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BDS3 Oral Pathology > Odontogenic Cysts - radicular cysts > Flashcards

Odontogenic Cysts - radicular cysts Flashcards

1
Q

What is a cyst?

A

Pathological cavity filled by a fluid or a semi-fluid which has not been created by pus accumulation

They jaws are the most common bones affected by cysts

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2
Q

What bone is the most affected by cysts?

A

Jaws

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3
Q

Cyst vs abscess?

A

Abscess has pus

Cysts has a fluid

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4
Q

Cysts of the jaws types/categories?

A

Epithelial cysts- odontogenic or non odontogenic

Non-epithelialized primary bone cysts

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5
Q

2 types of cysts?

A

Costs of the jaws

Soft tissue cysts

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6
Q

What are odontogenic cysts?

A

Cysts with an epithelial lining that originates from
residues of tooth forming enamel organ.

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7
Q

Origin of odontogenic cysts?

A

Rests of serres - remnants of dental lamina

Rests of malassez - remnants of hertwogs root sheath

Reduced enamel epithelium

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8
Q

2 types of odontogenic cysts?

A

Inflammatory

Developmental

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9
Q

Types of inflammatory odontogenic cysts?

A

Radicular

Paradental - not as common

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10
Q

Types of developmental cysts?

A
  • Dentigerous cyst
  • Eruption cyst
  • Lateral periodontal cyst
  • Gingival cyst
  • Glandular odontogenic cyst
  • Odontogenic keratocyst
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11
Q

What is the most common type of odontogenic cysts of the jaw?

A

Radicular

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12
Q

Types of Radicular cysts?

A

Apical Radicular cysts

Lateral Radicular cysts

Residual cysts

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13
Q

Rarest type of Radicular cysts?

A

Lateral Radicular

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14
Q

Most common type or Radicular cysts?

A

Apical Radicular cysts

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15
Q

What is shown here?

A

Radicular cysts

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16
Q

Differential diagnosis?

A

Periapical granuloma

Periapical abscess

Radicular cysts

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17
Q

What is shown here?

A

Lateral Radicular cysts

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18
Q

Margins of a lateral Radicular cysts?

A

Formation next to lateral root tooth

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19
Q

What is shown here?

A

Residual Radicular cysts

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20
Q

How do residual Radicular cysts differ from Radicular cysts?

A

Involved tooth has been extracted

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21
Q

Pathogens of Radicular cysts?

A

proliferation of rests of malassez within a periapical granuloma - develop into a cysts
- epithelium is not vascularised tissue - cells in centre have no blood supply so die/degeneration of central cells within a proliferating mass of epithelium = cavity lined with epithelium

epithelium start to proliferated due to neutrophils, GF, cytokines etc

Inflammatory stimuli

Bacterial endotoxins

Cytokines

GF

not all periapical granulomas develop into cysts

or degeneration of granulation tissues surrounded y proliferating epithelium
- area of necrosis leading to cysts formation

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22
Q

Radicular cysts arise from what?

A

Proliferation of rests of malassez within a periapical granuloma

23
Q

Describe the lining of Radicular cysts?

A

Non-keratinised stratified squamous epithelial lining

Chronically inflamed fibrous tissue capsule

24
Q

2 types of epithelial cysts?

A

odontogenic and non-odontogenic

25
Q

What is the most common type of odontogenic cysts?

A

inflammatory - radicular

26
Q

2 most common types of cysts?

A

radicular and dentigerous

27
Q

Residual cysts?

A

cysts remains in jaw after tooth extracted

radiolucency

28
Q

How do cysts appear on radiograph?

A

radiolucent lesions due to bone resorption

radiopaque due to margin

29
Q

What type of tooth are radicular cysts associated with?

A

non-vital tooth

30
Q

Why are radicular cysts rare in primary dentition?

A

the tooth is usually extracted before cysts formation

31
Q

Clinical presentation of radicular cysts?

A

apical cysts associated with apices of non-vital teeth

symptomless if small

incidental findings on radiographs

alveolar bone expansion when they enlarge

may discharge through sinus

most cysts do not grow or very large dimensions

pain is rare unless superimposed by infection

32
Q

When do radicular cysts cause alveolar bone expansion?

A

enlargement of cysts

33
Q

How does the cysts cause bone expansion?

A

so much hydrostatic pressure in the cyts s

causes pressur eon the bien and osteoclast ion the bine are activated and causes bone resorption

also, bone make sup form it by firming layers of periosteum

rate of expansion is greater than bony deposition leading to eggshell cracking

34
Q

eggshell crackling?

A

rate of expansion is greater than bony deposition

thinning of cortex

bone bulges into mucosa- appears as blue swelling

35
Q

eggshell crackling also called what?

A

oil can bottling

36
Q

What is the radiopaque margin of the radicular cysts continuous with?

A

lamina dura

37
Q

What is the shape of a radicular cysts?

A

round to ovoid periapical radiolucency

38
Q

Do all periapical granulomas develop into cysts?

A

no

39
Q

Microcyst formation?

A

degeneration of central cells within a proliferating mass of epithelium

40
Q

What is the origin of the epithelium of a cyst?

A

cell rests of malassez

41
Q

epithelium regular or irregular?

A

irregular

as time goes by, it becomes more regular and uniform

42
Q

What type of radicular cysts is this?

A

pocket cysts

43
Q

Pocket cysts?

A

pocket cysts surround he root apex

more prone to heal after endodontic tx

44
Q

What happens to the epithelium over time?

A

thinner stratified squamous epithelium and more regular

inflamed cause surrounding it

45
Q

what happens to a radicular cysts over time?

A

the epithelial lining in established cysts is regular

even thickness

metaplasia gives rise to mucous cells

respiratory epithelium

cholesterol clefts, cant see fat in preparation- breakdown of red blood cells

46
Q

What is this?

A

rushton bodies

hyaline eosinophilic bodies - can sometimes be found in radicular cysts.

with inflammation cells produce them

no clinical significance

47
Q

With time if the inflammation is more contained, what are the features of the radicular cysts?

A

the capsule become more fibrous and less cellular with time - less inflamed

cholesterol clefts within the capsule

giant cells associated with them

48
Q

What is the appearance of the cysts contents?

A

watery straw coloured fluid

semi solid brownish paste like consistency

shimmering appearance due to cholesterol crystals

49
Q

What are the contents of the cysts?

A

breakdown products - epithelial, inflammatory and connective tissue cells

serum proteins
- high level immunoglobulins

water

electrolytes

cholesterol crystals

50
Q

How would you describe the contents of the cysts?

A

hypertonic - highly concentrated

high osmolality of the cysts contents

51
Q

How does hypertonic nature of the cysts affect expansion?

A

leads to expansion of the cysts due to osmosis

fluids move form the lower to higher conc of electrolytes

movement of fluids into the cysts lumen

cysts lining acts as a permeable membrane

52
Q

Does the hydrostatic pressure of the radicular cyst cause bone resorption?

A

yes

water move in, cysts expands like a balloon (even on all sides)

pressure = osteoclast activation and bone resorption

53
Q

is the cysts wall permeable or impermeable?

A

semi permeable

BDS3 Oral Pathology (31 decks)

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