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

Cyst of Jaw - Classification Flashcards

1
Q

What is a cyst?

A

A pathological cavity filled with fluid, semi-fluid or gaseous content and which is usually, but not always lined by epithelium

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2
Q

Can a cyst ever be filled with pus?

A

No - not created by accumulation of pus

If pus this would be abscess

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3
Q

What’s the most common cyst found in the jaw ?

A

Odontogenic cyst

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4
Q

How do odontogenic cyst arise?

A

From tooth forming tissue

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5
Q

What are different types of odontogenic cysts?

A

Inflammatory or developmental

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6
Q

Example of inflammatory odontogenic cysts?

A

RPR

Radicular
Residual
Paradental

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7
Q

Examples of developmental odontogenic cysts?

A

FLOCK GG

Folicular 
Lateral periodontal 
Orthokeratinised o.c
Calcifying odontogenic 
odontogenic Keratocyst

Gingival cyst
Glandular odontogenic

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8
Q

Most common odontogenic jaw cyst?

A

Radicular - 65%

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9
Q

Second most common odontogenic jaw cyst?

A

Follicular

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10
Q

How does cyst grow?

A

Need a source of epithelium - give lining
Stimulus for proliferation and growth
Way resorb bone

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11
Q

Epithelial source for radicular cyst?

A

Remnants Hertwigs root sheath - remnants round PDL follow root shape

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12
Q

Epithelial source for follicular cyst?

A

Reduced enamel epithelium

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13
Q

Epithelial source for odontogenic keratocyst?

A

Remnant dental lamina

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14
Q

What is apical granuloma?

A

Ball of granulation tissue - lots of inflammatory cells and mediators

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15
Q

Can apical granuloma turn into cyst?

A

Yes can become radicular cyst - if acts upon epithelium will provoke proliferation

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16
Q

3 ways cysts can grow and expand?

A
  1. Osmosis and hydrostatic pressures
  2. Proliferation of lining
  3. Bone resorption
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17
Q

Where does dental lamina develop from?

A

Enamel organ

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18
Q

What does peridontal ligament contain?

A

Remnants of Hertwig’s root sheath - rest cells of malassez

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19
Q

What is radicular cyst?

A

Inflammatory odontogenic cyst which is associated w/ non-vital tooth

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20
Q

How does radicular cyst arise?

A

Arise from periodontal ligament from epithelial rests of Malassez as result of inflammation following death of pulp

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21
Q

Epidemiology of radicular cyst?

A

Male > female

Tend young- middle aged pt

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22
Q

Where most likely to see radicular cyst?

A

Anterior maxilla teeth most common

Always non-vital

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23
Q

3 types of radicular cyst?

A
  1. Apical - at apex of tooth associated w/ opening canal
  2. Lateral - at side associated w/ lateral branch of canal
  3. Residual
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24
Q

What is a residual cyst?

A

A radicular cyst which persist after extraction of tooth - left in alveolus

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25
Q

What expect to see radiograph radicular cyst?

A

Radiolucent lesion which is corticated
Continuity with PDL
Well defined

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26
Q

Pathogenesis of radicular cyst?

A
  1. Caries, extension bacteria into pulp = non-vital tooth
  2. Periapical granuloma - ongoing inflammation = tissue destruction = granulation tissue form
  3. Proliferation odontogenic epithelium
  4. Cyst form
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27
Q

Key features of radicular cyst on histology?

A

Cyst wall
Lining
Lumen cyst
Non-keratinised epithelium!

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28
Q

Why important to look at epithelium on histology radicular cyst?

A

Won’t be keratinised - differentiate from odontogenic keratocyst

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29
Q

What are some histological features could see in radicular cyst?

A 
Keratin - very rare
CIllia - like seen respiratory epitheium
Hyaline bodies - Ruston bodies within epithelium
Mucous cells - goblet cells
Cholesterol/ cholesterol clefts
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30
Q

How to differentiate radicular cyst and apical granuloma?

A

Cysts tend to be larger, more radiolucent, well-defined, corticated and painlesss

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31
Q

What size would indicate apical granuloma or radicular cyst?

A

If less 1cm likely granuloma

If >1cm likely radicular cyst

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32
Q

Another word for paradental cyst?

A

Collateral cyst

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33
Q

What is a paradental cyst?

A

Inflammatory odontogenic cyst which develops alongside developing teeth

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34
Q

Definition of paradental cyst?

A

Cyst arise on lateral aspect of tooth as a result of inflammation in periodontal pocket

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35
Q

Common tooth to get paradental/ collateral cyst?

A

PE 8s - classically in disto-buccal corner

36
Q

What expect to see on histology of paradental cyst?

A 
To be attached on/around ACJ
Similar radicular cyst
Wall - fibrous connective tissue/ chronic inflammation cells
Non-keratinised epithelium
Arcaded proliferation pattern
37
Q

What is a follicular cyst?

A

Developmental odontogenic cyst

A cyst which surrounds crown on unerupted tooth arising from reduced enamel epithelium

38
Q

Two types of follicular cyst?

A

Dentigerous - associated impacted tooth

Eruption - associated erupting tooth

39
Q

What radiographic features expect to see of follicular cyst?

A

Radiolucency surrounding crown of unerupted tooth
Well defined and corticated
Looks to be attached ACJ

40
Q

What histology expect follicular cyst?

A 
Cyst - wall, lining and lumen
Attached tooth ACJ 
No inflammation 
Lining - thin non-keratinised epithelium lining 
Wall - fibrous wall
41
Q

What expect see clinically on eruption cyst?

