CYST (man &manag) Flashcards by Love Dog

Q

a pathologic space lined with epithelium

A

CYSTS

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Q

T or F

pseudocysts are lined with epithelium

A

False

(pseudocysts are NOT lined with epithelium)

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Q

HOW IT STARTED

→ periapical infections

→ chronic and acute pathways that untreated infections and their
accompanying clinical lesions may take depending on the type of the ____, ____, _____

A

preceding pulpitis, virulence of the bacteria, and the presence or absence of drainage

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Q

origin/etiology

dental lamina remnants

A

RUSHTON BODIES

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Q

origin/etiology

sources of ameloblastoma

A

RUSHTON BODIES

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Q

Cysts derived from:

A

Rests of Malassez

Reduced Enamel Epithelium

Dental Lamina (Rests of Serres)

Unclassified

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Q

→ periapical cyst
→ residual cyst

A. Rests of Malassez
B. Reduced Enamel Epithelium
C. Dental Lamina (Rests of Serres)
D. Unclassified

A

A

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Q

→ dentigerous cyst
→ eruption cyst

A. Rests of Malassez
B. Reduced Enamel Epithelium
C. Dental Lamina (Rests of Serres)
D. Unclassified

A

B

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Q

→ odontogenic keratocyst
o multiple

→ lateral periodontal cyst
o polycystic (botryoid)

A. Rests of Malassez
B. Reduced Enamel Epithelium
C. Dental Lamina (Rests of Serres)
D. Unclassified

A

C

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Q

→ gingival cyst of the adult
→ dental lamina cyst of the newborn
→ glandular odontogenic cyst

A. Rests of Malassez
B. Reduced Enamel Epithelium
C. Dental Lamina (Rests of Serres)
D. Unclassified

A

C

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Q

paradental cyst

A. Rests of Malassez
B. Reduced Enamel Epithelium
C. Dental Lamina (Rests of Serres)
D. Unclassified

A

D

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Q

CLASSIFICATION OF CYSTS

A

→ odontogenic cysts
→ non-odontogenic
→ soft tissue cysts of the neck
→ pseudocysts

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Q

→ periapical cyst
→ dentigerous cyst
→ eruption cyst
→ lateral periodontal cyst
→ gingival cyst of the newborn
→ odontogenic keratocyst
→ calcifying odontogenic cyst
→ primordial cyst
→ residual cyst

Are what CLASSIFICATION OF CYSTS?

A

ODONTOGENIC CYSTS

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Q

also called radicular or apical periodontal cyst

A

PERIAPICAL CYST

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Q

their epithelial lining is from growth of Rests Cells of Malassez

A

PERIAPICAL CYST

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Q

ETIOLOGY AND PATHOGENESIS

→ develops from a periapical granuloma; this is a chronic inflammation
→ a product of necrotic pulp tissue
→ when the epithelial rest cells of malassez are stimulated in
response to inflammation, a cyst is formed

A

PERIAPICAL CYST

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Q

→ increase in fluid will increase the size of the cyst
→ osteoclasts will resorb bone, resulting to cyst expansion
→ other bone resorbing factors are:
o prostaglandins
o interleukins
o proteinases

A

PERIAPICAL CYST

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Q

CLINICAL FEATURES
→ almost half or 3⁄4 of cysts in the oral cavity
→ most affected are maxillary incisors
→ asymptomatic, discovered only by routine radiograph
→ cannot differentiate from granuloma by x-ray
→ round or ovoid

A

PERIAPICAL CYST

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Q

→ Russel bodies are round
→ Rushton bodies are hairpin-shaped; sign of previous
hemorrhage

A

PERIAPICAL CYST

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Q

TREATMENT AND PROGNOSIS
Of PERIAPICAL CYST

A

→ extraction
→ followed by curettage of apical area
→ RCT with apicoectomy if RCT does not resolve
→ if epithelium is left, residual cyst will form

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Q

also known as follicular cyst

A

DENTIGEROUS CYST

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Q

→ 2nd most common odontogenic cyst
→ associated with crown of unerupted or developing tooth

A

DENTIGEROUS CYST

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Q

DIFFERENCE FROM PRIMORDIAL CYST
→ both are attached to the crown of unerupted or developing tooth but the dentigerous cyst is attached on the _____

A

Cervical area

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Q

enamel organ (its remnants are called REE)

A

DENTIGEROUS CYST

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CLINICAL FEATURES → common in 3rd molars & maxillary canines → late eruption of tooth → well-defined unilocular radiolucency

DENTIGEROUS CYST

HISTOPATHOLOGY → cyst lining is stratified squamous epithelium → 4-6 layers thick

DENTIGEROUS CYST

DENTIGEROUS CYST TREATMENT

→ remove tooth involved → enucleation o complete removal of the whole lesion including the lining of the cyst; thus, exposing the adjacent bone → if cyst is too big, marsupialization is done

→ untreated dentigerous cyst can become ____ → if mucous cells are present, cyst can become _____

ameloblastoma, mucoepidermoid carcinoma

a dentigerous cyst resulting from fluid accumulation within the follicular space of an erupting tooth

