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Finals SCR > Oral Surgery - Cysts and Tumours > Flashcards

Oral Surgery - Cysts and Tumours Flashcards

1
Q

what is the definition of a cyst

A

pathological cavity filled with fluid or air - that is not filled with the accumulation of pus

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2
Q

what are the broad classifications of odontogenic cysts

A

inflammatory - radicular, paradental, mandibular buccal bifurcation
developmental - dentigerous cyst, OKC, lateral periodontal, gingival, calcifying odontogenic cyst

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3
Q

what are the three types of non-odontogenic cysts

A

nasopalatine duct cyst
staphne’s bone cavity
aneurysmal bone cyst

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4
Q

what are radicular cysts

A

associated with non vital tooth
due to proliferation of epithelial rests of malassez (HERS)

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5
Q

what are residual cysts

A

radicular cysts that remain in the jaws after an extraction of the affected tooth

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6
Q

name histopathological aspects of radicular/ residual cysts

A

regular lining of non-keratinised squamous cell epithelium
deposits of cholesterol
vascular capsule
inflammatory infiltrate
rushton bodies

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7
Q

what is the radiographic appearance of radicular/ residual cyst

A

round or oval
unilocular and well defined
uniform radiolucency

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8
Q

what are paradental cysts

A

associated with PE 3rd molars where the inflammatory stimulus is periocoronitis

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9
Q

what are mandibular buccal bifurcation cysts

A

occur in children and associated with buccal aspect of erupting FPM

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10
Q

what is a dentigerous cyst

A

they embrace the whole crown of an unerupted tooth and attach at CEJ
lined with epithelium derived from reduced enamel epithelium (REE)
associated with impacted mandibular 8s

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11
Q

what is an eruption cyst

A

overlies an erupting tooth
most frequently seen in deciduous incisors of FPMs

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12
Q

what is the histopathology of dentigerous/ eruption cysts

A

thin regular layer of non-keratinising stratified squamous epithelium
capsule resembles dental follicle
myxoid areas
lined with reduced enamel epithelium

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13
Q

how do dentigerous cysts present radiologically

A

round or oval
well defined unilocular
uniform radiolucency
attached to crown of unerupted tooth

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14
Q

what is an OKC

A

arises from cell rests of serres (dental lamina)
has an unusual growth pattern with high risk of recurrence
grows mesio-distally before any bony expansion bucco-lingually

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15
Q

what is the histopathology of OKCs

A

thin connective tissue wall
uninflamed
lined with parakeratinised stratified squamous epithelium
can lead to daughter cells

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16
Q

how do OKCs present radiographically

A

oval
well-defined
uni or multilocular

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17
Q

what syndrome is associated with OKCs

A

basal cell naevus (Gorlin Goltz)
multiple naevoid basal cell carcinomas of the skin

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18
Q

what is orthokeratinised odontogenic cyst

A

uncommon developmental cyst
similar presentation to OKC
unilocular without epithelial proliferations or satellite cells

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19
Q

what is the histopathology of orthokeratinised odontogenic cyst

A

prominent orthokeratinisation
flattened basal cell layer
no association with naevoid basal cell carcinoma syndrome

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20
Q

what is a lateral periodontal cyst

A

associated with lateral surface of root (canine/ premolar region)

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21
Q

what is the histopathology of lateral periodontal cysts

A

thin lining stratified squamous epithelium
similar to gingival cysts

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22
Q

what are gingival cysts

A

appear on attached gingivae as less than 1cm pink/blue swellings
derived from rests of serres (dental lamina) in gingival or alveolar soft tissues

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23
Q

what are gingival cysts that appear on the palate of infants termed

A

epsteins pearls

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24
Q

what are glandular odontogenic cysts

A

mulitlocular
mainly in anterior mandible
high recurrence

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25
Q

what is the histopathology of glandular odontogenic cysts

A

uninflamed fibrous wall lined by glandular cuboidal epithelium

26
Q

what is calcifying odontogenic cysts

A

benign lesion that are about 1-3cm diameter
adjacent teeth displaced
bony expansion occurs

27
Q

what is a nasopalatine duct cyst

A

non-odontogenic
comes from epithelial remnants pf naso-palatine duct
heart shaped on true maxillary occlusal radiograph

