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CMS2 > Cysts of the jaw and other orofacial tissues > Flashcards

Cysts of the jaw and other orofacial tissues Flashcards

1
Q

what is the definition of a cyst?

A

a pathological epithelial lined cavity within tissue

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2
Q

what do hard tissue (odontogenic) cysts have to arise from?

A

dental lamina, dental follicle, enamel organ or epithelial cell rests

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3
Q

what are examples of odontogenic inflammatory cysts

A

radicular (periapical) or residual

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4
Q

what are examples of odontogenic developmental cysts

A

dentigerous or keratocyst

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5
Q

how do cysts usually present?

A
  • usually asymptomatic
  • usually incidental
  • can cause some swelling
  • can be associated with movement, migration or failure to erupt teeth
  • can become infected and cause pain/swelling
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6
Q

what can present if an infected CYST is close to the ID nerve?

A

can cause numbness in the distribution of the ID nerve

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7
Q

how do cysts typically present radiographically?

A

well-defined, corticated

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8
Q

what is the significance of cortication in cysts?

A

because they grow very slowly, they tend to push bone out of the way and as a result bone margins are very defined

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9
Q

are cysts uni or multi locular?

A

they can be both

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10
Q

why are cysts a problem?

A
  • they grow!!!
  • they can move/loosen or damage teeth
  • they can become infected (if they get big enough and come to the surface)
  • they can move or damage structures (ID nerve)
  • they can weaken bone - leading to fracture
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11
Q

what is the most common type of odontogenic cyst?

A

Periapical, radicular/inflammatory periapical cyst

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12
Q

how do radicular (inflammatory) cysts arise?

A

from cell rests that are activated by inflammation

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13
Q

explain how radicular cysts respond to inflammation

A
  • tooth is carious, pulp dies off, chronic inflammation a the apex of the tooth causes PROLIFERATION of a number of cells around the apex (epithelial cells and cell rests), they expand to form a ball
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14
Q

how can you distinguish between a periapical granuloma and periapical cyst?

A

pathologist

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15
Q

when does a granuloma progress onto a cyst?

A

tooth is not treated = central liquefaction and necrosis of the cells leaving epithelial cells around the outside of the cyst cavity

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16
Q

what are residual cysts?

A

present when you hava a periapical cyst and tooth is taken away but the cyst is left - it can persist as a residual cyst

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17
Q

what is a dentigerous cyst always associated with?

A

UNERUPTED teeth

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18
Q

where are dentigerous cysts typically seen?

A

around lower wisdom teeth or around premolars/canines

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19
Q

how do dentigerous cysts arise?

A

from the dental follicle (as the crown of the tooth is formed and enamel is laid down, once the crown of the tooth is completed, the dental follicle is the remnant of the enamel organ. if the tooth doesn’t erupt, you can get some fluid caught between the enamel surface and the dental follicle - starts to expand = cyst

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20
Q

what is a dental follicle?

A

made up of mesenchymal cells and fibres surrounding the enamel organ and dental papilla of a developing tooth.

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21
Q

where do dentigerous cysts tend to be limited to and why?

A

the amelo-cemental junction because thats where the dental follicle is attached to

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22
Q

why is it important to remove a dentigerous cyst with the associated unerupted tooth?

A

may cause resorption of other teeth / damage teeth

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23
Q

what is a keratocyst?

A

arise from the dental lamina (can get them where there has been no tooth BUT also in association with unerupted teeth

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24
Q

typically, do keratocysts give unilocular or multilocular appearance?

A

multilocular

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25
Q

are keratocysts expansile and extensive?

A

yes! they tend to be V LONG and can cause expansion of the mandible

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26
Q

why are keratocysts difficult to treat?

A

easy to miss out locules (and not take the whole cyst tissue and cyst lining tends to be very delicate

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27
Q

where are keratocysts commonly found

A

angle of the mandible

28
Q

what syndrome are keratocysts associated with?

A

gorlin golts syndrome

29
Q

what syndrome is frontal bossing associated with?

A

gorlin goltz syndrome

30
Q

what are eruption cysts always associated with?

A

erupting teeth

31
Q

when does an eruption cyst disappear?

A

as soon as the tooth erupts

32
Q

what colour do eruption cysts tend to be?

A

blue-ish

33
Q

what radiolucency will an eruption cyst present as?

A

none! as outside the bone!!

34
Q

what are the management options for an eruption cyst?

