Cysts Flashcards
Radicular cysts come from the remenants of what epithelium
Rests of mallaez from hertwigs root sheath
What two kinds of cysts come from remnants of the reduced enamel epithelium
Dentigerious cyst
Eruption cyst
Ameloblastoma
Keratocyst
Gingival cyst
All come from remenants of which odontogenic epithelium
Dental lamina - rest of serres
Radicular cysts make up what’s percentage of all odontogenic cysts
60%
What is a radicular cyst commonly associated with
A non vital tooth
How does a radicular cyst usually present Radiographically
Round or avoid radioluceny at root apex
Unilocular , well defined
Uniform radiolucency
what are the two kinds of inflammatory collateral cysts
Paradental
Mandibular buccal bifurcation
What kind of epithelium is seen in radiucular cyst
Lining of non keratinised squamous epithelium
What is the most common type of developmental odontogenic cyst
Dentigerous cyst
What is a characteristic feature of a Dentigerous cyst
Embrace all or part of the crown and attaches at the CEJ
A Dentigerous cyst is lined by epithelium derived from what
Reduced enamel epithelium from the enamel organ
What tooth is a Dentigerous cyst most commonly associated wuht
Impacted third molars
What does an odontogenic keratocyst arise from
Cell rests of serres originating from dental lamina
How does an odontogenic keratocyst expand and what does this mean
In an AP direction
Can reach a large size without causing gross bony expansion
What syndrome is assoaciated with odontogenic keratocyst
Basal cell naevus syndrome
Multiple naeviod BCCs of skin
What is the origin of nasopalatine duct cyst
Epithelial remnants of Naso-palatine duct
What is a nasopalatine duct cyst lined with
Stratified squamous epithelium and respiratory or cuboidal epithelium
What is cyst enucleation
Removal of the entire lining of the cyst and its contents
Depends on the size and cyst type
Name 4 complications associated with cyst enucleation
Damage to IAN
Commutation with maxillary sinus - OAC
Pathological fracture of mandible
Risk of recurrence
What is marsupilisation of a cyst
Creation of a surgical window in the wall of a cyst, removing the contents of the cyst and suturing the cyst wall to the surrounding epithelium
Encourages the cyst to decrease in size
Name 4 complications associated with marsupilisation
Needs further surgery for removal of cyst
Long treatment before completion
Chance of re-infection
Uncomfortable for the patient
What is a lateral periodontal cyst
Forms at the side of a tooth as a result of the opening of a lateral branch of a root canal
Occasionally can form as a result of inflammation in gingival pocket of a vital tooth
How does continued growth happen in a radicular cyst
2 ways
Osmotic effect with semi-permeable wall
Cytokine mediated growth
When sending a sample of a cyst to a lab what medium is it placed in
10% formalin
What is the typical size of a dental follicle
<2.5mm
Describe three histopathological features of an odontogenic keratocyst
Thin keratinsed epithelium
No rete pegs
Pallisading of basal cel nuceli
When doing an aspiration biopsy of a Odontogenic keratocyst what would you expect the protein content to be
Low solubale protein content <4g/dl
Why is inflammation in a cyst a problem for a pathologist?
Inflammed areas those their typical features leading to problems in diagnosis and surgical managment which could result in recurrence
What is the importance of daughter cysts
The clincal importance of these cysts is that if they are left behind after surgical removal they can cause recurrence
What is the normal width of an incisive papillae
6mm
3-6mm is the range
What are 3 advantages of enucleation
Whole lining can be examined pathologically
Primary closure
Little aftercare needed
What are 5 disadvantages of enucleation
Risk of a Mandibular fracture with a very large cyst
Clot filled cavity may become infected
With a Dentigerous cyst - ,may have wanted to preserve the tooth
Incomplete removal of lining may cause recurrence
Damage to adjacent structures
What are two advantages of marsupialisation
Simple to perform
May spare vital structures
4 disadvantages of marsupialisation
Opening may close and cystreforms
Complete lining isn’t available for histopatholgy
Difficult to keep clean and a lot of aftercare needed
Long time to fill in
Name 5 indications for marsupialisation over enucleation
If enucleation would damage surrounding structures ie. ID canal
Difficult access to the aera
May allow eruption of teeth i.e in a Dentigerous cyst
Elderly or immunocompromised pateitns who are unable to withstand extensive surgery
If enucleation would risk jaw fracture
What is a stafne cavity
This is a depression in the bone that is often mistaken for a cyst
Only occurs in the mandible and almost exclusively lingual
Where is stafne cavity most commonly found
In the mandible
Often in angle or posteior body and often inferior to IAn
Patient presenting with salty taste in mouth what cyst may you think of
Nasopalatine duct cyst
