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AU 16- Oral Path MT 3 > Odontogenic Cysts > Flashcards

Odontogenic Cysts Flashcards

1
Q

What are the three discussed Inflammatory Cysts?

A

Periapical (Radicular) Cyst
Residual Periapical (Radicular) Cyst
Buccal Bifurcation Cyst

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2
Q

What is the most common cyst of the jaws?

A

Periapical Cyst

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3
Q

The periapical cyst originates from stimulation of ______.

A

epithelial rests of Malassez (in the PDL)

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4
Q

What shape are periapical cysts?

A

round to ovoid [at the apex]

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5
Q

True or False: Periapical Cysts are associated with non-vital teeth.

A

True!

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6
Q

True or False: Periapical Cysts are asymptomatic.

A

True

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7
Q

What is a Lateral Radicular Cyst?

A

its a periapical cyst that develops on the lateral aspect of the root, due to presence of a lateral canal in the area

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8
Q

True or False: Periapical Cysts are fibrous connective tissue lined by nonkeratinized stratified squamous epithelium.

A

True

without the lining epithelium, it is a granuloma NOT a cyst

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9
Q

How is a periapical cyst treated?

A

root canal therapy
apicoectomy
extraction with curettage

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10
Q

Prognosis of a periapical cyst is excellent, but if the cyst is not removed, it may persist as a ______.

A

residual cyst

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11
Q

What is a residual cyst? How is it treated?

A

well-defined radiolucency in the site of a previous extaction which most often represents a periapical cyst which had not been removed
-treated with enucleation

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12
Q

True or False: Buccal Bifurcation Cysts usually occur in children.

A

True

Buccal for the Babies

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13
Q

Where are buccal bifurcation cysts usually found?

A

in the mandibular molars

think…bifurcation…mandibular molars have 2 roots

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14
Q

Buccal Bifurcation Cysts are due to proliferation of ______ epithelium association with enamel extensions in the furcation area.

A

crevicular

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15
Q

True or False: Buccal Bifurcation Cysts may produce swelling and a foul taste.

A

True

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16
Q

Radiographically, how are buccal bifurcation cysts identified?

A
  • on an occlusal radiograph, the root apices are tipped toward the lingual cortex
  • on PA radiographs, radiolucency in the furcation area
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17
Q

What is proliferative periostitis?

A

single or multiple layers of bone formation that may be seen in association with buccal bifurcation cysts

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18
Q

True or False: The tooth involved with a buccal bifurcation cyst may be lost due to bone destruction.

A

True

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19
Q

What is the most common DEVELOPMENTAL odontogenic cyst?

A

Dentigerous Cyst

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20
Q

What is the most common odontogenic cyst overall? Second most common overall?

A 
Periapical= most common cyst
Dentigerous= 2nd most common cyst, 1st most common developmental cyst
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21
Q

What is a Dentigerous Cyst?

A

accumulation of fluid between the crown of an unerupted tooth and the reduced enamel epithelium (the REE becomes the epithelial lining of the cyst)

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22
Q

If the radiolucency around a crown is greater than _____, it is probably safe to call it a dentigerous cyst. If it is smaller, it probably represents a ______.

A

5mm
hyperplastic dental follicle (histologically indistinguishable)

SIZE MATTERS :)

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23
Q

True or False: Any impacted tooth can potentially develop a dentigerous cyst.

A

True

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24
Q

What are the most common sites for a dentigerous cyst?

A

1st: Mandibular thirds
2nd: Maxillary canines
3rd: Maxillary thirds

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25
Q

Most dentigerous cysts present in the ____ or ____ decade.

A

2nd or 3rd

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26
Q

Radiographically, how are dentigerous cysts most easily identified?

A

the radiolucency surrounds the crown and CONNECTS AT THE “NECK OF THE TOOTH” (aka CEJ)

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27
Q

Dentigerous cysts have an uninflammed connective tissue wall lined by a thin layer of NKSS epithelium and a few scattered ____ cells in the lining.

A

mucous

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28
Q

How is a dentigerous cyst treated?

