OMS Cysts Flashcards
What is the most common type of odontogenic
cyst, and does it affect vital or nonvital teeth?
Periapical (radicular) cyst, which affects only nonvital teeth
It is primarily the manifestation of a small chronic dental
abscess.
How does a lateral periodontal cyst differ from a periapical cyst?
Lateral periodontal cysts are developmental, arising from the epithelial rests of Serres or Malassez, and are most commonly found lateral to premolars and canines. Peri-
apical cysts are found associated with any tooth and are found apically in the setting of chronic infection.
What is the preferred management for the most common type of odontogenic inflammatory cyst?
● The most common type of odontogenic inflammatory
cyst is a radicular or periapical cyst.
● Management may include extraction of the infected tooth
and enucleation of the cyst. In many cases, root canal
treatment may be indicated over extraction, depending on symptoms, chronicity, and prognosis of the tooth.
What odontogenic cyst develops in the place of absent teeth?
● Primordial cysts, which are the rarest of all odontogenic
cysts
● History is important in this instance to ensure that the
tooth has not simply been removed at an earlier date,
which would indicate a residual cyst or dentigerous cyst.
Are dentigerous cysts associated with erupted or
unerupted teeth, and where are they most likely to
be found?
Unerupted or impacted teeth, found with mandibular third
molars, maxillary third molars, and maxillary canines (in
decreasing order of frequency)
How common are dentigerous cysts, and what association do they have with odontogenic carcinoma?
Dentigerous cysts are the second most common odonto-
genic cysts.
Up to 25% of odontogenic malignancies are thought to
have transformed from an associated dentigerous cyst.
How can botryoid odontogenic cysts be distinguished from lateral periodontal cysts?
Both cysts manifest preferentially in the same alveolar
process locations (namely, the lateral surface of teeth,
usually the mandibular premolar or canines). However, the
botryoid cyst is multilocular, as its name indicates, and this is reflected histologically and radiographically. Botryoid cysts have a higher incidence of recurrence.
What are the components of Gorlin syndrome
(Gorlin-Goltz or basal cell nevus syndrome)?
Diagnosis requires two major criteria or one major and two
minor criteria. Major criteria: (1) excessive basal cells or basil
cell carcinoma earlier than age 20; (2) odontogenic
keratocyst when younger than 20; (3) palmar or plantar
pitting; (4) lamellar calcification of the falx cerebri; (5)
medulloblastoma, typically desmoplastic; (6) first-degree
relative with basal cell nevus syndrome.
Minor components: (1) rib anomalies (e.g., bifid rib); (2) skeletal malformations and radiologic changes (i.e., vertebral anomalies, kyphoscoliosis, short fourth metacarpals,
postaxial polydactyly); (3) macrocephaly; (4) cleft lip/palate;
(5) ovarian/cardiac fibroma; (6) lymphomesenteric cysts; (7) ocular abnormalities (i.e., strabismus, hypertelorism,
congenital cataracts, glaucoma, coloboma)
Describe the manifestation of odontogenic
keratocysts.
Odontogenic keratocysts occur in any jaw location,
although they are most commonly noted in the posterior
mandibular body and in the ramus. They are frequently
noted in association with the crown of an unerupted tooth
or near the tooth root. Recurrence is common (between 5
and 60%).
What are the histologic features of a “ghost cell,” and with what odontogenic cyst is this most commonly associated?
Ghost cells are large, eosinophilic epithelial cells that lack a
nucleus and are most commonly associated with calcifying
odontogenic (or Gorlin) cysts. These ghost cells may later
become calcified and may cause a foreign-body reaction
that gives rise to the cyst. Ghost cells are also occasionally
seen in odontomas, ameloblastic fibro-odontomas, and
ameloblastomas.
What is the preferred management for extraosseous calcifying odontogenic cysts (Gorlin cyst)?
Simple lesion removal. These cysts account for up to 25% of all Gorlin cysts and are often seen within the gingiva in
patients in their sixth decade of life or later, and they are often seen in association with other odontogenic tumors.
What is the preferred management for calcifying odontogenic cysts (Gorlin cysts)?
If the cyst is unilocular, enucleation is preferred. Multi-
locular lesions often require bony curettage.
Describe the clinical features of glandular odontogenic cysts.
Rare and recently described, glandular odontogenic cysts
(sialo-odontogenic cysts) may clinically resemble a low-
grade central mucoepidermoid carcinoma. They appear anywhere in the jaw but favor the anterior regions. They may be multilocular with epithelial lining including eosino-
philic columnar or cuboidal cells.
What is the preferred management for an infant with an eruption cyst?
Expectant management; no intervention is necessary.
What distinguishes a cyst from a pseudocyst?
Odontogenic cysts comprise an epithelial-lined pathologic
cavity, usually fluid or semisolid filled. Pseudocysts lack
epithelial lining.
