Lateral Periodontal Cysts with a 1-year Follow-Up and Literature Review

Lateral Periodontal Cysts with a 1-year Follow-Up and Literature Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Lateral Periodontal Cysts with a 1-year Follow-Up and Literature Review D. I. Chukwuma, T. O. Mudasiru This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7551908/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Lateral periodontal cyst (LPC) is a relatively rare, developmental odontogenic cyst that appears along the lateral surface of a vital tooth. It is often discovered incidentally during the review of routine dental radiographs. The purpose of this report is to present the successful management of this rare lesion in a 70-year-old man and discuss how it could be distinguished from similar pathologies. Case Presentation : A 70-year-old male Nigerian presented at the periodontology clinic of the Dental Centre, University College Hospital, Ibadan, on April 16, 2024, for treatment of a gingival swelling of seven weeks' duration in the lower left premolar region. The teeth #33 and #34 adjacent to the lesion were stable, with no diastema between teeth #34 and #35. The teeth showed no sensitivity to percussion, exhibited a normal response to the thermal (cold) test, and were non-carious. Periapical radiograph revealed a teardrop-shaped unilocular radiolucent lesion in the mandible, located buccally between the cervical regions of the roots of #34 and #35, measuring approximately 0.5 mm in diameter. Excision of the lesion and curettage of the surgical bed were done, and tissue was submitted for microscopic examination. This revealed a cystic lesion, lined by two to three layers of non-keratinised stratified squamous epithelium. At post-operative reviews, healing progressed well, and the area showed complete healing at one-year review using clinical and radiographic assessment. Conclusion : A case of LPC in a 70-year-old Nigerian treated by surgical excision was presented. There was no complication; soft tissue and bone healing were optimal at one-year review Lateral Periodontal cyst Non-Surgical Periodontal Debridement Excision Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The lateral periodontal cyst is a rare odontogenic cyst(OC), 1,2 constituting less than 0.4% of all OC. 3 Typically, odontogenic cysts affect the jaw bones and are inflammatory or developmental based on pathogenesis. 4 LPC is believed to originate from the reduced enamel epithelium, the dental lamina, or the epithelial rest of Malassez. 5 , 6 , 7 , 8 They typically present as asymptomatic gingival swellings adjacent to vital teeth, often between mandibular canines and premolars . 9 LPC shares histopathologic characteristics with extraosseous cysts such as gingival cyst of adults (GCA) 10 . LPC presents as a unicystic lesion, characterized by a single, fluid-filled cavity, lined by epithelium, or a multicystic lesion also known as the botryoid odontogenic cyst (BOC), due to the “bunch of grapes like” appearance of its gross and histological specimens. 11 LPC is a radiolucent lesion that develops along the lateral aspect of an erupted vital tooth, excluding inflammatory etiology based on clinical and histological features 12 . The mean age of occurrence is 52 years, with a predilection for patients in the fifth to seventh decades of life. LPC shows no racial or gender predilection 11 . The clinical manifestations tend to be mild, and the lesion is often detected through routine radiographic examinations. 13 Radiographically, LPC typically appears as a well-defined, unilocular or teardrop-shaped radiolucency located between the roots of teeth, and usually smaller than 10 mm in diameter. 3,14 Histologically, LPC is marked by a thin, non-keratinized, non-inflamed epithelial lining and cystic wall. 9 , 15 This epithelium is generally 1 to 5 cell layers thick and resembles reduced enamel epithelium. 14 , 15 The purpose of this report is to present the successful management of this rare lesion in a 70-year-old man and discuss how it could be distinguished from similar pathologies. Case Presentation In April 2024, a 70-year-old Nigerian man presented at the periodontology clinic of the Dental Center, University College Hospital, Ibadan, with a complaint of swelling between the lower left premolars (Fig. 1 ) of about 7 weeks duration. Swelling was gradual in onset. There was no history of trauma or pain associated with the swelling. No difficulty in chewing. However, there was a history of a road traffic accident in 2016 with resultant fracture of the lower right jaw. The fracture was treated by open reduction and internal fixation; the procedure was well-tolerated and uneventful. The patient has been hypertensive for 40 years and has a peptic ulcer condition, both of which are well managed. There was no history of smoking. On extraoral examination, there was no facial asymmetry. Intra-oral examination revealed adequate mouth opening. Oral hygiene was fair, as assessed by the simplified oral hygiene index (SOHI) developed by Green and Vermillion. SOHI was 2.6 There was moderate accumulation of