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Oral Path 3 > odontogenic cysts > Flashcards

odontogenic cysts Flashcards

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
Q

Primordial Cyst derived from what

A

from degenerating tooth bud epithelium

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26
Q

Primordial Cyst develops when

A

in place of a tooth, before any mineralized material is deposited

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27
Q

Primordial Cyst clinical/radiographically diagnosis

A

based on no history of extraction or surgery in the area

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28
Q

Primordial Cyst which tooth?

A

any tooth

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29
Q

Primordial Cyst radiographically

A

as a unilocular radiolucency in the area of a missing tooth, usually a 3rd molar

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30
Q

Primordial Cyst microscopically look like what

A

odontogenic keratocyst (OKC)

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31
Q

Primordial Cyst trt

A

Enucleation

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32
Q

Primordial Cyst prognosis

A

Good. With histologic diagnosis of OKC, periodic radiographic follow-up for local recurrence is warranted.

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33
Q

Odontogenic Keratocyst, common or rare? aggressiveness?

A

Relatively common, but locally aggressive cyst (keratocystic odontogenic tumor)

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34
Q

Odontogenic Keratocyst associated with what syndrome

A

Associated with nevoid basal cell carcinoma syndrome (suspected in pts.

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35
Q

Odontogenic Keratocyst who and where

A

peak at 3rd decade

mandible- posterior ramus

36
Q

Odontogenic Keratocyst, after 60 years old where is the most common site

A

anterior maxilla

37
Q

Odontogenic Keratocyst clinically

A

asymptomatic, can cause some swelling/discomfort with enlargement.

38
Q

Odontogenic Keratocyst radiographically

A

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
Q

Odontogenic Keratocyst 3 criteria histologically

A
  1. uniformly thin epithelial lining - stratified squamous – 6-8 cells thick
  2. corrugated surface layer of parakeratin
  3. palisaded, dark basal cell layer
40
Q

Odontogenic Keratocyst CT cell wall

A

can be inflammed or uninflammed. will look different histologically

41
Q

Odontogenic Keratocyst trt

A

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
Q

Odontogenic Keratocyst prognosis

A

guarded

43
Q

Odontogenic Keratocyst recurrence

A

3-62%

5-year minimum follow- up indicated a 40-50% recurrence rate

44
Q

Odontogenic Keratocyst should be monitored for how long

A

7 years after surgery

45
Q

Nevoid Basal Cell Carcinoma Syndrome

A

A complex syndrome of malformations and neoplasms exhibiting over 100 different features related to skin, CNS, and skeleton

46
Q

Nevoid Basal Cell Carcinoma Syndrome which gene and chromosome

A

PTCH gene,

chromosome 9

47
Q

Nevoid Basal Cell Carcinoma Syndrome genetic characteristic

A

Autosomal dominant, extremely variable expressivity, 40% are new mutations

48
Q

Nevoid Basal Cell Carcinoma Syndrome Craniofacial features:

A

– Enlarged occipitofrontal cranial circumference (60 cm or more in adults)
– Heavy brow ridges
– Broad nasal root
– Mild ocular hypertelorism

49
Q

Nevoid Basal Cell Carcinoma Syndrome skin features:

A
  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
Q

Nevoid Basal Cell Carcinoma Syndrome radiographic findings

A

Lamellar calcification of the falx cerebri (85%)

 Bifid, fused or hypoplastic ribs (60%)

51
Q

Nevoid Basal Cell Carcinoma Syndrome dental concerns

A

Odontogenic keratocysts of the jaws (85%) may develop during 1st decade, but after age 7 years

52
Q

patient is more likely to have syndrome if ______

A

multiple

53
Q

Nevoid Basal Cell Carcinoma Syndrome trt

A
  1. genetic counseling
  2. remove OKCs as needed 3. remove BCCs as needed
  3. patient should use sunscreen and reduce sun exposure to decrease risk of basal cell Ca
54
Q

Nevoid Basal Cell Carcinoma Syndrome prognosis

A

guarded, radiographically follow ups

55
Q

Gingival Cyst of the Newborn also called what

A

dental lamina cyst

56
Q

Gingival Cyst of the Newborn, where do they come from

A

enlarged structures probably from dental lamina

57
Q

Gingival Cyst of the Newborn what are they

A

Present as 1-2 mm yellow-white papules, often multiple on alveolar ridge of newborn infant

58
Q

Gingival Cyst of the Newborn where are they found

A

maxilla usually

59
Q

Gingival Cyst of the Newborn histo

A

Thin, uniform stratified squamous epithelial lining
Cyst lumen is packed with keratin debris


60
Q

Gingival Cyst of the Newborn trt

A

None, self marsupialize.

61
Q

Gingival Cyst of the Adult forms from

A

Related to the lateral periodontal cyst

Arises from dental lamina rests in the gingival connective tissue (rests of Serres)

62
Q

Gingival Cyst of the Adult who and where

A

adults, 40 years and older, anterior segments

63
Q

Gingival Cyst of the Adult clinical appearance

A

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
Q

Gingival Cyst of the Adult may look like a resemble

A

May mimic mucocele, but on attached gingiva

Minimal, if any, findings on radiograph

65
Q

Gingival Cyst of the Adult histo

A

a cystic cavity lined by a thin, uniform layer of cuboidal or attenuated non-keratinized stratified squamous epithelium

66
Q

Gingival Cyst of the Adult trt

A

conservative excision

67
Q

Gingival Cyst of the Adult prognosis

A

excellent

68
Q

Lateral Periodontal Cyst

A

Defined as a developmental cyst occurring adjacent or lateral to the root of a tooth,

69
Q

Lateral Periodontal Cyst arises from what

A

intrabony rests of dental lamina

70
Q

Lateral Periodontal Cyst where

A

Mandibular premolar area, maxillary lateral incisor region

71
Q

Lateral Periodontal Cyst who and when

A

5th and 6th decade

72
Q

Lateral Periodontal Cyst clinical

A

Asymptomatic unilocular radiolucency, lateral root surface of vital tooth
Typically less than 1 cm in diameter

73
Q

Lateral Periodontal Cyst histo

A

thin non-keratinized stratified squamous epithelium lining, uninflamed fibrous connective tissue

74
Q

Lateral Periodontal Cyst trt

A

curettage

75
Q

Lateral Periodontal Cyst prognosis

A

excellent

76
Q

Calcifying Odontogenic Cyst also known as

A

Gorlin cyst

77
Q

Calcifying Odontogenic Cyst found where

A

Equal distribution between maxilla and mandible; anterior > posterior jaws

78
Q

Calcifying Odontogenic Cyst, when

A

May occur at any age, with peak occurrence in second and third decade (mean age - 33 years)


79
Q

Calcifying Odontogenic Cyst radiographically

A

Usually a well-defined, unilocular radiolucency

Scattered radiopacities in about 50% of cases

80
Q

Calcifying Odontogenic Cyst, MOST 85% are ____

A

cystic

some solid variants though

81
Q

30% of COC’s are associated with an ______, 20% with ______, (~ 80% of cases __________)

A

impacted tooth, odontoma, resorption of adjacent tooth roots common

82
Q

Calcifying Odontogenic Cyst histo

A

with proliferation of odontogenic epithelial cells which at their periphery show a cuboidal or columnar appearance of the basal cells, similar to ameloblastoma

83
Q

Calcifying Odontogenic Cyst, as cells approach the lumen what happens

A

“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
Q

Calcifying Odontogenic Cyst trt

A

enucleation with curettage

85
Q

Calcifying Odontogenic Cyst reoccurrence?

A

possible, follow up periodically

Oral Path 3 (3 decks)

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