causes the development of follicular dental cysts around some unerupted teeth is unknown. A few works reported that it occurred most frequently in mandibular second premolars and mentioned the possibility of injury to the permanent tooth dental germ by endodontic treatment of deciduous teeth in childhood.
To elucidate the pathogenesis of FDC, the authors investigated 11 cases of FDC in children with special regard to the clinical and radiographic findings and to the inflammatory changes of cyst fluids by biochemical analysis, including the studies on the generation of superoxide (O2-), SOD activity, free radicals and leukotorienes in cyst fluids.
Clinical and radiographic findings revealed that the root apex of pulp-treated deciduous teeth contacted with cyst walls in 8 cases. Anaerobic bacteria were identified in 8 cases. Neutrophils separated from cyst fluid showed the same O2-production ability as those separated from peripheral blood of patients. SOD activity and free radical intensity of cyst fluid varied with the clinical findings of inflammation. Leukotorienes, migration mediator of leukocytes, were detected by HPLC in cyst fluid. Therefore, it was useful for improving inflammatory symptoms to treat FDC with the solvent of radical scavengers replacing the cyst fluid.
These results suggested that the periapical lesion of a deciduous tooth mainly caused the pathogenesis and enlargement of the follicular dental cyst in children.
