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5th yr- CMS2 > Cyst management > Flashcards

Cyst management Flashcards

1
Q

Define cyst

A

A pathological cavity that is epithelial lined filled with fluid, semi fluid or gas

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2
Q

What will a cyst never be filled with

A

Pus

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3
Q

How do we classify cysts

A

Odontogenic
Non odontogenic

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4
Q

What are odontogenic cyst split into

A

Inflammatory
Developmental

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5
Q

Give examples of inflammatory odontogenic cysts

A

Radicular
residual

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6
Q

Give examples,es of developmental cysts

A

Dentigerous
Eruption
Odontogenic keratocyst
Gingival cyst
Developmental
lateral periodontal

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7
Q

How do we classify non odontogenic cyst

A
  1. Fissure
  2. Bone
  3. Soft tissue
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8
Q

Give examples of developmental non odontogenic cysts

A

Nasopalatine
Nasolabial
Median palatine

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9
Q

Give examples of non odontogenic bone cyst

A

Solitary bone cyst
Aneurysmal bone cyst

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10
Q

Give examples of non odontogenic soft tissue cyst

A

mucous extravasation
Mucous retention

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11
Q

Name the most common cysts

A

Radicular (65%)
Dentigerous (20%)
Odontogenic Keratocyst (5%)

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12
Q

Where are the originator cells of an inflammatory cyst found

A

Remnants of henrtwigs roots sheath called cell rests of malassez found in the periodontal ligament

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13
Q

Where are the originator cells of a dentigerous cyst found

A

Reduced enamel epithelial

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14
Q

Where are the originator cells of an Odontogenic Keratocyst cyst found

A

dental lamina called glands of serres

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15
Q

Where are the originator cells of an nasopalatine cyst found

A

Nasopalatine duct epithelium

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16
Q

Where are the originator cells of an mucous retention cyst found

A

Salivary duct epithelium

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17
Q

Talk through the pathogenisis of cyst formation

A
  1. Site specific Inflammation
  2. Inflammatory cells secrete cytokines such as IL-1 IL-6 TNF and growth factors
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18
Q

State a genetic condition linked to increased cyst development

A

Gorlin Goltz syndrome

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19
Q

What is Gorlin Goltz syndrome linked with

A

Genetic defects in the tumour suppressor gene leadign to multiple odontogenic keratocyst

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20
Q

Name the mechanism that describes how cysts get bigger

A

Hydrostatic mechanism

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21
Q

Talk through the hydrostatic mechanism

A
  1. Protein accumulates within the cyst and the wall acts as a semi permeable membrane
  2. Fluid accumulates in cyst lumen creating positive pressure in the cyst
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22
Q

How can the enlargement of cysts lead to bone resorption

A

Pro inflammatory cytokines IL1, TNF and PGE2 (Fibroblasts) induce bone resorption
these are produced by cysts stimulation bone resorption

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23
Q

Briefly talk through the mechanism of cyst enlargement

A
  1. Inflammation
  2. Cell proliferation
  3. Increased protein content
  4. Fluid accumulates within cyst
  5. Increased positive pressure
  6. Displacement of soft tissue
  7. Resorption of bone
  8. Cyst increases in size to fill available space
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24
Q

