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Odontogenic cysts Flashcards

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1
Q

What is the definition of a cyst?

A

A pathological cavity with fluid or semi-fluid contents, usually lined by epithelium and not created by pus.

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1
Q

What is the typical presentation of cysts?

A

Slow growing
Asymptomatic
Found as incidental findings sometimes (radiographs)

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2
Q

What are the dangers of an untreated cyst?

A
  • Infection
  • Displacement of teeth
  • Bone resorption (increased risk of pathological fracture)
  • Bone infection
  • De vitalise teeth
  • Can impact vital structures
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3
Q

How do you report a radiographic presentation of a cyst?

A

STOP
S - site, size and shape
T - translucent or opaque
O - outline (well circumscribed etc)
P - any previous imaging

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4
Q

What are odontogenic cysts?

A

Epithelial lining derived from epithelial residues of tooth forming organ (epithelial rests of serres, reduced enamel epithelium, rests of Malassez)

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5
Q

What is the most common odontogenic cyst?

A

Radicular cyst

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6
Q

What does a cyst need to grow?

A

1) source of epithelium
2) stimulus for proliferation of epithelium
3) mechanism of growth and bone resorption

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7
Q

What two categories can odontogenic cysts be?

A

Inflammatory and non inflammatory

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8
Q

What are the types of inflammatory odontogenic cysts?

A
  • Radicular
  • Residual
  • Paradental
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9
Q

What are the types of non inflammatory odontogenic cysts?

A
  • Denigerous
  • Keratocyst
  • Lateral periodontal
  • Calcifying odontogenic
  • Glandular odontogenic
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10
Q

What is the common sites for a radicular cyst?

A

Jaws - most common in maxilla (anterior maxilla)

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11
Q

How do radicular cysts present?

A
  • Asymptomatic usually
  • Incidental finding on radiograph
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12
Q

What are radicular cysts associated with?

A

A non vital tooth (usually near apex but can be lateral if a root canal is necrotic)

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13
Q

How would you differentiate between a radicular cyst and periapical granuloma?

A

The larger the lesion the more likely it is to be a cyst

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14
Q

What are the radiological features of a radicular cyst?

A
  • round or ovoid radiolucency
    surrounded by a narrow, radiopaque or corticated margin
  • extends from lamina dura of involved tooth
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15
Q

What are the features of a residual cyst?

A
  • round or ovoid radiolucency
  • well demarcated and often corticated margin
  • located in edentulous areas of the jaw
16
Q

What is the differential cyst for a residual cyst?

A

Keratocyst

17
Q

What are the features of a dentigerous cyst?

A
  • odontogenic
  • contains/surrounds crown of unerupted tooth
  • attaches to the cervical aspect at the CEJ
  • develops from expansion of follicle
  • eruption cyst
18
Q

Where is it common to have a dentigerous cyst?

A

Unerupted third molars and canines

19
Q

What are the radiological features of a dentigerous cyst?

A

Radiolucency envelops the crown of an unerupted tooth (only the crown in the radiolucency)
Unilocular
Corticated margin - continuous with lamina dura
Can become large and displace teeth/resorption on adjacent teeth/distort local anatomy

20
Q

What are the radiological features of an odontogenic keratocyst?

A
  • well defined unilocular radiolucency
  • corticated margin
  • wide variation
  • larger lesions can be multi-locular
  • can be associated with unerupted tooth
21
Q

What condition do you need to be aware of when a OKC is diagnosed?

A

Gorlin Goltz syndrome

22
Q

What are the major features of OKC?

A
  • Multiple BCC’s
  • OKC of jaw
  • 3 or more palmar pits
    Falx cerebri calcification
    Rib abnormalities
    First degree realtive with basal cell nevus syndrome
23
Q

What is the minor criteria for gorlin goltz syndrome?

A

Rib abnormalities
Other specific skeletal and radiological abnormalities
Macroencephaly
Cleft lip or palate
Ovarian or cardiac fibroma
Lymph mesenteric cysts
Ocular anomalies

24
Q

What is an eruption cyst?

A

Painless, blue or translucent cyst that overlies erupted teeth. Common in children.

25
Q

What is a lateral periodontal cyst?

A

Developmental:
Lateral aspect of tooth/between roots of unerupted teeth
Vital tooth
Asymptomatic
Distinct histopathology
Rare
Adults - peak 5th/6th decade

26
Q

What are the radiological features of a lateral periodontal cyst?

A
  • lateral aspect of tooth between the roots of two teeth
  • round/ovoid
  • well circumscribed radiolucent area
  • corticated, sclerotic margin
  • may become tear/pear shaped if teeth are displaced
  • usually mid third of root
  • mostly <10mm and don’t disrupt lamina dura
27
Q

What is a multi cystic version of a lateral periodontal cyst called?

A

Botryoid odontogenic cyst

28
Q

What is a glandular odontogenic cyst?

A

-Epithelium resembles salivary/glandular tissue
-Mandible often cross the midline and symmetrical

29
Q

What are the radiological features of glandular odontogenic cysts?

A

Well defined, corticated, uni locular or multi, sometimes dentigerous relationship.j

30
Q
A

CMS 2 (9 decks)

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