ERUPTION CYST

→ the epithelial lining is REE → trauma can cause blood to pool within the tissue space and is called an “________”

eruption hematoma (ERUPTION CYST)

ERUPTION CYST txt

none because the tooth will erupt through the cyst and it disappears

round or teardrop-shaped

LATERAL PERIODONTAL CYST

common in mandibular premolar and cuspids and maxillary lateral incisors

LATERAL PERIODONTAL CYST

a lateral periodontal cyst which is multilocular

BOTRYOID ODONTOGENIC CYST

LATERAL PERIODONTAL CYST Txt.

local excision

also known as dental lamina cyst of the newborn

GINGIVAL CYST OF THE NEWBORN

also known as Bohn’s nodules

GINGIVAL CYST OF THE NEWBORN

→ found along alveolar ridge → origin: o remnants of dental lamina within alveolar ridge

GINGIVAL CYST OF THE NEWBORN

GINGIVAL CYST OF THE NEWBORN txt.

none; they degenerate or rupture into the cavity before 3 months of age

SIMILAR CYSTS → palatine cysts of the newborn or Epstein pearls → origin: o remnants in the fusion lines between palatal shelves and nasal processes

GINGIVAL CYST OF THE NEWBORN

a cyst which occurs in place of a tooth owing to cystic degeneration of an enamel organ

PRIMORDIAL CYST

→ globulomaxillary lesions → nasolabial cyst → median mandibular cyst → nasopalatine canal cyst Are CLASSIFICATION OF what CYSTS?

NON-ODONTOGENIC CYSTS

→ origin: o odontogenic epithelium located between maxillary lateral incisor and canine o it shows a radiolucency between these 2 teeth

GLOBULOMAXILLARY LESIONS

pear-shaped

GLOBULOMAXILLARY LESIONS

→ pathogenesis: o epithelial cells trapped at the fusion of globular portion of the nasal & maxillary processes o may also come from solid cord cells that forms the nasolacrimal duct

NASOLABIAL CYST

origin: o there is a mesenchyme tissue that gradually becomes lost as the mandible develops and the embryonic processes does not fuse

MEDIAN MANDIBULAR CYST

also known as incisive canal cyst

NASOPALATINE CYST

located inside nasopalatine canal or inside palatal soft tissues at the opening of the canal; thus, may be termed as cyst of palatine papilla

NASOPALATINE CYST

heart-shaped

NASOPALATINE CYST

all of the above terms fall under the general term: ________ o many believe this term means the cyst is in the posterior area of the nasopalatine canal o the median alveolar cyst is in the anterior area of the nasopalatine canal

median palatine cyst

DERMOID AND EPIDERMOID CYST THYROGLOSSAL TRACT CYST BRANCHIAL CYST Classification?

SOFT TISSUE CYSTS

form of cystic teratoma

DERMOID AND EPIDERMOID CYST

→ derived from embryonic germinal epithelium → presumed to be derived from enclavement (retention due to constriction) of epithelial debris in the midline during closure of the mandibular and hyoid branchial arches

DERMOID AND EPIDERMOID CYST

looks like a golf ball

DERMOID AND EPIDERMOID CYST

→ majority occurs in young adults → a bulge in the floor of the mouth is seen and the tongue becomes elevated o because of elevation, there is difficulty in eating and talking → when the cyst is palpated, it is dough-like or soft

DERMOID AND EPIDERMOID CYST

→ derived from embryonic germinal epithelium → presumed to be derived from enclavement (retention due to constriction) of epithelial debris in the midline during closure of the mandibular and hyoid branchial arches

DERMOID AND EPIDERMOID CYST

connective tissue wall: o lined on the inner surface by a thin layer of stratified squamous epithelium contains: o sebaceous glands o hair follicles o sweat glands

DERMOID AND EPIDERMOID CYST

lumen contains sebaceous material and keratin A. Dermoid Cyst B. Epidermoid Cyst

A

lumen contains only keratin A. Dermoid Cyst B. Epidermoid Cyst

B

DERMOID AND EPIDERMOID CYST txt.

→ surgical excision → does not recur

location: o a developmental cyst that form anywhere along the embryonic thryoglossal tract between the foramen caecum of the tongue and the thyroid glands → as we grow old, it is supposed to be obliterated; however, in cases it does not, the remnants of the tract become thyroglossal tract cyst

THYROGLOSSAL TRACT CYST

→ location: o sometimes may lie to one side of the midline o foramen cecum o floor of the mouth → if formed near the tongue, usually cause difficulty in swallowing or dysphagia

THYROGLOSSAL TRACT CYST

THYROGLOSSAL TRACT CYST if occurs: Above Level of Hyoid Bone A. lined by stratified squamous epithelium B. lined by columnar or ciliated columnar epithelium

A

THYROGLOSSAL TRACT CYST if occurs: Below Level of Hyoid Bone A. lined by stratified squamous epithelium B. lined by columnar or ciliated columnar epithelium

TREATMENT of THYROGLOSSAL TRACT CYST

completed surgical excision

→ slowly growing soft tissue cysts of the neck → usually, asymptomatic

BRANCHIAL CYST

→ location: o occurs on the lateral aspect of the neck o may also occur in the angle of the mandible, submandibular areas, preauricular area or parotid area

BRANCHIAL CYST

ETIOLOGY → originates through cystic transformation in tract in the cervical lymph nodes

BRANCHIAL CYST

HISTOLOGIC FEATURES → connective tissue wall is lined by stratified squamous or pseudostratified columnar epithelium → connective wall of the cyst exhibits lymphoid tissue and contains thin, watery fluid or thick gelatinous mucoid material

BRANCHIAL CYST

BRANCHIAL CYST txt.

