Cysts and Odontogenic Tumors Flashcards
CYST DEFINITION
Epithelial lined pathologic cavity
DEVELOPMENTAL
NON-ODONTOGENIC CYSTS
(2)
Nasopalatine Duct Cyst
Median Palatine Cyst
Nasopalatine Duct Cyst
(5)
- Incisive Canal Cyst
- Most common non-
odontogenic cyst of oral
cavity - A developmental cyst that
arises from epithelial
remnants of nasopalatine
duct - Vital teeth
- Adults - 4th to 6th Decades
Symptoms associated with
Nasopalatine Duct Cyst
(3)
- Radiolucency - 0.6 cm is the upper limit of normal for the incisive foramen
- Swelling of anterior palate
- Drainage and pain, if inflamed
Median Palatine Cyst
(4)
- Well-circumscribed palatal lucency
- Epithelium entrapped during fusion of palatal shelves
- Stratified squamous or pseudostratified columnar
- May be difficult to distinguish from Nasopalatine Duct Cyst
ODONTOGENIC CYSTS
(2)
INFLAMMATORY CYSTS AND DEVELOPMENTAL CYSTS
INFLAMMATORY ODONTOGENIC CYSTS
(3)
Periapical Cyst
Residual Cyst
Buccal Bifurcation Cyst
Periapical Cyst (Radicular Cyst)
(2)
- Apex of non-vital tooth
- Arises from rests of Malassez
Buccal Bifurcation Cyst
(2)
- Paradental cyst
- Buccal bifurcation of vital mandiblar molar teeth with
cervical enamel projection
DEVELOPMENTAL ODONTOGENIC CYSTS
(6)
Dentigerous Cyst
Eruption Cyst
Dental Lamina Cyst
Odontokeratocyst
Calcifying Odontogenic Cyst
Glandular Odontogenic Cyst
Dentigerous Cyst
(3)
- Most common type of developmental odontogenic cyst
- Arises from dental follicle - attached to the cervix, enclosing
the crown of an unerupted tooth - Enlarged follicular space > 4 mm
“Globulomaxillary Cyst”
(3)
- The globulomaxillary position is located at the junction of
maxilla with premaxilla, between maxillary lateral incisor
and canine - No developmental fissural cyst in this position
- A developmental “globulomaxillary cyst” does not exist
Globulomaxillary Lesions
* Periapical cyst –%
* Periapical granuloma –%
* Lateral periodontal cyst –%
* Odontogenic keratocyst –%
* Giant cell tumor –%
* Other lesions –%
50
15
10
10
7
3
- Other lesions 3%
(5)
- Gorlin cyst
- Odontogenic myxoma
- Adenomatoid odontogenic tumor
- Neurofibroma
- Hemangioma
DENTAL LAMINA CYSTS
(4)
Lateral Periodontal Cyst
Botryoid Odontogenic Cyst
Gingiva Cyst of Adult
Dental Lamina Cyst of Newborn
Lateral Periodontal Cyst
(4)
- A developmental cyst that arises from dental lamina rests
(rests of Serres) - Vital teeth of adult males (3:1)
- Mandibular premolar area
- Maxillary incisor-canine area
Botryoid Odontogenic Cyst
(2)
- Polycystic variant of the lateral periodontal cyst
- A developmental odontogenic cyst that presents as a
multilocular lucency associated with the vital mandibular
premolars of adults
Gingival Cyst of the Adult
(4)
- Soft tissue counterpart of the lateral periodontal cyst
- A developmental cyst that arises from dental lamina rests
(rests of Serres) - Vital teeth of adult males (3:1)
- Mandibular premolar area and maxillary incisor-canine area
PALATAL CYST OF NEWBORN
(2)
Epstein’s Pearls
Bohn’s Nodule
Dental lamina cysts -
epithelial remnants of dental lamina
from odontogenesis
* Odontogenic cysts
Epstein’s pearls -
epithelial remnants from palatal shelf
fusion
* Non-odontogenic cysts
Bohn’s nodules -
epithelial remnants from minor salivary
gland formation
* Non-odontogenic cysts
Primordial Cyst
(2)
- Radiographic term for a cyst that develops in place of a tooth
- Likely to be an Odontogenic Keratocyst (OKC)
Odontogenic Keratocyst
(OKC)
(4)
- World Health Organization (WHO)
- 2005 Classification of Odontogenic Tumors
- Keratinizing Cystic Odontogenic Tumor (KCOT)
- Posterior jaws of teenagers, young adults
- Aggressive growth with 30% recurrence
- A unilocular or multilocular radiolucency; imitates other
lucencies
Radiographic Presentations
OKC
* Primordial cysts –%
* Lateral periodontal –%
* Dentigerous –%
* Globulomaxillary –%
50
25
10
10
Odontogenic Keratocyst
Histology
(3)
- Compact epithelium, no rete ridges, 8 to 10 cell layers thick
- Corrugated surface parakeratin
- Prominent, palisaded, hyperchromatic basal layer
Significance of the
Odontogenic Keratocyst
(3)
- Aggressive behavior
- Recurrence - 30%
- Nevoid Basal Cell Carcinoma Syndrome
Clinical Settings
Odontogenic Keratocyst
* Non-syndrome-associated OKC -
* Syndrome-associated OKC –
idiopathic
multiple OKCs common in the nevoid basal cell carcinoma syndrome
NEVOID BASAL CELL
CARCINOMA SYNDROME
aka
Gorlin Syndrome
Nevoid Basal Cell
Carcinoma Syndrome
(5)
- Basal cell nevus syndrome
- Gorlin-Goltz syndrome
- Gorlin syndrome
- Autosomal dominant - highly penetrant and variably
expressive - Mutation in PTCH (PATCHED) tumor supressor gene at
9q22.3
Nevoid Basal Cell
Carcinoma Syndrome
symptoms (4)
- Skeletal anomalies: Bifid ribs
- Jaw cyst: Multiple OKCs
- Skin tumors: Multiple, early onset basal cell carcinomas
- Neoplasms: CNS –Medulloblastoma
Nevoid Basal Cell
Carcinoma Syndrome
- Multiple basal cell carcinomas that occur early in life