What is the aetiology of radicular cyst

A

Inflammation

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25
Were are radicular cysts most commonly found
Everywhere but commonest site in maxillary incisors
26
Describe the presentation of a radical cyst
1. Related to a non vital tooth 2. Develop within periapical granuloma 3. Limited buccal expansion
27
Describe the radiographic appearance of a radicular cyst
Unilocular well defined well corticated radiolucency at apex of non vital tooth
28
What is the tx for a radicular cyst
Endodontic tx of non vital tooth XLA of non vital tooth
29
What complications can arise form a radicular cyst
Can form a residual cyst following XLA
30
What is the aetiology of residual cysts
Develops after incomplete removal of a radicular cyst
31
Where are residual cysts most commonly found
at sites of dental XLA
32
Describe the radiographic appearance of a residual cyst
Well defined unilocular corticated radiolucency
33
What is the tx for a residual cyst
Surgical enucleation
34
What is enucleation
Removal of the cyst epithelium
35
What is the aetiology of dentigerous cysts
Developmental with an unerupted tooth
36
Where do dentigerous cyst commonly form
Attached at the CEJ surrounding the crown of unerupted tooth (8s and 3s)
37
List some of the key points in relation to a dentigerous cyst
Late buccal expansion
38
Describe the radiographic appearance of a dentigerous cyst
Unilocular well corticated radiolucency
39
What is the tx for a dentigerous cyst
Surgical removal or uncover the tooth
40
What is the aetiology of an eruption cyst
Developmental associated with an erupting tooth
41
Describe the presentation of an eruption cyst
Blue swelling over erupting tooth
42
What is the tx for an erupting tooth
Usually resolves following eruption of associated tooth
43
What is the aetiology of an Odontogenic Keratocyst (OKC)
Developmental
44
Where are Odontogenic Keratocyst most commonly found
Angle of the mandible or ramus
45
What are some key points we should be aware of in regards to Odontogenic Keratocyst
Multiple cysts are associated with Gorlin Goltz syndrome can lead to bone resorption if buccal expansion occurs
46
Describe the radiographic appearance of Odontogenic Keratocysts
Usually multilocular
47
What is the tx for Odontogenic Keratocyst
Enucleation Marsupialisaion
48
What are the complication associated with Odontogenic Keratocyst
Recurrence is high due to difficult in removing and the presence of daughter cysts
49
what is Marsupialisaion
Opening up the cyst cavity to decompress the cyst
50
What is the aetiology of a lateral periodontal cyst
Developmental
51
Where do lateral periodontal cysts occur
Lateral to a vital tooth most commonly mandivualr molars and canines
52
What are some key points to note in relation to lateral periodontal cysts
Often incidental findings sometimes soft tissues swelling may present below the papillae
53
Describe the radiographic appearance of a lateral periodontal cyst
Well defined unilocular oval/round/ tear drop shaped
54
What is the tx for a lateral periodontal cyst
Enucleation
55
Give examples of gingival cysts
Epstein pearls and Bohns nodules
56
At what age do gingival cysts occur
Usually within the first 6 months after birth
57
Where do Epstein pearls form
Hard palate
58
Where do Bohns nodules form
Occur on gingiva
59
What is the tx for gingival cysts
No tx usually resolve on their own
60
What is the aetiology of nasopalatine cysts
Developmental
61
Where do nasopalatine cysts form
Hard palate just behind maxillary incisors
62
What are seen key points to note in relation to nasopalatine cysts
Can be ssociated with a VITAL maxillary incisor
63
Describe the radiographic appearance of a nasopalatien cyst
Well defined corticated radiolucent can appear heart shaped
64
What is the tx for a nasopalatine cyst
Excision
65
What is the aetiology for a nasolabial cyst
Developmental malformation
66
Where is a nasoplabial cyst found
Located over the nasolabial fold under the Alar of the nose
67
What are some key points to Note in relation to a nasolabial cyst
1. Can be a non tender fluctuant mobile swelling 2. Slowly enlarging 3. Asymptomatic 4. Rarely becomes infected and causes pain 5. Usually diagnosed relatively early
68
What is a nasolabial cyst not seen on
An OPT
69
What radiograph must we take to see a nasoloabial cyst
CT
70
Describe how a nasolabial cyst appears on a CT
Well demarcated rounded homogenous low density soft tissue lesion
71
What is the tx for a nasolabial cyst
Surgical exision through sublabial incision
72
What is the aetiology of a median palatine cyst
Developmental
73
Where do median palatine cysts usually develop
Symmetrical along midline of hard palate posterior to the palatine papillae
74
What are some key points to note inr elatin to a median palatine cyst
Firm or fluctuant but usually asymptomatic
75
how do we tx a median palatine cyst
enucleation
76
Give examples of non odontgenic bone cysts
Solitary bone cysts Auneurysmal bone cysts
77
Where are solitary bone cysts found
Body of the mandible
78
Describe a solitary bone cyst on a radiogrpah
Well corticated radiolucency extending between tooth root
79
Descibe how an aneurysmal bone cyst appears on a radiograph
Multilocualr radiolucency int he mandivle with cortical expansion
80
What are aneurysmal bone cysts fulled with
Blood filled granuslation tissue and giant cells
81
What is the aetiology of a mucous extravassaiton cyst
Trauma
82
Where do mucous extravasation cysts usually form
Lower lip or floor of the mouth
83
What is a mucous extravasation cyst on th efloor of the mouth called
A ranula
84
How do we tx mucous extraversion cysts
Excision
85
What is the aetiology of mucous retention cysts
Obstructed salivary ducts
86
Where do mucous retention cysts form
Commonly effect salacity glands
87
How are mucous retention cysts tx
Excision
88
What are the indication for removing a cyst
1. Pain 2. Funciton 3. Aesthetics 4. Continual growth 5. Pressure on adjacent structures 6. Weakening of structures 7. Infection
89
Name the three main approaches we can take to manage cysts
1. Excision- cut away 2. Enucleation- scoop cyst out 3. Marsupialisaion- decompress cyst

5th yr- CMS2 (9 decks)

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