dental plaque accompanied by gingival inflammation (Fig. 1 b). Other findings included mild supragingival calculus around the teeth. There were no periodontal pockets or gingival recession around the lower left premolars, #34 and #35. A sessile, non-tender, nonulcerated, fluctuant, pinkish-brown swelling, measuring 1.2 x 1.0 cm, was noted around the attached gingiva and mucogingival junction of teeth #34 and #35. These teeth were non-carious, non-mobile, not sensitive to percussion, well-aligned with no diastema between them, and exhibited a normal response to the thermal (cold) test. Missing teeth included 17, 26, 46, and 36, while teeth 43 to 33 were splinted. Periapical radiograph revealed a teardrop-shaped radiolucent lesion buccally situated between the cervical regions of the roots of teeth #34 and #35 (Fig. 2). There was widening of the periodontal ligament space, no loss of lamina dura, or resorption of the teeth (Fig. 2). The provisional diagnosis was LPC. The mode of treatment was explained to the patient, and written informed consent was obtained. Before the surgical excision, the patient was educated on proper oral hygiene maintenance practices, he also had scaling and polishing. Surgical Procedure Periodontal surgery was performed under strict aseptic conditions using local anesthesia (1:80000 lignocaine with adrenaline). A crevicular incision was made around the labial surfaces of teeth #34 and #35, and a vertical incision was made on the mesial aspect of #34. A mucoperiosteal flap was raised to expose the bone. The lesion was completely excised, the underlying bone was curetted, and irrigated with saline solution. The flap was sutured with a 4 − 0 resorbable Vicryl suture. The patient was prescribed Tables 1000mg Acetaminophen every 8 hours for 5 days, Tab Clindamycin 300mg every 12 hours, and Tab Metronidazole 200mg every 8 hours for 5 days, respectively. He was instructed to rinse with warm saline eight times daily for two weeks, starting 24 hours after surgery. He was also advised to avoid trauma or pressure at the surgical site. Tooth brushing at the operated sites was performed using a soft-bristle toothbrush during this period until 1 week after the operation to prevent traumatizing the surgical wound. Home care instructions were provided, and professional prophylaxis was performed every three months to maintain oral hygiene. The excised lesion was fixed in 10% neutral buffered formalin and submitted for histopathological examination at the Oral Pathology Department, UCH, Ibadan. Microscopic examination revealed a cystic cavity lined by two to three layers of non-keratinizing squamous cells. The cystic cavity contained a few red blood cells from surgical hemorrhage (►Figure 3a-3d). The cystic wall was non-inflamed, well-vascularized fibrous connective tissue. Microscopic features are consistent with lateral periodontal cyst. The blue arrow points to the cystic lining (Hematoxylin and eosin, X 400). Figure 3d. Clinical Observations Four weeks following surgery, the affected area had completely healed, and there were no complications. The patient’s oral hygiene was good, although moderate tooth staining was apparent. The patient was followed up for 1 year post-operation. The surgical site healed (Fig. 4 b, c) well. Periapical radiography taken 12 months post-op showed adequate bone regeneration, presence of widening of periodontal ligament space, and interdental bone resorption between #34 and #35 (Fig. 5a). Discussion In this report, LPC was treated with surgical excision instead of enucleation to reduce the risk of recurrence. Here, the patient did not present with pain or difficulty eating, as is sometimes associated with an inflamed cyst, but showed a swelling around the lower left premolars #34 and #35. The most common site is the mandibular premolar region, as seen in this case, followed by the upper lateral incisor and canine regions. 3 Generally, LPC is noted to have no sex predilection; however, a few studies have shown a male predilection between the fifth and seventh decades of life. 16 The present case, where the patient is in his eighth decade of life, is slightly older than the peak age of the 5th to 7th decade. LPC is a rare cyst in the oral cavity, with a prevalence of 0.7%–1.5% among all jaw cysts. 17 It may sometimes present as a gingival swelling during its development and growth. 2 The LPC in this report is very small in diameter and is not associated with the divergence of the roots of teeth close to it. Literature review shows that root divergence is more commonly associated with large cysts.’ (Fig. 2). 18,19 The diagnosis of LPCs is based on clinical, radiographic, and histopathological findings. 20 Hence, in our case, we relied on clinical, radiological, and histopathological findings, as some benign developmental lesions identified through clinical and radiological investigation alone may prove to be malignant upon histological examination. 21 This illustrates the importance of histopathological evaluation. The diagnosis of LPC is also established by differentiating it from other developmental and inflammatory cysts of the jaw that occur on the periodontium. Criteria for ruling out similar cysts are based on clinical, radiographic, and histological findings. 