Gingival cyst of the adult: regenerative therapy of associated root exposure. A case report and literature review.
BACKGROUND
The gingival cyst of the adult (GCA) is an uncommon developmental cyst of odontogenic origin most frequently seen near mandibular canines and premolars and is routinely treated with excisional biopsy. This article presents a case of a GCA treated with a combined regenerative approach and reviews the GCA literature with an emphasis on the clinical aspects of this lesion.


METHODS
A 54 year-old man presented for treatment of generalized severe chronic periodontitis. Clinical examination revealed a cystic lesion in the gingiva of the mandibular canine-premolar area. Radiographs revealed a well-defined radiolucency in the coronal one-third of the tooth roots. Surgical enucleation of the lesion revealed root exposure of the second premolar. Because of the anatomy of the lesion-associated defect, regenerative treatment, using a combination of freeze-dried bone allograft and a collagen membrane, was considered the therapeutic approach of choice.


RESULTS
The biopsy revealed histologic features consistent with a GCA. Clinical and radiographic examinations 1 year post-surgery indicated uneventful soft tissue healing and bone fill of the initial defect. The review of the literature revealed only one other case of root exposure associated with GCA and no previous report of regenerative therapy.


CONCLUSIONS
In rare instances, a GCA lesion may result in tooth-root exposure. In such cases, a combined regenerative treatment approach may be used to achieve resolution.
Kelsey
W Patrick
WP
Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
Kalmar
John R
JR
Tatakis
Dimitris N
DN
D001641:Bicuspid / Q000473:pathology; D001706:Biopsy; D016025:Bone Transplantation / Q000379:methods; D003094:Collagen; D003481:Cuspid / Q000473:pathology; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005882:Gingival Diseases / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology; D008567:Membranes, Artificial; D008875:Middle Aged; D010509:Periodontal Cyst / Q000601:surgery*; D014092:Tooth Root / Q000601:surgery
D008567:Membranes, Artificial; D003094:Collagen