Cysts Flashcards
What % of odontogenic cysts are radicular cysts?
60%
Are radicular cysts more common in male or female and in mandible or maxilla?
Male, maxilla
Where do radicular cysts arise from (embryology)?
Rests of malassez
Growth of radicular cysts
Typically slow growing with limited expansion
Radiographic features of radicular cysts
Round or oval radiolucency, well defined, corticated margins continuous with lamina dura of non vital tooth, unilocular, uniform radiolucency
What may larger or long standing radicular cysts cause?
Larger - displace adjacent structures
Long standing - external root resorption and/or contain dystrophic calcification
What differentiates radicular cyst from periapical granuoma?
Typically larger, if diameter >15mm in 2/3s cases will be radicular cyst
What kind of teeth are inflammatory collateral cysts associated with?
Partially erupted, vital teeth
What % of odontogenic cysts are dentigerous cysts?
20%
Are dentigerous cysts more common in male or female and in mandible or maxilla?
Male, mandible
Dentigerous cysts lined by enamel from…
Reduced enamel epithelium (from enamel organ)
Treatment of dentigerous cyst
Enucleation or marsupialisation if large
Why may it take while before patient notices symptoms from dentigerous cyst?
Don’t get too much buccal/lingual expansion
What would make you think it could be a dentigerous cyst rather than just enlarged follicle?
Normal follicle about/no bigger than 3mm
Consider cyst if >4mm
Assume cyst if >10mm
If radiolucency is asymmetrical
What is an eruption cyst?
Variant of dentigerous cyst but contained within soft tissue rather than bone and associated with an erupting tooth
Treatment of eruption cyst
Treated conservatively and tooth usually erupts, surgical excision sometimes required
3rd most common odontogenic cyst
Odontogenic keratocyst
What % of cysts in maxillofacial region are odontogenic keratocysts?
12%
Where do odontogenic keratocysts arise from?
Cell rests of serres (from remnants of dental lamina)
What is there a huge risk of with odontogenic keratocysts?
Pathological fracture
What epithelium is an odontogenic keratocyst lined by?
Thin, folded parakeratinised stratified squamous epithelium
What might you find doing a cyst aspirate test on an odontogenic keratocyst?
Squames
Protein content of odontogenic keratocyst
Low (generally 40g per litre)
Reasons for odontogenic keratocyst recurrence
- thin epithelium lining that breaks up very quickly
- Daughter cysts - tiny keratocysts that occur within wall of main cyst, occur from cell nests, if one of these left behind in jaw bone continues to grow and get a recurrence
- Growth tends to occur in clusters (some areas grow quicker than others), infiltrative nature
