Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Medicine & Disease > Cyst of the jaw > Flashcards

Cyst of the jaw Flashcards

1
Q

what is a cyst

A

pathologicalcavity filled with fluid, semi fluid or gasous content. Not created by pus accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how are cysts classified

A
  1. epithelial lined (most)
  2. odontogenic/non odontogenic
  3. inflam/developmental
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

appropriate further inv of a cyst

A

plain Rg - OPT/PA/occ
other views - occipitomental/PA mandible
CBCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

should a biopsy be taken - how

describe cystic fluid

A

wide bore needle - FNA
blood/cystic fluid/air/pus
-clear straw coloured fluid (crystals present)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the purpose of an incisional biopsy - when

- how

A

to take a sample of cyst lining for histological analysis

  • during marsupilisation
  • usually under L.A.; select place where “cyst” appears superficial; raise mucoperiosteal flap; remove bone as required – using rongeurs or a round bur; incise and remove a section of lining
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

name the types of cysts of the jaw

A

odontogenic

  • radicular
  • dentigerous
  • keratocyst (keratocystic odontogenic tumour)

non odontogenic

  • nasopalatine
  • stafne cavity
  • aneurysmal bone cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

sources of epithelium for odontogenic cysts

A
  • rests (debris)of malassez, hertwig’s root sheath
  • rests of serres - lamina remnants
  • reduced enamel ep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

radicular cyst

  • what
  • synonyms
  • aetiology
  • features
A

periapical cyst attached to the apex of a NV tooth
inflammatory origin = pulpitis then PA granuloma then cyst
- periapical/dental cyst
-slow painless swelling, no symps until big enough to be noticed
-at first = hard and rounded, later eggshell thickness and cracking on pressure. Eventually wall resorbed leaving soft bluish swelling.
- originate from rests of malassez (hertwig’s root sheath)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

radicular cyst - histology

A

epithelial lining (often incomplete), CT capsule,
plasma cells and macrophages - inflammation
-peripherally osteoclasts allow bony expansion, osteocblasts react to inflammation by depositing bone causing corticated margin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name 2 variations of a radicuar cyst

A

residual cyst

inflamatory lateral periodontal cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a dentigerous cyst

A

a developmental cyst surrounding the crown of an unerupted tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

who and where are dentigerous cysts most likely to occur

A

male>female
mandible>max
Lower 8’s and up 3’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

histology of a dentigerous cyst

A

thin non keratinised stratified squamous epithelium
- arises from separation of reduced enamel epithelium and fromation of follicular space - internal pressure causes expansion of this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical features of dentigerous cyst

Rg features

A
  • grow by internal pressure - expansion and displacement of adjacent structures. Slow growing
  • developmental but can be caused by inflammation of pericoronitis/adjacent NV teeth.
  • Rg - circumscribed, rounded and unilocular. Contain crown of tooth.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what condition can appear with multiple dentigerous cysts

name one other feature of this condition

A

cleidocranial dysplasia
partly missing collarbones = hypermobility
prognathic mandible
hyperdontia - many supernumeraries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

measurements of dentigerous cyst and follicle

A

-<2.5mm = follicle
-> 4.2mm = probable cyst
>10mm - definite cyst
asymmetrical radiolucency = cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is an odontogenic keratocyst
who
clinical presentation

A 
developmental cyst
m>f
mostly mandible -third molar and ramus
multilocular
- symptomless until infected
recurrence issue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cyst aspirate of a keratocyst

histology

A

white keratin - contains sqaumes - low soluble protein content
-parakeratosis of cyst lining, basal palisading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why is recurrence likely to occur for a keratocyst

A

thin friable lining - left behind
many daughter cysts missed
cell nests

20
Q

what syndrome is associated with multiple keratocysts

other features

A

gorlin-goltz syndrome (basal cell naevus)
autosomal dominant
skeletal abnormalities and basal cell carcinomas
-frontal & temporalparietal bossing hypertelorism
mild mandibular prognathism
Abnormalities of Ca & PO4 metabolism

21
Q

appearance of a keratocyst on a Rg

growth pattern

A

well defined radiolucent area, scalloped margin , usually ramus/3rd molar, sharply demarcated
- pattern = extensive spread forwardand backward along medullary cavity. MINIMAL expansion
AP growth

22
Q

pathogenesis of an odontogenic keratocyst

A

develop from rests of odontogenic epithelium left after tooth development - eg rests od serres
-Mutation/deletion/inactivation of ptch gene (tumour suppressor gene)

23
Q

nasopalatine cyst
origin
where
presentation

A

found in midline - incisive canal

  • epithelial reminants of nasopaltine duct
  • dependant on canal affected - superficial soft tissue cyst, can grow primarily into nose - salty discharge
24
Q

what differentiates odontogenic and non odontogenic cysts

A

distibution of cytokeratin in cyst epithelium

25
Q

Rg and pathological features nasopalatine cyst

A

Radiograph
Well-defined round, ovoid or heart shaped radiolucency
Sclerotic margin
anterior region of palate

