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Class: Exam 2 Odontogenic Cysts Flashcards

1
Q

What is Odontogenesis?

A

Odontogenesis starts with surface ectoderm (epithelium) growing into jaw (dental lamina) and producing the tooth germ, a portion of which is the enamel organ

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2
Q

Define Odontogenic Cysts

A

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

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3
Q

Etiology of odontogenic cysts

A
  1. inflammation

2. Unknown, these are called developmental cysts but are not inflammatory

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4
Q

Which cysts are inflammatory?

A

Radicular cyst and buccal bifurcation cysts are inflammatory

All the rest are developmental

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5
Q

Define Primordial Cysts

A

Cyst arising from degeneration of enamel organ prior to tooth formation aborts odontogenesis resulting in radiolucency in place of a missing tooth
- Mandibular 3rd molars

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6
Q

Define Dentigerous Cyst (Follicular Cyst)

A

Cyst resulting from separation of the follicle from around the crown of developing tooth

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7
Q

Where and within what population is Dentigerous cysts most commonly found?

A

Any age
Mandibular 3rd molars
Maxillary cuspids

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8
Q

Clinical findings of Dentigerous cysts

A

Asymptomatic

Usually no expansion

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9
Q

Radiographic findings of Dentigerous Cyst

A

Well circumscribed pericoronal radiolucency

From CEJ around crown

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10
Q

Histological features of Dentigerous Cyst

A

Stratified squamous epithelium without keratinization (this was originally the ameloblasts which following odontogenesis becomes reduced enamel epithelium)

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11
Q

Treatment of Dentigerous Cyst

A

Surgical removal of tooth and cyst if 3M

For Cuspid, may be able to decompress and pull Cuspid in orthodontically

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12
Q

Variants of Dentigerous Cyst

A
  1. Eruption Cyst - A dentigerous cyst that gets pushed into oral cavity by erupting tooth, may treat with decompression so tooth can erupt
  2. Lateral - > Md 3M - Laterally placed
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13
Q

Neoplastic potential of Dentigerous cyst

A

Exceedingly rare

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14
Q

What three neoplastic lesions may develop from the lining of a dentigerous cyst?

A

Ameloblastoma
Squamous cell carcinoma
Mucoepidermoid Carcinoma

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15
Q

Name the Periodontal Cysts

A

Apical Periodontal Cyst (Radicular cyst)

Lateral Periodontal Cyst

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16
Q

Describe the Apical Periodontal Cyst

A

Most common of all odontogenic cysts
Inflammatory origin secondary to devitalized pulp

  1. Lateral radicular cyst
  2. Residual cyst
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17
Q

Describe the Lateral Periodontal cyst

A

Arises from cystic degeneration of rests of Malassez in PDL

Teeth are vital

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18
Q

Where are Lateral Periodontal cysts most comon?

A

Mandibular Cuspid and Bicuspids

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19
Q

Radiographic findings of Lateral Periodontal cyts

A

Small well circumscribed radiolucency along lateral root surface of vital tooth

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20
Q

Histological findings of Lateral Periodontal cysts

A

Nonkeratinizing stratified Squamous epithelial lining

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21
Q

Treatment of Lateral Periodontal cysts

A

Excision

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22
Q

Variant of Lateral Periodontal cysts

A

Botryoid odontogenic cyst

- polycystic, multilocular, may recur after removal

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23
Q

Describe the Newborn (dental lamina cyst)

A

Soft tissue cysts on gingiva or alveolar ridge from degenerating dental lamina
Very common

24
Q

When are newborn (Dental lamina cysts) found?

