Epithelial Cell Rests Research Articles

The IL-1β-p65 axis stimulates quiescent odontogenic epithelial cell rests via TGF-β signalling to promote cell proliferation of the lining epithelia in radicular cysts: A laboratory investigation.

Cyst formation of the jaws is frequently accompanied by the proliferation of odontogenic epithelial cells located in the periodontal ligament (PDL), which consists of heterozygous cells and includes the most fibroblasts. The lining epithelium of radicular cyst, an odontogenic cyst of inflammatory origin, is derived from the proliferation of the remnants of the Hertwig epithelial root sheath (odontogenic epithelial cell rests of Malassez; ERMs) in the PDL. ERMs are maintained at a lower proliferative state under physiological conditions, but the regulatory mechanisms underlying the inflammation-dependent enhanced-proliferative capabilities of ERMs are not fully understood. The aim of this study was to evaluate the effects of cytokine pathway association between TGF-β signalling and IL-1β signalling on the regulation of odontogenic epithelial cell proliferation using radicular cyst pathological specimens and odontogenic epithelial cell lines. Immunofluorescence analyses were performed to clarify the expression levels of Smad2/3 and Ki-67 in ERMs of 8-week-old mouse molar specimens. In radicular cyst (n = 52) and dentigerous cysts (n = 6) specimens from human patients, the expression of p65 (a main subunit of NF-κB), Smad2/3 and Ki-67 were investigated using immunohistochemical analyses. Odontogenic epithelial cells and PDL fibroblastic cells were co-cultured with or without an inhibitor or siRNAs. Odontogenic epithelial cells were cultured with or without TGF-β1 and IL-1β. The proliferative capabilities and Smad2 phosphorylation levels of odontogenic epithelial cells were examined. Immunohistochemically, Smad2/3-positivity was increased, and p65-positivity and Ki-67-positivity were decreased both in ERMs and in the epithelial cells in dentigerous cysts, a non-inflammatory developmental cyst. In contrast, p65-positive cells, along with the expression of Ki-67, were increased and Smad2/3-positive cells were decreased in the lining epithelia of radicular cysts. Co-culture experiments with odontogenic epithelial cells and PDL fibroblastic cells revealed that PDL cells-derived TGF-β1/2 and their downstream signalling suppressed odontogenic epithelial cell proliferation. Moreover, TGF-β1 stimulation induced Smad2 phosphorylation and suppressed odontogenic epithelial cell proliferation, while IL-1β stimulation reversed these phenotypes through p65 transactivation. These results suggest that IL-1β-p65 signalling promotes odontogenic epithelial cell proliferation through suppressing TGF-β-Smad2 signalling, which would be involved in the pathogenesis of radicular cysts.

Impaired breakdown of Herwig's epithelial root sheath disturbs tooth root development.

Wnt/β-catenin signaling plays a variety of roles in both the dental epithelium and mesenchyme at most stages of tooth development. In this study, we verified the roles of Hertwig's epithelial root sheath (HERS) breakdown in tooth root development. This breakdown results in formation of epithelial cell rests of Malassez (ERM). Following induction of β-catenin stabilization in the epithelium of developing tooth at the moment of HERS breakdown, HERS failed to break down for ERM formation. HERS with stabilized β-catenin was altered into a multicellular layer enveloping elongated root dentin with higher expression of junctional proteins such as Zo-1 and E-cadherin. Importantly, this impairment of HERS breakdown led to arrest of further root elongation. In addition, the portion of root dentin enveloped by the undissociated HERS remained in a hypomineralized state. The odontoblasts showed ectopically higher expression of pyrophosphate regulators including Ank and Npp1, whereas Tnap expression was unchanged. Our data suggest that Wnt/β-catenin signaling is decreased in HERS for ERM formation during root development. Furthermore, ERM formation is important for further elongation and dentin mineralization of the tooth roots. These findings may provide new insight to understand the contribution of ERM to root formation.

Case Report: Introduction of antibiotic releasing calcium sulfate bone void filler beads (Stimulan) for management of an infected cyst of the maxilla

Radicular cysts are the most common odontogenic cyst arising from epithelial cell rests of Malassez in the periodontal ligament and proliferate peripherally as a result of inflammation caused by infection at the root apices. They slowly grow apically causing bone resorption and displacement of the adjacent teeth which radiographically is seen as a radiolucent unilocular lesion. Management of such bone defects can be done by using various bone graft substitutes such as autogenous, allografts, xenografts and alloplasts. Taking account of the benefits of using synthetic bone graft substitutes, the following case represents the successful management of a radicular cyst, which includes endodontic treatment and cyst enucleation, chemical cauterization followed by introduction of antibiotic (Vancomycin) releasing calcium sulfate filler beads into the defect.