28
Q

what is the histopathology of naso-palatine duct cyst

A

stratified squamous epithelium lining
also has respiratory cuboidal lining
neurovascular bundles found in capsule

29
Q

what are three examples of non-epithelial cysts found in the jaws

A

solitary bone cyst
staphne’s cavity
aneurysmal bone cyst

30
Q

what is solitary bone cyst

A

unknown aetiology
varied size and radiolucency with irregular outline
scalloping prominent

31
Q

what is stafne’s idiopathic bone cavity

A

round or oval radiolucency lies below level of IAN

32
Q

how are cysts managed

A

referral
initial consultation
special radiographs - including plain film radiograph, CBCT or CT
biopsy
diagnosis
treatment plan and discussion

33
Q

what are the treatment options for cysts

A

enucleation
marsupialisation
surgical resection

34
Q

what is cyst enucleation

A

removal of entire cyst lining and contents
used for radicular, residual or keratocysts

35
Q

what are potential complications of cyst enucleation

A

damage to IAN
communication with maxillary sinus
pathological fracture of mandible
risk of recurrence

36
Q

what is marsupialisation

A

removing part of the cyst and leaving the top uncovered
useful for large simple cysts, keratocyst or dentigerous cysts

37
Q

what are complications of marsupialisation

A

needs further surgery to remove cyst
long treatment time before completion
chance of infection
uncomfortable

38
Q

what is segmental resection

A

removal of cyst with margin of normal bone
used for ameloblastoma and sarcoma

39
Q

what are the three types of origin of odontogenic tumours

A

epithelial
mesenchyme
mixed

40
Q

what are three examples of epithelial odontogenic tumours

A

ameloblastoma
calcifying epithelial odontogenic
adenomatoid odontogenic tumour

41
Q

what is an ameloblastoma

A

benign but locally destructive
posterior mandible
knife edged external replacement resorption of neighbouring teeth

42
Q

what are the two types of ameloblastoma

A

follicular
plexiform

43
Q

what is follicular ameloblastoma

A

islands present in fibrous tissue
stellate reticulum tissue
no connective tissue capsule

44
Q

what is plexiform ameloblastoma

A

cells arranged in strands rather than islands
stellate reticulum tissue
no connective tissue capsule

45
Q

what is the management of an ameloblastoma

A

surgical resection with margin of 1mm sound bone

46
Q

what is an adenomatoid odontogenic tumour

A

benign
unilocular radiolucency with internal calcifications surround crown of unerupted maxillary canine
attaches APICAL to CEJ (not like dentigerous)

47
Q

what is the histopathology of adenomatoid odontogenic tumour

A

epithelial cells arranged in duct like structures
rosette appearance
patchy calcification and fibrous tissue capsule

48
Q

what is the management for an adenomatoid odontogenic tumour

A

surgical removal

49
Q

what is calcifying epithelial odontogenic tumour

A

benign
radiolucency has internal radiopacities
variable appearance
pleomorphic epithelial cells with dark nuclei
pink staining amyloid

50
Q

what is an example of an odontogenic mesenchymal tumour

A

odontogenic myxoma

51
Q

what is an odontogenic myxoma

A

benign
occurs more in mandible
well- defined radiolucency with thin corticated margin
soap bubble appearance

52
Q

what is the histopathology of odontogenic myxoma

A

loose myxoid tissue with stellate cells
islands of inactive odontogenic epithelium
no capsule - locally invasive

53
Q

what is the management of an odontogenic myxoma

A

curettage or resection due to high recurrence rate

54
Q

what is the only mixed odontogenic tumour

A

odontoma

55
Q

what is an odontoma

A

benign tumour
odontome supernumerary
malformation of dental tissues (enamel = epithelial and dentine = mesenchyme)

56
Q

what are the two types of odontoma

A

compound = ordered structures appear as mini teeth (anterior maxilla)
complex - disordered mass of dental tissues (posterior mandible)

57
Q

what is the aetiology of radicular/ residual/ lateral cysts

A

rests of malassez from HERS

58
Q

what is the aetiology of dentigerous cyst

A

reduced enamel epithelium

59
Q

what is the aetiology of OKC

A

rests of serres

60
Q

what is the aetiology of ameloblastoma

A

rests of serres
rests of malassez
reduced enamel epithelium

Finals SCR (8 decks)

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