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5th Oral Disease - Other > Cyst of Jaw > Flashcards

Cyst of Jaw Flashcards

1
Q

What are the 4 options for management of cyst?

A

Enucleation
Curettage
Resection
Marsupialisation

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2
Q

What is enucleation?

A

Removal as cyst in entirety w/o cutting

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3
Q

What is curettage?

A

Removal of tissue by scraping or scooping

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4
Q

What is resection?

A

Removal of part of organ - takes pathology and margin in normal tissue

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5
Q

What is marsupilisation?

A

Creating of a pouch by suturing cyst lining to external surface

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6
Q

What are 5 main types of cysts?

A 
Radicular
Dentigerous 
Odontogenic keratocyst
Mucocele
Sebaceous
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7
Q

What cysts are potentially manageable in dental practice?

A

Radicular

Dentigerous

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8
Q

What is a radicular cyst?

A

Cyst develop around non-vital tooth

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9
Q

Features of radicular cyst on radiograph?

A

Larger 1cm

Corticated margin

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10
Q

Differential of radicular cyst?

A

Apical granuloma

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11
Q

Management of radicular cyst?

A

RCT - if apical granuloma will resolve

XLA causative tooth then enucleate cyst

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12
Q

When could apicetomy be used for radicular cyst?

A

If anterior tooth
Acceptable orthograde
RCT
Pt accept risks

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13
Q

What are 2 main indications of apicetomy?

A
  1. Persistent symptoms/ pathology in non-vital tooth

2. (RE)RCT is unfeasible

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14
Q

What persistent symptoms could indicate apicetomy?

A

Cyst, swelling, infection, discharge of pus, excessive mobility or pain

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15
Q

Why would (re)rct be unfeasible?

A 
Established cyst
Scleroritc canals
Unfavourable morphology - curvature, accessory 
Fractured roots
Perforations
Unretrivable instruments
Post-core can't be removed
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16
Q

What are relative contraindications of apicetomy?

A 
Previous apicetomy
Molars - more complicatied
Poor OH
Active caries
Sinus disease
Implants
High mobility
Advanced perio
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17
Q

What are absolute contraindications of apicetomy?

A

Severe bleeding risk
Endocarditis risk
Unrestorable

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18
Q

What are 3 flap designs used for apicetomy?

A

Mucoperiosteal
Semilunar
Leubke-Oschenbein

19
Q

Adv/disadv? mucoperiosteal flap?

A

Follow ginigval contour = best access and minimal scaring

Risk gingival recession

20
Q

Why are semilunar flaps no longer used?

A

Scarring

Potential to leave margin of incision overlying cyst cavity = void

21
Q

How is Leubke-Oschenbein carried out?

A

4mm below gingival margin but on attached mucosa

22
Q

When can Leubke-Oschenbein not be used?

A

If thin mucosa

23
Q

Why do you want to removal 3mm of apical tissue during apicetomy
?

A

apical delta = front like distribution of canal towards apex last 3mm of tooth

24
Q

Why do you want to cut at 90 degree during apicetomy?

A

If cut at angle will leave delta or remove too much tissue and lose support

25
Q

What is the best procedure following flap - ideally?

A

Enucleate cyst, apicect, retrograde filling

26
Q

What material can be used for retrograde filling?

27
Q

What syndrome is associated w/ keratocyst?

A

Gorlin goltz

28
Q

What is gorlin goltz?

A

Basal cell naevus syndrome - autosomal dominant condition

29
Q

What syndrome would you see multiple osetomas?

A

Gardner’s

30
Q

What are the features seen in GG’s?

A 
Multiple keratocysts
Multiple basal cell carcinoma
Skeletal defect - bifid ribs 
Cranial defect - frontal bossing
Calcified fall cerebri
Predisposed to epilepsy
31
Q

What is the best tx for keratocyst - but why is this not used?

A

Resection - 0% recurrence

But unfavourable due to removal of tissue

32
Q

What is the risk associated w/ Carnoy’s

A

Risk of fixing surrounding tissue - risk of damage to nerves

33
Q

What is Vorschmidt’s technique?

A

Enucleate cyst after being fixed w/ Carnoy’s

Content of cyst removed and carnoy’s placed
Lining turns rubbery - can be removed

34
Q

What is management of dentigerous cyst?

A

Unerupted tooth - enucleate and XLA tooth

If risk of ID damage/ fracture jaw - coronectomy

35
Q

What is mucous extravasation cyst?

A

Type of mucocele - not true cyst as doesn’t have cyst lining

36
Q

Why are mucous extravasatiom cysts hard to remove?

A

Housed in soft tissue - no border
Issue scarring/ fibrosis
Need to remove surrounding salivary glands that may contribute to cyst

37
Q

What is a sebaceous cyst?

A

Contain keratin due to trauma of epithelium in sub-epithelial layers

38
Q

What is punctum?

A

Induration of cyst around cyst surface where trauma has occurred

39
Q

Cause of sebaceous cyst?

A

Acquired

Traumatic implantation of skin

40
Q

How many mm of root removed in apicectomy?

41
Q

What angle should apicectomy be performed at?

42
Q

What in management of eruption cyst?

A

Conservative advice and review

43
Q

Difference between MTA and Portland cement?

A

MTA has 20% bismuth oxide added q

44
Q

What do sebaceous cyst contain?

5th Oral Disease - Other (13 decks)

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