A

Lesion lying beneath oral mucosa w/ colouration of fluid

42
Q

How treat eruption cyst?

A

Open/ excise to allow eruption

43
Q

How to eruption cyst form?

A

Retention of primary teeth can impede eruption of permanent teeth = eruption cyst

44
Q

What is odontogenic keratocyst?

A

Cyst arising in tooth bearing area characteristics by thin lining of parakeratinised epithelium

45
Q

What type of cyst is odontogenic keratocyst?

A

Developmental odontogenic cyst

46
Q

Where does odontogenic keratocyst arise form?

A

Dental lamina

47
Q

What expect to see histology odontogenic keratocyst?

A

Lining = thin parakeratinised SSE

Nuclear palisading on basal layer

48
Q

What does parakeratinised mean

A

Has nuclei

49
Q

Why is diagnosis harder if odontogenic keratocyst becomes inflamed?

A

Loses characteristic epithelium lining

50
Q

Most common area to see odontogenic keratocyst?

A

Posterior mandible

51
Q

What expect to see radiograph odotogenic keratocyst?

A

Large radiolucent lesion
Scalloped outline = multilocular
Well defined and corticated

52
Q

What radiographic feature is useful to note of odontogenic keratocyst?

A

Little expansion - useful diff from tumour

53
Q

Why do odontogenic keratocyst recur?

A

Lining fragile - can be left behind as break easily during surgery
Daughter cysts

54
Q

In what syndrome can see odontogenic keratocyst?

A

Gorlin goltz - basal cell nevus syndrome

55
Q

What features see gorlin goltz?

A 
Multiple/ recurrent odontogenic keratocyst 
Basal cell carcinoma
Frontal bossing
Skeletal abnormality- bifid ribs
Cranial abnormalities
56
Q

Why is it suggests o. keratocyst is a benign neoplasm?

A

High rate of proliferation in epithelial lining
High rate recurrent
Aggressive and infiltrative growth

57
Q

What is lateral periodontal cyst?

A

Occur lateral aspect of roots between vital teeth

58
Q

Where do lateral periodontal cyst arise from?

A

Rests of Serres

59
Q

What expect to see radiographically lateral periodontal cyst?

A

Radiolucency between vital teeth

Well-defined and corticular

60
Q

What is a botryoid odontogenic cyst?

A

Multilocular lateral periodontal cyst

61
Q

Histological feature lateral periodontal cyst?

A

Focal thickening in walls = plaque

62
Q

Where do gingival cyst arise form in infants?

A

Dental lamina of alveolar mucous - lies over crown of tooth before erupted

63
Q

Where do gingival cyst arise from in adults?

A

Dental lamina in attached gingiva

64
Q

Difference of lining in gingival cyst in infants and adults?

A

Infants - parakeratinised

Adults - non-keratinised

65
Q

Where expect see gingival cyst in adult?

A

Buccal surface

66
Q

What is glandular odontogenic cyst?

A

Cyst characterised by cuboidal or column epithelium with mucous production - forms duct/ gland like structure

67
Q

What expect see histology glandular odontogenic cyst?

A

Focal thickening
Goblet cell - mucous production
Duct like structure

68
Q

What see radiograph calcifying odonogenic cyst?

A

Well defined but uncorticated lesion

Calcified material in cyst

69
Q

Histology of calcifying odontogenic cyst?

A

Lined by ameloblastoma - ghost cells and dentine in wall

70
Q

Example of non-odontogenic cyst?

A

Nasopalatine cyst

Nasolabial cyst

71
Q

Where do non-odontogenic cyst arise?

A

From epithelium other than that from tooth developing strucutres
Due different fusion in embryological process

72
Q

Where does nasopalatine duct cyst arise?

A

In nasopalatine (incisive) canal from epithelial residue to nasopalatine duct

73
Q

What are nasopalatine duct cyst lined with?

A

Respiratory epithelium or SSE

74
Q

What see clinically in nasopalatine duct cyst?

A

Palatal swelling behind incisors

75
Q

Histology see for nasopalatine duct cyst?

A

Respiratory type lining - columnar pseudostatified
Can see mucosa cells
Can see filial
Lining mixed - respiratory and squamous

76
Q

How confirm nasopalatine cyst?

A

Needs to have come from nasopalatine canal - see neurovascular bundles

77
Q

What see radiograph nasopalatine cyst?

A

Midline anterior maxilla
Well-defined, oval shape
Sometimes corticated
Above root tips central incisor

78
Q

Differential nasopalatine cyst and how to decide?

A

See if teeth vital

Trace PDL radiograph - if can likely separate from teeth

79
Q

What is nasolabial cyst?

A

Arise in soft tissue overlying alveolar process at base of nostril

80
Q

Where does nasolabial cyst arise?

A

Remnant of nasolacrimal duct

81
Q

What lines nasolabial cyst?

A

Pseudostartified columnar epithelium

82
Q

What is a cyst like lesion?

A

Cyst in jaw w/o epitheliumm lining

83
Q

Example of cyst like lesion

A

Stafne bone cavity

84
Q

How expect Stafne bone cavity look?

A

Well defined
Cortciated
Radiolucency
Angle of mandible - deep to inferior nerve

85
Q

What can be associated w/ stafne bone cavity?

A

Due to defect lingual side mandible = depression

Salivary gland tissue can extend into defect

5th Oral Disease - Other (13 decks)

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