Pathology
Lined by st. squ. Respiratory or cuboidal epithelium
Neurovascular bundles found in capsule

26
Q

solitary bone cyst (simple bone cyst)

clinical features -who, where

A

child & adults
premolar/molar region
asymp, chance finding on Rg

27
Q

Rg features of solitary bone cyst

-surgical exploration findings

A

variable sized radiolucency, irregular margin, well defined. Scalloping!
Rough bony-walled cavity devoid of any detectable lining. NO epithelial lining
Rapid healing follows
Although will resolve spontaneously without

28
Q

Aneurysmal bone cyst
clinical
Rg

A

Clinical
Children or young adults
Mandible, post. part of body or angle
Firm, painless swelling

Radiograph
Uni- or mulitilocular radiolucency with a ballooned out appearance due to gross cortical expansion

29
Q

Aneurysmal bone cyst

pathology

A 
numerous, non-endothelial lined, blood-filled spaces
varying size
separated by cellular fibrous tissue
multinucleated giant cells
Pathogenesis unknown
Many preceded by other 10 lesion of bone
30
Q

Stafne idiopathic bone cavity - what

Rg features

A

developmental anomaly of mandible
asymptomatic
- Radiograph
Round or oval, well demarcated radiolucency
Between premolar region & angle of jaw
usually located below inferior dental canal

31
Q

Stafne idiographic bone cavity -surgical exploration

A

Depression or concavity lingual aspect of mandible
Varying depth
Majority of cases, contains ectopic salivary tissue in continuity with SMG

32
Q 
Ameloblastoma features
-age
-features
-site/shape
-
A

Aggressive tumour
originates from remnants of odontogenic epithelium of enamel organ/dental lamina

PEAK AGE: adults (Usually >40 years old)

FREQUENCY: Rare, but still most common odontogenic tumour

SITE & SIZE: Posterior body/angle/ramus of mandible. Occasionally maxilla. Size very variable depending of age of lesion but can become very large and disfiguring

SHAPE: multilocular, occasionally monolocular at early stage. Well defined and well corticated.

33
Q

Ameloblastoma

  • radiodensity
  • signs,symps
  • treatment
A

RADIODENSITY: Radiolucent with internal radiopaque septae

SIGNS AND SYMPTOMS: 
   early stages asymptomatic
   adjacent teeth displaced 
   facial deformity  
   extensive expansion in all directions
   expansion usually bony hard and non tender (latter stages may get “egg shell crackling”)

TREATMENT: Surgical resection with margin normal bone.

34
Q 
Ameloblastoma fibroma 
-age
-frequency
-site/shape
clinical features
A

Rare, benign mixed odontogenic tumour originating from both odontogenic epithelium and connective tissue of developing tooth germ.
Radiographically closely resembles ameloblastoma but develops in younger age group
AGE: Children and adolescents

FREQUENCY: Rare

SITE & SHAPE: Usually mandible in premolar/molar region. Variable size. Multilocular (monolocular in early stages). Smooth outline. Well defined and well corticated

-adjacent teeth displaced

35
Q

Calcifying odontogenic cyst

  • age
  • site
  • size/shape
  • radiodensity
  • effect
A

AGE: wide age range but usually < 40 years old
SITE: 75% are intraosseous and either jaw may be involved. Majority arise anterior to first permanent molar.
SIZE&SHAPE: Usually small about 1-3 cm in diameter. Shape is variable but usually monolocular.
RADIODENSITY: initially radiolucent but in more advanced stage contains a variable amount of calcified radiopaque material
EFFECTS: adjacent teeth usually displaced +/or resorbed. Bony expansion.

36
Q

odontogenic myxoma and fibroma

  • age
  • site
  • shape/size
  • Rg
A

Very similar non-invasive tumours which originate from odontogenic CT fibroblasts of the developing tooth germ, which produce either excessive fibrous collagen (FIBROMA) or excessive ground substance (MYXOMA). Radiographically often indistinguishable.
AGE: Young adults
SITE: Usually posterior mandible or maxilla
May arise in relation to root of tooth/crown or
unerupted tooth or may take place of tooth
missing from arch
SIZE&SHAPE: Size is variable but may become large if left untreated. Usually multilocular
-Rg -radiolucent with fine radiopaque septa

-adjacent teeth loosened/displaced

37
Q

chondroma

  • what
  • where
A

Rare, benign slow growing tumour producing a rounded lobulated radiolucency of variable definition within the bone with a variable amount of internal calcification
Anterior maxilla and posterior mandible most common sites. Although can also occur in the condylar and coronoid process.
-intrinsic primary benign bone tumour

