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BDS4 Tutorials > Cysts > Flashcards

Cysts Flashcards

1
Q

What is a cyst?

A

Pathological cavity containing fluid, semi-fluid or gas
-> not created by accumulation of pus

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2
Q

What are the inflammatory types of odontogenic cyst?

A

Radicular
-> residual (subtype)

Collateral
-> Paradental
-> buccal bifurcation

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3
Q

What are the developmental types of odontogenic cysts?

A

Dentigerous
-> eruption

OK

Lateral periodontal

Gingival

Glandular odontogenic

Calcifying odontogenic

Orthokeratinised odontogenic

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4
Q

What are the non-odontogenic epithelial cysts?

A

Nasolabial

Nasopalatine

Globulomaxillary

Median

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5
Q

What are the non-epithelial odontogenic cysts?

A

Solitary bone cyst

Aneurysmal bone cyst

** Stafne’s idiopathic bone cavity

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6
Q

What are the features of Radicular cysts?

A

Associated with non-vital tooth
-> follow on from apical periodontitis due to necrosis of pulp

Can be apical, lateral or residual

May expand bone and cause discharge

Ofren in lateral incisor region

60% maxilla

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7
Q

What is the origin of radicular cysts?

A

Rests of mallassez
-> from HERS (dental follicle)

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8
Q

What are residual cysts?

A

Radicular cysts remaining in jaws following extraction

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9
Q

How are radicular cysts treated?

A

Enucleation

Removal of associated tooth

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10
Q

When do radicular cysts tend to present?

A

4th-5th decades

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11
Q

How do radicular cysts appear radiographically?

A

Round or ovoid radiolucency at root apex

Unilocular

Well defined

Uniform

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12
Q

How do radicular cysts appear histologically?

A

Regular lining- NK squamous epithelium

Cholesterol depsits

Vascular capsule

Presence of inflammatory infiltrate

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13
Q

What are the contents of a radicular cyst?

A

Watery straw coloured fluid

Semi-solid brown material

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14
Q

Where do inflammatory collateral cysts tend to occur?

A

buccal aspect of partially erupted vital tooth

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15
Q

What teeth are paradental cysts usually associated with?

A

Partially erupted 8s
-> inflammatory stimulus is pericoronitis

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16
Q

Where do mandibular bifurcation cysts occur?

A

In children on buccal aspect of erupting FPM

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17
Q

How does a paradental cyst appear radiographically?

A

Well defined radiolucency related to neck and coronal third of root
-> similar to radicular

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18
Q

What are the features of a dnetigerous cyst?

A

Most common of this type

Associated with impacted 8s

M>F

2nd-3rd decades

Incidental finding- asymptomatic

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19
Q

Where do denitgerous cysts arise from?

A

Reduced enamel epithelium (enamel organ)

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20
Q

How do dentigerous cysts present radiographically?

A

Embrace all/part of crown of unerupted tooth- attaches at CEJ

Round/oviod radiolucency

Well-defined/uniform

Unilocular

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21
Q

What are the histopathological features of dentigerous cyst?

A

Thin regular layer of NK stratified squamous epithelium

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22
Q

What are the contents of a dentigerous cyst?

A

Proteinacous yellowish fluid
-> cholesterol crystals common

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23
Q

How are dentigerous cysts treated?

A

Enucleation with associated tooth

Marsupialisation if large

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24
Q

What are the features of an eruption cyst?

A

Overlies an erupting tooth
-> deciduous teeth/FPM

Similar histopathology to dnetigerous

Surgical excision may be required

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25
Q

What is the third most common odontogenic cyst?

A

OK

26
Q

What does an OK arise from?

A

Rests of serres (dental lamina)

27
Q

What are the issues in OKs?

A

High risk of recurrence

Enlarges AP- unusual pattern, can reach large size without causing bony expansion

28
Q

What are the clinical features of OK?

A

M>F

Wide age range

70-80% occur in mandible
-> mostly in 8 region

Asymptomatic

29
Q

How do OKs present radiographically?

A

Oval radiolucency

Well defined/uniform

Uni or multilocular

30
Q

How do OKs appear histopathologically?

A

Thin connective tissue wall

No inflammation

Lined by thin- folded parakeratinsied stratified squamous epithelium

31
Q

What is the contents of an OK?

A

Thick grey/white material with keratinous debris

32
Q

What is Gorlin-Goltz syndrome?

A

Autosomal dominant syndrome

Multiple OKs

Multiple Naevoid Basal cell Carcinomas on skin

Skeletal abnormalities (abnormal Ca/PO metabolism)
-> Ribs/vertebrae affected
-> Calcified falx

33
Q

What are the facial characteristics of Gorlin-Goltz?

A

Frontal, temporal, parietal bossing

Hypertolerism

Mild mandibular prognathism

34
Q

What is an orthokeratinised odontogenic cyst how is it different from an OK?