2 The gingival cyst, radicular cyst, and odontogenic keratocyst are common differentials of LPC. 3 . The gingival cyst is a rare soft tissue odontogenic cyst that presents some similar clinical features to the LPC. 2 However, in contrast, gingival cysts are a soft tissue pathology, with no involvement of bone. 22 Another differential is radicular cysts, a relatively more common lesion. Unlike LPC, radicular cysts tend to affect nonvital teeth and are located at the apex of the tooth. 23 To avoid unnecessary endodontic therapy, the LPC must always be distinguished from lateral radicular cysts. In the case of the botryoid odontogenic cyst (BOC), which is often larger, it can be differentiated from LPC as it is more likely to be multilocular (appearing as many connected cysts radiographically). In addition, BOC has a higher recurrence rate of up to 21.7% compared to approximately 2.4% for LPC. 24 Odontogenic keratocyst (OKC) is another differential of LPC. It has a characteristic histology. The cystic lining is keratinising squamous epithelial lining with a corrugated, parakeratinized surface and a palisaded basal cell layer. 25 OKC is often a multilocular radiolucent lesion. It is an aggressive lesion with a high recurrence rate. Furthermore, dentigerous cysts, another differential of LPC, are invariably associated to an impacted tooth, whilst OKCs are predominantly found in the ascending mandibular ramus and, as such are easily differentiated from LPC. 9 , 17 LPC is characterised by a thin layer of nonkeratinised epithelium with a thickness of 1–5 mm, which resembles the reduced enamel epithelium.’ The treatment of LPC involves complete enucleation/curettage of the lesion. 5 Treatment of this highlighted case of LPC was done by surgical excision and curettage. Studies on lateral periodontal cysts often highlight enucleation as the primary treatment, but still acknowledge the possibility of recurrence. However, it is generally infrequent 2 , 5 , 24 . At one-year follow-up, both soft and hard tissues were completely healed, but a slight widening of the periodontal ligament space was noticed, as shown in Fig. 5, and this may be connected to apprehension on the patient's side, leading to poor brushing at the surgical site. However, the patient was placed on periodic maintenance periodontal therapy to prevent any complication from arising, such as periodontitis following poor oral hygiene, as we noticed plaque and calculus accumulations. It is important to note that the present case was followed up for one year with no recurrence. Generally, LPC treated by enucleation has a low recurrence rate of 0.4%. 3 Nasti et al, 21 reported a LPC that recurred four years after management. However, the possibility of recurrence is extremely low in this present case because it was treated by surgical excision. Nonetheless, we recommend long-term follow-up for at least 10 years. Conclusion In conclusion, a case of LPC in a 70-year-old man with a year of post-therapy follow-up was presented, and close clinical as well as radiographic differentials were discussed. Long-term follow-up of patients would be prudent, though the risk of recurrence is extremely low. Declarations The authors are grateful to Prof. EEU Akang of the Department of Pathology for editing the script and Mr. A Odetunde of the Institute of Advanced Medical Research and Training, College of Medicine, University College Hospital, Ibadan, Nigeria Ethics approval and consent to participate : Not applicable Consent for Publication : Written informed consent for publication was obtained. Availability of data and materials : Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. Competing interests : Not applicable Funding : Not applicable Authors' contributions: DC managed and wrote the patient`s case. TM performed the histological examination of the tissue and was a major contributor to writing the report. Authors read and approved the final manuscript. Acknowledgements : The authors are grateful to Prof. Bukola F. Adeyemi of the Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan, for providing the microscopic description of the lesion and for editing the script. Conflict of interest: The authors declare that they have no competing interests in this section. References McLean AC, Vargas PA. Cystic Lesions of the Jaws: The Top 10 Differential Diagnoses to Ponder. Head Neck Pathol [Internet]. 2023;17(1):85–98. Available from: https://doi.org/10.1007/s12105-023-01525-1 Ramesh R, Sadasivan A. Lateral Periodontal Cyst – A diagnostic dilemma: Report of a rare case with CBCT and histological findings. Int J Surg Case Rep [Internet]. 2020;75:454–7. 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Journalism. 2010;11(3):369–73. Palareti G, Legnani C, Cosmi B, Antonucci E, Erba N, Poli D, et al. Gingival cyst of the adult, lateral periodontal cyst, and botryoid odontogenic cyst: An updated systematic review. Int J Lab Hematol. 