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Oral Path Exam 3 > Odontogenic Cysts > Flashcards

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
Q

Who is affected and what are the clinical signs of an Eruption Cyst

A

Children

- Bluish swelling “eruption hematoma”

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26
Q

What is a rare lesion thought to be derived from a degenerating tooth bud epithelium

A

Primordial Cyst

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27
Q

Where does a Primordial Cyst develop and what is the mandatory criteria

A
  • In place of a tooth before any mineralized material (any tooth in dentition including supernumeraries)
  • Not history of extraction or surgery
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28
Q

Radiographic evidence of a Primordial Cyst

A

Unilocular radiolucenct in area of missing tooth

29
Q

What cyst does a Primordial Cyst share microscopic features with?

A

Odontogenic Keratocyst

30
Q

Treatment and prognosis of Primordial Cyst

A
  • Enuclueate, good but if OKC it has higher recurrence rate
31
Q

Common benign, but aggressive (compared to other odontogenic cysts) developmental odontogenic cysts

A

Odontogenic Keratocyst

32
Q

What syndrome is associated w/ Odontogenic Keratocysts

A

Nevoid basal cell carcinoma syndrome

33
Q

Age Odontogenic Keratocysts are common

A

10+, peak in 3rd decade

34
Q

Most common sites for an Odontogenic Keratocyst and symptoms

A
  • Mandible 2:1 (post. quadrants of ramus)
  • Ant. maxilla if over 70
  • None or can hollow out mandible w/o expansion
35
Q

Are the majority unilocular or multilocular radiolucencies (percent and presentation for both)

A
  • 80% unilocular well demarcated margins w/ a thin sclerotic border
  • 20% multi, expansile radiolocent appearance
36
Q

3 histopathologic criteria to be considered an Odontogenic Keratocyst

A
  • 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
Q

Is the connective tissue wall of an Odontogenic Keratocyst inflamed or uninflamed

A

Uninflamed, if inflamed alters the histology

38
Q

Treatment and prognosis for an Odontogenic Keratocyst (% recurrence)

A
  • Smaller- Enucleate in one piece
  • Larger- Marsupialization and enucleation
  • Guarded, around 30% recur (w/ in 5 year), follow up for at least 7
39
Q

Complex hamartoneoplastic/malformation syndrome w/ 100+ signs or symptoms associated w/ skin, CNS, skeletal systom, and multiple Odontogenic Keratocysts arising at an early age

A

Nevoid Basal Cell Carcinoma Synrdome

40
Q

Nevoid Basal Cell Carcinoma Synrdome is also known as what

A

Gorlin-Goltz syndrome

41
Q

What is the cause of Nevoid Basal Cell Carcinoma Synrdome

A
  • AD chromosome 9, 40% are new mutations related to PTCH gene
  • Complete penetrance w/ variable expressitivity
  • 500+ cases reported to date
42
Q

What are the craniofacial features associated with Nevoid Basal Cell Carcinoma Synrdome

A

Enlarged occipitofrontal circumference (60+ cm)
Heavy brow ridges
Broad nasal root
Mild hypertelorism

43
Q

Skin conditions associated w/ Nevoid Basal Cell Carcinoma Synrdome

A

BCC that are multiple, on exposed and unexposed skin, develop early (puberty-35), pigmented, and usually quiescent (some aggressive)

44
Q

What percent of Nevoid Basal Cell Carcinoma Synrdome patients show milia and show 1-2 m shallow pits of palms/soles

A
  • 50% milia or epidermal cysts

- 65% pitting

45
Q

Musculoskeletal and radiographic findings w/ Nevoid Basal Cell Carcinoma Synrdome (percentages)

A
  • Lamellar calcifications of falx cerebri (85%)

- Bifid or hypoplastic ribs (60%)

46
Q

What percent of Nevoid Basal Cell Carcinoma Synrdome patients have OKCs and when do they present

A
  • 75% between (7-10)

