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Odontogenic Cysts Flashcards

1
Q

What is the most common cyst of the jaw

A

Periapical cyst

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2
Q

Cyst that originates due to inf stimulation of epithelial rests of Mellassez

A

Periapical cyst

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3
Q

2 other names for Periapical cyst

A

Radicular or apical periodontal Periapical cyst

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4
Q

What are the radiographic signs and vitality tests associated with a Periapical cyst

A
  • Ovoid radioluceny at apex
  • Loss of lamina dura
  • Asymptomatic, tests non vital
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5
Q

Where and how does a lateral radicular cyst form

A
  • Lateral aspect of root from presence of a lateral canal
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6
Q

What cyst shows inflamed granulation or fibrous CT lined by Non-keratinized SSE

A

Periapical cyst

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7
Q

What is a Periapical cyst called if there is no lingin

A

Periapical granuloma

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8
Q

Treatment and Prognosis for Periapical cyst

A
  • RCT, apicoectomy, or extraction w/ curretage

- Excellent but may persist as a residual cyst

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9
Q

What are signs and treatment of a Residual Cyst

A
  • Periapical cyst that hasn’t been removed w/ extraction
  • Well defined radiolucency at extraction site
  • Enucleation and excellent prognosis
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10
Q

Cyst that forms due to proliferation of crevicular epithlium associated w/ enamel extension in furcation area, seen in children

A

Buccal Bifurcation Cyst

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11
Q

What location and clinical symptoms are there associated w/ a Buccal Bifurcation Cyst

A
  • Mandibular molars of children

- Localized swelling of buccal aspect of alveolar process, +/- pain or foul taste

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12
Q

Another term for Buccal Bifurcation Cyst

A

Paradental cyst

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13
Q

Radiographic signs of a Buccal Bifurcation Cyst

A
  • Difficult to detect
  • Possibly well defined radiolucency in furcation ara, root apices tipped toward lingual cortex (occlusal film), proliferative periostitis
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14
Q

What cyst does the Buccal Bifurcation Cyst look like microscopically

A

Periapical

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15
Q

Treatment and prognosis for Buccal Bifurcation Cyst

A
  • Good

- May need to recountour furcation or perio surgery, involved tooth may be lost due to bone destruction

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16
Q

What is the most common developmental cyst and 2nd most common cyst overall?

A

Dentigerous cyst

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17
Q

Cyst that develops due to accumulation of fluid between the crown and reduced enamel epithelium and is associated w/ the crown of an unerupted tooth

A

Dentigerous cyst

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18
Q

That eventually forms the lining of a Dentigerous cyst

A

Reduced enamel epithelium

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19
Q

What is the size differentiation for a Dentigerous cyst and what is it called of smaller

A
  • 5 mm

- Hyperplastic dental follicle

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20
Q

What sites can develop a Dentigerous cyst and which 3 are most common

A
  • Any impacted tooth
    1) Mand 3rd molar
    2) Max canine
    3) Max 3rd
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21
Q

When do most Dentigerous cyst present and what symptoms are involved?

A
  • 2nd and 3rd decades

- Usually asymptomatic, but possible swelling or resorption of adjacent tooth roots

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22
Q

What cyst shows an uninflamed fibrous CT wall lined by a thing layer of NK SSE, w. scattered mucous cells

A

Dentigerous cyst

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23
Q

Treatment and prognosis for Dentigerous cyst

A
  • Remove tooth and enucleate cyst

- Excellent, examine microscopically to roll out OKC and cancers

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24
Q

A Dentigerous cyst that forms in the soft tissue of an overlying crown of an erupting tooth?

