Chapter 15 Flashcards
Dentigerous Cyst
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
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)
Odontogenic Cysts
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)
Eruption Cyst
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
Eruption Cyst
Looked radiographically for an errupting tooth
Odontogenic Keratocyst
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
Histopathology of Odontogenic Keratocyst
Thin Friable Wall
Epithelial lining is uniform – 6-8 layers thick
Basal Cell Layer – Pallisading and hyperchromatic
Corrugated parakeratin
May have small satellite cysts – Daughter cysts (Cause for recurrence)
Odontogenic keratocyst
Histology:
Thin and friable
Pallisaded and hyperchromatic
Corrugated parakeratin
Daughter cysts
Most common developmental odontogentic cyst?
Dentigerous Cyst
Nevoid Basal Cell Carcinoma
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
What syndrome is Odontogenic keratocyst typically associated with?
Nevoid Basal Cell Carcinoma Syndrome
(Gorlin Syndrome)
Associated with multiple odontogenic keratocysts
Nevoid Basal Cell Carcinoma Syndrome
(Gorlin Syndrome)
Will also see basal cell carcinoma in areas where the sun doesn’t shine
Odontogenic Keratocysts
“GORLIN SYNDROME” – multiple lesions
Orthokeratinized Odontogenic Cyst
Orthokeratinized lining and NO BASAL PALISADING
Young adults
Posterior Mandible
UNILOCULAR - May appear like a dentigerous cyst
Recurrance is RARE
Gingival Cyst of the Adult
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)