- Single or multiple

47
Q

Treatment and prognosis for Nevoid Basal Cell Carcinoma Synrdome

A
  • Genetic counseling, remove OKCs and BCCS, use sunscreen

- Guarded usually BCCs are small and nonaggressive

48
Q

Cysts that represent an enlarged version of normal microcystic structures that arise from dental lamina rests (rests of Serres)

A

Gingival Cyst of the Newborn

49
Q

All encompassing term for Gingival Cyst of the Newborn (AKA, dental lamina cyst or alveolar cyst of newborn), Epstein Pearls, and Bohn’s nodules

A

Palatal Cyst of the Newborn

50
Q

Presentation and site of Gingival Cyst of the Newborn

A
  • 1-2 mm yellow/white papules

- Alveolar ride of newborn, usually maxillary

51
Q

Cyst w/ thing uniform SSE, and lumen packed w/ keratin debris

A

Gingival Cyst of the Newborn

52
Q

Treatment for Gingival Cyst of the Newborn

A

None, will self marsupialize of involute

53
Q

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

A

Gingival Cyst of the Adult

54
Q

Age and location of Gingival Cyst of the Adult

A
  • Over 40

- Anterior segments of the jaw, above or below MGJ, typically on facial

55
Q

Clinical presentation of Gingival Cyst of the Adult

A
  • Smooth surface, dome shaped elevation affecting the attached gingiva
  • Asymptomatic, <1 cm, tense
  • Bluish color change and minimal radiolucent change for larger
56
Q

Cyst that gingical CT contains cystic cavity lined by thing later or cuboidal or attenuated SSE

A

Gingival Cyst of the Adult

57
Q

Treatment of Prognosis for Gingival Cyst of the Adult

A
  • Conservative excision, excellent
58
Q

Non-keratinized developmental cyst occuring adjacent/lateral to the root of a tooth that arises from the rests of dental lamina

A

Lateral Periodontal Cyst

59
Q

Where and when do Lateral Periodontal Cysts present

A
  • Majority in mandibular PM area, few in max lat incisor

- Peak incidence in 5th-6th decade

60
Q

Presentation of Lateral Periodontal Cyst

A
  • Asymptomatic unilocular radiolucency, less than 1 cm in diameter
61
Q

Cyst w/ epithelial lining of uninflamed fibrous CT, identical to gingival cyst of the adult

A

Lateral Periodontal Cyst

62
Q

Treatment and prognosis for Lateral Periodontal Cyst

A

Curretage, excellent

63
Q

Cyst that arises from rests of dental lamina, also known as Gorlin Cyst

A

Calcifying Odontogenic Cyst

64
Q

Age and distribution/location of Calcifying Odontogenic Cyst

A
  • Equal between mandible and maxilla
  • Any age, average age is 33
  • 65% in incisor/canine region
  • 13-21% reported in gingival soft tissue
65
Q

Radiographic presentation of Calcifying Odontogenic Cyst, (% mulitlocular and w/ scattered radiopacities)

A
  • Expansion of alveolar bone
  • Well defined unilocular radiolucency
  • 10% multi
  • 50% have scattered radiopacities
66
Q

Percent of Calcifying Odontogenic Cysts associated w/ impacted teeth and odontomas

A
  • 30% impacted teeth
  • 20% odontomas
  • Resorption and divergence of root often seen
67
Q

Cyst appearing similar to ameloblastomas microscopically w/ peripheral palisading cells and stellate reticulum like areas?

A

Calcifying Odontogenic Cyst

68
Q

What cysts are ghost cells changes seen and what are ghost cells

A

Calcifying Odontogenic Cyst, Cells that are pale and eosinophilic w/ a swollen cytoplasm, loss of nucleus w/ remnant of nuclear membrane remaining

69
Q

Treatment and prognosis of Calcifying Odontogenic Cyst

A
  • Enucleation and curretage

- Recurrence is uncommon

Oral Path Exam 3 (4 decks)

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