2016;38(1):42–9. Alparslan Esen1*, Ali Kilinc1, Yigit Guler1 MT and OG. Keratocystic Odontogenic Tumor Mimicking Lateral Periodontal Cyst: A Case Report. 2016;1(Fig. 2):15–8. The authors are grateful to Prof. EEU Akang of the Department of Pathology for editing the script and Mr. A Odetunde of the Institute of Advanced Medical Research and Training, College of Medicine, University College Hospital, Ibadan, Nigeria. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7551908","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":533010965,"identity":"8b9e79ee-fe00-4ea6-ac88-45d661d73d52","order_by":0,"name":"D. I. 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11:46:13","extension":"html","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":63968,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/81879f5438f9564c8650ea0c.html"},{"id":94916281,"identity":"cc622b2a-4c2d-4cb1-8253-5ed2d11be745","added_by":"auto","created_at":"2025-11-01 11:46:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":289532,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 1a Clinical Picture\u003c/p\u003e\n\u003cp\u003eFigure 1b Clinical Picture \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 1c Clinical Picture\u0026nbsp;\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/b87bd95286def92b6bc37872.png"},{"id":94916286,"identity":"0d9c317e-c55d-4404-998f-74b4bd582564","added_by":"auto","created_at":"2025-11-01 11:46:13","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":391421,"visible":true,"origin":"","legend":"\u003cp\u003ePeriapical Radiograph shows #33-#35 and #37\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/cb3595ee956b12bcfd36149d.png"},{"id":94916283,"identity":"1259d70e-2a4a-4b78-85a1-36fcfc2078a2","added_by":"auto","created_at":"2025-11-01 11:46:12","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":669497,"visible":true,"origin":"","legend":"\u003cp\u003ePhotomicrography (Hematoxylin and eosin, X 400).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/a33bf50dd05b641fb308a6d6.png"},{"id":94987506,"identity":"1b4c39aa-30e2-411d-a915-fb904f5b4425","added_by":"auto","created_at":"2025-11-03 07:02:02","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":420337,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 4a One Day Post-Op\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 4b One Month Post-Op\u003c/p\u003e\n\u003cp\u003eFigure 4c\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/3f47274b521c9f5dd4cb7a5c.png"},{"id":94916299,"identity":"7cc09749-d614-47e7-86e9-c519e27cd36b","added_by":"auto","created_at":"2025-11-01 11:46:13","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":245545,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 5a: One Year Post-Op periapical radiograph\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/df56ec1fe6695f58c637e358.png"},{"id":96919940,"identity":"04fb6add-f6ec-4a83-abc9-cf83a0f14385","added_by":"auto","created_at":"2025-11-27 14:14:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3497626,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7551908/v1/e2da0dd9-30d4-4ca1-b8bd-a85f3bc8e48d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Lateral Periodontal Cysts with a 1-year Follow-Up and Literature Review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe lateral periodontal cyst is a rare odontogenic cyst(OC),\u003csup\u003e1,2\u003c/sup\u003e constituting less than 0.4% of all OC.\u003csup\u003e3\u003c/sup\u003e Typically, odontogenic cysts affect the jaw bones and are inflammatory or developmental based on pathogenesis.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e LPC is believed to originate from the reduced enamel epithelium, the dental lamina, or the epithelial rest of Malassez.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e They typically present as asymptomatic gingival swellings adjacent to vital teeth, often between mandibular canines and premolars .\u003csup\u003e9\u003c/sup\u003e LPC shares histopathologic characteristics with extraosseous cysts such as gingival cyst of adults (GCA)\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. LPC presents as a unicystic lesion, characterized by a single, fluid-filled cavity, lined by epithelium, or a multicystic lesion also known as the botryoid odontogenic cyst (BOC), due to the \u0026ldquo;bunch of grapes like\u0026rdquo; appearance of its gross and histological specimens.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e LPC is a radiolucent lesion that develops along the lateral aspect of an erupted vital tooth, excluding inflammatory etiology based on clinical and histological features\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. The mean age of occurrence is 52 years, with a predilection for patients in the fifth to seventh decades of life. LPC shows no racial or gender predilection\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. The clinical manifestations tend to be mild, and the lesion is often detected through routine radiographic examinations.