Classification
Periapical Granuloma
Granulation tissue mass without epithelial lining; most common (75–85%)
- • Diffuse poorly-defined radiolucency
- • Asymptomatic
- • Responds to non-surgical root canal treatment
- • Histology: macrophages, lymphocytes, plasma cells, fibroblasts
Radicular Cyst
Epithelium-lined cystic cavity; formed by Malassez epithelial rests proliferation
- • Well-defined corticated radiolucency
- • Often larger than granulomas
- • Pocket cyst responds to RCT; true cyst may require surgery
- • Histology: stratified squamous epithelium + inflammatory cell infiltrate in lining
Asymptomatic Apical Periodontitis
Clinical diagnosis correlating to granuloma/cyst histologically
- • No symptoms
- • Radiographic periapical lesion
- • Negative/absent vitality test
- • Incidental finding on routine radiograph