→ through surgical excision → recurs if residual remnants are left or if lesion is just drained

→ false cysts → appears cystic but has no epithelial lining

PSEUDOCYSTS

CLINICAL FEATURES → generally, a lesion in young person’s mostly <20 years old → often, a history of traumatic injury is noted → usually a tender or painful which limits the movement of the affected bone

ANEURYSMAL BONE CYST

→ swelling in the bone involved → resembles a blood-soaked sponge

ANEURYSMAL BONE CYST

RADIOGRAPHIC FEATURES → expanded bone → tooth may be displaced with or without root resorption → presence of osteolytic process (lysis of bone or bone destruction)

ANEURYSMAL BONE CYST

appears cystic with honeycomb or soap bubble appearance

ANEURYSMAL BONE CYST

HISTOLOGIC FEATURES → consists of fibrous connective tissue stroma containing cavernous spaces or sinusoidal blood-filled spaces → contains: o young fibroblast o multinucleated giant cells → presence of hemosiderin, new osteoid, and bone formation

ANEURYSMAL BONE CYST

ANEURYSMAL BONE CYST txt. J

→ surgical excision with curettage with low doses of radiation

also called developmental Stafne defect or developmental lingual mandibular salivary gland depression

STATIC BONE CYST

→ rare change in size; sometimes doesn’t grow at all → usually asymptomatic → developmental defect = no treatment → often, salivary gland depression that lies below the mandibular canal

STATIC BONE CYST

developmental depression of mandible secondary to: *entrapment of salivary gland parenchyma during the development of mandible *indentation along the lingual aspect of the mandible within which there’s extension of the submandibular gland

STATIC BONE CYST

most affected: o usually seen in the 2nd or 3rd molar area

STATIC BONE CYST

→ also called simple bone cyst, big cyst → there is expansion or swelling → usually asymptomatic, though on some occasions, patients will complain of pain

TRAUMATIC BONE CYST

→ even if the cyst is big, the teeth involved are usually vital → most affected: o frequently occurs in the mandible (posterior area) lying below the mandibular canal

TRAUMATIC BONE CYST

ETIOLOGY → obstruction of the duct of the minor or accessory salivary glands due to traumatic severance of a salivary duct → if the duct is severed or traumatized, there would be spillage of the mucous to the connective tissue or mucin causing secondary inflammation reaction → granulation tissue formation which will now form around the mucin pool

MUCOCELE: MUCUS EXTRAVASATION PHENOMENON

CLINICAL FEATURES → location: o usually found in the lower lip → has peripheral inflammatory change → painless mass that contains: o thick mucinous material → connective tissue wall: o made of granulation → tissue and fibroblast not lined by epithelium and have a cavity containing mucin in the connective tissue and submucosa

MUCOCELE: MUCUS EXTRAVASATION PHENOMENON

→ usually asymptomatic → size is usually 3-10 mm → usually appears after 50 years old → normal color and there are intact overlying mucosa

MUCOCELE: MUCOUS RETENTION CYST

sometimes, it will involve the maxillary sinus and if that happens, you’ll have a dome-shaped, semilunar radiopacity noted along the floor of the sinus

MUCOCELE: MUCOUS RETENTION CYST

→ on palpation: o mobile o non-tender o no peripheral inflammatory change → location: o palate o cheeks o floor of the mouth

MUCOCELE: MUCOUS RETENTION CYST

ETIOLOGY → obstruction of salivary flow HISTOLOGIC FEATURES → connective tissue wall: o lined by pseudostratified columnar or cuboidal epithelium (true cyst) → lack of inflammatory cell infiltrate → cystic cavity lined by oncocytes (ductal epithelial cells

MUCOCELE: MUCOUS RETENTION CYST

MUCOCELE: MUCOUS RETENTION CYST txt.

→ surgical excision and mucus retention cyst → complete removal of associated lobules of minor salivary gland elements → to prevent recurrence: o remove the associated salivary gland acini

a mucocele on the floor of the mouth

RANULA

CLINICAL FEATURES → slowly enlarging painless mass → bluish-frog cystic lesion → usually fluctuant, unilateral soft tissue mass

RANULA

RANULA txt

TREATMENT → marsupialization may be performed before definitive surgical excision → because the mass is big, this compresses the lesion (the cyst) into a smaller size