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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
Q

Were are radicular cysts most commonly found

A

Everywhere but commonest site in maxillary incisors

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26
Q

Describe the presentation of a radical cyst

A
  1. Related to a non vital tooth
  2. Develop within periapical granuloma
  3. Limited buccal expansion
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27
Q

Describe the radiographic appearance of a radicular cyst

A

Unilocular well defined well corticated radiolucency at apex of non vital tooth

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28
Q

What is the tx for a radicular cyst

A

Endodontic tx of non vital tooth
XLA of non vital tooth

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29
Q

What complications can arise form a radicular cyst

A

Can form a residual cyst following XLA

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30
Q

What is the aetiology of residual cysts

A

Develops after incomplete removal of a radicular cyst

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31
Q

Where are residual cysts most commonly found

A

at sites of dental XLA

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32
Q

Describe the radiographic appearance of a residual cyst

A

Well defined unilocular corticated radiolucency

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33
Q

What is the tx for a residual cyst

A

Surgical enucleation

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34
Q

What is enucleation

A

Removal of the cyst epithelium

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35
Q

What is the aetiology of dentigerous cysts

A

Developmental with an unerupted tooth

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36
Q

Where do dentigerous cyst commonly form

A

Attached at the CEJ surrounding the crown of unerupted tooth (8s and 3s)

37
Q

List some of the key points in relation to a dentigerous cyst

A

Late buccal expansion

38
Q

Describe the radiographic appearance of a dentigerous cyst

A

Unilocular well corticated radiolucency

39
Q

What is the tx for a dentigerous cyst

A

Surgical removal or uncover the tooth

40
Q

What is the aetiology of an eruption cyst

A

Developmental associated with an erupting tooth

41
Q

Describe the presentation of an eruption cyst

A

Blue swelling over erupting tooth

42
Q

What is the tx for an erupting tooth

A

Usually resolves following eruption of associated tooth

43
Q

What is the aetiology of an Odontogenic Keratocyst (OKC)

A

Developmental

44
Q

Where are Odontogenic Keratocyst most commonly found

A

Angle of the mandible or ramus

45
Q

What are some key points we should be aware of in regards to Odontogenic Keratocyst

A

Multiple cysts are associated with Gorlin Goltz syndrome
can lead to bone resorption if buccal expansion occurs

46
Q

Describe the radiographic appearance of Odontogenic Keratocysts

A

Usually multilocular

47
Q

What is the tx for Odontogenic Keratocyst

A

Enucleation
Marsupialisaion

48
Q

What are the complication associated with Odontogenic Keratocyst

A

Recurrence is high due to difficult in removing and the presence of daughter cysts

49
Q

what is Marsupialisaion

A

Opening up the cyst cavity to decompress the cyst

50
Q

What is the aetiology of a lateral periodontal cyst

A

Developmental

51
Q

Where do lateral periodontal cysts occur

A

Lateral to a vital tooth most commonly mandivualr molars and canines

52
Q

What are some key points to note in relation to lateral periodontal cysts

A

Often incidental findings
sometimes soft tissues swelling may present below the papillae

53
Q

Describe the radiographic appearance of a lateral periodontal cyst

A

Well defined unilocular oval/round/ tear drop shaped

54
Q

What is the tx for a lateral periodontal cyst

A

Enucleation

55
Q

Give examples of gingival cysts

A

Epstein pearls and Bohns nodules

56
Q

At what age do gingival cysts occur

A

Usually within the first 6 months after birth

57
Q

Where do Epstein pearls form

A

Hard palate

58
Q

Where do Bohns nodules form

A

Occur on gingiva

59
Q

What is the tx for gingival cysts

A

No tx usually resolve on their own

60
Q

What is the aetiology of nasopalatine cysts

A

Developmental

61
Q

Where do nasopalatine cysts form

A

Hard palate just behind maxillary incisors

62
Q

What are seen key points to note in relation to nasopalatine cysts

A

Can be ssociated with a VITAL maxillary incisor

63
Q

Describe the radiographic appearance of a nasopalatien cyst

A

Well defined corticated radiolucent can appear heart shaped

64
Q

What is the tx for a nasopalatine cyst

65
Q

What is the aetiology for a nasolabial cyst

A

Developmental malformation

66
Q

Where is a nasoplabial cyst found

A

Located over the nasolabial fold under the Alar of the nose

67
Q

What are some key points to Note in relation to a nasolabial cyst

A
  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
Q

What is a nasolabial cyst not seen on

69
Q

What radiograph must we take to see a nasoloabial cyst

70
Q

Describe how a nasolabial cyst appears on a CT

A

Well demarcated rounded homogenous low density soft tissue lesion

71
Q

What is the tx for a nasolabial cyst

A

Surgical exision through sublabial incision

72
Q

What is the aetiology of a median palatine cyst

A

Developmental

73
Q

Where do median palatine cysts usually develop

A

Symmetrical along midline of hard palate posterior to the palatine papillae

74
Q

What are some key points to note inr elatin to a median palatine cyst

A

Firm or fluctuant but usually asymptomatic

75
Q

how do we tx a median palatine cyst

A

enucleation

76
Q

Give examples of non odontgenic bone cysts

A

Solitary bone cysts
Auneurysmal bone cysts

77
Q

Where are solitary bone cysts found

A

Body of the mandible

78
Q

Describe a solitary bone cyst on a radiogrpah

A

Well corticated radiolucency extending between tooth root

79
Q

Descibe how an aneurysmal bone cyst appears on a radiograph

A

Multilocualr radiolucency int he mandivle with cortical expansion

80
Q

What are aneurysmal bone cysts fulled with

A

Blood filled granuslation tissue and giant cells

81
Q

What is the aetiology of a mucous extravassaiton cyst

82
Q

Where do mucous extravasation cysts usually form

A

Lower lip or floor of the mouth

83
Q

What is a mucous extravasation cyst on th efloor of the mouth called

84
Q

How do we tx mucous extraversion cysts

85
Q

What is the aetiology of mucous retention cysts

A

Obstructed salivary ducts

86
Q

Where do mucous retention cysts form

A

Commonly effect salacity glands

87
Q

How are mucous retention cysts tx

88
Q

What are the indication for removing a cyst

A
  1. Pain
  2. Funciton
  3. Aesthetics
  4. Continual growth
  5. Pressure on adjacent structures
  6. Weakening of structures
  7. Infection
89
Q

Name the three main approaches we can take to manage cysts

A
  1. Excision- cut away
  2. Enucleation- scoop cyst out
  3. Marsupialisaion- decompress cyst

5th yr- CMS2 (9 decks)

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