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e Radiographically, LPC typically appears as a well-defined, unilocular or teardrop-shaped radiolucency located between the roots of teeth, and usually smaller than 10 mm in diameter. \u003csup\u003e3,14\u003c/sup\u003e Histologically, LPC is marked by a thin, non-keratinized, non-inflamed epithelial lining and cystic wall.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e This epithelium is generally 1 to 5 cell layers thick and resembles reduced enamel epithelium.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e The purpose of this report is to present the successful management of this rare lesion in a 70-year-old man and discuss how it could be distinguished from similar pathologies.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eIn April 2024, a 70-year-old Nigerian man presented at the periodontology clinic of the Dental Center, University College Hospital, Ibadan, with a complaint of swelling between the lower left premolars (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e) of about 7 weeks duration. Swelling was gradual in onset. There was no history of trauma or pain associated with the swelling. No difficulty in chewing. However, there was a history of a road traffic accident in 2016 with resultant fracture of the lower right jaw. The fracture was treated by open reduction and internal fixation; the procedure was well-tolerated and uneventful. The patient has been hypertensive for 40 years and has a peptic ulcer condition, both of which are well managed. There was no history of smoking. On extraoral examination, there was no facial asymmetry. Intra-oral examination revealed adequate mouth opening. Oral hygiene was fair, as assessed by the simplified oral hygiene index (SOHI) developed by Green and Vermillion. SOHI was 2.6\u003c/p\u003e\u003cp\u003eThere was moderate accumulation of dental plaque accompanied by gingival inflammation (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb). Other findings included mild supragingival calculus around the teeth. There were no periodontal pockets or gingival recession around the lower left premolars, #34 and #35. A sessile, non-tender, nonulcerated, fluctuant, pinkish-brown swelling, measuring 1.2 x 1.0 cm, was noted around the attached gingiva and mucogingival junction of teeth #34 and #35. These teeth were non-carious, non-mobile, not sensitive to percussion, well-aligned with no diastema between them, and exhibited a normal response to the thermal (cold) test. Missing teeth included 17, 26, 46, and 36, while teeth 43 to 33 were splinted. Periapical radiograph revealed a teardrop-shaped radiolucent lesion buccally situated between the cervical regions of the roots of teeth #34 and #35 (Fig.\u0026nbsp;2). There was widening of the periodontal ligament space, no loss of lamina dura, or resorption of the teeth (Fig.\u0026nbsp;2). The provisional diagnosis was LPC. The mode of treatment was explained to the patient, and written informed consent was obtained. Before the surgical excision, the patient was educated on proper oral hygiene maintenance practices, he also had scaling and polishing.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e\u003cb\u003eSurgical Procedure\u003c/b\u003e\u003c/h2\u003e\u003cp\u003ePeriodontal surgery was performed under strict aseptic conditions using local anesthesia (1:80000 lignocaine with adrenaline). A crevicular incision was made around the labial surfaces of teeth #34 and #35, and a vertical incision was made on the mesial aspect of #34. A mucoperiosteal flap was raised to expose the bone. The lesion was completely excised, the underlying bone was curetted, and irrigated with saline solution. The flap was sutured with a 4\u0026thinsp;\u0026minus;\u0026thinsp;0 resorbable Vicryl suture. The patient was prescribed Tables\u0026nbsp;1000mg Acetaminophen every 8 hours for 5 days, Tab Clindamycin 300mg every 12 hours, and Tab Metronidazole 200mg every 8 hours for 5 days, respectively. He was instructed to rinse with warm saline eight times daily for two weeks, starting 24 hours after surgery.\u003c/p\u003e\u003cp\u003eHe was also advised to avoid trauma or pressure at the surgical site. Tooth brushing at the operated sites was performed using a soft-bristle toothbrush during this period until 1 week after the operation to prevent traumatizing the surgical wound. Home care instructions were provided, and professional prophylaxis was performed every three months to maintain oral hygiene.\u003c/p\u003e\u003cp\u003eThe excised lesion was fixed in 10% neutral buffered formalin and submitted for histopathological examination at the Oral Pathology Department, UCH, Ibadan. Microscopic examination revealed a cystic cavity lined by two to three layers of non-keratinizing squamous cells. The cystic cavity contained a few red blood cells from surgical hemorrhage (►Figure 3a-3d). The cystic wall was non-inflamed, well-vascularized fibrous connective tissue. Microscopic features are consistent with lateral periodontal cyst. The blue arrow points to the cystic lining (Hematoxylin and eosin, X 400). Figure\u0026nbsp;3d.