Programmed cell death of periodontal ligament cells.

The periodontal ligament is a crucial tissue that provides support to the periodontium. Situated between the alveolar bone and the tooth root, it consists primarily of fibroblasts, cementoblasts, osteoblasts, osteoclasts, periodontal ligament stem cells (PDLSCs), and epithelial cell rests of Malassez. Fibroblasts, cementoblasts, osteoblasts, and osteoclasts are functionally differentiated cells, whereas PDLSCs are undifferentiated mesenchymal stem cells. The dynamic development of these cells is intricately linked to periodontal changes and homeostasis. Notably, the regulation of programmed cell death facilitates the clearance of necrotic tissue and plays a pivotal role in immune response. However, it also potentially contributes to the loss of periodontal supporting tissues and root resorption. These findings have significant implications for understanding the occurrence and progression of periodontitis, as well as the mechanisms underlying orthodontic root resorption. Further, the regulation of periodontal ligament cell (PDLC) death is influenced by both systemic and local factors. This comprehensive review focuses on recent studies reporting the mechanisms of PDLC death and related factors.

The ameliorating role of epithelial cell rests of Malassez in the alleviation of experimentally-induced periodontitis in rats

ObjectiveThe present study aimed to investigate the effect of experimentally-induced periodontitis on epithelial cell rests of Malassez (ERM) distribution and its subsequent role in regenerating periodontal ligament (PDL). Design: The study included 60 rats, aged seven months, randomly and equally divided into two groups: Group I, the control group, and Group II, the experimental group, in which ligature-periodontitis was induced. Ten rats from each group were euthanized at 1, 2, and 4 weeks. For ERM detection, specimens were processed for histological and immunohistochemical examination of cytokeratin-14. Additionally, specimens were prepared for the transmission electron microscope. Results: Group I demonstrated well-organized PDL fibers with few ERM clumps close to the cervical root portion. In contrast, one week after periodontitis induction, Group II showed marked degeneration, a damaged cluster of ERM cells, narrowing of the PDL space, and early signs of PDL hyalinization. After two weeks, a disorganized PDL was observed with the detection of small ERM clumps enclosing very few cells. After four weeks, PDL fibers were reorganized, and ERM clusters increased significantly. Notably, ERM cells were positive for CK14 in all groups. Conclusion: Early-stage ERM may be affected by periodontitis. However, ERM is capable of recovering its putative role in PDL maintenance.

The effect of intentionally perforating the floor of the pulp chamber on pulpal healing after tooth replantation in mice

ObjectivesShortening the root of a mouse molar prior to tooth replantation results in early revascularization in the pulp cavity and activation of the dental pulp quiescent stem cells. This study aimed to validate the effects of pulp chamber floor perforation on pulpal healing after tooth replantation as a strategy to promote early revascularization into the pulp. MethodsThe maxillary first molars of three-week-old Crlj:CD1 mice were extracted and repositioned into the original socket: the left teeth were immediately replanted (control group: CG), whereas the floor of the pulp chamber of the right teeth was perforated with a tungsten carbide bur before tooth replantation (experimental group: EG). The samples were collected from three days to eight weeks postoperatively. In addition to the TUNEL assay, immunohistochemistry for Nestin, CK14, and Ki-67 was conducted. ResultsIn the EG, early revascularization occurred with a decrease in apoptosis and an increase in cell proliferation, facilitating pulpal healing, compared with the CG. The rate of Nestin-positive perimeter in the distal root significantly increased on days 5 and 14 and the amount of Nestin-positive hard tissue increased on day 14. However, on day 7, the number of epithelial cell rests of Malassez in the EG significantly decreased, making the EG susceptible to ankylosis at the floor. ConclusionsIntentionally perforating the floor of the pulp chamber provides a route for early revascularization, resulting in better pulpal healing after tooth replantation.

