Odontogenic Cysts (3) Flashcards
What is the most common cyst of the jaws?
Periapical cyst
What is the origination of a periapical cysts?
Due to inflammatory stimulation of the epithelial rests of Malassez
T/F: Periapical cysts are associated with vital teeth.
False
Periapical cysts = non-vital tooth
T/F: Periapical cysts are symptomatic.
False
Asymptomatic unless secondarily infected or very large
T/F: Loss of lamina dura is seen with a Periapical cyst.
True
What are the histopathological features of a periapical cysts?
Granulation tissue lined by non-keratinized stratified squamous epithelium
*if no epithelial lining -> periapical granuloma
What is the treatment/prognosis for a periapical cysts?
Endodontic therapy/apicoectomy/extraction
Excellent
T/F: Buccal bifurcation cysts are usually seen in lower molars of children.
True
Flat v-shaped extension of enamel into the buccal bifurcation of a mandibular molar can cause what?
Buccal bifurcation cysts
In a buccal bifurcation cyst, which way will the apices of the tooth appear to be leaning?
Toward the lingual
T/F: A buccal bifurcation cyst has the same histopathological features as a periapical cyst.
True
T/F: Treatment for buccal bifurcation cyst is extraction of the tooth.
False
Enucleation
Good prognosis
What is the most common developmental odontogenic cyst?
Dentigerous cyst
*2nd most common cyst overall after periapical
What is the cause of a dentigerous cyst?
Fluid accumulation between crown and reduced enamel epithelium
_____________ are associated with the crown of an unerupted tooth.
Dentigerous cysts
If the radiolucency is greater than ________, it is probably a cyst.
5mm
Which tooth is the most common to have a dentigerous cyst?
Mandibular 3rd molars
What is the treatment/prognosis for dentigerous cyst?
Removal of tooth and cyst
Excellent
What type of cyst is sometimes called an “eruption hematoma”?
Eruption cyst
Dentigerous cyst that forms in the soft tissue
Bluish swelling
T/F: Eruption cysts must always be unroofed.
False
Only if causing problems
What is a primordial cyst?
Rare lesion that develops in place of a tooth
*to diagnose there must have never been extraction in that area
Which lesion is thought to possibly be the same as a primordial cyst?
Odontogenic keratocyst (OKC)
What is the treatment/prognosis of a primordial cyst?
Enucleation
Good
What syndrome can an OKC be associated with if multiple are seen?
Nevoid basal cell carcinoma syndrome (NBCCS)
T/F: OKCs are benign, but more aggressive than other odontogenic cysts.
True
When is someone most likely to develop an OKC?
3rd decade
*anterior maxilla after 70 y.o.
T/F: The majority of OKCs are multilocular and develop in the posterior mandible.
False
Unilocular and in posterior mandible
What are the three histopathological criteria for an OKC?
- Thin epithelial lining
- Corrugated parakeratin surface
- Palisaded basal cell layer
What is the treatment for an OKC?
Smaller - enucleate in one piece
Larger - marsupialization followed by enucleation
What is the prognosis for an OKC?
Guarded
What is a condition that involves multiple odontogenic keratocysts (OKCs) arising at an early age?
Nevoid basal cell carcinoma syndrome (NBCCS)
*Gorlin syndrome
Which three cysts are inflammatory?
- Periapical cyst
- Residual periapical cyst
- Buccal bifurcation cyst
*the rest are developmental
What are some clinical features of NBCCS?
OKCs in jaws, hypertelorism, large head, frontal bossing, milia and epidermal cysts, and multiple BCCs
What might you see in a radiograph of a patient with NBCCS?
Calcification of falx cerebri, hypoplastic/bifid rips, multiple OKCs
What is also called a dental lamina cyst?
Gingival cyst of the newborn
What is the average recurrence rate of an OKC?
30%
Most will happen within 5 years
Need annual follow up for 7 years
What is the treatment and prognosis for gingival cysts of the newborn?
No treatment. Excellent prognosis.
Where are gingival cysts of the adult most likely to be seen?
Facial surfaces in anterior segments of the jaws just below mucogingival junction
T/F: No treatment is needed for patients with gingival cysts of the adult.
False
Conservative excision; prognosis is excellent
T/F: Calcifying odontogenic cysts are more likely to be seen in the mandible.
False
Equal in max and mand
Where on the jaw do most calcifying odontogenic cysts occur?
Incisor-canine region
T/F: The majority of calcifying odontogenic cysts are intrabony.
True
What features are associated with some calcifying odontogenic cysts?
Scattered radiopacities (50%) Impacted teeth (30%) Odontomas (20%)
What is another term for a calcifying odontogenic cyst?
Gorlin cyst
In a _____________ cyst, some lesional cells undergo “ghost cell” change then may calcify.
Calcifying odontogenic cysts
What is the treatment/prognosis for calcifying odontogenic cysts?
Enucleation w/ curettage
Good
What is the definition of a lateral periodontal cyst?
Defined as a non-keratinized developmental cyst occurring adjacent or lateral to the root of a tooth
What is the treatment/prognosis of lateral periodontal cysts?
Curettage
Excellent
