Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 SCR > Cysts > Flashcards

Cysts Flashcards

1
Q

What is a cyst?

A

A pathologial cavity having fluid , semi-fluid or gaseous contents and which is not created by the accumulation of pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and symptoms of cysts?

A
  • mostly benign unless infected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What investigations to carry out for cysts?

A

initial
- periapical radiograph
- occlusal radiograaph
- Panoramic radiograph
supplemental
- cone beam CT (CBCT)
- Facial radiographs
- PA mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are cysts classified?

A

Structure - epithelium lined : non epithelial lining
Origin : odontogenic : non-odontogenic
Pathogenesis : developmental vs inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of odontogenic developmental cysts?

A
  • dentigerous cysts
  • odontogenic keratocyst
  • lateral periodontal cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of odontogenic inflammatory cysts

A
  • radicular cyst and residual cyst
  • inflammatory collateral cyst (paradental and buccal bifurcation cyst)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

non odontogenic developmental cysts?

A
  • nasopalatine duct cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

non epithelial cysts

A
  • solitary bone cyst
  • aneurysmal bone cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are odontogenic cysts?

A

They occur in tooth bearing areas
- most common cause of bony swelling in the jaws
- they are all lined with epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Odontogenic sources of epithelium?

A
  • Rests of malassez - remnants of hertwig’s epithelial root sheath
  • Rests of serres - remants of the dental lamina
  • Reduced enamel epithelium - remnants of the enamel organ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the most common odontogenic cysts?

A
  • Radicular cysts (residual cyst) - 60%
  • Dentigerous cysts (eruption cyst) - 18%
  • Odontogenic keratocyst - 12%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a radicular cyst?

A
  • it is an inflammatory odontogenic cyst
  • associated with non vital tooth
  • initiated by chronic inflammation at apex of tooth due to pulp necrosis
  • mostly affecting maxilla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the presentation of a radicular cyst?

A
  • asymptomatic unless indected
  • slow growing with limited expansion
  • radiolucency more than 15mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the radiographic features of radicular cysts?

A
  • well defined, round or oval radiolucency
  • corticated margin continuous with lamina dura of non vital tooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What might be the dental effects of radicular cysts?

A
  • may cause displacement of adjacent structures
  • may cause external root resorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the histology of radicular cysts

A
  • epithelial lining (often incomplete)
  • connective tissue capsule
  • inflammation in capsule
  • originate from epithelial cells of malaasez
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How due radicular cysts form?

A
  • rests of malassez proliferate in periapical granuloma
  • they can then form by proliferating epithelium with central necrosis or epithelium surrounds fluid area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the two growth mechanisms for radicular cysts ?

A
  • Osmotic effect with semi-permeable wall
  • Cytokine mediated growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the histological features of radicular cysts?

A
  • variable inflammation
  • cholestrol clefts
  • mucous metaplsia
  • Hyaline/rushton bodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can you describe radicular cysts on palpation?

A

eggshell crackling

21
Q

What are the two variants of radicular cysts?

A
  • residual cyst : radicular cyst that persists after loss of tooth
  • Lateral radicular cyst : associated with an accessory canal , located at side of tooth instead of apex
22
Q

What is an inflammatory collateral cyst?

A

it is an inflammatory odontogenic cyst associated with a vital tooth

23
Q

What are the types of inflammatory collateral cysts?

A
  • paradental - distal aspect of partially erupted third molar
  • Buccal bifurcation cyst - buccal aspect of mandibular first molar
24
Q

What is dentigerous cyst

A

It is a developmental odontogenic cyst associated with a crown of unerupted ot impacted tooth (mandibular 8s or upper 3s)
- associated with cystic change of dental follicle

25
Q

How are dentigerous cysts present radiographically?

A
  • corticated margins attached to cemento-enamel junction of tooth
  • may displace involved tooth
26
Q

what is the histopathology of dentigerous cysts?

A

thin non keratinised stratified sqaumous epithelium

27
Q

How to differentiate between dentigerous cyst and enlarged follicle?

