Cysts of the mouth and jaws

Question 1

cyst

Answer 1

pathological cavity
not formed by accumulation of pus
lined by epithelium
contains fluid or semi-fluid contents

Question 2

apical granuloma

Answer 2

mass of fibrous tissue/granulation tissue related to the apex of a non-vital tooth

Question 3

dental cyst

Answer 3

an inflammatory epithelial lined cyst associated with a root of a non-vital tooth
most common jaw cyst
70% of all cysts
M>F
wide age range
prevalent in maxilla
anterior

Question 4

dentigerous cyst

Answer 4

developmental, epithelial lined cyst
surrounds crown of unerupted tooth and is attached to the amelo-cemental junction
associated with the. erupting tooth (eruption cyst)

Question 5

Aetiology of dental cysts

Answer 5

proliferation of epithelial lining (stimulated by inflammation)
accumulation of fluid within a cyst
keratin formation
resorption of surrounding bone and attempts at repair
slow expansive growth

Question 6

inflammatory cysts

Answer 6

dental cyst
residual cyst
paradental cyst

Question 7

dental cyst clinical features

Answer 7

pain/swelling/mobility from the tooth
associated with non-vital tooth
gradual progressive swelling
increasing pain/swelling may indicate infection of cyst
egg shell cracking – rate of expansion exceeds the rate of subperiosteal deposition of bone, causing progressive thinning of cortical bone

Question 8

radiological features of dental cyst

Answer 8

may be large 10-20mm
unilocular radiolucency
margins well defined
may expand surrounding bone
90% related to the apex/10% related to the lateral aspect

Question 9

pathogenesis of dental cyst

Answer 9

contents of necrotic pulp escape out of apical foramen
acute inflammatory response evoked
persistent stimulus initiates attempts at healing
proliferation of rests of malassez
central cavity develops
enlarges by fluid accumulation

Question 10

contents of dental cyst

Answer 10

fluid/pus
high level of soluble protein
cholesterol crystals

Question 11

residual dental cyst

Answer 11

dental cyst which has failed to resolve post extraction

Question 12

clinical presentation of dental cyst

Answer 12

incidental finding
20% of all dental cysts

Question 13

paradental cysts

Answer 13

inflammatory odontogenic cyst that develops in relation to the crown or root of a partially erupted tooth

Question 14

radiological findings of paradental cyst

Answer 14

well defined radiolucency related to the neck of the tooth and coronal 1/3 of tooth

Question 15

apical granuloma

Answer 15

mass of fibrous tissue related to the apex of a non-vital tooth

Question 16

clinical presentation of dentigerous cyst

Answer 16

15% of all jaw cysts
M:F
wide age range
lower anterior region of jaw

Question 17

clinical features of dentigerous cyst

Answer 17

swelling
no pain unless infection
facial asymmetry

Question 18

Keratocyst

Answer 18

developmental odontogenic cyst
epithelial lining
high tendency to recur
angle of mandible

Question 19

clinical signs keratocyst

Answer 19

10% of all jaw cysts
M>F
20-40yrs
angle of mandible
gorlin syndrome

Question 20

clinical features keratocyst

Answer 20

swelling/UE tooth/facial asymmetry
large number detected as incidental finding
gradual progressive swelling

Question 21

Gorlin syndrome

Answer 21

multiple basal cell naevi syndrome
autosomal dominant trait
multiple basal cell carcinoma of the skin and vertebral and rib anomalies, temporoparietal bossing with broad nasal root, calcification falx cerebri, abnormal sella

Question 22

Nasopalatine cysts

Answer 22

developmental cyst of incisive canal in the palate
10% of all jaw cysts
m>f

Question 23

clinical presentation of nasopalatine cysts

Answer 23

anterior hard palate
swelling with discharge
painful

Question 24

radiological findings of nasopalatine cysts

Answer 24

well defined radiolucency
unilocular
greater than 6mm

Question 25

pathology of nasopalatine cysts

Answer 25

thin lining of stratified squamous and respiratory type epithelium

Question 26

dermoid cyst

Answer 26

rare developmental non-odontogenic cyst
doughy painless swelling in the midline of the floor of the mouth
involves soft tissues only
F>M
wide age range

Question 27

pathology of dermoid cyst

Answer 27

thin lining of squamous epithelium with associated hair follicle and sebaceous glands

Question 28

management of cysts

Answer 28

enucleation
marsupialisation
resection

Question 29

enucleation

Answer 29

complete removal of cyst lining

Question 30

marsupialisation

Answer 30

partial removal of cyst lining
less invasive