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AU'18 Oral Path II > Odontogenic Cysts - part I > Flashcards

Odontogenic Cysts - part I Flashcards

1
Q

inflammatory cysts

A
  1. periapical (radicular) cyst
  2. residual periapical (radicular) cyst
  3. buccal bifurcation cyst
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2
Q

developmental cyst

A
  1. dentigerous cyst
  2. eruption cyst
  3. primordial cyst
  4. odontogenic keratocyst (OKC)
  5. gingival (alveolar) cyst of the newborn
  6. gingival cyst of the adult
  7. lateral periodontal cyst
  8. calcifying odontogenic cyst (COD)
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3
Q

what is the most common cyst of the jaws?

A

periapical cyst

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4
Q

what is periapical cyst also known as?

A
  1. radicular cyst

2. apical periodontal cyst

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5
Q

what causes periapical cyst?

A

inflammatory stimulation of epithelial rests of Malassez

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6
Q

epithelial rests of Malassez

A
  1. PDL

2. clusters of residual cells of Hertwig’s epithelial root sheath

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7
Q

T/F: periapical cyst is asymptomatic

A

true

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8
Q

what is a a periapical cyst associated with?

A

non-vital tooth - pulp test!

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9
Q

what happens if periapical cyst is secondarily infected or if large?

A

may get swelling, pain

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10
Q

radiographic features of periapical cyst

A
  1. round to ovoid radiolucency at apex
  2. loss of lamina dura
  3. may develop on lateral aspect of root
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11
Q

why might a periapical cyst develop on the lateral aspect of the root?

A

due to presence of lateral canal in the area “lateral radicular cyst”

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12
Q

histopathologic features of periapical cyst

A
  1. inflamed granulation tissue or fibrous CT lined by non-keratinized stratified squamous epithelium
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13
Q

if no cyst lining is seen histopathologically in a periapical cyst, what is it called?

A

periapical granuloma

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14
Q

tx of periapical cyst

A
  1. endo
  2. apicoectomy
  3. extraction w curettage
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15
Q

what should be done to confirm healing from periapical cyst?

A

radiographic follow-up

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16
Q

prognosis of periapical cyst

A

excellent

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17
Q

what may happen if the periapical cyst is not completely removed?

A

may persist as a residual cyst

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18
Q

what does residual cyst often represent?

A

periapical cyst which had not been removed with the extraction or resolved with endo

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19
Q

what is seen in the site of a residual cyst due to previous extraction or endo treated tooth?

A

well-defined radiolucency

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20
Q

tx of residual cyst

A

enucleation

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21
Q

prognosis of residual cyst

A

excellent

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22
Q

who is normally affected by buccal bifurcation cyst?

A

children

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23
Q

which tooth is typically involved with a buccal bifurcation cyst?

A

mandibular molars

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24
Q

clinical features of buccal bifurcation cyst

A
  1. localized swelling buccal aspect of alveolar process
  2. ± pain
  3. possible foul taste
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25
Q

T/F: buccal bifurcation cyst may be hard to detect radiographically

A

true

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26
Q

radiographic features of buccal bifurcation cyst

A
  1. may have well-defined radiolucency in the furcation, superimposed over the roots
  2. apices typically tipped to lingual cortex
  3. may see proliferative periostitis
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27
Q

proliferative periostitis

A

single or multiple subperiosteal layers of bone formation

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28
Q

histopathologic features of buccal bifurcation cyst

A

inflamed granulation tissue or fibrous CT lined by non-keratinzed stratified squamous epithelium (like periapical cyst)

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29
Q

tx of buccal bifurcation cyst

A
  1. enucleation

2. may heal spontaneously

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30
Q

T/F: tooth involved in buccal bifurcation cyst needs to be extracted

A

false, tooth does not require extraction

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31
Q

prognosis of buccal bifurcation cyst

A

good

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32
Q

how long does it take for bone to fill in and have normal perio probe depths after tx’ing buccal bifurcation cyst?

A

~1 year

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33
Q

what may need to be done after tx’ing buccal bifurcation cyst?

A

recontouring of furcation or periodontal surgery

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34
Q

T/F: involved tooth with buccal bifurcation cyst may be lost due to bone destruction

A

true

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35
Q

what is the most common DEVELOPMENTAL odontogenic cyst?

A

dentigerous cyst

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36
Q

what is the 2nd most common cyst overall?

A

dentigerous cyst

37
Q

what is the most common cyst overall?

A

periapical cyst

38
Q

how does a dentigerous cyst develop?

A

due to accumulation of fluid between the crown and the reduced enamel epithelium, which eventually forms the epithelial lining of cyst

39
Q

T/F: dentigerous cyst is usually asymptomatic

A

true

40
Q

clinical features of dentigerous cyst

A
  1. may have swelling

2. can cause root resorption adjacent tooth

41
Q

radiographic features of dentigerous cyst is associated with what?

