Cysts of the Jaw 2

Question 1

odontogenic keratocyst

Answer 1

developmental odontogenic cyst with no specific relationship to teeth
very high recurrent rate

Question 2

what age group are OKCs most common

Answer 2

teens -30s

Question 3

growth pattern tendency of odontogenic keratocysts

Answer 3

tend to grow mesio-distally rather than bucco-lingual so can grow unoticed for some time

Question 4

what is characteristic of a biopsy of an OKC

Answer 4

low protein content
white solid or semi solid

Question 5

what is notable about the epithelial lining of a OKC

Answer 5

it is parakeratinised

Question 6

palisading

Answer 6

nuclei same shape and very uniform order

Question 7

why are OKCs difficult to remove and likely to reccur

Answer 7

thin lining
daughter cysts

Question 8

gorlin goltz syndrome

Answer 8

syndrome that may see multiple odontogenic keratocysts and is at risk of multiple basal cell carcinomas

(basal cell naevus syndrome)

Question 9

name 3 reasons for numbness in the face

Answer 9

needle injury during injection
physical trauma e.g mandible fracture
cyst
tumour
infection e.g ORN

Question 10

nasopalatine duct cyst

Answer 10

developmental non odontogenic cyst arising from remnanets of the nasopalatine duct epithelium

Question 11

cyst vs incisive fossa

Answer 11

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

Question 12

what cyst may be described as heart shaped

Answer 12

nasopalatine duct cyst due to superimposition of nasal spine

Question 13

solitary bone cyst

Answer 13

non odontogenic cyst with no epithelial lining
empty
tend to resolve on their own

Question 14

stafne cavity

Answer 14

NOT a cyst
indentation on the lingual aspect of the mandible
usually located below IA canal

Question 15

normal appearance of cyst fluid

Answer 15

clear, straw coloured fluid

Question 16

enucleation

Answer 16

all of cystic lesion is removed

Question 17

marsupialisation

Answer 17

creation of a surgical window in a wall of a cyst to allow contents to be removed, aims to decrease cyst size

Question 18

indications for marsupialisation

Answer 18

enucleation risks surrounding structures, very large cysts with risk of jaw fracture, elderly or immunocompromised patient, spare vital structures

Question 19

advantages and disadvantages of enucleation

Answer 19

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

Question 20

advantages of marsupialisation

Answer 20

easy to perform
may spare vital structures
enucleation can be done at a later date

Question 21

disadvantages of marsupialisation

Answer 21

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