Giant apical cyst in anterior maxilla: A case report

Apical or periapical cysts are the most common type of cyst, affecting the local and systemic health of patients. This pathology can manifest as an inflammatory condition in periodontal tissues due to the stimulation and proliferation of the epithelial cell rests of Malassez and it can be identified in clinical visits and imaging exams of routine. Apical cysts do not cause facial pain and/or swelling and appear as a well-defined radiolucent region when analyzed radiographically. Differential diagnosis include dentigerous cyst, ameloblastoma, odontogenic keratocyst, and periapical cementoma. Only a histopathological analysis can provide a definite diagnosis. Several methods have been described to treat apical cysts, such as endodontic therapies, decompression, marsupialization and cystectomy. A healthy 60-year-old man looked the dental office and reported successful endodontic treatment in the upper central and lateral incisors teeth and a tomographic exam suggested the presence of the large periapical cystic lesions located in the anterior region of the maxillary. After complementary exams, the cystic lesion was enucleated without endodontic. Histopathological analysis confirmed the hypothetical diagnosis which had been observed in the imaging exam. The patient’s clinical follow-up showed good evolution with no clinical symptoms and bone healing was observed in the region of the lesion. It is essential for dentists to have knowledge about diagnostic methods and treatments to avoid adverse effects in healthy teeth or other structures present in the face. Disseminating information about an uncommon case to the scientific community may help achieving success in similar situations.

Induction of Periodontal Ligament–like Cells by Coculture of Dental Pulp Cells, Dedifferentiated Cells Generated from Epithelial Cell Rests of Malassez, and Umbilical Vein Endothelial Cells

IntroductionApart from the epithelial cell rests of Malassez (ERMs), dental pulp (DP) contains the same types of mesenchymal cells as the periodontal ligament (PDL). ERMs may affect the characteristics of the mesenchymal cells in the PDL. The aim of this study was to examine whether DP cells cultured with ERMs and human umbilical vein endothelial cells (HUVECs) could transform into PDL-like cells. MethodsProgenitor-dedifferentiated into stem-like cells (Pro-DSLCs) were produced by the induction of ERMs with 5-Azacytidine and valproic acid. DP cells were cultured in mesenchymal stem cell medium for 1 week under the following conditions: DP cells alone (controls); PDL cells alone; coculture of DP cells and ERMs (DP + ERM) or Pro-DSLCs (DP + Pro-DSLC); and coculture of DP cells, HUVECs, and ERMs (DP + ERM + HUVEC) or Pro-DSLCs (DP + Pro-DSLC + HUVEC). Quantitative real-time reverse transcription polymerase chain reaction, quantitative methylation-specific polymerase chain reaction, and flow cytometry were performed. ResultsThe expression levels of PDL-related markers Msx1, Msx2, Ncam1, Postn, and S100a4 and mesenchymal stem cell–positive markers Cd29, Cd90, and Cd105 were significantly higher in the PDL cells and DP + Pro-DSLC + HUVEC cultures than in the controls (P < .05). The DNA methylation levels of Msx1 and Cd29 in the PDL cells and the DP + Pro-DSLC + HUVEC culture were significantly lower than in the controls (P < .01). We found a significant increase in the number of cells stained with MSX1 (P < .05) and CD29 (P < .01) in the DP + Pro-DSLC + HUVEC culture than in the controls. ConclusionsCoculture of DP cells with Pro-DSLCs and HUVECs induced their transformation into PDL-like cells. This method may prove to be useful for periodontal regeneration via tissue engineering.

Fibrillin protein, a candidate for creating a suitable scaffold in PDL regeneration while avoiding ankylosis.

The tooth is stabilized by fiber-rich tissue called the periodontal ligament (PDL). The narrow space of the PDL does not calcify in the physiological state even thought it exists between two calcified tissues, namely, the cementum of the root and alveolar bone. Two situations that require PDL regeneration are periodontitis and dental trauma. Periodontitis induces the loss of PDL and alveolar bone due to inflammation related to infection. Conversely, in PDLs damaged by dental trauma, accelerating bone formation as an overreaction of the healing process is induced, thereby inducing dentoalveolar ankylosis at the tooth root surface. PDL regeneration following dental trauma must therefore be considered separately from periodontitis. Therefore, PDL regeneration in dental trauma must be considered separately from periodontitis. This review focuses on the components involved in avoiding dentoalveolar ankylosis, including oxytalan fibers, aggregated microfibrils, epithelial cell rests of Malassez (ERM), and TGF-β signaling. During root development, oxytalan fibers produced by PDL cells work in collaboration with the epithelial components in the PDL (e.g., Hertwig's root sheath [HERS] and ERM). We herein describe the functions of oxytalan fibers, ERM, and TGF-β signals which are involved in the avoidance of bone formation.