A

Used to be considered variant of OK
-> similar presentation but histologically disntinct (orthokeratinisation and flattened basal cell layer)
-> unilocular without epithelial proliferations or satellite cells
-> No naevoid BCCs
-> rarely recur

35
Q

What teeth are lateral periodontal cysts associated with?

A

Canine and premolar region in mandible

Vital teeth

-> Asymptomatic/incidental (may present with expansion)

36
Q

How do lateral periodontal cysts appear radiographically?

A

Well demarcated radiolucent area in lateral periodontium

37
Q

What are the histological features of Lateral periodontal cysts?

A

Thin Stratified squamous lining

Similar to gingival cyst

38
Q

How are Lateral periodontal cysts treated?

A

Enucleation

39
Q

What is a botryoid odontogenic cyst?

A

Multi-locular variant of LPC

Often larger

More likely to recur

40
Q

What is the origin of gingival cysts?

A

Rests of serres (dental lamina) in gingival or alveolar soft tissues

41
Q

How do gingival cysts present?

A

As a <1cm pink/blueish sessile swelling in the attached mandibular gingivae

42
Q

What are gingival cysts in infants called, how do they present?

A

Bohn’s nodules
-> small yellow nodules on edentulous alveolar mucosa
-> degenerate, no tx required

43
Q

What are the features of Glandular odontogenic cysts?

A

Rare

Potentially aggressive, locally invasive
-> can cause erosions of cortical plate

High recurrence

Uni/multilocular radiolucency

Uninflamed fibrous wall with cuboidal epithelium (glandular)

44
Q

Where do glandular odontogenic cysts tend to occur?

A

Anterior mandible- slow growing and painless

45
Q

What is a calcifying odonotogenic cyst?

A

Member of ghost cell family of odontgenic lesions
-> appear as ghost epithelial cells histologically

46
Q

How does calcifying odontogenic cyst present clincially?

A

Wide age rage- usually <40

Intraosseous

Arise anterior to FPM

1-3mm in diameter

Rarely recur

Benign

47
Q

What are the radiographic features of calcifying odontogenic cysts?

A

Initially radiolucent- then starts to contain calcified radiopaque material

Uni/multilocular

Adjacent teeth may be displaced or resorbed by bony expansion

48
Q

What is the origin of nasopalatine duct cyst?

A

Epithelial remnants of naso-palatine duct

49
Q

How do naso-palatine duct cysts present?

A

M>F

5-6th decades

Asymptomatic/incidental

Slowly enlarging swelling in anterior region of palate at midline

50
Q

How do nasopalatine duct cysts appear radiographically?

A

Round, ovoid, heart-shaped radiolucency

Sclerotic margin

Well-defined

51
Q

What are the histopathological characteristics of NPDC?

A

Lined by stratified squamous and respiratory epithelium

Neuromuscular bundles found in capsule

52
Q

What is the aetiology of a solitary bone cyst?
(known as simple, haemorrhage, traumatic)

A

Unknown

53
Q

How does a solitary bone cyst present?

A

Any age/sex

Premolar/molar region of mandible

Asymptomatic/incidental

Bone expansion in 25%

54
Q

How do solitary bone cysts appear radiographically?

A

Radiolucent

Variable size

Irregular outline- scalloped
-> Moderately well defined

55
Q

What occurs on surgical exploration of solitary bone cysts?

A

Rough bony walled cavity with no lining
-> rapid healing occurs
-> spontaeously resolves

56
Q

What is stafne’s bone cavity?

A

Developmental anomaly of mandible
-> asymptomatic and incidental

57
Q

What are the radiographic features of Stafne’s bone cavity?

A

Round or oval radiolucency

Occurs between premolars and angle of mandible

Located below IDC

Can be bilateral

58
Q

What is found on surgical exploration of Stafne’s?

A

Saucer shaped depression in lingual aspect of mandible
-> contains ectopic salivary tissue

59
Q

What are examples of differential diagnoses for radiolucent lesions that are non-cystic

A

Odontogenic tumours
-> ameloblastoma, ameloblastic fibroma, odontogenic fibroma and myxoma

Giant cell lesions
-> cherubism, peripheral/central giant cell granuloma, Brown tumour

Fibro-cemento-osseus lesions
-> Periapical cemento-osseous dysplasia, fibrous dysplasia

Non-odontogenic tumours
-> chondroma, osteosarcoma, SCC, metastatic bone tumours, central haemangioma

60
Q

What are the treatment options for Cysts?

A

Enucleation- remove entire lining and contents
-> radicular, residual, dentigerous, kerato

Marsupialisation- create fenestration with tube or grommet
-> larger cysts

Surgical resection- removal of cyst with margin of normal bone
-> ameloblastoma/sarcoma
-> may require secondary surgery

61
Q

What are the complications for enucleation?

A

Damage to IAN

OAC

Pathological fracture of mandible

Risk of recurrence

62
Q

What are the complications of marsupialisation?

A

Further surgery required for removal of cyst

Long treatment

Chance of re-infection of cyst

Uncomfortable

BDS4 Tutorials (9 decks)

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