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Dr. Murrahs class > Chapter 15: Odontogenic Cysts and Tumors > Flashcards

Chapter 15: Odontogenic Cysts and Tumors Flashcards

1
Q
A

dentigerous cyst

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2
Q

what is the radiographic presentation of dentigerous cysts?

A
  • unilocular radiolucency associated with the crown of unerupted tooth
  • well-defined and usually sclerotic border
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3
Q

describe the basal cell carcinomas that characterize nevoid basal cell carcinoma syndrome

A
  • appear around puberty
  • on skin not exposed to sunlight
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4
Q

what is the recurrence of odontogenic keratocysts?

A

30%, which may happen 10+ years after surgery (long-term follow up is required)

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5
Q

calcifying epithelial odontogenic tumor is also called ___

A

pindborg tumor

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6
Q

odontogenic keratocysts are a type of ___ cyst

A

odontogenic

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7
Q
A

dentigerous cyst

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8
Q

gingival cysts of the adult are derived from ___

A

rests of the dental lamina (rests of serres)

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9
Q

___ is involved in 1/3 of odontogenic keratocyst cases

A

an unerupted tooth

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10
Q

patients with nevoid basal cell carcinoma syndrome usually do not have ___

A

life threatening anomolies

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11
Q

eruption cysts are a type of ___ cyst

A

odontogenic

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12
Q

what is the most common location of odontogenic keratocysts? what direction do they tend to grow?

A

posterior mandible, in an anterior-posterior direction

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13
Q

WHO has reclassified odontogenic keratocysts as ___

A

keratocystic odontogenic tumors

most clinicians still refer to it as odontogenic keratocysts

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14
Q

odontogenic tumors are tumors of ___ origin

A

odontogenic epithelial

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15
Q
A

dentigerous cyst

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16
Q

is a biopsy required for the diagnosis of odontogenic keratocysts?

A

yes

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17
Q
A

dentigerous cyst

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18
Q

nevoid basal cell carcinoma syndrome is a system complex characterized by what 4 things?

A
  • multiple basal cell carcinomas
  • odontogenic keratocysts
  • calcification of the falx cerebri
  • rib anomolies (splayed or bifid ribs)
  • many others
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19
Q

describe the chromosome and gene involved in nevoid basal cell carcinoma syndrome

A
  • chromosome 9
  • PTCH gene
    • this gene abnormality has been detected in odontogenic keratocysts, which is why WHO wanted to change the name to represent a cystic neoplasm rather than a cyst
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20
Q

dentigerous cysts are most frequently found in patients of what age?

A

10-30

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21
Q

what location are orthokeratinized odontogenic cysts more common?

A

posterior mandible

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22
Q
A

Orthokeratinized Odontogenic Cyst

The basal epithelial layer does not demonstrate palisading. Keratohyaline granules are present, and a thick layer of orthokeratin is seen on the luminal surface.

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23
Q

what are the 4 types of odontogenic ectomesenchyme tumors?

A
  • central odontogenic fibroma
  • peripheral odontogenic fibroma
  • odontogenic myxoma
  • cementoblastoma
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24
Q

gingival cysts of the adult have a striking predilection to occur in what location?

A

mandibular canine/premolar area

located on the facial gingiva or alveolar mucosa

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25
Q

what age patient is often affected by orthokeratinized odontogenic cysts? male to female ratio?

A
  • young adults
  • M:F 2:1
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26
Q

what are orthokeratinized odontogenic cysts?

A

odontogenic cysts with orthokeratinized lining and NO basal palisading

*remember* odontogenic keratocysts have parakeratin and a palisaded basal layer

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27
Q

what is the clinical presentation of gingival cysts of the adult?

A

painless, dome-like swellings which are less than 5mm

may be blue in color

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28
Q
A

Orthokeratinized Odontogenic Cyst

A large cyst involving a horizontally impacted lower third molar

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29
Q
A

dentigerous cyst

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30
Q

what are the 5 types of odontogenic tumors?

A
  • ameloblastoma
  • ameloblastic carcinoma
  • malignant ameloblastoma
  • adenomatoid odontogenic tumor
  • calcifying epithelial odontogenic tumor
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31
Q

what is an eruption hematoma?

A

occurs when an eruption cyst is subjected to surface trauma, resulting in the blood to accumulate in the cystic fluid, which imparts a blue or purple color

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32
Q

do odontogenic keratocysts cause bone expansion?

A

no

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33
Q

what are the two most important things to remember about odontogenic keratocysts?

A
  1. 30% recurrence rate
  2. associated with a syndrome
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34
Q
A

eruption cyst

35
Q

why do dentigerous cysts need to be removed?

A
  • they can grown to considerable size, expand bone, and cause facial asymmetry, but they usually do not
  • also to rule out other cysts
36
Q

calcifying odontogenic cysts are a type of ___ cyst

A

odontogenic

37
Q
A

nevoid basal cell carcinoma syndrome

characterized by:

  • multiple basal cell carcinomas (top)
  • bifid ribs (LL)
  • calcification of falx cerebri (LR)
38
Q

___ is the soft tissue analogue of the dentigerous cyst

A

eruption cyst

39
Q

___ is the most common developmental cyst

A

dentigerous cyst

40
Q

what is the treatment and recurrence of orthokeratinized odontogenic cysts?

A

rarely recur after enucleation with currettage (around 2% recur)

41
Q

do odontogenic keratocysts resorb roots of adjacent teeth?

