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cysts Flashcards

1
Q

what are the two types of cysts of the jaws?

what are the differences?

A

odontgenic cysts

  • elithelial lining derived from epithelial residues the the tooth forming organ
  • have epithelial linings

non-odontogenic cysts

  • epithelial lining, if present, derived from sources other than tooth forming organ
  • may not have epithelial lining
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2
Q

what are the groups of odontogenic cysts?

A
  • developmental
  • inflammatory
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3
Q

name developmental odontogenic cysts?

A
  • dentigerous cyst (eruption cyst)
  • odontogenic keratocyst
  • developmental lateral periodontal cyst
  • gingival cyst
  • glandular odontogenic cyst
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4
Q

name inflammatory odontogenic cysts

A
  • radicular cyst
    • apical periodontal cyst
      • associated with apex of tooth of nonvital tooth
    • lateral periodontal cyst
      • associated with lateral root canals in non vital tooth
    • residual cyst
      • remain in jaw after extraction of associated tooth
  • paradental cyst
    • uncommon
    • associated with partially erupted lower 3rd molars with a history of repeated pericoronitis
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5
Q

what is the prevelance of cysts of the jaws?

A
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6
Q

which odontogenic cysts are derived from dental lamina and glands of serres

A
  • odontogenic keratocyst
  • developmental lateral periodontal cyst
  • gingival cyst
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7
Q

which odontogenic cysts are derived from the enamel organ and reduced enamel epithelium?

A
  • dentigerous cyst
  • eruption cyst
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8
Q

which odontogenic cysts are derived from the root sheath of hertwig and rests of malassez?

A
  • radicular cysts
    • apical
    • lateral
    • residual
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9
Q

in a table, summarise the origin of epithelial lining of the odontogenic cysts

A
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10
Q

what is the definition of a radicular cyst?

where do the majority arise?

A
  • definition
    • cyst arising from epithelial rests of malassez in the PDL
    • as a consequence of inflammation
      • usually following death of dental pulp
  • majority arise in
    • apical region
      • apical periodontal / radicular cyst
  • some arise in lateral root canals
    • inflammatory lateral periodontal cyst
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11
Q

what are the symptoms of an apical periodontal (radicular) cyst?

A
  • can be symptomless
  • larger cysts - slowly enlarging swellings
  • may be acute inflammation signs due to infection
  • related to tooth with non-vital pulp
  • may be more than 1 cyst
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12
Q

what are the signs of an apical periodonta (radicular) cyst?

A
  • labial or buccal sweeling
  • may be palatal swelling but rarely lingual swelling
  • small cysts
    • bony hard swellings
  • larger cysts
    • springy swellings with eggshell crackling
    • may erode the bone and be fluctuant
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13
Q

identify this

what radiological features are present?

A

apical periodontal (radicular) cyst

  • radiolucent round or oval lesion
  • at apex of tooth root
  • well demarcated periphery
  • surrounded by narrow radiopaque margin which extends from the lamina sura of the involved tooth
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14
Q

what is the management for an apical periodontal cyst?

A
  • extraction
  • endodontic treatment - RCT
  • enucleation
    • removal of cyst wall from bony cavity
  • marsupialisation
    • for large cysts
    • decompression of cyst by opening into oral cavity to allow gradual infilling of bony cavity
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15
Q

what is the definition for a paradental cyst?

A
  • occuring near to cervical margin of the lateral aspect of a root
  • as a consequence of inflammatory process in the periodontal pocket
    • usually pericoronitis
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16
Q

what are the clinical features of a paradental cyst?

site and presentation?

A
  • site
    • mandibular third molars
    • usually bucally or distobuccally placed
  • presentation
    • usually identified on radiograph
    • usually small so no clinical swelling
    • history of pericoronitis
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17
Q

identify this

what features present?

A

paradental cyst

  • well defined radiolucency
  • related to neck of the rooth and coronal third of the root
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18
Q

what is the management for a paradental cyst?

A

remove with impacted tooth usually

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19
Q

what is a dentigerous cyst?

A
  • cyst ensloing part or all of crown of an unerupted tooth
  • attached to the amelocemental junction
  • arises in follicular tissues
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20
Q

what is an eruption cyst?

A

a dentigerous cyst which arises in an extra-alveolar location

after erupting tooth has penetrated alveolar bone to enter soft tissues

uncommon cysts

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21
Q

whom do dentigerous cysts more commonly occur in?

A
  • age
    • wide
    • many in adolescents and young adults
  • sex
    • twice as common in males
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22
Q

where do dentigerous cysts occur more commonly?

