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Oral Pathology > Class: Exam 2 Odontogenic Cysts > Flashcards

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
Q

Clinical features of newborn (Dental lamina cysts)

A

Small yellowish elevations

26
Q

Treatment of newborn (dental lamina cysts)

A

No treatment

Will self-marsupialize and heal

27
Q

Define Adult Gingival cysts

A

Cysts of attached gingiva from degeneration of rests or glands of Serres (Dental lamina)
Soft compressible swellings

28
Q

Where are Adult gingival cysts commonly found?

A

Mandibular cuspid and bicuspids

29
Q

Adult gingival cysts are clinically similar to what?

A

Clinically similar to mucocele but mucoceles don’t occur on gingiva

30
Q

Treatment of adult gingival cysts

31
Q

Define Odontogenic Keratocyst

A

Developmental cyst from dental lamina

32
Q

Odontogenic Keratocysts are classified how?

A

90% parakeratinized

10% orthokeratinized (orthokeratinized odontogenic cyst)

33
Q

Where and within what age group are Parakeratinized keratocysts found?

A

All ages but more common 2-3 & 6-7 decades

Mandibular:Maxillary = 2:1
Increase –> Posterior Mandible

34
Q

Clinical features of Parakeratinized keratocysts

A

1/4 exapnsion +- drainage and pain

Clinically aggressive

35
Q

Radiographic findings of Parakeratinized keratocysts

A

Unilocular or multilocular radiolucency

Commonly mimics other types of odontogenic cysts

36
Q

Histologic findings of Parakeratinzied keratocysts

A

Parakeratotic stratified squamous epithelial lining with well developed palisaded and hyperchromatic basal cells
Often daughter or microcysts in wall

37
Q

Treatment/Prognosis of Parakeratinized keratocysts

A

Conservative surgical removal to resection to decompression

*about 1/3 recur

38
Q

What is Basal cell nevus-bifid rib syndrome

A

About 5% of patients with keratocyst have
Almost all multiple OKC’s
- Autosomal dominant (mutation of a tumor suppressor gene 9q22)

39
Q

Clinical features of Basal cell nevus-bifid rib syndrome

A

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
Q

Keratocysts known for what?

A

Clinical aggressiveness
Recurrence after removal
Association with basal cell nevus-bifid rib syndrome

41
Q

Describe orthokeratinized odontogenic cysts

A

Smaller
Less aggressive
Minimal recurrence
Not associated with syndrome

42
Q

Where and what age are Calcifying odontogenic cysts (Gorlin Cyst) most common?

A

Any age
> Mandible
Maybe associated with unerupted teeth or odontomas

43
Q

Clinical features of Calcifying odontogenic cysts (Gorlin Cyst)

A

Asymptomatic
Rarely expansion
Occur extraosseously

44
Q

Radiographic findings of Calcifying odontogenic cysts (Gorlin Cyst)

A

Radiolucent to mixed radiolucent/opaque

45
Q

Histologic findings of Calcifying odontogenic cysts (Gorlin Cyst)

A

Fully or partially cystic

cystic epithelium contains ghost cells (prematurely keratinized) which tends to calcify

46
Q

Treatment of Calcifying odontogenic cysts (Gorlin Cyst)

A

Conservative surgical removal - low recurrence

47
Q

Where are Glandular Odontogenic cysts most common?

A

Mandible, May be large

48
Q

Radiographic findings of Glandular Odontogenic cysts

A

Unilocular to multilocular radiolucency

49
Q

Histologic findings of Glandular Odontogenic cysts

A

Cyst showing glandular differentiation (mucus cells, columnar epithelium with cilia, lumina)

50
Q

Treatment of Glandular Odontogenic cysts

A

Surgical excision

30-50% recurrence

51
Q

Define Buccal Bifurcation cyst (Paradental cyst)

A

Inflammatory cyst occuring on buccal of erupting tooth

52
Q

Where and within what age group are Buccal bifurcation cysts most common?

A

Children
Mandibular first molar (often enamel extension into furcation)
Buccal swelling

53
Q

Radiographic findings of Buccal bifurcation cysts

A

Unilocular lucency involving furcation of roots

54
Q

Histologic findings of Buccal bifurcation cysts

A

Inflamed cyst lined by stratified squamous epithelium

55
Q

Treatment of Buccal bifurcation cysts

A

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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