Chapter 15 Flashcards

1
Q

Dentigerous Cyst

A

Cyst tht originates by separation of the follicle from the crown of unerrupted tooth.

Accumulation of fluid between the REE and tooth crown

Follicular space is larger than 3mm

Encloses the crown of the unerrupted tooth and is attached at the CEJ

Completely asymptomatic – discoveredon routine xray

XRAY: UNILOCULAR radiolucency, well defined (sclerotic border)

Most commonly associated with 3rd molars

MOST COMMON DEVELOPMENTAL ODONTOGENIC CYST

Treatment: Enucleation of the cyst with the unerrupted tooth.

May marsupialization

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2
Q
A

Dentigerous Odontogenic Cyst

**MOST COMMON DEVELOPMENTAL ODONOTGENIC CYST**

UNILOCULAR LESION

Most commonly associated with 3rd molars

Asymptomatic

NEED to remove – cysts continue to grow

(may need to remove tooth and cyst)

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3
Q

Odontogenic Cysts

A

Pathologic cavity lined by odontogenic epithlium and filled with fluid or semisolid material

Originates from: Rests of Sire (90%) or Rest of Malessez (10%)

Come from the dental lamin (dental epithelium)

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4
Q

Eruption Cyst

A

SOFT TISSUE analogue of the dentigerous cyst

Tooth will errupt

Develops as result of separation of the dental follicle from around the crown o an erupting tooth

Clinically –> blue swelling

Radiographically –> tooth is erupting

Younger children

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5
Q
A

Eruption Cyst

Looked radiographically for an errupting tooth

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6
Q

Odontogenic Keratocyst

A

Keratocystic odontogenic tumor (KOT)

Tend to grow in an anterior - posterior direction

Doesn’t cause bone expansion

Cheese material inside the cyst

XRAY: Unilocular or multilocular

Corticated margins

Know HISTOLOGY!

Associated GORLIN SYNDROME

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7
Q

Histopathology of Odontogenic Keratocyst

A

Thin Friable Wall

Epithelial lining is uniform – 6-8 layers thick

Basal Cell LayerPallisading and hyperchromatic

Corrugated parakeratin

May have small satellite cysts – Daughter cysts (Cause for recurrence)

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8
Q
A

Odontogenic keratocyst

Histology:

Thin and friable

Pallisaded and hyperchromatic

Corrugated parakeratin

Daughter cysts

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9
Q

Most common developmental odontogentic cyst?

A

Dentigerous Cyst

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10
Q

Nevoid Basal Cell Carcinoma

A

GORLIN SYNDROME

Chromosome 9 – PTCH gene

Characterized by:

Multiple Basal Cell Carcinoma’s - appear around puberty, where sun doesn’t shine

Odontogenci keratocysts - one of the most CONSTANT FEATURE

Calcification of Falx Cerbri

Rib abnormalities – BIFID ribs

Dangerous becuase of Basal Cell Carcinoma

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11
Q

What syndrome is Odontogenic keratocyst typically associated with?

A

Nevoid Basal Cell Carcinoma Syndrome

(Gorlin Syndrome)

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12
Q

Associated with multiple odontogenic keratocysts

A

Nevoid Basal Cell Carcinoma Syndrome

(Gorlin Syndrome)

Will also see basal cell carcinoma in areas where the sun doesn’t shine

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13
Q
A

Odontogenic Keratocysts

“GORLIN SYNDROME” – multiple lesions

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14
Q

Orthokeratinized Odontogenic Cyst

A

Orthokeratinized lining and NO BASAL PALISADING

Young adults

Posterior Mandible

UNILOCULAR - May appear like a dentigerous cyst

Recurrance is RARE

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15
Q

Gingival Cyst of the Adult

A

Represents the SOFT TISSUE counterpart of lateral periodontal cyst

Derived from Rests of Serres (dental lamina)

Mandibular canine and premolar region

Facial gingiva or alveolar mucosa

Painless domelike structure – may be BLUE in coloration

Palpation –> Fluid, fluctuant

(Peripheral ossifying fibroma will be hard on palpation)

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16
Q

Lateral Periodontal Cyst

A

Developmental odontogenic cyst – typically occurs aong the LATERAL ROOT SURFACE inside bone

Arise from rests of dental lamina – RESTS of SERRES

Premolar-Canine-Lateral Incisor region

TEETH ARE VITAL

Unilocular or Multilocular (botryoid odontogenic cyst)

Recurrence is RARE

17
Q
A

Lateral Bone Cyst

Arises from Rests of Serres

Soft tissue counterpart –> Gingival Cyst

18
Q
A

Multilocular Lateral Periodontoal Cyst

BOTRYOID ODONTOGENIC CYSTS

19
Q

Calcifying Odontogenic Cyst

A

GORLIN CYST (not associated with Gorlin Syndrome)

Incisor-canine area

Associated with ODONTOMAS

Rest cells of SERES ?

Xray:

Unilocular - well defined

Radiopaque structure seen within the RL

No radiopacity – think lateral periodontal cyst

Rare recurrences

20
Q
A

Calcifying Odontogenic Cyst

GOLRIN CYST

Associated with odontomas

Unilocular – radiopaque center

21
Q

Cyst can push unerrupted teeth into the sinus… what cyst can do this?

A

Odontogenic Keratocyst

22
Q

Gorlin Cyst?

A

Calcifying Odontogenic Cyst (COC)

23
Q

Glandular Odontogenic Cyst (GOC)

A

RARE and doesn’t appear as much

Developmental cyst with glandular and/or salivary gland features (odontogenic cyst)

Majority in the MANDIBLE

Anterior jaw – may cross the midline

Size can vary

XRAY:

Unilocular** or **multilocular

may look similar to dentigerous cyst – do not always have to be associated with an impacted tooth

Well defined

Sclerotic rim

Treatment –> enucleation or curettage

30% reccurence rate – will need to follow up with patient

(multilocular lesion more likely to recur – hard to remove all of the cyst)

24
Q

Buccal Bifurcation Cyst

A

Inflammatory cyst with uncertain pathogenesis

Develops on BUCCAL aspect of the mandibular 1st permanent molar (2nd molar) – PARTIALLY ERUPTED

Pushes the crown buccally and the roots lingually (develops below CEJ)

Occurs in avg age of 10

Symptoms: Tenderness, swelling, or fout tasting discharge