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Oral Path 3 > odontogenic cysts > Flashcards

odontogenic cysts Flashcards

(85 cards)

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1
Q

Periapical Cyst

A

most common cysts of jaw, inflammatory origin

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2
Q

Periapical Cyst caused by what

A

inflammatory stimulation of the epithelial rests of Malassez

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3
Q

Periapical Cyst clinically

A

asymmptomatic,

non vital tooth

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4
Q

Periapical Cyst radiographically

A

roud ovid radiolucency at apex

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5
Q

Periapical Cyst microscopically

A

inflamed granulation tissue or fibrous connective tissue lined by non- keratinized stratified squamous epithelium

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6
Q

Periapical Cyst, inflammation through lateral canals can lead to what

A

lateral radicular cyst

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7
Q

Periapical Cyst trt

A

endodontic therapy +/- apicoectomy, or extraction with curettage

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8
Q

Periapical Cyst prognosis

A

excellent

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9
Q

Periapical Cyst, if tooth is removed lesion may occasionally persist…called what

A

residual periapical cyst

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10
Q

Dentigerous Cyst is what kind of cyst

A

Most common developmental odontogenic cyst, second overall only to periapical (inflammatory)

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11
Q

Dentigerous Cyst, whats happening

A

Fluid accumulates between the crown of the tooth and the reduced enamel epithelium (increased osmotic pressure), leading to gradual enlargement of the cyst
leads to Subsequent infection/inflammation may occur

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12
Q

Dentigerous Cyst characteristic

A

When lucent space around the crown is > 3-4 mm, considered consistent with dentigerous cyst

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13
Q

Dentigerous Cyst radiographically

A

are mimicked by many odontogenic cysts and tumors

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14
Q

Dentigerous Cyst most common site

A

mandibular 3rd molar region, maxillary canines, maxillary 3rds

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15
Q

Dentigerous Cyst present when

A

2nd 3rd decade of life.

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16
Q

Dentigerous Cyst clinically

A

usually asymptomatic. unless infection is present, may resorb adjacent roots or produce swelling

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17
Q

Dentigerous Cyst microscopically

A

uninflamed fibrous connective tissue lined by a thin non-keratinized stratified squamous epithelium
can have scattered mucus cells in lining

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18
Q

Dentigerous Cyst trt

A

Removal of the tooth and enucleation of the cyst, decompression of large cysts

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19
Q

Dentigerous Cyst prognosis

A

excellent

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20
Q

Dentigerous Cyst what do you do after enucleation of the cyst

A

Microscopic exam of lesional tissue to rule out OKC, ameloblastoma, other odontogenic cysts/tumors, or (rarely) central mucoepidermoid carcinoma

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21
Q

Eruption Cyst

A

Adentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth

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22
Q

Eruption Cyst what does it look like

A

Bluish swelling common (bleeding), thus the term “eruption hematoma”

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23
Q

Eruption Cyst affects who

A

mostly children

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24
Q

Primordial Cyst common or rare?

