Lin 1-26-14 Flashcards
Odontoma is this a true tumor
no not a true tumor
Dentigerous cyst is the ____ most common odontogenic cyst
waht is the first most common
2nd most common
first = periodontal cyst
____ is the most common developmental odonotgenic cyst
dentigerous cyst
dentigerous cyst
fluid accumulation bt the crown of the ___ tooth and ____ tissue
unerupted
follicular
dentigerous cysts is derived from _____ _____ epithelium
and has ____ shape
reduced enamel
balloon
clinically
dentigerous cyst has to have an asociation with ____
of an ___ tooth
crown
UNERUPTED
where is the most common dentigerous cysts
____
Man 3rd Molars
rarely does dentigerous cyst involve ___ ___
deciduous tooth
most dentigerous cyst are small
if large, uncommon, and due to increased size usually is caused excessive accumulation of ___ by inflamm of presence of high numbers of ___ cells
flud
mucus cells
in the diff diagnosis for dentigerous cyst
conisder:
_______
____
odontogenic keratocyst
unicystic ameloblastoma
usually discover dentigerous syst in young adults
10 - 30 yo
TF
true
what is the tx and prognosis of dentigerous cyst
surgical removal
excellent
waht is the most common type of epi involved with dentigerous cyst
stratisfied sq epit
true f
you can use expansion of the bone as a diff diagnosis of dentigerous cyst
FALSE, cant used expansion to exclude or confirm diagnosis
does dentigerous cyst reoccur
no
_____ radioleuncy associated with CROWN ____ of an UNERUPTED tooth
unilocular
pericoronal
the attachment of the cyst is at hte ___ in most cases of dentigerous cyst
CEJ
the border of the dentigerous cyst is ____ and ___
well - defined and sclerotic
the cystic lining of dentigerous cyst
- ____ epi
- ______
. non - KERATINIZED epi
multipotentil
the conn tissue wall of dentigerous cyst resemble
_____ ____
dental papilla
when the cyss is sign inflamed, the histology is indistinguishable from ___ ___ cyst
apical peridontal cyst
when biopsy specimen not contains ___ ___, it may be misdiagnosed when no clinical 411 is provided
cystic lining
___ is a soft tissue analogue of the dentigerou cyst and the tooth has ERUPTED and the follicular tissue is intact, WE HAVE A TUMOR LIKE SOFT TISSUE MASS
eruption cyst
usually affects ___
young children less than 10 yo
eruption cysts
- soft
- transleucent swelling in the
gingival mucosa
overlying the crown of the
erupting deciduous or
permanent tooth
when you think youre dealing with eruption cyst waht do you do first
take a radiograph
tx for eruption cyst
no treatment
cyst spontaneously ruptures
an** uncommon **inflammatory odontogenic cyst in children
buccal bifurcation cyst
pathogenesis ___ but may be assocaited with __ __ __ which leads to buccal pocket formation
uncertain
buccal enamel extension = cervical enamel projection
with bee, enamel has apical projection have a ectopic projection on the root surface, this causes
pdl to no attach there and get a DEEP NARROW opening
a buccal bifurcation cyst happens most in which tooth
man 1st perm molar
for buccal bifurcation cyst
well circumscirbed raidoleuncy invovling the ___ __ and root area of the tooth
buccal bifurcation
also see the crown of the tooth tilted buccally
waht is the best radiogrpah used for buccal bifuration cyst
occlusal
histology is not specifc
similar to apcial peridontal cyst
for buccal bifurcation cyst
true
true
tx for buccal bifurcation cyst
enucleation [keep the tooth]
why doesnt buccal bifurcation cyst happen in adults?
same category as dentigerous cyst,
cyst taht occurs ___ or ___ of partially erupted MAN 3RD MOLARS
paradental cyst
paradental cyst has a history of
pericoronitis
is paradental cyst a dentigerous cyst
yes, still involved with the crown of an unerupted tooth
waht is the most common odontogenic cyst
apical peridontal cyst
what are the other 2 names of apical peridontal cyst
periapical cyst
radicular cyst
apical periodontal cyst
apical peridontal cyst
inflammatory cyst assocaited with
**non - vital tooth **
waht is the firs thing you do when you think a cyst is apical peridontal cyst
vitality test to estabilish diagnosis
waht is the cause of apical peridontal cyst
infection spread through the root canal
major root canal ___
accessory canal ___
apical peridontal cyst
periapica area = major root canal, most common
along the lateral aspect of the root= accessory canal.