Organoids from human tooth showing epithelial stemness phenotype and differentiation potential

Insight into human tooth epithelial stem cells and their biology is sparse. Tissue-derived organoid models typically replicate the tissue’s epithelial stem cell compartment. Here, we developed a first-in-time epithelial organoid model starting from human tooth. Dental follicle (DF) tissue, isolated from unerupted wisdom teeth, efficiently generated epithelial organoids that were long-term expandable. The organoids displayed a tooth epithelial stemness phenotype similar to the DF’s epithelial cell rests of Malassez (ERM), a compartment containing dental epithelial stem cells. Single-cell transcriptomics reinforced this organoid-ERM congruence, and uncovered novel, mouse-mirroring stem cell features. Exposure of the organoids to epidermal growth factor induced transient proliferation and eventual epithelial-mesenchymal transition, highly mimicking events taking place in the ERM in vivo. Moreover, the ERM stemness organoids were able to unfold an ameloblast differentiation process, further enhanced by transforming growth factor-β (TGFβ) and abrogated by TGFβ receptor inhibition, thereby reproducing TGFβ's known key position in amelogenesis. Interestingly, by creating a mesenchymal-epithelial composite organoid (assembloid) model, we demonstrated that the presence of dental mesenchymal cells (i.e. pulp stem cells) triggered ameloblast differentiation in the epithelial stem cells, thus replicating the known importance of mesenchyme-epithelium interaction in tooth development and amelogenesis. Also here, differentiation was abrogated by TGFβ receptor inhibition. Together, we developed novel organoid models empowering the exploration of human tooth epithelial stem cell biology and function as well as their interplay with dental mesenchyme, all at present only poorly defined in humans. Moreover, the new models may pave the way to future tooth-regenerative perspectives.

Analysis of the cells isolated from epithelial cell rests of Malassez through single-cell limiting dilution

The epithelial cell rests of Malassez (ERM) are essential in preventing ankylosis between the alveolar bone and the tooth (dentoalveolar ankylosis). Despite extensive research, the mechanism by which ERM cells suppress ankylosis remains uncertain; perhaps its varied population is to reason. Therefore, in this study, eighteen unique clones of ERM (CRUDE) were isolated using the single-cell limiting dilution and designated as ERM 1–18. qRT-PCR, ELISA, and western blot analyses revealed that ERM-2 and -3 had the highest and lowest amelogenin expression, respectively. Mineralization of human periodontal ligament fibroblasts (HPDLF) was reduced in vitro co-culture with CRUDE ERM, ERM-2, and -3 cells, but recovered when an anti-amelogenin antibody was introduced. Transplanted rat molars grown in ERM-2 cell supernatants produced substantially less bone than those cultured in other cell supernatants; inhibition was rescued when an anti-amelogenin antibody was added to the supernatants. Anti-Osterix antibody staining was used to confirm the development of new bones. In addition, next-generation sequencing (NGS) data were analysed to discover genes related to the distinct roles of CRUDE ERM, ERM-2, and ERM-3. According to this study, amelogenin produced by ERM cells helps to prevent dentoalveolar ankylosis and maintain periodontal ligament (PDL) space, depending on their clonal diversity.

Closure of Oroantral Communication with Gelfoam and Collagen Membrane after Periapical Cyst EnucleationA Case Report

Periapical cyst is the most common inflammatory cyst that occurs in jaw bones. Epithelial cell rests of Malassez in periodontal ligaments are the main cause for the periapical cysts to be formed. Periapical cyst occurs commonly in infected and necrotic periapical area, with male sex predilection and occurs especially in the 3rd to 6th decades of life. Non vital tooth left untreated for long time predisposes to periapical cyst formation. Oroantral Communication (OAC) is one of the most routinely encountered complications during surgical procedure by oral and maxillofacial surgeons when attempting to remove a cyst from maxilla. Oroantral communication is the abnormal, pathologic, unnatural open connection between the oral cavity and maxillary sinus. If such a communication remains open it can cause ingress of microorganisms from the oral cavity into the antrum resulting in maxillary sinusitis, and develops into an Oroantral Fistula (OAF). Hereby, authors presented a case report of a 32-year-old female patient with the complaint of pain and swelling in relation to the left upper back tooth region. The gelfoam and collagen membrane used to close an oroantral communication, which was developed after periapical cyst enucleation.

