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Bds4 Oral Surgery > Cysts > Flashcards

Cysts Flashcards

1
Q

What is a cyst?

A

A pathological cavity containing fluid, semi-fluid or gaseous contents
Not been created by accumulation of pus

Can be epithelial or non epithelial

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2
Q

What are the subdivisions of epithelial cysts

A

Odontogenic (inflammatory/ developmental)
Non odontogenic

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3
Q

What are the two main types of odontogenic inflammatory cysts?

A

Radicular cysts
Inflammatory collateral cysts

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4
Q

What are the main features of a radicular cyst?

A

Inflammation causing proliferation of epithelium (rests of malessez - originates from hertwigs root sheath, dental follicle)
Associated with non vital tooth
Could be apical/ lateral/ residual

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5
Q

What is a residual cyst?

A

A radicular cyst remaining in the jaw after extraction of affected tooth

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6
Q

What is the treatment for a radicular cyst?

A

Simple enucleation and removal of associated tooth

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7
Q

What are the histological features of a radicular cyst?

A

Regular lining of non keratinised squamous epithelium
Vascular capsule
Inflammatory infiltrate

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8
Q

What is the radiographic presentation of a radicular cyst?

A

Round radiolucency at root apex
Unilocular, well defined
Uniform radiolucency

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9
Q

What is an inflammatory collateral cyst?

A

Occurs on the lateral aspect of a partially erupted, vital tooth
(M3Ms the inflammatory stimulus is pericoronitis)

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10
Q

What type of cysts occurs on the buccal aspect of erupting fist molars in children?

A

Mandibular buccal bifurcation cysts

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11
Q

What type of cyst is a dentigerous cyst?

A

A developmental cyst

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12
Q

What are the radio graphic features of a dentigerous cyst?

A

Round, unilocular, well defined, uniform radiolucency
Attached to crown of unerupted tooth

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13
Q

What is the lining of a dentigerous cyst derived from?

A

Reduced enamel epithelium

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14
Q

What are the histopathology features of a dentigerous cyst?

A

Thin regular layer of non keratinised stratified squamous epithelium

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15
Q

What a re the main features of a dentigerous cyst?

A

Mostly with impacted mandibular third molars
Embraces all/ part of the crown of an unerupted tooth (attached at CEJ)

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16
Q

What is the treatment of a dentigerous cyst?

A

Cyst enucleation/ marsupialisation if large

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17
Q

What is an eruption cyst?

A

A type of developmental cyst overlying an erupting tooth
Most commonly deciduous incisors/ FPMs

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18
Q

What is an odontogenic keratocyst?

A

A type of developmental cyst which arises from the cell rests of serres (remnants of dental lamina)
Has an unusual growth pattern with high risk of recurrence
Enlarges in anterior posterior direction

19
Q

Where are odontogenic keratocysts most common?

A

In the mandible, especially third molar region

20
Q

What is the radio graphic presentation of an odontogenic keratocyst?

A

Oval
Well defines, uniform
Uni or multi locular

21
Q

What are the histopathological features of an odontogenic keratocyst?

A

Thin connective tissue wall
Lined by thin, folded parakeratinised stratified squamous epithelium

22
Q

What is basal cell naevus syndrome?

A

Autosomal dominant condition which can result in multiple odontogenic keratocysts (and increased risk of basal cell carcinoma)

23
Q

What is the difference between an orthokeratinised odontogenic cyst and an odontogenic keratocyst?

A

Orthokeratinised odontogenic cysts rarely recur, have no occurrence with basal cell naevus syndrome and have distinct flattened basal cell layer (histologically)

24
Q

What is a lateral periodontal cyst?

A

A rare odontogenic developmental cyst which is associated with canine/ premolar region in mandible and vital tooth
Treated with simple enucleation

25
Q

What are gingival cysts?

A

Cysts derived from rests of serres (dental lamina)
Common in infants (bohns nodules) appearing as white/ yellow nodules on edentulous mucosa. These cysts naturally degenerate.

Can occur in adults as <1cm pink swellings on attached gingiva

26
Q

What are examples of non odontogenic cysts?

A

Nasolabial cyst
Nasopalatine cyst

27
Q

What is a nasopalatine cyst?

A

Most common non odontogenic cyst
Originates from epithelial remnants of nano palatine duct
Slowly enlarging swelling in anterior region of midline of palate
Appears as a heart shape radiographically

28
Q

What is the lining of nasopalatine cyst?

A

Stratified squamous and respiratory epithelium

29
Q

What are examples of non epithelial cysts of the jaw?

A

Solitary bone cyst
Aneurysmal bone cyst
Stafnes idiopathic bone cavity

30
Q

What is a solitary bone cyst?

A

Aetiology is unknown
A simple/ haemorrhagic/ traumatic bone cyst

Radiographic presentation - irregular outline, moderately well defined, scalloping a prominent feature

Surgical exploration allows rapidly healing and resolving

31
Q

What is stafnes idiopathic bone cavity?

A

Developmental anomaly of the mandible
Usually at angle of mandible
Below inferior dental canal

Saucer shape depression on lingual aspect, usually from enlarged sub mandibular gland

32
Q

What is enucleation?

A

Removal of entire cyst lining and contents
Useful for radicular/ residual, dentigerous cysts and keratocysts

33
Q

Why is enucleation not a treatment option for ameloblastomas?

A

Ameloblastomas have high recurrence rates due to thin, fragile lining. Therefore 1cm sound tissue must also be removed - in the mandible this is too large

34
Q

What are complications of enucleation?

A

Damage to IAN
OAC
Pathological fracture of mandible
Risk of recurrence

35
Q

What is marsupilisation?

A

Shrinking of the cyst by allowing drainage
Useful for large cysts, karatocyst, dentigerous cyst

36
Q

What are complications of marsupilisation?

A

Needs further surgical treatment for removal
Long treatment before completion (1 year)
Chance of re infection
Uncomfortable

37
Q

What is the size of a cyst v granuloma?

A

Granuloma <10mm
Cyst >10mm

38
Q

Why would marsupilisation be the preferred treatment option over enucleation?

A

If enucleation would damage surrounding structures
If difficult access for enucleation
To allow eruption of teeth
If enucleation may risk pathological jaw fracture

39
Q

What can be utilised to keep marsupilisation window open?

A

An obturator

40
Q

What can be utilised to keep marsupilisation window clean?

A

Chlorhexidine mouthwash

41
Q

What is an example of an odontogenic tumour?

A

Ameloblastoma
Ameloblastic fibroma

42
Q

What are examples of giant cell lesions in the jaw?

A

Peripheral and central giant cell granuloma
Cherubism

43
Q

What are examples of radiolucent non odontogenic tumours which may be found in the jaw?

A

Chondroma
Osteosarcoma
Squamous cell carcinoma
Central haemangioma

Bds4 Oral Surgery (17 decks)

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