A

removal of the tooth and enucleation of the cyst

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29
Q

The tissue removed from a dentigerous cyst should be evaluated to rule out _____, ________, _____, or _____.

A

OKC
ameloblastoma
squamous cell carcinoma
intraosseous mucoepidermoid carcinoma

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30
Q

What is an eruption cyst?

A

a bluish swelling that forms in the soft tissue overlying the erupting crown (dentigerous is impacted)

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31
Q

Who is generally affected by eruption cysts?

A

children

-no treatment needed unless the child is biting on the cyst

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32
Q

A Primordial Cyst is a rare lesion that is thought to be histogenetically derived from the ________ epithelium.

A

degenerating tooth bud epithelium
(develops in place of a tooth before any mineralized material is deposited- it LOOKS like a residual cyst but there was never a tooth to begin with)

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33
Q

True or False: A primordial cyst may arise from any tooth in the dentition, even a supernumerary.

A

True

34
Q

Primordial cysts have the microscopic features of ______.

A

OKC (odontogenic keratocyst)

35
Q

Enucleation of a primordial cyst gives it a good prognosis. However, it the histology is that of OKC, why is the recurrence rate higher?

A

friable cyst lining

36
Q

True or False: The odontogenic keratocyst is a common developmental odontogenic cyst.

A

True

37
Q

Odontogenic Keratocysts are benign and ______.

A

aggressive

38
Q

Which syndrome are OKCs associated with?

A

Nevoid Basal Cell Carcinoma Syndrome

39
Q

Unless the patient has Nevoid Basal Cell Carcinoma Syndrome, OKC lesions are uncommon under the age of _____. Which decade shows peak incidence of OKC?

A 
10 years old
3rd decade (20s)
40
Q

True or False: OKC is more common in the maxilla.

A

False, mandible (2:1)

41
Q

True or False: OKC is more common in the anterior region.

A

False, posterior

42
Q

Patients over 70 years old, frequently have OKC lesions in the _____.

A

anterior maxilla

43
Q

True or False: OKC lesions may occur anywhere in the maxilla or mandible.

A

True

44
Q

Order of most common occurrence for OKC:

A

Posterior Mandible 49%
Posterior Maxilla 20%
Anterior Maxilla 13% (due to prevalence in elderly)
Anterior Mandible 9%

45
Q

Up to 80% of OKC presents as a unilocular radiolucency with a ______ border.

A

thin, sclerotic

46
Q

What type of material is usually noted inside the cyst during removal?

A

“cheesy” keratin material

47
Q

What are the 3 histopathologic criteria for OKC?

A
  1. Uniform, thin, SS epithelial lining (8-10 cells thick)
  2. Surface layer of parakeratin
  3. Palisaded basal cell layer
48
Q

The recurrence rate of OKC is increased if the cyst wall contains “______” lesions or “_____” cysts. What is the range of recurrence rates?

A

satellite lesions
daughter cysts

3-62% (average 30% recur)

49
Q

Treatment for small OKC lesions is ______. Treatment for large OKC lesions is _______.

A

small: enucleation
large: marsupialization–> enucleation

50
Q

True or False: If OKC is going to recur, it will do so within a year.

A

False, within 5 years

follow pts for 7 years to prevent recurrence

51
Q

______ : A complex hamartoneoplastic malformation syndrome exhibiting over 100 different signs and symptoms related to the skin, CNS, and skeletal system.

A

Nevoid Basal Cell Carcinoma Syndrome

red flag: multiple OKC at an age less then 10

52
Q

Nevoid Basal Cell Carcinoma Syndrome is also known as ______.

A

Gorlin-Goltz Syndrome

53
Q

Gorlin Syndrome is an AD inherited disease associated with chromosome ___ and showing variable expressivity.

A

9

40% of cases are new mutations related to PTCH gene

54
Q

Patients with Gorlin Syndrome (NBCCS) have what craniofacial attributes?

A

enlarged orbitofrontal circumference >60cm
heavy brow ridges
broad nasal roots
increased space between eyes (hypertelorism)

55
Q

How does Gorlin Syndrome affect the rate of BCC?

