Cysts

Question 1

Define a cyst

Answer 1

Pathological cavity with fluid/semifluid/gaseous contents not created by accumulation of pus

Question 2

Define an abscess

Answer 2

Pathological cavity containing fluid and pus

Question 3

Clinical signs and symptoms of cysts

Answer 3

Pain
Slow swelling (abscess = fast)
Numbness/tingling
Tenderness
Sensitivity
Mobility
Spacing
Blueish discolouration
Displacement of teeth
Failed eruption

Question 4

Why does eggshell cracking occur?

Answer 4

Thinning of bone

Question 5

First lining imaging for a suspected cystic lesion

Answer 5

PA

Occlusal

OPT

Question 6

Indications for PA for cysts

Answer 6

Most detail
Small lesions

Question 7

Indications for Occlusal for cysts

Answer 7

Larger lesion
Not seen on PA

Question 8

Indications for OPT for cysts

Answer 8

Posterior mandible: larger lesions

Question 9

Disadvantage of OPT for cysts

Answer 9

Not good for anteriors (cervical spine blurs image)

Question 10

Supplemental imaging for cysts

Answer 10

CBCT
Facial radiographs: PA mandible/occipitomental view

Question 11

Limitations of OPT

Answer 11

Nose/soft tissues can create radiopacity and obstruct view

Cervical spine can blur anteriors

Hard palate can obstruct and create a white line

If tongue not at root of mouth = air shadow created so can’t see roots of upper teeth

Don’t know buccolingual dimension

Question 12

One feature of ALL odontogenic cysts

Answer 12

They dont go below the IA canal

Question 13

Important radiographic features to determine cysts (7)

Answer 13

1. Location
2. Shape
3. Margins
4. Locularity
5. Multiplicity
6. Effect on surrounding anatomy
7. Include UE teeth?

Question 14

3 ways cysts can be classified

Answer 14

Structure
Origin
Pathogenesis

Question 15

Most common way to classify cysts

Answer 15

Origin:
Odontogenic epithelium
Non odontogenic epithelium

Question 16

Main branches of odontogenic cysts and examples

Answer 16

Developmental
- Dentigerous
- OK
- Lateral periodontal

Inflammatory
- Radicular + residual
- Inflammatory collateral:
Paradental cyst
Buccal bifurcation cyst

Question 17

Main branches of non odontogenic cysts and examples

Answer 17

Developmental
- Nasopalatine

Other
- Solitary bone cyst
- Aneurysmal bone cyst

Question 18

What 2 cysts have no epithelial lining

Answer 18

Solitary bone cyst
Aneurysmal bone cyst

Both non odontogenic others

Question 19

Histological findings of a radicular cyst

Answer 19

Cholesterol clefts

Hyaline bodies

Question 20

Compare dentigerous cyst and enlarged follicle

Answer 20

Large follicle = no island of odontogenic epithelium

Dentigerous cyst >4mm

Normal dental follicle up to 3mm around crown

Question 21

What are multiple OK’s related to?

Answer 21

Basal cell naves syndrome

Question 22

Nasopalatine cyst vs incisive fossa

Answer 22

<6mm = incisive fossa
Unless clinical swelling /salty discharge

6-10mm = monitor

> 10mm = suspect cyst

Question 23

Type of fluid for radicular cyst

Answer 23

Yellow straw like fluid

Question 24

Type of fluid for OK cyst

Answer 24

White or creamy semi solid

Question 25

3 types of biopsy

Answer 25

Aspiration biopsy
Incisional biopsy
Excisional biopsy

Question 26

Tx options for cysts

Answer 26

1. Enucleation
2. Marsupilisation

Question 27

Advantages of enucleation

Answer 27

Whole lining can be examined

Little aftercare needed

Primary healing

Question 28

Contraindications of enucleation

Answer 28

Very large lesion - risk of mandibular fracture

Old/ill