Hazardous Impact of Prophetic Variables in The Development of Radicular Cyst and Associated Periapical Osteo-Invasion

Abstract Background: The long-standing pulpitis may result in apical periodontitis, which, if left untreated, will ultimately develop into a periapical cyst. Our study aimed to evaluate the hazardous impact of prophetic variables on the development of radicular cysts and associated periapical osteo-invasion. Methodology: One hundred patients with radicular cysts and 100 samples of individuals with normal pulp were selected. For the analytical assessment, periapical tissue samples were obtained from patients experiencing periapical surgery. Tissue homogenate was prepared by using a Potter-Elvehjem homogenizer. The levels of antioxidants and pro-oxidants were assessed by their respective protocols. The anti-inflammatory status, levels of matrix metalloproteinases (MMPs), and bone remodeling biomarkers were determined by designated ELISA kits. Results: Increased levels of pro-oxidants and inflammatory agents while a diminished quantity of antioxidants were observed in the patients with radicular cysts. The levels of MMPs and sRANKL levels were raised, whereas OPG levels were reduced, indicating the osteo-invasion process in radicular cyst patients. Conclusions: The underlying mechanisms of progression of the radicular cyst into adjacent peri-apical bone provide interesting relationships among the biomarkers of oxidative stress, pro-inflammatory cytokines, and bone remodeling. Thus, novel therapies based on targeting MMPs through the action of TIMPs and abrogating sRANKL-RANK interactions can play a significant role in preventing radicular cyst proliferation.