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Oral Medicine - My deck > Odontogenic Cysts > Flashcards

Odontogenic Cysts Flashcards

1
Q

What is the definition of an odontogenic cyst? What do they arise from?

A

Pathologic cavity lined by odontogenic epithelium and filled with fluid of semisolid material

Arise from the rests of the dental lamina (Serres and Malassez)

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2
Q

What are the top 4 odontogenic cysts?

A

Dentigerous cyst
Odontogenic Keratocyst
Orthokeratinized Odontogenic Cyst
Calcifying Odontogenic Cyst

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3
Q

What are the top odontogenic tumors based of epithelial and mixed origin?

A

Epithelial origin = Adenomatoid Odontogenic Tumor, Calcifying Epithelial Odontogenic Tumor

Mixed origin= Ameloblastic Fibroma, Ameloblastic Fibro-odontoma, Odontoma

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4
Q

What is the most common development cyst? What does it originate from?

A

Dentigerous cyst

Originates by separation of the follicle from around the crown of an unerupted tooth

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5
Q

Where are dentigerous cysts attached at on the unerupted tooth?

A

The CEJ

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6
Q

What teeth are most commonly involved in a dentigerous cyst?

A

The mandibular 3rd molars

Followed by Maxillary 3rds, then Maxillary canines

Almost never occur in deciduous teeth

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7
Q

What term describes a cyst filled with keratin (cottage cheese like) debris?

A

Odontogenic keratocyst

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8
Q

What are the 2 most important things to remember about odontogenic keratocysts?

A

30% recurrence rate and Associated with Gorlin’s syndrome

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9
Q

What is another name for Gorlin’s syndrome? What is Gorlin’s syndrome? What is it caused by?

A

Nevoid basal cell carcinoma syndrome

Characterized by multiple Basal cell carcinomas, OKCs, calcification of the falx cerebri, rib anomalies

Caused by abnormality in PTCH gener on Chromosome 9

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10
Q

Why do so many Odontogenic Keratocysts recur?

A

OKCs have thin, friable walls so complete removal is often difficult

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11
Q

What are the histopathologic features of odontogenic keratocysts?

A

Thin, friable wall
Wavy, parakeratinized epithelial lining that is a uniform 6-8 layers thick
Palisading, hyperchromatic basal cell layer (like a picket fence)
Daughter cysts

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12
Q

What do odontogenic keratocysts radiographically appear as?

A

Radiolucent lesions with corticated rims

Large lesions can be multilocular

1/3 are associated with an unerupted tooth

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13
Q

What makes orthokeratnized odontogenic cysts different than odontogenic keratocysts?

A

Orthokeratinized odontogenic cysts have an orthokeratinized lining and no basal palisading

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14
Q

Why is the term traumatic bone cyst a misnomer?

A

Because the lesion does not have an epithelial lining

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15
Q

What is the current theory of the etiology of traumatic bone cysts?

A

Trauma-hemorrhage theory = trauma to the bone which causes a hematoma, but hte hematoma does not undergo organization and repair, resulting in a defect

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16
Q

In what age population are traumatic bone cysts in the jaw most commonly found? Where are they found?

A

In patients between 10-20, and they exclusively occur in the mandible

There may be swelling, but usually asymptomatic

17
Q

What term describes a unilocular, well defined RL with RO structures usually found in the incisor canine area? What age are most patients with this lesion?

A

Calcifying odontogenic cyst

35

18
Q

What is another name for calcifying odontogenic cyst?

A

Gorlin cyst

19
Q

What term describes a unilocular, well defined RL lesion in the anterior maxilla with snowflake calcifications? What age are most patients with this lesion?

A

Adenomatoid odontogenic tumor

Between ages 10-20, and more often female

Asymptomatic, around a tooth that has not erupted

20
Q

What term describes a unilocular/multilocular, with well defined scalloped margins and calcifications in a driven snow pattern? What are the histopathologic features of this lesion?

A

Calcifying Epithelial Odonotgenic Tumor

Nuclear pleomorphism and atypia
Amyloid like ECM - stains congo red, and has an apple green birefringence when viewed under polarized light
Calcifications form concentric rings in amyloid like areas (liesegang rings)

21
Q

What is another name for calcifying epithelial odontogenic tumor?

A

Pindborg tumor

22
Q

What is the most common odontogenic tumor? Is it a true neoplasm?

A

Odontoma

Not a true neoplasm, considered a hamartoma

23
Q

What are the two types of odontomas and what are the differences between these types?

A

Compound and Complex

Compound = composed of multiple, small tooth like structures

Complex = conglomerate mass of enamel and dentin

24
Q

What is the average age of patients with odontomas? What are they associated with? What type is more common?

A

15

Unerupted tooth

Compound more common in anterior, complex more common in molar regions

25
Q

What term describes a true mixed tumor with islands of dental papilla like tissue and ameloblasts? What is the average age of patients with this lesion and where do they occur?

A

Ameloblastic fibroma

Occur in younger patients, before age 20

Located in the posterior mandible

26
Q

What term describes a lesion that is a true mixed tumor and has enamel and dentin? What is the average age of patients with this lesion and where do they occur?

A

Ameloblastic Fibro-Odontoma

Average age is 10

Occurs in the posterior jaws

27
Q

What is the most common clinically significant odontogenic tumor? (not on ppt)

A

Ameloblastoma

28
Q

What are the 3 different types of ameloblastomas?

not on ppt

A

Convention solid/multicystic
Unicystic
Peripheral

29
Q

What is the clinical presentation of ameloblastomas?

not on ppt

A

Painless swelling posterior mandible (except desmoplastic which is anterior maxilla)

30
Q

What is the radiographic presentation of ameloblastomas?

not on ppt

A

Mulitlocular RL that is either soap bubble or honeycombed in appearance

Buccal and lingual cortical expansion is frequently present

31
Q

What are the histopathologic features of ameloblastomas?

not on ppt

A

Palisading, hyperchromatic basal layer
Reverse polarity
Apical vacuolization

32
Q

What is the difference between malignant ameloblastoma and metastatic ameloblastoma?
(not on ppt)

A

Malignant is cancer, metastatic is benign but is somewhere it shouldn’t be – once the patient gets the matastatic removed they will be fine and have no worries

Oral Medicine - My deck (7 decks)

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