Cysts of the Jaw 2 Flashcards
odontogenic keratocyst
developmental odontogenic cyst with no specific relationship to teeth
very high recurrent rate
what age group are OKCs most common
teens -30s
growth pattern tendency of odontogenic keratocysts
tend to grow mesio-distally rather than bucco-lingual so can grow unoticed for some time
what is characteristic of a biopsy of an OKC
low protein content
white solid or semi solid
what is notable about the epithelial lining of a OKC
it is parakeratinised
palisading
nuclei same shape and very uniform order
why are OKCs difficult to remove and likely to reccur
thin lining
daughter cysts
gorlin goltz syndrome
syndrome that may see multiple odontogenic keratocysts and is at risk of multiple basal cell carcinomas
(basal cell naevus syndrome)
name 3 reasons for numbness in the face
needle injury during injection
physical trauma e.g mandible fracture
cyst
tumour
infection e.g ORN
nasopalatine duct cyst
developmental non odontogenic cyst arising from remnanets of the nasopalatine duct epithelium
cyst vs incisive fossa
incisive fossa may or may not be visible on radiographs - if it is it is an oval shaped radiolucency in the midline that is not usually visibly corticated
<6mm assume fossa
6-10mm consider cyst
>6mm presume cyst
what cyst may be described as heart shaped
nasopalatine duct cyst due to superimposition of nasal spine
solitary bone cyst
non odontogenic cyst with no epithelial lining
empty
tend to resolve on their own
stafne cavity
NOT a cyst
indentation on the lingual aspect of the mandible
usually located below IA canal
normal appearance of cyst fluid
clear, straw coloured fluid
enucleation
all of cystic lesion is removed
marsupialisation
creation of a surgical window in a wall of a cyst to allow contents to be removed, aims to decrease cyst size
indications for marsupialisation
enucleation risks surrounding structures, very large cysts with risk of jaw fracture, elderly or immunocompromised patient, spare vital structures
advantages and disadvantages of enucleation
advantages: whole lining can be examined, primary closure, minimal aftercare
disadvantages: risk of mandible fracture in large cysts, clot filled cavity may become infected, damage to adjacent structures, incomplete removal risks recurrence
advantages of marsupialisation
easy to perform
may spare vital structures
enucleation can be done at a later date
disadvantages of marsupialisation
opening may close and cyst may reform
complete lining not available for histology
lots of aftercare
long course of treatment
high level of co-operation required