Epithelial Cell Rests of Malassez Provide a Favorable Microenvironment for Ameliorating the Impaired Osteogenic Potential of Human Periodontal Ligament Stem Cells.

Human periodontal ligament stromal/stem cells (PDLSCs) are ideal candidates for periodontal regeneration and are of significant importance in clinical practice. However, PDLSCs derived from diseased microenvironments exert impaired behavior, which leads to the failure of periodontal regeneration. The epithelial cell rests of Malassez (ERM), which are involved in periodontal homeostasis, are residual cells from Hertwig's epithelial root sheath (HERS). However, the function of ERM remains largely unknown. Therefore, the aim of this study was to evaluate the effect of ERM on the osteogenic potential of PDLSCs from an impaired microenvironment. PDLSCs from healthy donors (H-PDLSCs), periodontitis donors (P-PDLSCs) and human ERM were harvested. Osteogenic evaluation showed a lower osteogenic potential of P-PDLSCs compared to that of H-PDLSCs. Then, we co-cultured ERM with P-PDLSCs, and the data showed that ERM promoted the expression of osteogenic genes and proteins in P-PDLSCs. In addition, we collected the PDLSCs from aged donors (A-PDLSCs) and analyzed the osteogenesis capacity of the A-PDLSCs and A-PDLSCs + ERM groups, which displayed similar results to P-PDLSCs. Finally, we evaluated the Wnt pathway, which is associated with osteogenic differentiation of stromal/stem cells, in A-PDLSCs + ERM and P-PDLSCs + ERM groups, which indicated that suppression of the Wnt pathway may result in an increase in the osteogenic properties of A-PDLSCs + ERM and P-PDLSCs + ERM groups. Taken together, the above findings shed new light on the function of ERM and provide a novel therapeutic for optimizing PDLSCs-based periodontal regeneration.

Immunohistochemical Evaluation of Periodontal Regeneration Using a Porous Collagen Scaffold.

(1) Aim: To immunohistochemically evaluate the effect of a volume-stable collagen scaffold (VCMX) on periodontal regeneration. (2) Methods: In eight beagle dogs, acute two-wall intrabony defects were treated with open flap debridement either with VCMX (test) or without (control). After 12 weeks, eight defects out of four animals were processed for paraffin histology and immunohistochemistry. (3) Results: All defects (four test + four control) revealed periodontal regeneration with cementum and bone formation. VCMX remnants were integrated in bone, periodontal ligament (PDL), and cementum. No differences in immunohistochemical labeling patterns were observed between test and control sites. New bone and cementum were labeled for bone sialoprotein, while the regenerated PDL was labeled for periostin and collagen type 1. Cytokeratin-positive epithelial cell rests of Malassez were detected in 50% of the defects. The regenerated PDL demonstrated a larger blood vessel area at the test (14.48% ± 3.52%) than at control sites (8.04% ± 1.85%, p = 0.0007). The number of blood vessels was higher in the regenerated PDL (test + control) compared to the pristine one (p = 0.012). The cell proliferative index was not statistically significantly different in pristine and regenerated PDL. (4) Conclusions: The data suggest a positive effect of VCMX on angiogenesis and an equally high cell turnover in the regenerated and pristine PDL. This VCMX supported periodontal regeneration in intrabony defects.

Direct reprogramming of epithelial cell rests of malassez into mesenchymal-like cells by epigenetic agents

The DNA demethylating agent, 5-Azacytidine (5Aza), and histone deacetylase inhibitor, valproic acid (Vpa), can improve the reprogramming efficiencies of pluripotent cells. This study aimed to examine the roles of 5Aza and Vpa in the dedifferentiation of epithelial cell rests of Malassez (ERM) into stem-like cells. Additionally, the ability of stem-like cells to differentiate into mesenchymal cells was evaluated. ERM was cultured in embryonic stem cell medium (ESCM) with 1 µM of 5Aza, or 2 mM of Vpa, or a combination of 5Aza and Vpa. The cells stimulated with both 5Aza and Vpa were named as progenitor-dedifferentiated into stem-like cells (Pro-DSLCs). The Pro-DSLCs cultured in ESCM alone for another week were named as DSLCs. The stem cell markers were significantly higher in the DSLCs than the controls (no additions). The mRNA and protein levels of the endothelial, mesenchymal stem, and osteogenic cell markers were significantly higher in the Pro-DSLCs and DSLCs than the controls. The combination of a demethylating agent and a deacetylated inhibitor induced the dedifferentiation of ERM into DSLCs. The Pro-DSLCs derived from ERM can be directly reprogrammed into mesenchymal-like cells without dedifferentiation into stem-like cells. Isolated ERM treated with epigenetic agents may be used for periodontal regeneration.

