Cysts of the jaws and oral tissues Flashcards
Define a cyst
Pathological epithelial lined cavity in a tissue
Types of hard tissue cysts (3)
Odontogenic
Non odontogenic
Non epithelialised (not cysts)
Types of soft tissue cysts (2)
Developmental
Non developmental
Define odontogenic cyst
Cyst arising from tooth forming tissue
Which types of tooth forming tissue can odontogenic cysts arise from?
Enamel organ
Follicle
Epithelial cell rests
Types of odontogenic cysts (4)
Radicular / periapical - 70%
Dentigerous - 15%
Keratocyst - 10%
Other - 5%
Which odontogenic cysts are inflammatory?
- Radicular / periapical
Which odontogenic cysts are non-inflammatory?
- Dentigerous
- Keratocyst
How do odontogenic cysts present?
Asymptomatic
Incidental radiographic finding
Tooth migration
Swelling IO
Can be infected / pain
How do odontogenic cysts appear radiographically?
Well defined
Corticated
Unilocular or multilocular (single or multiple centres)
Radiolucency
Why are cysts a problem?
Grow
Move / damage teeth
Move / damage structures
Infection
Weaken bone - fractures
Makes tx more complex
How do periapical / radicular cysts form?
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
How do periapical cysts appear radiographically?
Centred on apex
Unilocular
Well defined, corticated
Non vital tooth - RCT / caries / trauma
How does a residual cyst develop?
Periapical cyst formed
Tooth removed
Residual cyst remains
What is the cause of periapical cysts?
Inflammation / chronic infection
Where does dentigerous cyst arise from?
Dental follicle
Fluid collects between the follicle and enamel
Where can you find dentigerous cysts?
Crown of an unerupted tooth
Amelocemental junction
What are effects of dentigerous cyst?
Move teeth
Cause resorption of other teeth
Where does odontogenic keratocyst arise from?
Dental lamina
How will an odontogenic keratocyst appear radiographically?
Multilocular
Well defined
At angle of mandible
Minimal expansion
Associated with unerupted teeth
Which syndrome can be associated with odontogenic keratocysts?
Gorlin-Goltz
What are the major criteria for Gorlin-Goltz syndrome AKA Nevoid Basal Cell Carcinoma Syndrome?
- Multiple Basal Cell Carcinomas <20 years
- Odontogenic keratocysts of jaw
- Rib anomalies
- 1st degree relative with Nevoid Basal Cell Carcinoma Syndrome
What are eruption cysts?
Overlay erupting tooth in children
How to manage eruption cysts?
Rupture spontaneously
May require incision
Self resolve once tooth begins to erupt
Where do lateral periodontal cysts come from?
Origin uncertain
Dental lamina OR follicle
Between amelocemental junction and apex
Lateral periodontal cysts in vital or non vital teeth?
Vital
How do glandular odontogenic cysts present?
Like other cysts
Rare
Recurrence likely
How do calcifying odontogenic cysts present?
Like other cysts
Rare
Contain areas of calcification
Where do non-odontogenic hard tissue cysts arise from?
Developmental
Not from tooth forming tissues
Fusion of structures
Palatal plates and premaxilla
Types of non-epithelialised cysts (2)
Not cysts by definition
- Solitary bone cyst
- Aneurysmal bone cyst
Describe solitary bone cyst
Non odontogenic
Not epithelial lined
No expansion / movement
AKA traumatic bone cyst
Describe aneurysmal bone cyst
Not epithelial lined
Expansile
Faint trabeculation radiographically
2 types of soft tissue cysts?
Developmental
Non developmental
Examples of developmental soft tissue cysts
Dermoid cyst
Branchial cleft - cyst may present as neck lump
Thyroglossal duct cyst - Adam’s apple region
What do non developmental cysts affect?
SG tissue
How are SGs affected by non developmental cysts?
Mucus retention - saliva blocked in gland / duct
Mucus extravasation - escape of saliva from traumatised gland / duct
Example of non developmental cyst
Ranula
Identifying features of Ranula?
FoM
Mucus extravasation
Sublingual gland
(Frog ballooned up appearance under tongue)
How does plunging ranula differ?
In FoM
Extends through mylohyoid muscle
Neck swelling
Needs IO and EO approach
Where are lip mucoceles found?
ONLY lower lip
Children / young pt
Describe lip mucocele
Painless soft fluid filled selling
May appear blueish
Lower lip only
Management of lip mucocele
Cryotherapy
Excision
Risks of excising lip mucocele?
Recurrence
Scarring
Swelling
Bleeding
Bruising