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eClinical Observations\u003c/h3\u003e\n\u003cp\u003eFour weeks following surgery, the affected area had completely healed, and there were no complications. The patient\u0026rsquo;s oral hygiene was good, although moderate tooth staining was apparent. The patient was followed up for 1 year post-operation. The surgical site healed (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e4\u003c/span\u003eb, c) well. Periapical radiography taken 12 months post-op showed adequate bone regeneration, presence of widening of periodontal ligament space, and interdental bone resorption between #34 and #35 (Fig.\u0026nbsp;5a).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this report, LPC was treated with surgical excision instead of enucleation to reduce the risk of recurrence. Here, the patient did not present with pain or difficulty eating, as is sometimes associated with an inflamed cyst, but showed a swelling around the lower left premolars #34 and #35. The most common site is the mandibular premolar region, as seen in this case, followed by the upper lateral incisor and canine regions.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Generally, LPC is noted to have no sex predilection; however, a few studies have shown a male predilection between the fifth and seventh decades of life.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e The present case, where the patient is in his eighth decade of life, is slightly older than the peak age of the 5th to 7th decade. LPC is a rare cyst in the oral cavity, with a prevalence of 0.7%\u0026ndash;1.5% among all jaw cysts.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e It may sometimes present as a gingival swelling during its development and growth.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe LPC in this report is very small in diameter and is not associated with the divergence of the roots of teeth close to it. Literature review shows that root divergence is more commonly associated with large cysts.\u0026rsquo;\u003c/p\u003e\u003cp\u003e(Fig.\u0026nbsp;2). \u003csup\u003e18,19\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe diagnosis of LPCs is based on clinical, radiographic, and histopathological findings.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Hence, in our case, we relied on clinical, radiological, and histopathological findings, as some benign developmental lesions identified through clinical and radiological investigation alone may prove to be malignant upon histological examination.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e This illustrates the importance of histopathological evaluation.\u003c/p\u003e\u003cp\u003eThe diagnosis of LPC is also established by differentiating it from other developmental and inflammatory cysts of the jaw that occur on the periodontium. Criteria for ruling out similar cysts are based on clinical, radiographic, and histological findings.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e The gingival cyst, radicular cyst, and odontogenic keratocyst are common differentials of LPC.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. The gingival cyst is a rare soft tissue odontogenic cyst that presents some similar clinical features to the LPC.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e However, in contrast, gingival cysts are a soft tissue pathology, with no involvement of bone.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAnother differential is radicular cysts, a relatively more common lesion. Unlike LPC, radicular cysts tend to affect nonvital teeth and are located at the apex of the tooth. \u003csup\u003e23\u003c/sup\u003e To avoid unnecessary endodontic therapy, the LPC must always be distinguished from lateral radicular cysts. In the case of the botryoid odontogenic cyst (BOC), which is often larger, it can be differentiated from LPC as it is more likely to be multilocular (appearing as many connected cysts radiographically). In addition, BOC has a higher recurrence rate of up to 21.7% compared to approximately 2.4% for LPC.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003eOdontogenic keratocyst (OKC) is another differential of LPC. It has a characteristic histology. The cystic lining is keratinising squamous epithelial lining with a corrugated, parakeratinized surface and a palisaded basal cell layer.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e OKC is often a multilocular radiolucent lesion. It is an aggressive lesion with a high recurrence rate. Furthermore, dentigerous cysts, another differential of LPC, are invariably associated to an impacted tooth, whilst OKCs are predominantly found in the ascending mandibular ramus and, as such are easily differentiated from LPC.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e LPC is characterised by a thin layer of nonkeratinised epithelium with a thickness of 1\u0026ndash;5 mm, which resembles the reduced enamel epithelium.\u0026rsquo;\u003c/p\u003e\u003cp\u003eThe treatment of LPC involves complete enucleation/curettage of the lesion.