A
  • twice as common in mandible
  • majority mandibular third molars
    • ​then
      • ​maxillary canines
      • maxillary third molars
      • mandibular premolars
  • occasionally associated with supernumerary teeth and odontomes
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23
Q

describe the presentation of a dentigerous cyst

A

tooth missing from arch

expansion of jaw

retained deciduous tooth

routine radiographic examination

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24
Q

identify

what features

A

dentigerous cyst

  • well defined radiolucency
  • associated with crown of unertuped tooth
  • tooth may be displaced
  • unilocular
  • from cementoamelo junction
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25
Q

describe the presentation of an eruption cyst

A

extra-alveolar location so present as fluctuant swellin gon alveolar mucosa

often bluish in colour

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26
Q

how do dentigerous cysts expand?

A

expansion due to raised hydrostatic pressure

27
Q

what is the management for a dentigerous cyst?

A
  • enucleation of cyst
    • with extraction of associated tooth
  • marsupialisation of cyst
    • esp in children - to allow tooth to erupt
      *
28
Q

whom are odontogenic keratocysts more common in?

A
  • age
    • peak in second and third decades
  • more common in males
  • more common in mandigble
  • posterior to first premolar
29
Q

what are the clinical features of an odontogenic keratocyst

symptoms?

A
  • few symptoms unless secondarily infected
  • enlarge in antero-posterior direction
  • can reach large size without causing marked bone expansion
  • majority solitary
    • multiple cysts associated with basal cell naevus syndome
30
Q

identify this

A

odontogenic keratocyst

  • well defined radiolucency
  • can be unilocular or multilocular
  • not involving crowns of tooth
  • extension into ramus of the mandible
31
Q

what does the cyst fluid of a odontogenic keratocyst contain?

A
  • desquamated epithelial cells and keratin
  • lower soluble protein concentration than other odontogenic cysts

properative diagnosis can be made

32
Q

what is the management for an odontogenic keratocyst?

A
  • histological confirmation before definitive treatment
  • complete enucleation
    • difficult to remove all of thin lining
    • partiaicular from multilocaulated cysts
    • use Carnoy’s solution and liquid nitrogen to ensure destruction of epithelial lining
  • marupialisation
  • resection if large

high tendency to recur

33
Q

what are the main manifestations of basal cell naevus syndrome?

A
  • multiple odontogenic keratocysts
  • multple naevoid BCC on skin
    • can occur anywhere
    • commonly around puberty
  • skeletal abnormalities
    • particularly rib
    • vertebral deformities
34
Q

what groups can u classify non-odontogenic cysts into?

A
  1. inclusion cysts
    • formed by epithelium trapped in process of jaw and face fused during embryonic development
  2. congenital cysts
    • result of developmental abnormalities
  3. cysts without epithelial lining
  4. epidermoid cyst
    • skin cysts
35
Q

where do inclusion cysts arise?

name inclusion cysts

A

arise at sites of fusion of facial processes during embryonic development

  • nasopalatine cyst
    • incisive canal cyst
    • cyst of incisive papilla
  • nasoalveolar cyst
    • occurs in upper lip
  • medial palatal cyst
    • along midline of palate
36
Q

name congenital cysts

A
  • thyroglossal duct cyst
  • lymphoepithelial cyst
  • dermoid cyst
37
Q

name cysts without epithelial lining

A
  • bone cysts
    • solitary bone cyst
    • aneurysmal bone cyst
    • stafne’s idiopathic bone cavity
  • salivary gand cysts
  • stromal cysts in neoplasms
38
Q

what is a nasopalatine duct cyst

what are the clinical features

A

aka incisive canal cyst

a cyst arising from epithelial residues in the nasopalatine (incisive) canal

  • clinical features
    • 40% asymptomatic
    • remainder present when infected
39
Q

identify this

what are the radiographic features common?

A
  • ovoid or heart shaped radiolucent lesion
  • bilaterally symmetrical in midline of maxilla
  • behind the central incisors
  • can see the PDL around incisors - therefore not an apical cyst

nasopalatine cyst

40
Q

what is the treatment for a nasopalatine cyst?

A

enucleation

41
Q

what is a thyroglossal duct cyst?

what are the clinical features

what is the treatment?

A

cyst arising from remnants of the thryoglossal duct

  • firm, cystic midline mass, 2-4mm diameter
  • around the hyoid
  • treatment
    • enucleation with excision of thyroglossal tract
42
Q

what is a lymphoepithelial cyst?

what are the clinical features

what is the treatment?

A

cyst lined by squamous epithelium with lymphoid tissue forming the capsule

  • clinical features
    • asymptomatic
    • soft mass
    • usually lat aspect of neck, along anterior border of sternomastoid
  • treatment
    • excision
43
Q

what is a dermoid cyst?

what are the clinical features

what is the treatment?