A 
Patients have:
multiple BCC
BCC in nonexposed areas
BCC with melanin pigmentation
BCC at an early age
56
Q

What are two common skin ailments associated with Nevoid Basal Cell Carcinoma Syndrom?

A

Milia and Multiple Epidermal Cysts (50%)

1-2mm Shallow pits of palms and soles (65%)

57
Q

What are the musculoskeletal and radiographic findings of Nevoid Basal Cell Carcinoma Syndrome?

A

Lamellar Calcification of the Falx Cerebri (85%)

Bifid/Fused/Hypoplastic Ribs (60%)

58
Q

How often do Gorlin Syndrom patients have OKC of the jaws?

A

75% of patients

59
Q

Gingival cysts of the newborn are microcystic structures that arise from ________.

A

dental lamina rests (rests of Serres)

aka dental lamina cysts

60
Q

“Palatal Cyst of the Newborn” is a term used to describe three gingival cysts in infants. They are:
alveolar ridge =
palatal raphe =
jxn. hard/soft palate =

A

dental lamina cyst
Epstein’s Pearls
Bohn’s Nodules

61
Q

Gingival Cyst of the newborn are ____ mm yellow-white papules, that often occur in multiples on the _______ of the newborn. The papules contain _____debris.

A

1-2 mm
alveolar ridge
keratin

62
Q

True or False: The Gingival Cyst of the Adult arises from the rests of dental lamina just like those of the newborn.

A

True (rests of serres)

63
Q

True or False: Gingival Cysts of the adult are more common in males.

A

False, no sex predilection

64
Q

Gingival cysts of the adult occur in the ____ segments of the jaws and usually appear in patients over the age of ____.

A

anterior

40

65
Q

How does a gingival cyst appear clinically?

A
  • could be above or below MGJ
  • often on facial
  • less than 1 cm
  • tense on palpation
  • smooth surface, dome-shaped elevation
  • no color change until larger (become bluish)
66
Q

Gingival cyst cavities are lined by a thin layer of _____ stratified squamous epithelium.

A

cuboidal

67
Q

Other than gingival cysts, which adult cysts develop from rests of serres?

A

Lateral Periodontal Cysts
Calcifying Odontogenic Cysts

same histology

68
Q

The majority of Lateral Periodontal Cysts occur in the ______ _______ area with a few developing in the _______ _____ region.

A

most: mandibular premolar
some: maxillary lateral incisor

69
Q

The peak incidence for lateral periodontal cysts is in the _____ and ____ decades.

A

5th and 6th

70
Q

True or False: Lateral Periodontal Cysts are unilocular radiolucencies that are less than 1 cm in diameter.

A

True

71
Q

Treatment of lateral periodontal cysts is ____.

A

curettage

72
Q

Calcifying Odontogenic Cysts are also known as ______.

A

Gorlin Cysts

73
Q

True or False: Gorlin Cysts are more common in the mandible.

A

False! Equal distribution

74
Q

What percentage of Gorlin Cysts are found in the incisor/canine region?

A

65%

75
Q

Calcifying Odontogenic Cysts are usually intrabony but 13-21% have been found in the ______.

A

gingival soft tissues (peripheral)

76
Q

How do Calcifying Odontogenic Cysts usually affect adjacent roots?

A

resorption and divergence of the roots

77
Q

____% of COCs are associated with an impacted tooth. _____% of COCs are associated with an odontoma.

A

30%

20%

78
Q

The mean age for Calcifying Odontogenic Cysts is around _____ years.

A

33 years old

79
Q

Calcifying Odontogenic Cysts have lesional cells that undergo a process termed _______ change and peripheral cells that ______.

A

Ghost Cell

palisate (line up)

80
Q

Ghost Cells are pale and _____ with a swollen cytoplasm and lost nucleus.

A

eosinophilic

81
Q

True or False: After enucleation and curretage, recurrence of COCs is not common.

A

True

AU 16- Oral Path MT 3 (7 decks)

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