A

Eruption Cyst

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25
Who is affected and what are the clinical signs of an Eruption Cyst
Children | - Bluish swelling "eruption hematoma"
26
What is a rare lesion thought to be derived from a degenerating tooth bud epithelium
Primordial Cyst
27
Where does a Primordial Cyst develop and what is the mandatory criteria
- In place of a tooth before any mineralized material (any tooth in dentition including supernumeraries) - Not history of extraction or surgery
28
Radiographic evidence of a Primordial Cyst
Unilocular radiolucenct in area of missing tooth
29
What cyst does a Primordial Cyst share microscopic features with?
Odontogenic Keratocyst
30
Treatment and prognosis of Primordial Cyst
- Enuclueate, good but if OKC it has higher recurrence rate
31
Common benign, but aggressive (compared to other odontogenic cysts) developmental odontogenic cysts
Odontogenic Keratocyst
32
What syndrome is associated w/ Odontogenic Keratocysts
Nevoid basal cell carcinoma syndrome
33
Age Odontogenic Keratocysts are common
10+, peak in 3rd decade
34
Most common sites for an Odontogenic Keratocyst and symptoms
- Mandible 2:1 (post. quadrants of ramus) - Ant. maxilla if over 70 - None or can hollow out mandible w/o expansion
35
Are the majority unilocular or multilocular radiolucencies (percent and presentation for both)
- 80% unilocular well demarcated margins w/ a thin sclerotic border - 20% multi, expansile radiolocent appearance
36
3 histopathologic criteria to be considered an Odontogenic Keratocyst
- Cheesy material noted at surgery 1) Uniformly thing epithelial lining, SSE (8-10 cells thick) 2) Currugated surface layer of parakeratin 3) Palisaded basal layer
37
Is the connective tissue wall of an Odontogenic Keratocyst inflamed or uninflamed
Uninflamed, if inflamed alters the histology
38
Treatment and prognosis for an Odontogenic Keratocyst (% recurrence)
- Smaller- Enucleate in one piece - Larger- Marsupialization and enucleation - Guarded, around 30% recur (w/ in 5 year), follow up for at least 7
39
Complex hamartoneoplastic/malformation syndrome w/ 100+ signs or symptoms associated w/ skin, CNS, skeletal systom, and multiple Odontogenic Keratocysts arising at an early age
Nevoid Basal Cell Carcinoma Synrdome
40
Nevoid Basal Cell Carcinoma Synrdome is also known as what
Gorlin-Goltz syndrome
41
What is the cause of Nevoid Basal Cell Carcinoma Synrdome
- AD chromosome 9, 40% are new mutations related to PTCH gene - Complete penetrance w/ variable expressitivity - 500+ cases reported to date
42
What are the craniofacial features associated with Nevoid Basal Cell Carcinoma Synrdome
Enlarged occipitofrontal circumference (60+ cm) Heavy brow ridges Broad nasal root Mild hypertelorism
43
Skin conditions associated w/ Nevoid Basal Cell Carcinoma Synrdome
BCC that are multiple, on exposed and unexposed skin, develop early (puberty-35), pigmented, and usually quiescent (some aggressive)
44
What percent of Nevoid Basal Cell Carcinoma Synrdome patients show milia and show 1-2 m shallow pits of palms/soles
- 50% milia or epidermal cysts | - 65% pitting
45
Musculoskeletal and radiographic findings w/ Nevoid Basal Cell Carcinoma Synrdome (percentages)
- Lamellar calcifications of falx cerebri (85%) | - Bifid or hypoplastic ribs (60%)
46
What percent of Nevoid Basal Cell Carcinoma Synrdome patients have OKCs and when do they present
- 75% between (7-10) | - Single or multiple
47
Treatment and prognosis for Nevoid Basal Cell Carcinoma Synrdome
- Genetic counseling, remove OKCs and BCCS, use sunscreen | - Guarded usually BCCs are small and nonaggressive
48
Cysts that represent an enlarged version of normal microcystic structures that arise from dental lamina rests (rests of Serres)
Gingival Cyst of the Newborn
49
All encompassing term for Gingival Cyst of the Newborn (AKA, dental lamina cyst or alveolar cyst of newborn), Epstein Pearls, and Bohn's nodules
Palatal Cyst of the Newborn
50
Presentation and site of Gingival Cyst of the Newborn
- 1-2 mm yellow/white papules | - Alveolar ride of newborn, usually maxillary
51
Cyst w/ thing uniform SSE, and lumen packed w/ keratin debris
Gingival Cyst of the Newborn
52
Treatment for Gingival Cyst of the Newborn
None, will self marsupialize of involute
53
Cyst related to lateral periodontal cyst that arises from the rests of the dental lamina and found in the gingival CT, cystic degeneration of rests give rise to the cyst
Gingival Cyst of the Adult
54
Age and location of Gingival Cyst of the Adult
- Over 40 | - Anterior segments of the jaw, above or below MGJ, typically on facial
55
Clinical presentation of Gingival Cyst of the Adult
- Smooth surface, dome shaped elevation affecting the attached gingiva - Asymptomatic, <1 cm, tense - Bluish color change and minimal radiolucent change for larger
56
Cyst that gingical CT contains cystic cavity lined by thing later or cuboidal or attenuated SSE
Gingival Cyst of the Adult
57
Treatment of Prognosis for Gingival Cyst of the Adult
- Conservative excision, excellent
58
Non-keratinized developmental cyst occuring adjacent/lateral to the root of a tooth that arises from the rests of dental lamina
Lateral Periodontal Cyst
59
Where and when do Lateral Periodontal Cysts present
- Majority in mandibular PM area, few in max lat incisor | - Peak incidence in 5th-6th decade
60
Presentation of Lateral Periodontal Cyst
- Asymptomatic unilocular radiolucency, less than 1 cm in diameter
61
Cyst w/ epithelial lining of uninflamed fibrous CT, identical to gingival cyst of the adult
Lateral Periodontal Cyst
62
Treatment and prognosis for Lateral Periodontal Cyst
Curretage, excellent
63
Cyst that arises from rests of dental lamina, also known as Gorlin Cyst
Calcifying Odontogenic Cyst
64
Age and distribution/location of Calcifying Odontogenic Cyst
- Equal between mandible and maxilla - Any age, average age is 33 - 65% in incisor/canine region - 13-21% reported in gingival soft tissue
65
Radiographic presentation of Calcifying Odontogenic Cyst, (% mulitlocular and w/ scattered radiopacities)
- Expansion of alveolar bone - Well defined unilocular radiolucency - 10% multi - 50% have scattered radiopacities
66
Percent of Calcifying Odontogenic Cysts associated w/ impacted teeth and odontomas
- 30% impacted teeth - 20% odontomas - Resorption and divergence of root often seen
67
Cyst appearing similar to ameloblastomas microscopically w/ peripheral palisading cells and stellate reticulum like areas?
Calcifying Odontogenic Cyst
68
What cysts are ghost cells changes seen and what are ghost cells
Calcifying Odontogenic Cyst, Cells that are pale and eosinophilic w/ a swollen cytoplasm, loss of nucleus w/ remnant of nuclear membrane remaining
69
Treatment and prognosis of Calcifying Odontogenic Cyst
- Enucleation and curretage | - Recurrence is uncommon

Oral Path Exam 3 (4 decks)

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