Neurapraxia in an infected radicular cyst and its management

Radicular cysts are the most common inflammatory odontogenic cyst of jaw that emanates from the epithelial cell rests of malassez in the periodontal ligament. 60% of cases are found in maxilla, most commonly around incisors and canines with male predilection. Most of the cases remain silent until secondarily infected. Treatment modalities of Radicular cyst according to their size and severity are extraction of the associated tooth, endodontic treatment, apical surgery, enucleation and/or marsupialization. Though, radicular cyst involving inferior alveolar nerve may cause paraesthesia due the neurosensory disturbance caused by mechanical compression or stress. Here, we report a case of neurapraxia occurred in an infected radicular cyst involving roof of the inferior alveolar nerve canal. Keywords: Radicular cyst, Inferior alveolar nerve, Paraesthesia, Neurosensory disturbance, Compression, Stress.

Management of a nonvital discolored tooth associated with radicular cyst: A multidisciplinary approach

The radicular cyst arises from proliferated epithelial cell rests of malassez when they get stimulated by an inflammatory process originating from pulpal necrosis of a nonvital tooth. The associated tooth is usually asymptomatic and may result in swelling of the soft tissues and mobility of the teeth involved. The typical radiographic description of the lesion is a round or oval, well-circumscribed radiolucency involving the apex of the tooth. Radicular cysts can be managed either surgically or nonsurgically. The nonvital, discolored anterior tooth associated with the lesion is a common esthetic concern for patients. It can effect their self-confidence and employability. Discolored nonvital teeth are frequently compromised due to root canal treatment, previous trauma, or caries. Invasive treatment options like crowns or veneers further weaken the tooth structure. This case report presents the successful surgical management of a radicular cyst associated with a nonvital discolored anterior tooth. This will also include the technicalities involved in the inside/outside nonvital bleaching technique.

Radicular Cyst of The anterior Maxilla: An Insight into the Most Common Inflammatory Cyst of the Jaws

Radicular cyst is believed to be derived from the epithelial cell rests of Malassez. The associated tooth is nonvital, usually asymptomatic, and may result in swelling, tenderness, tooth mobility, or other problems with rare possibility of neoplastic transformation of its epithelial lining. The treatment options include endodontic procedure, extraction of offending tooth, enucleation with primary closure, and marsupialization. The present report describes the case of a radicular cyst of anterior maxillary region in a 31-year-old male patient, with a detailed description of clinical, radiographic, histopathologic features, pathogenesis, and its surgical management.

A Review of the Epithelial Cell Rests of Malassez on the Bicentennial of Their Description

The epithelial cell rests of Malassez (ERM) were first described in 1817, yet their significance has remained an enigma for more than 200 years. Given their embryological origins and persistence in adult periodontal tissue, recent research has investigated whether the ERM could be useful as stem cells to regenerate tissues lost as a consequence of periodontitis. The objective of this review is to describe results of studies that have vigorously investigated the functional capabilities of ERM, particularly with regard to periodontal ligament homeostasis and prevention of dentoalveolar ankylosis. The significance of the ERM relative to evolution of the dental attachment apparatus will be examined. The current status of use of ERM as stem cells for dental tissue engineering and in other applications will be reviewed.

Successful Conservative Surgical Approache of Large Paediatric Radicular Cysts Using Marsupialization Technique: A rare two case reports

Children exhibit many pathological lesions involving the jaw bones. Radicular cysts are common inflammatory odontogenic cysts that arise from epithelial cell rests of Malassez due to periapical infection, originating from pulpal necrosis of a non-vital tooth. Radicular cysts are relatively rare in the primary dentition because of the distinct biological cycle of primary teeth. It comprise about 52% to 68% of all the cysts which affect the human jaw. Radicular cysts are usually asymptomatic, unless secondary infected, and discovered during routine dental radiographic examination. The lesion is seen radiographically as a circumscribed, well-defined radiolucent area bound by a thin radiopaque line. The treatment of the cysts can be either non-surgical management or surgical management being either marsupialization or enucleation. However, the treatment option should be kept as conservative as possible.