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BDS5 oral disease > cysts of face and jaws > Flashcards

cysts of face and jaws Flashcards

1
Q

list inflammatory odontogenic cysts (3)

A

radicular cyst
residual radicular cyst
inflammatory collateral cyst

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2
Q

radiographic appearance of cysts

A

variable site/size
uni/multilocular
well-defined, often corticated
radiolucent +/- opacities
can cause jaw expansion, displacement, resorption

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3
Q

list developmental odontogenic cysts (7)

A

odontogenic keratocyst
dentigerous cyst
lateral periodontal cyst
botryoid cyst
glandular odontogenic cyst
calcifying odontogenic cyst/tumour
orthokeratinised odontogenic cyst

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4
Q

list developmental non-odontogenic cysts (2)

A

nasopalatine duct cyst
nasolabial cyst

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5
Q

what categories are cysts split into?

A

inflammatory or developmental
odontogenic or non-odontogenic

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6
Q

which cysts arise from rests of Serres? (3)

A

odontogenic keratocyst
lateral periodontal and botryoid cyst
orthokeratinised odontogenic cyst

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7
Q

which rests arise from rests of Malassez? (3)

A

radicular and residual cyst
inflammatory collateral cyst
glandular odontogenic cyst

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8
Q

what does structure does a dentigerous cyst arise from?

A

follicle (reduced enamel epithelium)

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9
Q

give features of radicular cyst (source, demographic, radiograph, histology)

A
  • inflammatory odontogenic
  • cell rests of Malassez, hydrostatic growth
  • middle age male
    S - apex of non-vital tooth (often upper 2)
    S - >1.5cm
    S - circular/oval, unilocular
    O - well-defined, corticated
    R - radiolucent
    E - tooth/structure displacement, bony expansion/thinning/perforation, rarely RR
    Histology - hyperplastic odontogenic epithelium, Rushton bodies, cholesterol crystals
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10
Q

radicular cyst management (2)

A

XLA/RCT +/- enucleation
monitor, radiograph 3/12

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11
Q

differentials for radicular cyst (3)

A
  • ameloblastoma
  • other odontogenic tumours
  • giant cell granuloma
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12
Q

how may residual radicular cyst differ from radicular cyst (2)

A
  • may have dystrophic mineralisation, better organised histology
  • no characteristic non-vital tooth
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13
Q

give features of inflammatory collateral cyst (type, source, age, radiograph, histology)

A
  • inflammatory odontogenic
  • cell rests of Malassez, hydrostatic growth
  • children 15-30yo
    S - furcation of VITAL lower molars
    S -
    S - round, unilocular
    O - well-defined, corticated
    R - RL
    E - tooth displacement, expansion
    Same histology as radicular
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14
Q

treatment of inflammatory collateral cyst (2)

A
  • enucleation
  • extraction if associated with 8
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15
Q

histology of radicular cyst (3)

A
  • hyperplastic odontogenic epithelium
  • Rushton bodies
  • cholesterol crystals
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16
Q

histology of inflammatory collateral cyst (3)

A
  • hyperplastic odontogenic epithelium
  • Rushton bodies
  • cholesterol crystals
17
Q

give features of odontogenic keratocyst (type, source, demographic, radiograph, histology)

A
  • developmental odontogenic
  • rests of Serres (keratinising), burrowing growth
  • 10-30yo or BCNS
    S - angle of mandible, UE 8 associated, next commonest U3
    S
    S - round-elongated, usually multilocular
    O - well-defined, corticated, scalloped
    R - RL, internal septa = soap bubble
    E - displacement and jaw expansion in late stage
    Histology:
  • regular stratified squamous epithelium, palisaded basal layer, ortho/parakeratinised
  • satellite cysts
  • Rushton bodies
18
Q

treatment of odontogenic keratocyst (2)

A
  • enucleation, marsupialisation, en bloc resection +/- peripheral ostectomy/Carnoy’s/cryotherapy
  • follow up for 7 years
19
Q

what syndrome may OKCs be associated with?