A
  • sublingual or submental swellin in the midline of the floor of mouth above or below mylohyoid muscle
  • lined by keratinising squamous epithelium
  • treatment
    • enucleation
44
Q

identify this

A

traumatic bone cyst

  • unilocular
  • in posterior mandible
  • upper border arches up between teeth
  • moderately well defined
  • lightly corticated
  • no effect on adjacent structures
45
Q

describe the radiographic features of a radicular cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site :
    • apex of non vital tooth
  • size :
    • >1.5cm in diatmeter
  • shape:
    • round, unilocular
  • outline:
    • well defined corticated outline continuous with lamina suraw of tooth
  • radiodensity:
    • uniformly radiolucent
  • effect on adjacent structures:
    • teeth displaced
    • expansion of buccal/lingual bone
46
Q

what type of cyst is shown here

A

radicular cyst

  • corticated margins
  • round
  • unilocular
  • associated with root apex
47
Q

describe the radiographic features of a residual cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • apical region of edentulous part of jaw
  • size:
    • >1.5cm in diameter
  • shape:
    • round unilocular
  • outline:
    • well defined corticated outline continuous with lamina dura
  • radiodensity:
    • uniformly radiolucent
  • effect on adjacent structures:
    • teeth displaced
    • expansion of buccal / lingual bone
48
Q

what type of cyst is this

A

residual cyst

in edentulous area of the jaw

similar appearance to radicular cyst

49
Q

describe the radiographic features of an inflammatory collateral cyst (paradental cyst)

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • in children and adolescents (first & second molars), age 20-40 (third molars)
  • site:
    • buccal aspect of erupting lower molars
    • sometimes associated with buccal enamel spur
  • size:
    • variable
    • up to 3cm diameter
  • shape:
    • unilocular
  • outline:
    • smooth, well defined, corticated
  • radiodensity:
    • uniformly
  • effect on adjacent structures:
    • tipped tooth
    • no resorption
50
Q

identify this cyst

A

inflammatory collateral cyst (paradental cyst)

51
Q

describe the radiographic features of a dentigerous cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • surrounding crown of an unerupted tooth
  • size:
    • suspect if follicular space >3mm
  • shape:
    • round / oval, unilocular
  • outline:
    • well defined, corticated
  • radiodensity:
    • uniformaly
  • effect on adjacent structures:
    • teeth displaced
    • expansion of buccal / lingual bone
52
Q

identify this cyst

A

dentigerous cyst

has cause expansion of the alveolar crest

53
Q

describe the radiographic features of a odontogenic keratocyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • most common in the posterior mandible
  • size:
    • variable
  • shape:
    • oval, pseudolocular or multilocular
  • outline:
    • well defined corticated
  • radiodensity:
    • uniformly
  • effect on adjacent structures:
    • teeth not displaced
    • little if any expansion of buccal / lingual bone
54
Q

identify this cyst

A

odontogenic keratocyst

55
Q

describe the radiographic features of a lateral periodontal cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • lateral surface of teeth
  • size:
    • 1cm
  • shape:
    • round, unilocular
  • outline:
    • well defined, corticated
  • radiodensity:
    • uniformly
  • effect on adjacent structures:
    • teeth displaced
    • expansion of the buccal / lingual bone if large
56
Q

what is a botryoid odontogenic cyst?

A

a variate of lateral periodontal cyst which is multilocular

57
Q

what is the management for a lateral periodontal cyst ?

A

enucleation

58
Q

what is glandular odontogenic cyst?

radiographic features?

A

a developmental cyst with epithelial features that simulate salivary gland tissue

unilocular or multilocular expansile lesion in anterior mandible

displacement but no resorption

59
Q

what is a calcifying odontogenic cyst?

A

rare cyst in anterior mandible or maxilla

  • in early stages = radiolucent
  • in later stages = calcified

often associated with unerupted tooth or odontome

60
Q

describe the radiographic features of a nasopalatine duct cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • midline, anterior maxilla posterior to central incisors
  • size:
    • variable
  • shape:
    • round/oval, unilocular, can be ‘heart shaped’
  • outline:
    • well defined corticated outline
  • radiodensity:
    • uniformly
  • effect on adjacent structures:
    • teeth displaced
    • expansion into palate
61
Q

describe the radiographic features of a simple bone cyst (traumatic bone cyst)

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • posterior mandible in children and young adults
  • size:
    • variable
  • shape:
    • unilocular
    • upper border arches up and between teeth
  • outline:
    • moderately well defined
    • lightly corticated
  • radiodensity:
    • uniformly
  • effect on adjacent structures:
    • no effect on adjacent structures
62
Q

what is an aneurysmal bone cyst?

how does it present?

what is the treatment?

A

rare expansile osteolytic lesion

presents as painless swelling

treatment : curettage

63
Q

describe the radiographic features of an aneurysmal bone cyst

site:

size:

shape:

outline:

radiodensity:

effect on adjacent structures:

A
  • site:
    • body/posterior manddible of adolescents and young adults
  • size:
    • variable may be several cms
  • shape:
    • unilocular or multilocular
  • outline:
    • moderately well defined
  • radiodensity:
    • radiolucent
    • may have internal trabeculations
  • effect on adjacent structures:
    • ballooning expansion
    • displacement of teeth
64
Q

identify this

A

aneurysmal bone cyst

ballooning expansion

z oral surgery / oral diseases (13 decks)

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