A cyst is defined as a pathological cavity lined by epithelium and the lumen is filled with cystic contents. The epithelium itself is surrounded by fibrocollagenous connective tissue and may be derived from various sources. Cysts are usually associated with carious, nonvital, discolored, or fractured teeth and are found mostly at the apices of the teeth. Radiologically, it arises from the apex of the root of a carious tooth and is bounded by a thin rim of cortical bone.They rarely become problematic and are incidentally found on routine dental radiographs. As they appear to reach a considerable size prior to medical attention due to their insidious and destructive growth characteristics during the intraosseous stage, treatment often requires extensive cystectomy and skeletal reconstruction.This case report shows the treatment of a big radicular cyst in the maxilla. After surgical enucleation and biopsy, histopathological picture revealed fragments of sections of a collagen cyst wall lined with multilayered squamous epithelium which were seen microscopically. Scarce inflammation is present. Immunohistochemically was found focal CD20+ lymphoid accumulations (up to 40%) with CD3+ T lymphocytes up to 60% of which a significant part is CD40+, and 10% CD8+, CD68 mark the reduced pres ence of resident histiocytes (up to 5%).The finding confirmed the presence of a chronically inflamed radicular cyst. The diagnosis of a cyst, in addition to clinical and paraclinical examinations must be confirmed by the pathohistological findings.

Odontogenic inflammatory cysts are pathological lesions that are often represented in clinical practice and they presented potential focal points with an impact on other organs and systems in the bodyThe aim of this research is to compare the patients' humoral immune response by verifying the level of immunoglobulins IgA, IgG and IgM in the serum before and one month after surgical therapy in patients with odontogenic inflammatory cysts.44 male and female patients were undergone surgical enucleation of the cysts in toto -Cystectomio (Partch II). The biopsy material was sent at the Institute of Pathological Anatomy-Skopje for histopathological verification. Patients diagnosed with odontogenic inflammatory cysts were divided into three groups. Тhe values of IgA, IgM and IgG in serum werе examined before and one month after the surgical therapy in Cobas 6000 model c501 (Roche, Germany).The level of IgA did not indicate a significant difference for p=0.2716 vs. p=0.2898. A significant difference, was also not found in terms of the IgG level for p=0.2692 vs. p=0.3614. The comparison of the three groups of patients regarding the level of IgM in serum indicated a significantly higher value of this parameter before the intervention (p=0.0067) and 1 month after the intervention (p=0.0263).The surgical removal generate a decrease in the levels of immunoglobulins' level. These findings suggest that IgA, IgG and IgM may play an important role in the occurrence, development and persistence of cystic lesions.

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