apical peridontal cyst is derived from
rest of malassez from the epithelial root sheath
apical peridontal cysts enalrgges bc
increased from osmotic pressure within the lumen
waht is the treatment of apical peridontal cyst
endo treatment or extraction
lesions usually resolve after appropriate treatment. May heal as a __ scar epecially when __ __ lost
fibrous
cortical plates
tf
somtimes need a 2nd biopsy to make sure the apical peridontal cyst has healed
true
paical peidontal cyst radio features
- well defined
- location:
- periapical area [classic]
- interproximal area - vary in size, can be large
if see radioleunt lesion around an endo treated tooth can be two causes
- failed lesion
- biopsy to see waht it can be
t f
biopsy if the size is huge and dont know for sure if its an apical peidontal cyst
true
2 histological features of the apical peridontal cyst
- an inflamed cyst
lining epi = non keratized strastifed squamous epithelium
- epithelium exhibits exocytosis [intraepithelial inflamm]
-
spongiosis [intracellulr edema of epithelium]
2. conn tissue = granulation tissue - mixed inflammation [very vascular and very inflammed]
- cholestrol clefts, dystropic calcification
___ apical peridontal cyst
after the infected TOOTH has been extracted
residual cyst
radiograph features of residual cyst
- well defined
- corticated
- radioleuncy
waht is another name for odontogenic keratocyst
keratocystic odontogenic tumor
odonotgenic keratocyst
___ cyst.
cystic lining derived from ___ ___ ___
common
rests of dental lamina [rests of serres]
a small amt of patients have multiple OKC and within this group some may have ___ ___ __ ___ ___
nevoid basal cell carcinoma syndrome
OKC happns any age but specifically
adults
OKC can be found anywehre in the jaw
most common site ____ ___ and ___
true
posterior man and ramus
true or false OKC does not reoccur
sometimes has an aggressive clinical behavorio
false, significant recurrene rate
true aggressive can be
another name of nevoid basal cell carcinoma syndrome
gorlin syndrome
3 clincal fx of OKC
- very thin, friable cyst wall [not uncommon for a small piece fall out when surgical excision and reoccurs]
- can be viewed as neoplasm and not simple cyst
- epithelial budding
- daughter cysts = cell like cyst
tx for OKC
- surgical excision with **peripheral osseous curettage **
**-or osteotectomy **
- FOLLOW UP IMPORTANT
diagnosis of OKC is purely ____
histology
histo features of OKC
- unilocular [most common]
- can be multilocular - well circumscrbied radioleuncy
- occurs **anywehre **in the jaws
whenever you see cyst that looks like OKC must biopsy
TF
true
pericoronal
unilocular radiolency
assocaited with unerupteed tooth DD =
dentigerous cyst
of OKC
periapical
unilocular radioleuncy
assocaite with vital or non-vital tooth DD =
apical periodntal cyst
or OKC
multilocular radiolucency DD=
ameloblastoma or OKC
unilocualr radilecny
bt teeth DD =
lateral apica cyst
….
tf
okc is purely diagnosed from histopatholgical features
true
okc histopath features for diagnosis has a ___ epithlial lining
cystic epithelial lining
- uniformly
- thin
- 6 - 10 cell layer thick - corrugated parakeratin SURFACE
- uneven appearance - palisaded and hyperchromatic basal cell layer
OKC can be 2nd inflammed and the characteristic features may be lost.
specific diagnosis may not be able to render
true
if OKC on the gingiva can be soft tissue nodule and look like a ___ and is not of clinical concern
fibroma
its a peripheral OKC and not a concern
Orthokeratin odontogenic cyst
is ____ ___
not ___ __ and
do not ___ if manage properly
less aggressive
not syndrome related
do not recur
3 histo features of orthokeratin odontogenic cyst
- orthokeratin
- promnent granular cell layer
- basal cell layer is NOT palisaded and
- less hyperchromatic
radiographic featrues of orthokeratin odontogenic cyst
unilocular radiolency
tf
can treat orthokeratin with enucleation with currettage
true
do not need bone treatment like OKC
__ ___ ___
less common than
DC
APC
OCK
lateral periodntal cyst
lateral peridontal cyst
considered the ___ [intrabony] counterpart of
___ __ of the adult
central
gingival cyst of the adult
t f
lateral periodntal cyst occurs on the lateral root surface of VITAL TOOTH
true
radiogphaphhy of lateral peidontal cyst
- well circumscribked radioleuncy
lateral to the root[s]s of VITAL tooth
- msot are less than 1.0 cm
LATERAL peridontal cyst can look liek 3 things
- apical periodotnal cyst
- OKC
- multilocualr or unilocular …
histopath of lateral periodontal cysts
- lined mostly uniformed
- flattened squamous cells
- focal nodular thickening [epithelial plaques]