Cysts of the mouth and jaws Flashcards
cyst
pathological cavity
not formed by accumulation of pus
lined by epithelium
contains fluid or semi-fluid contents
apical granuloma
mass of fibrous tissue/granulation tissue related to the apex of a non-vital tooth
dental cyst
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
dentigerous cyst
developmental, epithelial lined cyst
surrounds crown of unerupted tooth and is attached to the amelo-cemental junction
associated with the. erupting tooth (eruption cyst)
Aetiology of dental cysts
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
inflammatory cysts
dental cyst
residual cyst
paradental cyst
dental cyst clinical features
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
radiological features of dental cyst
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
pathogenesis of dental cyst
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
contents of dental cyst
fluid/pus
high level of soluble protein
cholesterol crystals
residual dental cyst
dental cyst which has failed to resolve post extraction
clinical presentation of dental cyst
incidental finding
20% of all dental cysts
paradental cysts
inflammatory odontogenic cyst that develops in relation to the crown or root of a partially erupted tooth
radiological findings of paradental cyst
well defined radiolucency related to the neck of the tooth and coronal 1/3 of tooth
apical granuloma
mass of fibrous tissue related to the apex of a non-vital tooth
clinical presentation of dentigerous cyst
15% of all jaw cysts
M:F
wide age range
lower anterior region of jaw
clinical features of dentigerous cyst
swelling
no pain unless infection
facial asymmetry
Keratocyst
developmental odontogenic cyst
epithelial lining
high tendency to recur
angle of mandible
clinical signs keratocyst
10% of all jaw cysts
M>F
20-40yrs
angle of mandible
gorlin syndrome
clinical features keratocyst
swelling/UE tooth/facial asymmetry
large number detected as incidental finding
gradual progressive swelling
Gorlin syndrome
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
Nasopalatine cysts
developmental cyst of incisive canal in the palate
10% of all jaw cysts
m>f
clinical presentation of nasopalatine cysts
anterior hard palate
swelling with discharge
painful
radiological findings of nasopalatine cysts
well defined radiolucency
unilocular
greater than 6mm
pathology of nasopalatine cysts
thin lining of stratified squamous and respiratory type epithelium
dermoid cyst
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
pathology of dermoid cyst
thin lining of squamous epithelium with associated hair follicle and sebaceous glands
management of cysts
enucleation
marsupialisation
resection
enucleation
complete removal of cyst lining
marsupialisation
partial removal of cyst lining
less invasive
