exam 3 Flashcards
What is the most common inflam odontogenic cyst?
periapical cyst
compare periapical granuloma, cyst and abscess?
- all from rests of malassez
- all non-vital
- only the abscess causes pain (with acute inflammatory cells)
What is a buccal bifurcation cyst?
What tooth is it common in?
This is a paradental cyst - this is an uncommon odontogenic cyst that develops on the buccal aspect of mandibular first molar
* 5-11 years, occlusal radiograph
lateral periodontal cyst
uncommon
80% MN canine-PM
gingival counterpart is gingival cyst
no inflam bc developmental
botryoid
multilocular
gingival cysts on adults
cause cupping of bone
facial aveolar mucosa
blue/grey… 60 yrs
bohn’s nodules
keratin cysts… gingival cyst of a new born
ON Alveolar MUCOSA
(Pearls on palate)
most common developmental odontogenic cyst ?
Details?
dentigerous cyst (follicular)
- unilocular
- root resorption
- attaches AT CEJ
- rarely but can undergo neoplastic transformation
eruption cysts common where?
MX 1 st molars and incisors
MULTIPLE OKC IS GOING TO BE ASSCOAITED WITH?
NEVOID BASLA CELL CARCINOMA or Gorlins Syndrome
MACHO
for multiocular radioloucency differencial diagnosis
Myxoma Ameloblastoma Central Giant Cell Granuloma Hemangioma OKC
OKC
cystic neoplasm PTCH gene 9q22 developmental recurs 30%, 60-80% in MN satalite cysts and retes 10-40 yrs, bimodal... men no root resorb
Gorlin syndrome
aka nevoid basal cell carcinoma
3 features?
overexoression of?
PTCH gene
- overexpress: Cyclin D1 and p53
1) intracranial calcification - -frontal bossing
2) multiple jaw cysts (OKCs) - bifid ribs 75%
3) palmar pitting 60%
- bifid ribs 75%
why must you excise skin lesions in nevoid basal cell carcinoma?
aggressive basal cell carcinoma with metastasis have been reported
orthokeratinized odontogenic cyst (OOC)
NOT associated with basal cell carcinoma
not a clinical cyst but refers to a odontogenic cyst with orthokeratinization in lining
- 30% with impacted tooth
-80% resorption
COC (calcifying odontogenic cysts) associated with?
-maybe associated with hamartoma, ameloblastomas, AOT
ghost cells
CCOT or COC
And odontomas
what are the only two keratinized cysts?
keratinized: OOC and OKC
FU: COC and OKC
glandular odontogenic cyst
sialo-odontogenic cysts that shows aggressive behavior that has glandular or salivary features (aka mucous cells) indicating pluripotential nature of the odontogenic epithelium
GOD ONLY KNOWS
Do carcinomas arise from odontogenic cysts? What is the percent?
only 1-2% of oral carcinomas come from odontogenic cysts… 25% of which seem to arise from the dentigerous cyst s
What are the four non-odontogenic cyst to know?
What is the most common non-odntogenic cyst
Globulomaxillary cyst
Nasolabial cyst
Median MN mandibular
Nasoplanatine duct or canal cyst MOST COMMON
globularmaxillary cyst clinical or diagnosis term?
clinical
nasolabial cyst
developmental soft tissue cyst located in 1) the cupsid-lateral incisor area or 2) on the upper lip to the midline
May arise due to remnants along the lines of fusion of maxillary, medial, nasal and lateral processes due to epithelial remenants of the naso-lacrimal duct
*asymptomatic unless 2nd infection
* elevate nose/lip
GOBLET CELLS
nasopalatine cyst
1% most common non-odntogenic cyst (MUST BE GREATER than 6mm heart shapedbw centrals)
- boney cyst, will have NERVES and VESSELS
- Entrapped epithelial cells from the nasopalatine duct
- males 40-60yrs
- SWELLING anterior hard palate, salty taste
- asymptomatic but may hurt while eating
What is a pseudocyst - definition?
FAST (what are the 4 types)
A cyst with No epithelial lining
FAST
1) Focal osteoporotic bone defect (W, ill defined radiograph)
2) Aneurysmal bone cyst (Young)
3) Stafne bone cyst (M)
4) Traumatic bone cyst (scalloping bw roots)
traumatic bone cyst
result from intraosseous hematoma
-no epithelial lining, and uninflammed fibrous connective tissue, RBC, giant cells
-10-20 asymptomatic painless swelling
MN
aneurysmal bone cyst (ABC)
caused by?
caused by: Traumatic event, Vascular malformation, Neoplasm
- in long bones, 2% of time in MN
- swelling and pain
- could be A in MACHO
Stafne’s defect?
90% MEN
asymptomatic radiolucency below the mandibular canal but above the lower border of the mandible in the posterior mandible by 1st molar
*Salivary gland lobules that come from the submandibular gland
What is an FOMD?