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e Treatment of this highlighted case of LPC was done by surgical excision and curettage. Studies on lateral periodontal cysts often highlight enucleation as the primary treatment, but still acknowledge the possibility of recurrence. However, it is generally infrequent \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. At one-year follow-up, both soft and hard tissues were completely healed, but a slight widening of the periodontal ligament space was noticed, as shown in Fig.\u0026nbsp;5, and this may be connected to apprehension on the patient's side, leading to poor brushing at the surgical site. However, the patient was placed on periodic maintenance periodontal therapy to prevent any complication from arising, such as periodontitis following poor oral hygiene, as we noticed plaque and calculus accumulations. It is important to note that the present case was followed up for one year with no recurrence. Generally, LPC treated by enucleation has a low recurrence rate of 0.4%.\u003csup\u003e3\u003c/sup\u003e Nasti et al,\u003csup\u003e21\u003c/sup\u003e reported a LPC that recurred four years after management. However, the possibility of recurrence is extremely low in this present case because it was treated by surgical excision. Nonetheless, we recommend long-term follow-up for at least 10 years.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, a case of LPC in a 70-year-old man with a year of post-therapy follow-up was presented, and close clinical as well as radiographic differentials were discussed. Long-term follow-up of patients would be prudent, though the risk of recurrence is extremely low.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authors are grateful to Prof. EEU Akang of the Department of Pathology for editing the script and Mr. A Odetunde of the Institute of Advanced Medical Research and Training, College of Medicine, University College Hospital, Ibadan, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics\u003c/strong\u003e \u003cstrong\u003eapproval\u003c/strong\u003e \u003cstrong\u003eand\u003c/strong\u003e \u003cstrong\u003econsent\u003c/strong\u003e \u003cstrong\u003eto\u003c/strong\u003e \u003cstrong\u003eparticipate\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent\u003c/strong\u003e \u003cstrong\u003efor\u003c/strong\u003e \u003cstrong\u003ePublication\u003c/strong\u003e: Written informed consent for publication was obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability\u003c/strong\u003e \u003cstrong\u003eof\u003c/strong\u003e \u003cstrong\u003edata\u003c/strong\u003e \u003cstrong\u003eand\u003c/strong\u003e \u003cstrong\u003ematerials\u003c/strong\u003e: Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting\u003c/strong\u003e \u003cstrong\u003einterests\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eDC managed and wrote the patient`s case. TM performed the histological examination of the tissue and was a major contributor to writing the report. Authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e:\u0026nbsp;The authors are grateful to Prof. Bukola F. Adeyemi of the Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan, for providing the microscopic description of the lesion and for editing the script.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003einterest:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests in this section.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMcLean AC, Vargas PA. Cystic Lesions of the Jaws: The Top 10 Differential Diagnoses to Ponder. Head Neck Pathol [Internet]. 2023;17(1):85\u0026ndash;98. 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Multifocal lateral periodontal cysts: A report of 4 cases and review of the literature. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology [Internet]. 2011;111(2):225\u0026ndash;33. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1016/j.tripleo.2010.09.072\u003c/span\u003e\u003cspan address=\"10.1016/j.tripleo.2010.09.072\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBabu S, Sudhakar, Rajesh E, Anitha N. Lateral periodontal cyst: A case report. Biomed Pharmacol J. 2017;10(1):435\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBalan P, Babu S, Shetty S, Dsouza D. Lateral Periodontal Cyst: A Report of Two Cases with Varying Clinico-Radiological Features. J Interdiscip Histopathol. 2012;1(1):41.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSultan N, Faisal M. Conservative Management of a Case of Lateral Periodontal Cyst Mimicking a Periodontal Abscess. ournal Dent Res Rev | P ublish. 2023;10(1):49\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChandel1 MR. Singh4 KABNAH, 1Department. Understanding Lateral Periodontal Cyst: A Case Report. Biomed Pharmacol J. 2017;10(1):435\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKolokythas A. Lateral Periodontal Cyst: a Case Report and Literature Review. J Oral Maxillofac Res. 2010;1(3):4\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBarbirato DdaS, Fogacci MF, Rodrigues MO, do, Egito Vasconcelos BC, de Barros MCM, Pires FR. Lateral periodontal cyst: A rare clinicopathological presentation mimicking a residual cyst. J Clin Exp Dent. 2022;14(1):95\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBuchholzer S, Bornert F, Di Donna D, Lombardi T. Atypical presentation of lateral periodontal cyst associated with impacted teeth: two case reports. BMC Oral Health [Internet]. 