Cysts of the Jaw Flashcards
(37 cards)
Define a cyst.
A pathological cavity having fluid, semi-fluid or gaseous contents and which is not created by the accumulation of pus.
What is the most common cause of bony swellings in the jaws?
odontogenic cysts
What are odontogenic cysts lined with?
Epithelium.
* rests of Malassez
* rests of Serres
* reduced enamel epithelium
What are the 3 most common odontogenic cysts?
- radicular cyst (and residual cyst) 60%
- dentigerous cyst (and eruption cyst) 18%
- odontogenic keratocyst 12%
What is a radicular cyst?
- inflammatory odontogenic cyst
- assciated with a non-vital tooth
- initiated by chronic inflammation at tooth apex due to pulp necrosis
- often asymptomatic unless infected
In which jaw are radicular cysts more common?
maxilla
What are the radiographic features of a radicular cyst?
- well-defined, round/oval radiolucency
- corticated margin continuous with lamina dura of non-vital tooth
- larger lesions may displace adjacent structures
- long-standing lesions may cause external root resorption and/or contain dystrophic calcification
What are histological features of a radicular cyst?
- incomplete epithelium
- connective tissue capsule
- inflammation in capsule
What is a residual cyst?
when radicular cyst persists after loss of tooth (or after tooth is successfully RCTed)
What is lateral radicular cyst?
- radicular cyst associated with an accessory canal
- located at side of tooth instead of apex
What are inflammatory collateral cysts?
- odontogenic
- associated with vital tooth
- collective term for paradental cyst and buccal bifurcation cyst
What is a paradental cyst?
- odontogenic
- associated with vital tooth
- typically occurs at distal aspect of partially erupted mandibular third molar
What is a buccal bifurcation cyst?
- odontogenic
- associated with vital tooth
- typically occurs at buccal aspect of mandibular first molar
What is a dentigerous cyst?
- also known as follicular cyst
- developmental odontogenic cyst
- associated with the crown of an unerupted (and usually impacted) tooth
What are radiographic features of a dentigerous follicular cyst?
- corticated margins attached to CEJ of the tooth
- may displace the involved tooth
What are histological features of a dentigerous follicular cyst?
- thin non-keratinised stratified squamous epithelium
- may resemble radicular cyst if inflamed
What is the difference between a dentigerous follicular cyst and an enlarged follicle?
consider cyst if follicular space > 4mm
* measure from crown surface to edge of follicle
* assume cyst if > 10mm
What is an eruption cyst?
- variable of dentigerous follicular cyst
- contained within soft tissue rather than bone
- associated with an erupting tooth
What is an odontogenic keratocyst?
- developmental odontogenic cyst
- no specific relationship to teeth
- M > F
- mandible > maxilla
- posterior > anterior
What are radiographic features of odontogenic keratocyst?
- scalloped margins
- 25% are multilocular
- often cause displacement of adjacent teeth
- characteristic expansion: significant mesio-distal expansion without bucco-lingual expansion (significant enlargement in medullary bone space before displacing cortical bone)
What is the presentation of Basal Cell Naevus Syndrome?
- multiple odontogenic keratocysts
- multiple basal cell carcinomas
- palmar and planter pitting
- calcification of intracranial dura mater
Also known as:
* Gorlin-Goltz syndrome
* bifid rib syndrome
What is the most common non-odontogenic cyst?
nasopalatine duct cyst
What is a nasopalatine duct cyst?
- developmental non-odontogenic cyst
- arises from nasopalatine duct epithelial remnants
- occurs in anterior maxilla
- also known as incisive canal cyst
What is the presentation of nasopalatine duct cyst?
- asymptomatic
- “salty” discharge
- larger cysts may displace teeth or cause swelling in palate
