Conservative management of a case of lateral periodontal cyst mimicking a periodontal abscess

Abstract

Lateral periodontal cyst (LPC) is a relatively uncommon, usually asymptomatic developmental odontogenic cyst occurring on the lateral aspect of a vital tooth. The present case reports one such lesion. The patient had pain in gums along lower front teeth with occasional pus discharge since two month. Lingually, the tooth 41 had a periodontal pocket of 6 mm. It was vital and grade II mobile. The distinct radiographic picture changed the management plan. The radiograph showed a distinct well defined radiolucency on the middle third portion of the root. A provisional diagnosis of LPC was made. Conservative surgical curettage and enucleation of the cyst was performed under local anesthesia. Autogenous bone graft was harvested from the parasymphyseal region and placed in the defect. Lower anterior teeth were splinted and periodontal dressing was placed. Histopathological report was suggestive of a developmental odontogenic cyst. The patient is regularly followed up with no recurrence yet and an improving bone-fill of the defect. The case could have been easily misdiagnosed and managed as an abscess draining through the periodontal pocket. A seemingly routine case was managed conservatively after proper diagnosis by thorough clinical, radiographic, and histopathological examination improving the prognosis of the involved tooth.