38
Q

Central haemangioma

  • what is it
  • age
  • radiograph appearance
A

Rare benign tumour that occasionally affects the jaws, particularly the mandible. It is usually a developmental malformation (hamartoma) of the blood vessels in the marrow spaces.
Can present at any age but usually adolescents
Variable radiograpgic appearance including;
moderately well defined zone of radiolucency within which trabeculae spaces are enlarged. Lesion presents therefore as multicystic “saop bubble or honecomb” appearance

39
Q

Osteosarcoma

  • age
  • site
  • signs/symptoms
A

Commonest primary malignant tumour of bone but is relatively rare in jaws.
AGE: Usually around 30 years old at diagnosis. Occasionally, tumour presents in older patients eg in association with Paget’s disease of bone.
SITE: Slightly more common in mandible than maxilla
SIGNS + SYMPTOMS: Fairly rapidly enlarging swelling that may be accompanied by pain, numbness of lip, trismus and displacement of teeth. Ulceration of overlying skin and mucosa is a late feature.

40
Q

Osteosarcoma
Rg features
prognosis

A

RADIOGRAPHIC APPEARANCE: variable and depends on amount of normal bone destroyed by tumour and amount of neoplastic bone formed within lesion.
Predominately osteolytic tumours produce irregular areas of radiolucency wheras sclerosing types in which tumour bone is formed, produce irregular areas of radiopacity. The two patterns may co-exist in the same tumour. A symmetrically widened PDL space has been reported as a feature of very early lesions
PROGNOSIS: Overall 5 year survival for osteosarcoma of jaws is about 40%. Jaw lesions,in contrast to osteosarcomas at other sites, metastasise infrequently. However local recurrence rates are high.

41
Q

Multiple myeloma

  • age
  • site
  • site/shape
  • radiodensity
  • effects
A

AGE: Adults, middle aged
SITE: Multiple lesions affecting
- skull vault
- posterior part of mandible
- other parts of skeleton
SIZE&SHAPE: Variable size. Round monolocular shape
though multifocal. Well defined outline.
Not corticated.
RADIODENSITY: Radiolecent
EFFECTS: Enlargement/Coalescence may lead to pathological fracture

42
Q

central giant cell granuloma

  • age
  • site
  • size/shape
  • radiodensity
  • effect
A

Uncommon, non neoplastic mass in the jaws producing an expansile radiolucent lesion.
AGE: Variable but usually young adolescents and adults under 30 years old.
SITE: Anterior mandible. In region of deciduous dentition, often crossing midline.
SIZE&SHAPE: Variable size. Can be up to 10 cm. Usually multilocular with well defined and well corticated outline.
RADIODENSITY: Radiolucent
-adjacent teeth displaced or resorbed

43
Q

cherubism

  • age
  • site
  • size/shape
  • radiodensity
  • effect
A

Inherited disorder. Usually autosomal dominant but many cases appear spontaneously. Radiographically lesions resemble closely other giant cell containing lesions.
AGE: Children 2-6 years old
SITE: Angle/Posterior mandible - bilateral
SIZE&SHAPE: Variable size, up to several cms diameter. Multilocular with bilateral lesions typically symmetrical.
RADIODENSITY: Radiolucent with internal radiopaque septa
EFFECTS: Gross displacement of deciduous/permanent teeth. Extensive buccal/lingual expansion

44
Q

Fibrous dyplasia

  • age
  • site
  • size/shape
  • radiodensity
  • effect
A

Considered to represent a developmental tumour like lesion. Most cases (80%) are monostotic (limited to a single bone, often the jaw).
AGE: 10 - 20 years of age
SITE: Usually posterior maxilla
SIZE&SHAPE: Variable size. Round shape. Poorly defined outline with no cortiaction
RADIODENSITY: Initially radiolucent. Gradually becomes radiopaque to produce “ground glass” or “orange peel”
-teeth displaced

45
Q

what cysts are best treated by enucleation

-complications

A

keratocyst / dentigerous cys t/ radicular and residual cyst

Complications:
Mainly related to size, position and type of cyst
interference with IDC
communication with Maxillary sinus
pathological fracture
Recurrence
46
Q

Masurpilisation
for?
complications

A

Fenestration’ +/- grommet insertion
Useful for large simple cysts, keratocyst, dentigerous cysts

Complications:
Needs further surgery for removal cyst
Long treatment before completion
chance of re-infection?
Uncomfortable with grommet in situ?
47
Q

ameloblastoma/sarcoma treatment

A

Removal of cyst with margin of ‘normal’ bone.
Mainly used for ameloblastoma/sarcoma cases
Normally have to have secondary procedure for reconstruction of defect

Oral Medicine & Disease (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions