Cyst Flashcards
What are the clinical signs and symptoms of a cyst?
- Increase in size of jaw or alveolar bone
- Salty taste
- Unable to wear dentures
- Loose teeth
- Occlusal changes
- Delayed eruption
- Occasional pain and dysaesthesia
- Bluish swelling on alveolus, fluctuant, egg-shell cracking/ pingpong feeling
Radiographic feature of a cyst
Generally well-circumscribed/ovoid radiolucent area with a radiopaque margin
List some Developmental Cysts
- Dentigerous cyst
- Eruption cyst
- Odontogenic keratocyst
- Ortho-keratinised odontogenic cyst
List some Inflammatory cyst?
- Periapical radicular cyst
- Residual cyst
List a gingival cyst
Lateral periodontal cyst
List some non-odontogenic cysts
- Nasopalatine duct cyst
- Dermoid cyst
- Simple bone cyst
- Stafne bone cyst
- Mucous extravasation
- Mucous retention cyst
Etiology of a Periapical Cyst
Inflammation in the PA area increases keratinocyte growth factor leads to the proliferation of epithelium
Periapical cyst is always associated with?
a non-vital tooth
What are the components of a cyst?
Thick fibrous CT wall lined by epithelium. Wall sometimes show cholesterol clefts
Protein content of cyst high in cyst fluid
Etiology of buccal bifurcation cyst?
Buccal enamel extensions in the bifurcation area, predispose to pocket formation form which inflammation could lead to cystic formation
Buccal bifurcation cyst/Paradental cyst are usually seen in what age and teeth?
6-11 years, lower 6s
What is a residual cyst?
Inflammatory cyst that has persisted after its associated tooth has been lost.
Growth from a remnant of a periapical cyst
Lateral Periodontal Cyst is usually seen in what age and teeth?
50-70 years, mandibular premolar region
How do you treat a lateral periodontal cyst?
Careful enucleation
Etiology of a Dentigerous Cyst
Separation of follicle from the crown of an unerupted tooth
Most common developmental odontogenic cyst
What is an Odontogenic Keratocyst?
Aggressive cyst known for its rapid growth and tendency to invade adjacent tissue
What is the age prevalence of Odontogenic Keratocyst?
10-40 years
Where does the Odontogenic Keratocyst originate from?
Dental lamina
Why is it difficult to enucleate an Odontogenic Keratocyst?
Thin friable lining and daughter cysts
Recurrence rate is 5-62%
What are the components of an Odontogenic Keratocyst
- Stratified squamous epithelium 6-8 layers thick
- Cyst fluid creamy yellowish or serous-like
How does an Odontogenic Keratocyst grow?
Grow in anterior-posterior direction within medulla
What is a naso-labial cyst?
Rare developmental soft tissue cyst made of pseudo stratified columnar epithelium
Nasolabial cyst can cause?
Nasal obstruction and denture wearing
What is a nasopalatine cyst?
Most common non-odontogenic cyst that arise from remnants of nasopalatine duct
Made of cuboidal-columnar epithelium
Nasopalatine duct cyst usually presents in which age?
40-60 years old
What is a simple bone cyst?
Benign cyst is generally empty or some fluid. No epithelium
What are the diagnostic tests done for a cyst?
- Aspiration of cyst fluid
- Biopsy of cyst lining
How to do biopsy for a cyst?
- Determine whether lesion is solid or cystic
- If cyst is near the surface, excise an ellipse of tissue of oral mucosa + cyst lining
- If cyst in infra-bony, raise flap, remove window of bone take an ellipse of cyst lining
- If bone is thin, take wedge of bone and cyst lining
Treatment of Cyst
- Surgical enucleation
- Enucleation with Carnoy’s solution
- Marsupialisation
- Marsupialisation followed by enucleation
- Osseous resection
- Endodontic management of periapical cyst
What is surgical enucleation?
Total removal of a cystic lesion
What are the grafting materials?
- Demineralised bone chips
- Mineralised bone chips
- Tri calcium phosphate
- Bovine hydroxyapatite
What is the endodontic management for periapical cyst?
Followed up for at least 2 years. If no improvement, lesion must be biopsied
What is Carnoy Solution made of?
- 3ml chloroform
- 6ml absolute alcohol
- 1ml glacial acetic acid
- 1gm ferric chloride
What is the use of Carnoy Solution?
Complementary treatment after the conservative excision of OKC.
Promotes a superficial chemical necrosis and is intended to reduce recurrence rates.
When is marsupialisation indicated?
Large cysts when enucleation will injure adjacent structures
Management of Ameloblastoma?
Treatment by enucleation gives a recurrence rate of 30%
Difference between cysts and odontogenic tumour
- Speed of growth
- Expansion of buccal and lingual cortical plates
- Erosion through cortical bone
- Erosion of adjacent teeth
- Radiographic patterns