A

may require incision BUT mostly resolve/rupture spontaneously when the tooth erupts and becomes exposed

35
Q

where do lateral periodontal cysts typically appear?

A

on the side of a tooth

36
Q

where do lateral periodontal cysts originate from?

A

origin is uncertain - could be dental lamina or follice

37
Q

what are the important distinctions of lateral periodontal cysts? (4)

A
  1. on the side of a tooth rather than apex
  2. associate with a vital tooth
  3. developmental NOT inflammatory
  4. tend to be pear shaped
38
Q

what is the unusual variant of lateral periodontal cysts called? how do they appear?

A

botryoid variant - appear like a bunch of grapes - they are multilocular

39
Q

what does a glandular odontogenic cyst have in it?

A

glandular epithelium

40
Q

how does a calcifying odontogenic cyst differ from a glandular cyst

A

it contains areas of calcification

41
Q

what are non-odontogenic hard tissue cysts usually associated with?

A

development/embryology of face NOT associated with teeth

42
Q

what hard tissue structures fuse to form the face?

A

palatal plates and premaxilla

43
Q

how do cysts form in non-odontogenic hard tissues?

A

lines of fusion between the structures - there is inclusion of epithelium which can go on to form a cyst

44
Q

which is the most common type of non-odontogenic hard tissue cyst?

A

nasopalatine duct cyst

45
Q

what cyst can arise between the line of fusion between the premaxilla and maxillary plates?

A

globulomaxillary cyst

46
Q

what is staphnes idiopathic bone cavity?

A

normal submandibular gland tissue in the lingual aspect of the mandible

47
Q

what treatment does staphnes idiopathic bone cavity require?

A

none!!!

48
Q

where does it present radiographically? is it corticated?

A

under the ID canal, not corticated

49
Q

what is a solitary bone cyst?

A

not lined by epithelium but tend to be lined by fibrous tissue or endothelial cells

50
Q

what is an aneurysmal bone cyst?

A

not epithelial lined but tend to expand more than a solitary bone cyst (can get a bit of trabeculation within the cyst cavity = soap bubble appearance)

51
Q

what is an aneurysmal bone cyst filled with?

A

filled with blood

52
Q

what are soft tissue cysts categorised into?

A

developmental and non-developmental

53
Q

how are soft tissue cysts formed?

A

fusion of the branchial arches and closure of the branchial cleft

54
Q

what is the commonest developmental cyst in the head and neck?

A

dermoid cyst

55
Q

how does a dermoid cyst arise?

A

caused by inclusion of material as the midline fuses (fusion of soft tissue - epithelium/epithelium structures get caught up in it)

56
Q

where do dermoid cysts tend to present?

A

sublingually

57
Q

what can branchial clefts also give rise to apart from cysts?

A

branchial sinuses

58
Q

what is a thyroglossal duct cyst?

A

thyroid develops from tissue that originates in the foramen cecum (part of the posterior tongue) where the back of the anterior 2/3 of the tongue and junction with posterior 1/3 of the tongue - that migrates down into the neck to form the thyroid tissue (can get a little bit of tissue caught along the way which fails to move and can in later life form a thyroglossal cyst

59
Q

what do non-developmental cysts tend to be associated with?

A

salivary gland tissue

60
Q

how are non-developmental cysts subdivided?

A
  1. mucous retention - saliva/mucous caught within the gland - blockage of saliva in the gland causes it to swell up
  2. mucous extravasation - saliva has got out of the gland/duct it was supposed to be contained by - once it is in the tissues because of the nature of epithelium it can migrate around the bag of saliva and form an epithelial cyst lining
61
Q

what is an example of a non-developmental cyst? what gland is it associated with?

A

ranula - usually associated with sublingual gland

62
Q

what is a plunging ranula?

A

swelling in the floor of the mouth but also the neck because of a developmental defect in the mylohyoid muscle - whole cyst needs to be removed otherwise will reoccur

63
Q

what is a lip mucoceles?

A

swellings in the lower lip

64
Q

how is a lip mucocele caused?

A
  • trauma?
  • retention of saliva wihtin the salivary galnds
65
Q

what is the treatment for lip mucocele?

A
  1. excision (works better)
  2. crytotherapy
66
Q

what are the obvious risks involved with treatment of mucoceles?

A

scar, swelling, bleeding and bruising

CMS2 (24 decks)

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