A

basal cell naevus syndrome

20
Q

describe basal cell naevus syndrome (AKA, mutation, age, s/s)

A

AKA jaw cyst, bifid rib syndrome
- AD patched gene mutation (hedgehog pathway)
- 0-30yo
- multiple OKCs
- multiple BCCs on non-sun exposed areas
- bifid fused supernumerary ribs
- falx cerebri calcification, frontal bossing, broad nasal root/hypertelorism, mild skeletal III
- skin pitting (palmar/plantar)
- 5% medulloblastoma

21
Q

give features of dentigerous cyst (type, source, age, radiograph, histology)

A
  • developmental odontogenic, reduced enamel epithelium, hydrostatic growth
  • 10-30yo
    S - around crown of UE tooth attaching at CEJ, L8 > U3 > U8
    S - >5mm (normal follicle <3mm)
    S - round-elongated, unilocular
    O - well-defined, corticated
    R - RL
    E - tooth/structure displacement, bone expansion, root resorption 50%
    Histology:
  • reduced enamel epithelium or thickened stratified non-keratinised
22
Q

treatment of dentigerous cyst

A

XLA with enucleation or marsupialisation and allow eruption

23
Q

give features of lateral periodontal cyst (type, source, age, radiograph, histology)

A
  • developmental odontogenic, rests of Serres
  • middle aged adult (40-70yo)
    S - VITAL lower canine/premolar, between roots of two teeth
    S
    S - round-oval
    O - well-defined, corticated
    R - RL
    E - lamina dura resorption, tooth displacement
    Characteristic histology - thin epithelium with plaque-like thickenings
24
Q

treatment of lateral periodontal cyst

A

enucleation + curettage

25
Q

how does botryoid cyst differ to lateral periodontal cyst? (3)

A
  • multilocular
  • more growth potential
  • requires conservative surgical excision and curettage
26
Q

give features of glandular odontogenic cyst (type, source, age, radiograph)

A
  • developmental odontogenic, rests of Malassez
  • wide age range
    S - mandible
    S
    S - usually multilocular
    O - well-defined, scalloped, corticated
    R - RL
    E - tooth displacement, expansion and perforation
27
Q

treatment of glandular odontogenic cyst (small vs large)

A

small = enucleated
large = excised with margin

28
Q

give features of nasopalatine duct cyst (type, age, radiograph, histology)

A
  • developmental non-odontogenic
  • 30-60yo
    S - vital teeth, maxillary midline overlying incisive foramen
    S - >10mm (normal <6mm, enlarges with age)
    S - round/oval, heart-shaped (anterior nasal spine)
    O - well-defined, corticated
    R - RL
    E - root displacement, rarely RR
    Histology - ciliated respiratory (columnar pseudostratified) or orthokeratinised, relatively unspecific
29
Q

treatment of nasopalatine duct cyst

A

enucleation

30
Q

give features of nasolabial cyst (type, demographic, site, effects, histology)

A
  • developmental non-odontogenic
  • middle aged female
    S - nasolabial fold, upper buccal sulcus/lip, 10% bilateral
    E - swelling, nasal obstruction, resorb nasal aperture bone
    Histology - respiratory epithelium (nasolacrimal duct)
31
Q

what structure do nasolabial cysts likely arise from?

A

nasolacrimal duct

32
Q

treatment of nasolabial cyst

A

enucleation (as not firmly attached to bone) and excision (as superficially adherent to soft tissue)

33
Q

histology of lateral periodontal cyst

A

thin epithelium with plaque-like thickenings

34
Q

describe Bohn’s nodules/Epstein’s pearls

A
  • developmental abnormalities
  • keratin-filled, small translucent swellings
  • alveolar ridge and palate of newborn
35
Q

treatment of gingival cyst in adult

A

conservative excision

36
Q

describe solitary bone cyst (cause, age, radiograph, histology, bloods)

A
  • possibly caused by trauma
  • childhood or early adulthood
  • radiographically = well-defined, not corticated RL lesion which arcs up between tooth roots
  • no epithelial lining, lack of tissue generally
  • elevated bilirubin levels
37
Q

solitary bone cyst management (2)

A
  • no treatment needed (reaches burnout stage, bone deposition)
  • but curettage/surgery may help trigger healing
38
Q

solitary bone cyst age group

A

childhood or early adulthood

39
Q

solitary bone cyst radiographic appearance

A

well-defined, not corticated RL lesion which arcs up between tooth roots

BDS5 oral disease (26 decks)

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