A

with the crown of an unerupted tooth

42
Q

radiolucency GREATER than 5 mm is probably what?

A

a cyst

43
Q

radiolucency SMALLER than 5 mm is probably what?

A

hyperplastic dental follice

44
Q

T/F: a cyst and hyperplastic dental follice are histologically indistinguishable

A

true

45
Q

radiographic features of dentigerous cyst

A
  1. unilocular
  2. attaches to cervical area of tooth
  3. well-defined, often corticated border
46
Q

what will the dentigerous cyst appear radiographically if it is infected?

A

borders may appear ill-defined

47
Q

T/F: any unerupted tooth may have a dentigerous cyst?

A

true

48
Q

what is the most common unerupted tooth that may have a dentigerous cyst?

A

mandibular 3rd molar

49
Q

list the order of the most to least common unerupted tooth that may have a dentigerous cyst

A

mandibular 3rd molar > max canine > max 3rd molar

50
Q

histopathologic features of dentigerous cyst

A
  1. uninflamed fibrous CT wall lined by thin, non-keratinized stratified squamous epithelium
  2. may see scattered mucous cells in lining
51
Q

tx of dentigerous cyst

A

removal of tooth and cyst

52
Q

prognosis of dentigerous cyst

A

excellent

53
Q

microscopic exam of dentigerous cyst is needed to rule out what?

A

other cyst or tumor

54
Q

the mucous cells in the lining of dentigerous cyst histopathologically may explain what?

A

central (intraossesous) mucoepidermoid carcinoma

55
Q

who is affected by eruption cyst?

A

children

56
Q

eruption cyst

A

dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth

57
Q

clinical features of eruption cyst

A

bluish swelling, “eruption hematoma”

58
Q

T/F: primordial cyst is common

A

false, rare

59
Q

where is primordial cyst thought to be histogenetically derived from?

A

degenerating tooth bud epithelium

60
Q

primordial cyst develops in place of what?

A

a tooth, before any mineralized material is deposited

61
Q

which tooth can be affected by primordial cyst?

A

any tooth, including supernumerary teeth

62
Q

what is mandatory for diagnosis of primordial cyst?

A

no hx of extraction or surgery in area

63
Q

radiographic features of primordial cyst

A

unilocular radiolucencu in area of missing tooth

64
Q

the majority of primordial cysts have the microscopic features of what?

A

odontogenic keratocyst (OKC)

65
Q

histopathologic features of primordial cyst

A
  1. corrugated surface
  2. cyst lined by parakeratotic stratified squamous epithelium
  3. hyperchromatic and palisaded basal cells
66
Q

tx of primordial cyst

A

enucleation

67
Q

prognosis of primordial cyst

A

good

68
Q

what can OKC be associated with?

A

nevoid basal cell carcinoma syndrome (NBCCS)

69
Q

what might OKC mimic?

A
  1. primordial cyst
  2. dentigerous cyst
  3. residual cyst
  4. lateral periodontal cyst
70
Q

T/F: OKC is uncommon

A

false, common

71
Q

T/F: OKC is benign but more aggressive compared to other odontogenic cysts

A

true

72
Q

T/F: OKC is symptomatic

A

false, asymptomatic

73
Q

where does OKC favor after 70 y.o.?

A

anterior maxilla

74
Q

T/F: there are no OKC cases under 10 y.o. unless pt has syndrome

A

true

75
Q

T/F: OKC has a maxilla 2:1

A

false, mandible 2:1

76
Q

what is noted at time of surgery for OKC?

A

“cheesy” material

77
Q

areas in the jaw most affected by OKC

A
  1. posterior mand (49%)
  2. posterior max (20%)
  3. anterior max (13%)
  4. anterior mand (9%)
  5. mand PM region (7%)
  6. max PM region (2%)
78
Q

radiographic features of OKC

A

majority (80%) unilocular radiolucencies with well-demarcated margins and a thin sclerotic borde

79
Q

T/F: OKC can hollow-out mandible without expansion

A

true

80
Q

T/F: OKC can be expansile and symptomatic

A

true

81
Q

a small percent of OKC cases exhibit what radiographically?

A

multilocular appearance

82
Q

OKC resembles dentigerous cyst radiographically except what?

A

the lucency for OKC is apical to the CEJ

83
Q

3 histopathologic criteria for OKC

A
  1. uniformly thin epithelial lining of stratified squamous epithelium 8-10 cells thick
  2. corrugated parakeratin surface
  3. palisaded basal cell layer
84
Q

T/F: OKC histopathologically has CT wall that is not inflammed

A

true

85
Q

tx for OKC depends on what?

A

size of lesion

86
Q

tx for smaller OKC

A

enucleate in one piece

87
Q

tx for larger OKC

A

marsupialization followed by enucleation

88
Q

prognosis of OKC

A

guarded

AU'18 Oral Path II (31 decks)

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