A

no

42
Q
A

eruption cyst

43
Q
A

odontogenic keratocyst

(this radiograph cannot be distinguished from lateral periodontal cyst)

44
Q

what is the histopathology of odontogenic keratocysts?

A
  • thin, friable wall (makes complete removal difficult)
  • epithelial lining is a uniform 6-8 layers thick
  • basal cell layer shows palisading and is hyperchromatic
  • epithelium is surfaced by wavy or “corrugated” parakeratin
  • may have small satellite cysts away from the primary lesion - “daughter cysts”
45
Q

___ appears as a soft, translucent swelling in the gingival mucosa overlying the crown of an erupting tooth

A

eruption cyst

46
Q

what is the treatment for dentigerous cysts? what about for larger cysts?

A
  • enucleation of the cyst together with the unerupted tooth
  • larger ones may be treated by marsupialization
47
Q

what is the radiographic presentation of orthokeratinized odontogenic cysts?

A
  • typically unilocular
  • usually appear as a dentigerous cyst around a 3rd molar
48
Q

what is the treatment of gingival cysts of the adult?

A

surgical excision is sufficient

49
Q

what is the inheritance of nevoid basal cell carcinoma syndrome?

A

autosomal dominant

50
Q

odontogenic keratocysts arise from ___

A

cell rests of the dental lamina

51
Q

how are most odontogenic keratocyst lesions treated?

A

enucleation and currettage

52
Q

lateral periodontal cysts are a type of ___ cyst

A

odontogenic

53
Q

are dentigerous cysts symptomatic or asymptomatic?

A

asymptomatic and discovered on routine xray

54
Q

eruption cysts develop as the result of a separation of the ___ from ___, and occurs within the soft tissues of the overlying alveolar bone

A

dental follicle from around the crown of an erupting tooth

55
Q

what is the treatment of an eruption cyst?

A
  • may not be required
  • cyst usually ruptures spontaneously
  • if this doesn’t occur, excision of the roof of the cyst permits eruption of the tooth
56
Q

in patients with nevoid basal cell carcinoma syndrome, varying degrees of ___ may result from operations for multiple odontogenic keratocysts

A

jaw deformity

57
Q

what is the prognosis of someone with nevoid basal cell carcinoma syndrome?

A

depends on the behavior of the skin tumors

58
Q

glandular odontogenic cysts are a type of ___ cyst

A

odontogenic

59
Q

gingival cysts of the adult are a type of ___ cyst

A

odontogenic

60
Q
A

odontogenic keratocyst

notice it’s a larger, multilocular lesion

61
Q

orthokeratinized odontogenic cysts are a type of ___ cyst

A

odontogenic

62
Q
A

gingival cyst of the adult

notice it is (kind of) in the mandibular canine/premolar area

63
Q

___ develops by accumulation of fluid between the reduced enamel epithelium and the tooth crown

A

dentigerous cyst

64
Q

buccal bifurcation cysts are a type of ___ cyst

A

odontogenic

65
Q

what is the prevalence of nevoid basal cell carcinoma syndrome?

A

1:60,000

66
Q

dentigerous cysts are a type of ___ cyst

A

odontogenic

67
Q
A

dentigerous cyst

68
Q

describe the odontogenic keratocysts that are characteristic of nevoid basal cell carcinoma syndrome

A
  • one of the most constant features of the syndrome
  • frequently multiple
69
Q
A

odontogenic keratocyst (cannot be differentiated from a dentigerous cyst in this radiograph)

70
Q
A

Orthokeratinized Odontogenic Cyst

Small unilocular radiolucency associated with the impacted mandibular left third molar

71
Q

what are the 5 types of mixed odontogenic tumors?

A
  • ameloblastic fibroma
  • ameloblastic fibro-odontoma
  • ameloblastic fibrosarcoma
  • odontoma
  • odontogenic tumors
72
Q

___ is a cyst that originates by separation of the follicle around the crown of an unerupted tooth

A

dentigerous cyst

73
Q
A

Odontogenic Keratocyst

The epithelial lining is 6 to 8 cells thick, with a hyperchromatic and palisaded basal cell layer. Note the corrugated parakeratotic surface.

74
Q

dentierous cysts enclose the ___ of the unerupted tooth and is attached at the ___

A
  • crown
  • CEJ
75
Q

dentigerous cysts most often involve what teeth? which teeth do they rarely involve?

A
  • mandibular 3rd molars
  • rarely involve unerupted deciduous teeth
76
Q

what is the prognosis and recurrence of dentigerous cysts?

A

prognosis is excellent and recurrence is rare

77
Q

gingival cysts of the adult are most commonly found in what age patient?

A

40-50 years old

78
Q

what is the radiographic presentation of odontogenic keratocysts (large vs small)?

A
  • smaller lesions: well-defined, unilocular RL with corticated margins
  • larger lesions: multilocular
79
Q

___ represents the soft tissue counterpart of the lateral periodontal cyst

A

gingival cyst of the adult

80
Q

if a patient <20 years old has an odontogenic keratocyst, they should be further evaluated to rule out ___

A

gorlin syndrome

81
Q

nevoid basal cell carcinoma syndrome is also called ___

A

gorlin syndrome

82
Q

most odontogenic keratocyst cases are diagnosed between what ages?

A

10-40 years old

83
Q

what age patient are eruption cysts usually seen in?

A

children <10 years old

Dr. Murrahs class (17 decks)

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