Odontogenic cysts

Question 1

What is it called when surface epithelium grows into the jaw to produce a tooth germ?

Answer 1

odontogenesis

Question 2

What are they called with a pathologic cavity lined by odontogenic epithelium is filled with fluid or semisolid material?

Answer 2

odontogenic cysts

Question 3

How can odontogenic cysts form?

Answer 3

inflammation

unknown through developmental

Question 4

What 2 cysts are inflammatory while all else are developmental?

Answer 4

Radicular cysts

buccal bifurcation cysts

Question 5

Patient has a radiolucent cyst in place of a missing tooth in the mandibular 3rd molars. What is it called and how?

Answer 5

primordial cyst

degeneration of enamel organ that aborted odontogenesis

Question 6

Patient walks in with asymptomatic, well circumscribed, pericoronal radiolucency from CEJ around crown in the mandibular 3rd molars and maxillary cuspids. What are they called and how?

Answer 6

dentigerious cyst (or follicular cyst)
separation of follicle from around the crown of developing tooth

Question 7

How do you treat dentigerous cysts (follicular cysts)?

Answer 7

surgical removal of Mn 3rd molars

Cuspids may be able to decompress and pull cuspids in orthodontically

Question 8

What is the most common type of salivary gland malignancy in adults?

Answer 8

mucoepidermoid carcinoma

Question 9

What is a rare, benign tumor of odontogenic epithelium?

Answer 9

ameloblastoma

Question 10

A patient has a periapical pathology and it has devitalized pulp and secondary inflammation. You deem it the most common odontogenic cysts. What is it?

Answer 10

apical periodontal cyst

Question 11

A patient has a small, well circumscribed radiolucency along the lateral root surface of vital mandibular cuspids bilaterally. What is it and how?

Answer 11

lateral periodontal cyst

from cystic degeneration of rests of Malaise in PDL

Question 12

A patient has a small, well circumscribed radiolucency along the lateral root surface of vital mandibular cuspids bilaterally. It is polycystic, multilocular, and has come back after you excised it before. What is it?

Answer 12

botryoid odontogenic cyst

Question 13

A patient’s newborn has some congenital, small yellowish elevations on their alveolar ridge. What is it and what should you do?

Answer 13

dental lamina cysts from degenerating dental lamina

Tx is no treatment. Will self-marsupialize and heal.

Question 14

An adult patient has soft compressible cysts on mandibular cuspids bilaterally that looks like a mucocele, but you know that mucoceles don’t occur on gingiva. What is it and how and what treatment?

Answer 14

adult gingival cyst
degeneration of rests or glands of Serres (dental lamina)
Tx is excision

Question 15

Two patients walk into your office. A grandpa and a 2-3 year-old. They both have unilocular or multilocular radiolucency on the posterior mandible (more than Mx). It has expanded and there is draining and pain and the prognosis is clinically aggressive. What is it and how?

Answer 15

parakeratinized odontogenic keratocyst

from dental lamina

Question 16

After excising a parakeratinized odontogenic keratocyst, what do you advise the patient and what syndrome is it linked to?

Answer 16

There is a 1/3 recurrence and they might have mutation of a tumor suppression gene called basal cell nevus-bifid rib syndrome

Question 17

What type of odontogenic keratocyst does not recur often and is smaller, less aggressive and not associated with the syndrome?

Answer 17

orthokeratinized odontogenic cyst

Question 18

A patient has a radiolucent to mixed radiolucent/opaque along the mandible that is asymptomatic and extraosseous. It appears calcified and the teeth have not been able to erupt. What is it and Tx?

Answer 18

calcifying odontogenic cyst (AKA Gorlin Cyst)

Tx; conservative surgical removal

Question 19

A patient has a large, unilocular to multilocular radiolucency on the mandible. What is it and Tx and what to tell the patient?

Answer 19

glandular odontogenic cyst

Tx surgical excision and 30-50% recurrence

Question 20

A child patient has an inflammatory cysts occurring on buccal of erupting mandibular 1st molar that is causing buccal swelling. Radiographic findings show unilocular lucency involving furcation of roots. What is it and Tx?

Answer 20

buccal bifurcation cyst or paradental cyst

Tx - enucleation of cyst (not cutting into or dissecting) and do not extract tooth