A

rare

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25
Primordial Cyst derived from what
from degenerating tooth bud epithelium
26
Primordial Cyst develops when
in place of a tooth, before any mineralized material is deposited
27
Primordial Cyst clinical/radiographically diagnosis
based on no history of extraction or surgery in the area
28
Primordial Cyst which tooth?
any tooth
29
Primordial Cyst radiographically
as a unilocular radiolucency in the area of a missing tooth, usually a 3rd molar
30
Primordial Cyst microscopically look like what
odontogenic keratocyst (OKC)
31
Primordial Cyst trt
Enucleation
32
Primordial Cyst prognosis
Good. With histologic diagnosis of OKC, periodic radiographic follow-up for local recurrence is warranted.
33
Odontogenic Keratocyst, common or rare? aggressiveness?
Relatively common, but locally aggressive cyst (keratocystic odontogenic tumor)
34
Odontogenic Keratocyst associated with what syndrome
Associated with nevoid basal cell carcinoma syndrome (suspected in pts.
35
Odontogenic Keratocyst who and where
peak at 3rd decade | mandible- posterior ramus
36
Odontogenic Keratocyst, after 60 years old where is the most common site
anterior maxilla
37
Odontogenic Keratocyst clinically
asymptomatic, can cause some swelling/discomfort with enlargement.
38
Odontogenic Keratocyst radiographically
Majority (up to 80%) present as unilocular radiolucencies with well-demarcated margins and a thin sclerotic border Only 20% exhibit the classic multilocular, expansile radiolucent appearance, which is probably related to the size of the lesion
39
Odontogenic Keratocyst 3 criteria histologically
1. uniformly thin epithelial lining - stratified squamous – 6-8 cells thick 2. corrugated surface layer of parakeratin 3. palisaded, dark basal cell layer
40
Odontogenic Keratocyst CT cell wall
can be inflammed or uninflammed. will look different histologically
41
Odontogenic Keratocyst trt
is controversial and depends on size of lesion With smaller lesion, careful enucleation as a single piece is ideal  With larger lesion, decompression followed by enucleation
42
Odontogenic Keratocyst prognosis
guarded
43
Odontogenic Keratocyst recurrence
3-62% | 5-year minimum follow- up indicated a 40-50% recurrence rate
44
Odontogenic Keratocyst should be monitored for how long
7 years after surgery
45
Nevoid Basal Cell Carcinoma Syndrome
A complex syndrome of malformations and neoplasms exhibiting over 100 different features related to skin, CNS, and skeleton
46
Nevoid Basal Cell Carcinoma Syndrome which gene and chromosome
PTCH gene, | chromosome 9
47
Nevoid Basal Cell Carcinoma Syndrome genetic characteristic
Autosomal dominant, extremely variable expressivity, 40% are new mutations
48
Nevoid Basal Cell Carcinoma Syndrome Craniofacial features:
– Enlarged occipitofrontal cranial circumference (60 cm or more in adults) – Heavy brow ridges – Broad nasal root – Mild ocular hypertelorism
49
Nevoid Basal Cell Carcinoma Syndrome skin features:
1. are multiple 2. occur in unexposed, as well as exposed, skin 3. develop at an earlier age (puberty-35 years) 4. often show melanin pigmentation 5. are usually quiescent, with a few being aggressive also 1-2 mm shallow pits of the palms and/or soles (65%)  Milia and multiple epidermoid cysts (50%)
50
Nevoid Basal Cell Carcinoma Syndrome radiographic findings
Lamellar calcification of the falx cerebri (85%) |  Bifid, fused or hypoplastic ribs (60%)
51
Nevoid Basal Cell Carcinoma Syndrome dental concerns
Odontogenic keratocysts of the jaws (85%) may develop during 1st decade, but after age 7 years
52
patient is more likely to have syndrome if ______
multiple
53
Nevoid Basal Cell Carcinoma Syndrome trt
1. genetic counseling 2. remove OKCs as needed 3. remove BCCs as needed 4. patient should use sunscreen and reduce sun exposure to decrease risk of basal cell Ca
54
Nevoid Basal Cell Carcinoma Syndrome prognosis
guarded, radiographically follow ups
55
Gingival Cyst of the Newborn also called what
dental lamina cyst
56
Gingival Cyst of the Newborn, where do they come from
enlarged structures probably from dental lamina
57
Gingival Cyst of the Newborn what are they
Present as 1-2 mm yellow-white papules, often multiple on alveolar ridge of newborn infant
58
Gingival Cyst of the Newborn where are they found
maxilla usually
59
Gingival Cyst of the Newborn histo
Thin, uniform stratified squamous epithelial lining Cyst lumen is packed with keratin debris 
60
Gingival Cyst of the Newborn trt
None, self marsupialize.
61
Gingival Cyst of the Adult forms from
Related to the lateral periodontal cyst | Arises from dental lamina rests in the gingival connective tissue (rests of Serres)
62
Gingival Cyst of the Adult who and where
adults, 40 years and older, anterior segments
63
Gingival Cyst of the Adult clinical appearance
Smooth-surfaced, dome-shaped elevation of the attached gingiva Usually less than 1 cm in diameter Tense on palpation Otherwise asymptomatic Translucent or bluish appearance is often noted
64
Gingival Cyst of the Adult may look like a resemble
May mimic mucocele, but on attached gingiva | Minimal, if any, findings on radiograph
65
Gingival Cyst of the Adult histo
a cystic cavity lined by a thin, uniform layer of cuboidal or attenuated non-keratinized stratified squamous epithelium
66
Gingival Cyst of the Adult trt
conservative excision
67
Gingival Cyst of the Adult prognosis
excellent
68
Lateral Periodontal Cyst
Defined as a developmental cyst occurring adjacent or lateral to the root of a tooth,
69
Lateral Periodontal Cyst arises from what
intrabony rests of dental lamina
70
Lateral Periodontal Cyst where
Mandibular premolar area, maxillary lateral incisor region
71
Lateral Periodontal Cyst who and when
5th and 6th decade
72
Lateral Periodontal Cyst clinical
Asymptomatic unilocular radiolucency, lateral root surface of vital tooth Typically less than 1 cm in diameter
73
Lateral Periodontal Cyst histo
thin non-keratinized stratified squamous epithelium lining, uninflamed fibrous connective tissue
74
Lateral Periodontal Cyst trt
curettage
75
Lateral Periodontal Cyst prognosis
excellent
76
Calcifying Odontogenic Cyst also known as
Gorlin cyst
77
Calcifying Odontogenic Cyst found where
Equal distribution between maxilla and mandible; anterior > posterior jaws
78
Calcifying Odontogenic Cyst, when
May occur at any age, with peak occurrence in second and third decade (mean age - 33 years) 
79
Calcifying Odontogenic Cyst radiographically
Usually a well-defined, unilocular radiolucency | Scattered radiopacities in about 50% of cases
80
Calcifying Odontogenic Cyst, MOST 85% are ____
cystic | some solid variants though
81
30% of COC's are associated with an ______, 20% with ______, (~ 80% of cases __________)
impacted tooth, odontoma, resorption of adjacent tooth roots common
82
Calcifying Odontogenic Cyst histo
with proliferation of odontogenic epithelial cells which at their periphery show a cuboidal or columnar appearance of the basal cells, similar to ameloblastoma
83
Calcifying Odontogenic Cyst, as cells approach the lumen what happens
"ghost cell change" Cells are pale and eosinophilic, with swollen cytoplasm and loss of the nucleus that exhibits a faint nuclear membrane outline maybe a form of coagulative necrosis
84
Calcifying Odontogenic Cyst trt
enucleation with curettage
85
Calcifying Odontogenic Cyst reoccurrence?
possible, follow up periodically

Oral Path 3 (3 decks)

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