A
  • if follicular space is 5mm or more
  • normal follicular space is 2-3mm
  • if radiolucency is asymmetrical consider cyst
28
Q

What is eruption cyst

A
  • it is a variant of dentigerous cyst
  • contained within soft tissue rather than bone
  • associated with an erupting tooth (more commonly incisors and in children)
29
Q

What is odontogenic keratocyst?

A

It is a developmental odontogenic cyst that is not associated with teeth

30
Q

How does it grow?

A
  • can enlarge in medullary bone
  • can have significant mesio-distal expansion without bucco-lingual expansion
31
Q

Histology of odonotogenic keratocyst

A
  • Have cyst aspirate (low soluble protein content)
  • Have parakeratosis
  • basal palisading
  • loss of keratin if inflammed
32
Q

What is basal cell naevus syndrome?

A
  • presents as multiple odontogenic keratocysts
  • can have calcification
  • known as gorlin-goltz syndrome
  • associated with multiple basal cell carcinomas
33
Q

Examples of non odontogenic cysts ?

A

nasopalatine duct cyst
solitary bone cyst
aneurysmal bone cyst

34
Q

What is nasopalatine duct cyst

A
  • it arises from nasopalatine duct epithelial remnants and occurs in anterior maxilla
  • AKA incisive canal cyst
35
Q

What is the presentation of nasopalatine duct cyst?

A
  • it is often asymptomatic
  • have salty discharge
  • large cysts may displace teeth or cause swelling in palate
  • always involve midline bit not always symmetrical
36
Q

What is the histology of nasopalatine cyst?

A
  • variable epithelial lining
  • non keratinised startified squamous and modified respiratory
37
Q

What further investigations for histology?

A
  • Aspirational biopsy - drainage of contents
  • Incisional biopsy - Partial removal
  • Excisional biopsy - complete removal
38
Q

What kind of fluid you might find when performing aspirational biopsy?

A

inflammatory or developmental
clear straw coloured fluid
keratocyst
white or cream semi-solid fluid indicated keratocyst

39
Q

What is the purpose of incisional biopsy?

A

to obtain a sample of the lining for histological analysis

40
Q

how to perform incisional biopsy?

A

Usually under LA
- select place where lesion appears superficial
- raise mucoperiosteal flap
- remove bone as required
- incise and remove a section of the lining
(this may be combined with marsupialisation)

41
Q

What are the treatment options of cysts?

A

Enucleation
Marsupialisation

42
Q

What is enucleation?

A

all of the cystic lesion is removed

43
Q

What is marsupialisation?

A
  • creation of a surgical window in the wall of the cyst, removing the content of the cysts and suturing the cyst wall to the surrounding epithelium
  • encourages the cyst to decrease in size and may be followed by enucleation at a later date
44
Q

What are the advantages of enucleation?

A
  • whole lining can be examined pathologically
  • primary closure
  • little aftercare needed
45
Q

What are the contraindicatoins and disadvantages of enucleation?

A
  • risk of mandibular fracture
  • may wish to preserve tooth for dentigerous cysts
  • old in age
  • incomplete removal of lining may lead to recurrance
  • damage to adjacent structures
  • Clott filled cavity may become infected
46
Q

What are the indications of marsupialisation?

A
  • if enucleation would damage adjacent structures
  • difficult access to the area
  • may allow eruption of teeth affected by a dentigerous cyst
  • Elderly or medically compromised patients that cannot withstand complex surgery
  • very large cysts which would risk jaw fracture if enucleation was performed
  • can combine with enucleation as a later procedure
47
Q

What are the advantages of marsupialisation?

A
  • simple to perform
  • may spare vital structures
48
Q

What are the contraindications of marsupialisation?

A
  • opening may close and cyst ay reform
  • complete lining not available for histology
  • difficult to keep clean and lots of aftercare needed
  • long time to fill in
49
Q
A

BDS4 SCR (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions