Cysts of the jaws and oral tissues Flashcards

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1
Q

Define a cyst

A

Pathological epithelial lined cavity in a tissue

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2
Q

Types of hard tissue cysts (3)

A

Odontogenic
Non odontogenic
Non epithelialised (not cysts)

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3
Q

Types of soft tissue cysts (2)

A

Developmental
Non developmental

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4
Q

Define odontogenic cyst

A

Cyst arising from tooth forming tissue

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5
Q

Which types of tooth forming tissue can odontogenic cysts arise from?

A

Enamel organ
Follicle
Epithelial cell rests

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6
Q

Types of odontogenic cysts (4)

A

Radicular / periapical - 70%
Dentigerous - 15%
Keratocyst - 10%
Other - 5%

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7
Q

Which odontogenic cysts are inflammatory?

A
  • Radicular / periapical
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8
Q

Which odontogenic cysts are non-inflammatory?

A
  • Dentigerous
  • Keratocyst
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9
Q

How do odontogenic cysts present?

A

Asymptomatic
Incidental radiographic finding
Tooth migration
Swelling IO
Can be infected / pain

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10
Q

How do odontogenic cysts appear radiographically?

A

Well defined
Corticated
Unilocular or multilocular (single or multiple centres)
Radiolucency

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11
Q

Why are cysts a problem?

A

Grow
Move / damage teeth
Move / damage structures
Infection
Weaken bone - fractures
Makes tx more complex

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12
Q

How do periapical / radicular cysts form?

A

Deeply carious tooth
Leads to PA infection
Bacterial endotoxins: IL-1, 3, 4 and 6, TNF alpha
Pulpally infected non vital tooth
Leads to radicular cyst forming at apex

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13
Q

How do periapical cysts appear radiographically?

A

Centred on apex
Unilocular
Well defined, corticated
Non vital tooth - RCT / caries / trauma

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14
Q

How does a residual cyst develop?

A

Periapical cyst formed
Tooth removed
Residual cyst remains

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15
Q

What is the cause of periapical cysts?

A

Inflammation / chronic infection

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16
Q

Where does dentigerous cyst arise from?

A

Dental follicle
Fluid collects between the follicle and enamel

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17
Q

Where can you find dentigerous cysts?

A

Crown of an unerupted tooth
Amelocemental junction

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18
Q

What are effects of dentigerous cyst?

A

Move teeth
Cause resorption of other teeth

19
Q

Where does odontogenic keratocyst arise from?

A

Dental lamina

20
Q

How will an odontogenic keratocyst appear radiographically?

A

Multilocular
Well defined
At angle of mandible
Minimal expansion
Associated with unerupted teeth

21
Q

Which syndrome can be associated with odontogenic keratocysts?

A

Gorlin-Goltz

22
Q

What are the major criteria for Gorlin-Goltz syndrome AKA Nevoid Basal Cell Carcinoma Syndrome?

A
  • Multiple Basal Cell Carcinomas <20 years
  • Odontogenic keratocysts of jaw
  • Rib anomalies
  • 1st degree relative with Nevoid Basal Cell Carcinoma Syndrome
23
Q

What are eruption cysts?

A

Overlay erupting tooth in children

24
Q

How to manage eruption cysts?

A

Rupture spontaneously
May require incision
Self resolve once tooth begins to erupt

25
Q

Where do lateral periodontal cysts come from?

A

Origin uncertain
Dental lamina OR follicle
Between amelocemental junction and apex

26
Q

Lateral periodontal cysts in vital or non vital teeth?

A

Vital

27
Q

How do glandular odontogenic cysts present?

A

Like other cysts
Rare
Recurrence likely

28
Q

How do calcifying odontogenic cysts present?

A

Like other cysts
Rare
Contain areas of calcification

29
Q

Where do non-odontogenic hard tissue cysts arise from?

A

Developmental
Not from tooth forming tissues
Fusion of structures
Palatal plates and premaxilla

30
Q

Types of non-epithelialised cysts (2)

A

Not cysts by definition
- Solitary bone cyst
- Aneurysmal bone cyst

31
Q

Describe solitary bone cyst

A

Non odontogenic
Not epithelial lined
No expansion / movement
AKA traumatic bone cyst

32
Q

Describe aneurysmal bone cyst

A

Not epithelial lined
Expansile
Faint trabeculation radiographically

33
Q

2 types of soft tissue cysts?

A

Developmental
Non developmental

34
Q

Examples of developmental soft tissue cysts

A

Dermoid cyst
Branchial cleft - cyst may present as neck lump
Thyroglossal duct cyst - Adam’s apple region

35
Q

What do non developmental cysts affect?

A

SG tissue

36
Q

How are SGs affected by non developmental cysts?

A

Mucus retention - saliva blocked in gland / duct
Mucus extravasation - escape of saliva from traumatised gland / duct

37
Q

Example of non developmental cyst

A

Ranula

38
Q

Identifying features of Ranula?

A

FoM
Mucus extravasation
Sublingual gland
(Frog ballooned up appearance under tongue)

39
Q

How does plunging ranula differ?

A

In FoM
Extends through mylohyoid muscle
Neck swelling
Needs IO and EO approach

40
Q

Where are lip mucoceles found?

A

ONLY lower lip
Children / young pt

41
Q

Describe lip mucocele

A

Painless soft fluid filled selling
May appear blueish
Lower lip only

42
Q

Management of lip mucocele

A

Cryotherapy
Excision

43
Q

Risks of excising lip mucocele?

A

Recurrence
Scarring
Swelling
Bleeding
Bruising