Cyst vs Granuloma Differentiation — NDEB AFK MCQ
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Correct answer: C — Histopathological examination of the excised tissue
Radiographically, periapical granulomas and periapical (radicular) cysts cannot be reliably distinguished — both present as periapical radiolucencies. The definitive differentiation requires histopathological examination of the excised tissue. A true cyst has a complete epithelial lining (derived from epithelial rests of Malassez) enclosing a lumen filled with fluid. A periapical granuloma shows granulation tissue with chronic inflammatory infiltrate and scattered epithelial rests without a complete lining. This distinction may influence treatment success — true cysts may be less likely to resolve with conventional RCT alone.
Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016