A

Congenital or early life

25
Clinical features of newborn (Dental lamina cysts)
Small yellowish elevations
26
Treatment of newborn (dental lamina cysts)
No treatment | Will self-marsupialize and heal
27
Define Adult Gingival cysts
Cysts of attached gingiva from degeneration of rests or glands of Serres (Dental lamina) Soft compressible swellings
28
Where are Adult gingival cysts commonly found?
Mandibular cuspid and bicuspids
29
Adult gingival cysts are clinically similar to what?
Clinically similar to mucocele but mucoceles don't occur on gingiva
30
Treatment of adult gingival cysts
Excision
31
Define Odontogenic Keratocyst
Developmental cyst from dental lamina
32
Odontogenic Keratocysts are classified how?
90% parakeratinized | 10% orthokeratinized (orthokeratinized odontogenic cyst)
33
Where and within what age group are Parakeratinized keratocysts found?
All ages but more common 2-3 & 6-7 decades Mandibular:Maxillary = 2:1 Increase --> Posterior Mandible
34
Clinical features of Parakeratinized keratocysts
1/4 exapnsion +- drainage and pain | Clinically aggressive
35
Radiographic findings of Parakeratinized keratocysts
Unilocular or multilocular radiolucency | Commonly mimics other types of odontogenic cysts
36
Histologic findings of Parakeratinzied keratocysts
Parakeratotic stratified squamous epithelial lining with well developed palisaded and hyperchromatic basal cells Often daughter or microcysts in wall
37
Treatment/Prognosis of Parakeratinized keratocysts
Conservative surgical removal to resection to decompression | *about 1/3 recur
38
What is Basal cell nevus-bifid rib syndrome
About 5% of patients with keratocyst have Almost all multiple OKC's - Autosomal dominant (mutation of a tumor suppressor gene 9q22)
39
Clinical features of Basal cell nevus-bifid rib syndrome
basal cell carcinomas (not nevi; not limited to sun-exposed areas or elderly) - calcification of falx cerebri - bone anomalies (bifid ribs) - OKCs usually multiple - Pits in palms and soles
40
Keratocysts known for what?
Clinical aggressiveness Recurrence after removal Association with basal cell nevus-bifid rib syndrome
41
Describe orthokeratinized odontogenic cysts
Smaller Less aggressive Minimal recurrence Not associated with syndrome
42
Where and what age are Calcifying odontogenic cysts (Gorlin Cyst) most common?
Any age > Mandible Maybe associated with unerupted teeth or odontomas
43
Clinical features of Calcifying odontogenic cysts (Gorlin Cyst)
Asymptomatic Rarely expansion Occur extraosseously
44
Radiographic findings of Calcifying odontogenic cysts (Gorlin Cyst)
Radiolucent to mixed radiolucent/opaque
45
Histologic findings of Calcifying odontogenic cysts (Gorlin Cyst)
Fully or partially cystic | cystic epithelium contains ghost cells (prematurely keratinized) which tends to calcify
46
Treatment of Calcifying odontogenic cysts (Gorlin Cyst)
Conservative surgical removal - low recurrence
47
Where are Glandular Odontogenic cysts most common?
Mandible, May be large
48
Radiographic findings of Glandular Odontogenic cysts
Unilocular to multilocular radiolucency
49
Histologic findings of Glandular Odontogenic cysts
Cyst showing glandular differentiation (mucus cells, columnar epithelium with cilia, lumina)
50
Treatment of Glandular Odontogenic cysts
Surgical excision | 30-50% recurrence
51
Define Buccal Bifurcation cyst (Paradental cyst)
Inflammatory cyst occuring on buccal of erupting tooth
52
Where and within what age group are Buccal bifurcation cysts most common?
Children Mandibular first molar (often enamel extension into furcation) Buccal swelling
53
Radiographic findings of Buccal bifurcation cysts
Unilocular lucency involving furcation of roots
54
Histologic findings of Buccal bifurcation cysts
Inflamed cyst lined by stratified squamous epithelium
55
Treatment of Buccal bifurcation cysts
Enucleation of cyst. If you recognize this clinically which you should, you do not have to extract the tooth

Oral Pathology (4 decks)

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