2021;21(1):1\u0026ndash;7. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12903-021-01539-7\u003c/span\u003e\u003cspan address=\"10.1186/s12903-021-01539-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKerezoudis NP, Donta-Bakoyianni C, Siskos G. The lateral periodontal cyst: Aetiology, clinical significance and diagnosis. Dent Traumatol. 2000;16(4):144\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ede Andrade M, Silva APP, de Moraes Ramos-Perez FM, Silva-Sousa YTC, da Cruz Perez DE. Lateral periodontal cyst: Report of case and review of the literature. Oral Maxillofac Surg. 2012;16(1):83\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCury AGMDV. Diagnosis and treatment of lateral periodontal cyst: report of three clinical cases\u0026thinsp;=\u0026thinsp;Diagn\u0026oacute;stico e tratamento de cisto periodontal lateral: relato de tr\u0026ecirc;s casos cl\u0026iacute;nicos. Rev Odonto Ci\u0026ecirc;ncia. 2009;24(1):213\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNasti S, Hassan M, Patel K, Khaja M. Lateral Periodontal Cysts: A Retrospective Study of 7. Cases J Chem Health Risks. 2024;14:2112\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eForte M, d\u0026rsquo;Amati A, Manfuso A, Vittoli M, Girone G, Cascardi E, et al. Gingival Cyst of the Adult: A Case Description with a Relevant Literature Analysis. Reports. 2024;7(3):51.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKilmer PD. Radicular Cyst and Treatment Concepts. Journalism. 2010;11(3):369\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePalareti G, Legnani C, Cosmi B, Antonucci E, Erba N, Poli D, et al. Gingival cyst of the adult, lateral periodontal cyst, and botryoid odontogenic cyst: An updated systematic review. Int J Lab Hematol. 2016;38(1):42\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlparslan Esen1*, Ali Kilinc1, Yigit Guler1 MT and OG. Keratocystic Odontogenic Tumor Mimicking Lateral Periodontal Cyst: A Case Report. 2016;1(Fig. 2):15\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThe authors are grateful to Prof. EEU Akang of the Department of Pathology for editing the script and Mr. A Odetunde of the Institute of Advanced Medical Research and Training, College of Medicine, University College Hospital, Ibadan, Nigeria.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lateral Periodontal cyst, Non-Surgical Periodontal Debridement, Excision","lastPublishedDoi":"10.21203/rs.3.rs-7551908/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7551908/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Lateral periodontal cyst (LPC) is a relatively rare, developmental odontogenic cyst that appears along the lateral surface of a vital tooth. It is often discovered incidentally during the review of routine dental radiographs. The purpose of this report is to present the successful management of this rare lesion in a 70-year-old man and discuss how it could be distinguished from similar pathologies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation\u003c/strong\u003e: A 70-year-old male Nigerian presented at the periodontology clinic of the Dental Centre, University College Hospital, Ibadan, on April 16, 2024, for treatment of a gingival swelling of seven weeks' duration in the lower left premolar region. The teeth #33 and #34 adjacent to the lesion were stable, with no diastema between teeth #34 and #35. The teeth showed no sensitivity to percussion, exhibited a normal response to the thermal (cold) test, and were non-carious. Periapical radiograph revealed a teardrop-shaped unilocular radiolucent lesion in the mandible, located buccally between the cervical regions of the roots of #34 and #35, measuring approximately 0.5 mm in diameter. Excision of the lesion and curettage of the surgical bed were done, and tissue was submitted for microscopic examination. This revealed a cystic lesion, lined by two to three layers of non-keratinised stratified squamous epithelium. At post-operative reviews, healing progressed well, and the area showed complete healing at one-year review using clinical and radiographic assessment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: A case of LPC in a 70-year-old Nigerian treated by surgical excision was presented. There was no complication; soft tissue and bone healing were optimal at one-year review\u003c/p\u003e","manuscriptTitle":"Lateral Periodontal Cysts with a 1-year Follow-Up and Literature Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-01 11:46:08","doi":"10.21203/rs.3.rs-7551908/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a5dd39c4-ea63-4a88-8eed-fef6e0445078","owner":[],"postedDate":"November 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-27T08:39:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-01 11:46:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7551908","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7551908","identity":"rs-7551908","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}