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Oral diagnosis > Cysts > Flashcards

Cysts Flashcards

1
Q

What % of odontogenic cysts are radicular cysts?

A

60%

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2
Q

Are radicular cysts more common in male or female and in mandible or maxilla?

A

Male, maxilla

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3
Q

Where do radicular cysts arise from (embryology)?

A

Rests of malassez

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4
Q

Growth of radicular cysts

A

Typically slow growing with limited expansion

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5
Q

Radiographic features of radicular cysts

A

Round or oval radiolucency, well defined, corticated margins continuous with lamina dura of non vital tooth, unilocular, uniform radiolucency

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6
Q

What may larger or long standing radicular cysts cause?

A

Larger - displace adjacent structures

Long standing - external root resorption and/or contain dystrophic calcification

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7
Q

What differentiates radicular cyst from periapical granuoma?

A

Typically larger, if diameter >15mm in 2/3s cases will be radicular cyst

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8
Q

What kind of teeth are inflammatory collateral cysts associated with?

A

Partially erupted, vital teeth

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9
Q

What % of odontogenic cysts are dentigerous cysts?

A

20%

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10
Q

Are dentigerous cysts more common in male or female and in mandible or maxilla?

A

Male, mandible

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11
Q

Dentigerous cysts lined by enamel from…

A

Reduced enamel epithelium (from enamel organ)

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12
Q

Treatment of dentigerous cyst

A

Enucleation or marsupialisation if large

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13
Q

Why may it take while before patient notices symptoms from dentigerous cyst?

A

Don’t get too much buccal/lingual expansion

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14
Q

What would make you think it could be a dentigerous cyst rather than just enlarged follicle?

A

Normal follicle about/no bigger than 3mm
Consider cyst if >4mm
Assume cyst if >10mm
If radiolucency is asymmetrical

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15
Q

What is an eruption cyst?

A

Variant of dentigerous cyst but contained within soft tissue rather than bone and associated with an erupting tooth

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16
Q

Treatment of eruption cyst

A

Treated conservatively and tooth usually erupts, surgical excision sometimes required

17
Q

3rd most common odontogenic cyst

A

Odontogenic keratocyst

18
Q

What % of cysts in maxillofacial region are odontogenic keratocysts?

A

12%

19
Q

Where do odontogenic keratocysts arise from?

A

Cell rests of serres (from remnants of dental lamina)

20
Q

What is there a huge risk of with odontogenic keratocysts?

A

Pathological fracture

21
Q

What epithelium is an odontogenic keratocyst lined by?

A

Thin, folded parakeratinised stratified squamous epithelium

22
Q

What might you find doing a cyst aspirate test on an odontogenic keratocyst?

A

Squames

23
Q

Protein content of odontogenic keratocyst

A

Low (generally 40g per litre)

24
Q

Reasons for odontogenic keratocyst recurrence

A
  • 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
25
Q

What syndrome results in multiple odontogenic keratocysts?

A

Basal cell naevus syndrome (Gorlin-Goltz)

26
Q

What may larger nasopalatine duct cysts cause?

A

Displacement of teeth or palatal swelling

27
Q

Where does nasopalatine duct cyst arise from?

A

Epithelial remnants of embryonic nasopalatine canal/ nasopalatine duct epithelial remnants

28
Q

How to differentiate nasopalatine duct cyst from incisive fossa

A

Incisive fossa typically not corticated

- <6mm: assume incisive fossa
- 6-10mm: consider monitoring
    - >10mm: suspect cyst
29
Q

What cysts are non epithelial?

A

Solitary bone cyst, aneurysmal bone cyst

30
Q

What may you get from an aspiration biopsy that may indicate an odontogenic keratocyst?

A

White or cream semi-solid thick cheesy material

31
Q

What other investigation could you do?

A

Incisional biopsy to get sample of lining for histopathological analysis

32
Q

What feature indicates needing further investigation?

A

Multilocular

33
Q

Enucleation

A

Removal of entire cyst lining and contents

34
Q

Marsupialisation

A
  • Creation of a surgical window in wall of cyst (release of pressure), removing the contents of cyst & suturing the cyst wall to the surrounding epithelium
    • Encourages the cyst to decrease in size & may be followed by enucleation at a later date
35
Q

Segmental resection

A

Removal of cyst with normal margin of bone

Oral diagnosis (2 decks)

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