Focal Osteoporotic Marrow Defect
WOMEN in posterios
*unique bc ill defined
What are the 3 soft tissue “true” cysts?
Dermoid cysts
Branchial cyst/lymphoepithelial
Thyroglossal tract cyst
**all true cyts
Dermoid cysts
developmental TERATOMA cyst (all 3 germ layers)
*above mylohyoid= painless, doughy FOM
below= submental swelling
branchail cyst aka lymphoepithelial cyst
occurs in lymphoid tissue such as Waldeyers ring including palantine tonsils, lingual tonsils, and pharyngeal adenoids
- FOM
- true cyst, small, well circumscribed swellings that are yellow when superifical or pink when deeper
ameloblastoma
soap bubble and honeycomb
M=W, more in AA
-worry when it is solid
desmoblastic ameloblastoma occurs in ANERTERIOR MAXILLA whereas it typically in Post MN
**B/L expansion (remember OKC had antirior/posterior)
lingual thyroid
uncommon nodule of the thyroid tissue that is found posterior to the foramen cecum in the posterior 1/3 of the tongue
WOMEN
70% etopic htyroid tissue
branchial cleft cyst
cyst formed from the degenerative tissue of the second branchial arch
- lateral aspect of anterior SCM
- needs surgical removal, 50-90% recur
- MX harder to heal
demsoplastic ameloblastoma
in anterior MX when most ameloblastomas are in Post MN
- also diff. from ameloblastoma bc diffuse and ill defined
- **Mcune Albright syndrome
ameloblastoma histology
1) Follicular - most common, likes like enamel organ
2) plexiform -cube/columnar
3) acanthomatous -keratin pearls present, SCC
4) granular cell pattern -young, agressive, turn into granular cells
5) desmoplastic -TGF-B, islands and cords
6) basal cell -LEAST common pattern
unicystic ameloblastoma
ameloblastoma that is NOT as solid tumor like multi is
This is the called cystic bc its lesions are unilocular with cortical perforations
Dentigerous cyst either becoming ameloblastoma OR originates as a de novo neoplasm
*YOUNG (20s)
If you see a large, radiolucent lesion, what should you do?
aspiration
What are the three types of histopaths for unicystics?
1) Luminal type which is where the tumor is confined to the luminal surface with a lining that’s like a traditional ameloblastoma
2) Intraluminal or plexiform that is going to have nodules small or large - so like the islands or cords
3) Mural which is going to be a fibrous wall of a cyst has follicles
peripheral ameloblastoma
arise from rests of dental lamina and basal cells of epi
- basically a gingival bump
- post MN ging or alveolar mucosa
malignant vs ameloblastic carcinoma
Malignant ameloblastoma = younger, well differentiated
Ameloblast carcinoma = less differentiated - look likes dysplastic cells and epithelial cells, hard to control
order of ameloblastoma recurance?
solid (50-90%) > peripheral (15%) > unicystic(10%)
calcifying epithelial odontogenic tumor (CEOT)
2-10 decade with average of 34 2x more common in MN M=W peripheral and central uni or multi D/D radiolucent=dentigerous and mixed=COC
pindborg tumor aka?
calcifying epithelial odontogenic tumor (CEOT)
Adenomatoid Odontogenic Tumor (AOT)
odontogenic tumor that is arranged in the form of glands and ducts
- HAMARTOMA; mixed neoplasm
- F>M, teenagers
- gingival fibrous lesoin may be present
- SNOWFLAKES due to foci calcification
squamous odontogenic tumor (SOT)
benign odontogenic neoplasm-rare
- arrise from dental lamina and malassez
- M=W,MN=MX (MX more aggressive)
- located in bone lateral to root surface of erupted bone
odontogenic myxoma
benign, aggressive and reoccurring tumor
- MN and 25yrs (no sex)
- agrressive bc of massive cortical expansion
- radiolucent honeycomb
- stellate spindle cells
recur 25%
Central odontogenic fibroma
Occurs in the jaw bone that is the counter part to the peripheral odontogenic fibroma
- ant MX or post MN
- looks like McFlurry
recurrance rate of ameloblastic firoma?
43.5%
complex vs compound odontoma
Complex odontomas = amorphous conglomerations of hard tissue with no idea which itssue is which post MN
Compound odontoma = numerous miniature rudimentary teeth (all 3 layers of tooth) ant MX
*HAMARTOMAS
Liesegang rings and eosinophils
CEOT
Dentigerous cyst
3-4mm PROPLASIA attaches at CEJ Most common devel odontogenous cyst Blood becomes cholesterol Marsupilization
OKC regrows easy Bc?
1) flat, no Reten, attachment allowing lining to be left
2) daughter/satalite cells
