Solitary & Interradicular Radiolucencies Flashcards
What are the interradicular and solitary radiolucencies?
- Incisive Canal (Nasopalatine) Cyst
- Median Mandibular Cyst
- Mid Palatine Cyst
- Lateral Periodontal Cyst
- (Traumatic) Solitary Bone Cyst
- Posterior Lingual Mandibular Salivary Gland Depression (Bone Defect), (Stafne Cyst)
- Focal Osteoporotic Bone Marrow Defect
- Residual Cyst
- Fibrous Healing Defect
- Neuroma, Neurofibroma
What are the lines of embryonic fusion and sites of developmental cyst?
naso-labial
naso-palatine duct
median palatal
What is the most common line of embryonic fusion for a cyst to form?
naso-palatine duct
What is the incisive canal cyst/naso-palatine duct cyst?
- Painless swelling
- Sinus tract may be present
- Not an aggressive cyst
- Slow growing
What does the incisive canal cyst/naso-palatine duct cyst look like radiographically?
- Unilocular radiolucency in vicinity of maxillary midline
- Cause alterations to walls of incisive canals
- Root divergence in cases of large cysts
incisive canal cyst/naso-palatine duct cyst
heart-shaped radiolucency
incisive canal cyst/naso-palatine duct cyst
aggressive incisive canal cyst/naso-palatine duct cyst
incisive canal cyst/naso-palatine duct cyst
What age/gender is the incisive canal cyst prevelant?
4th and 6th decades
male: female = 3:1
What site is most common for incisive canal cyst?
anterior maxilla; close to midline
What is the management for an incisive canal cyst?
- Simple enucleation; degree of surgery is dependent on size of lesion
- no treatment if not aggressive and patient wants to leave it
- recurrence unusual
What is a median mandibular cyst?
- asymptomatic
What does a median mandibular cyst look like radiographically?
- Unilocular radiolucency in the symphyseal region
What is a mid-palatine cyst?
- asymptomatic
What does a mid-palatine cyst look like radiographically?
- Unilocular radiolucency
- Palatal midline, posterior to papilla
What age/gender is the mid-palatine cyst prevelant?
- any age
- no gender predilection
What site is the most common for a mid-palatine cyst?
Midpalate posterior to papilla
What is the management for a mid-palatine cyst?
Simple enucleation; degree of surgery is dependent on size of lesion
What is a lateral periodontal cyst?
be very familar with this… easy to tell what it is
Asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva, or alveolar mucosa
What does a lateral periodontal cyst look like radiographically?
- Well defined radiolucency
- Round to ovoid
- Normally in interradicular areas between alveolar crest and apices
- May or may not come in contact with the root surface
lateral periodontal cyst
lateral periodontal cyst
What age/gender is the lateral periodontal cyst prevelant?
- adult
- male
What site is the lateral periodontal cyst most common?
Mandible – Canine–premolar region
What is the management for a lateral periodontal cyst?
- Surgical enucleation
- The cyst does not recur
- Must be differentiated from early stage OKC’s and ameloblastomas
What is a simple bone cyst?
Normally asymptomatic, may have swelling or pain
What are the other names for simple bone cyst?
Unicameral Bone cyst
Solitary Bone Cyst*
Hemorrahgic Bone Cyst*
Intravasational Bone Cyst
Traumatic Bone Cyst*
Extravasational Bone Cyst
* is the most common
What does the simple bone cyst look like radiographically?
- Unilocular radiolucency with interradicular scalloped superior margins
- Usually >10mm and associated with > 1 root apex
- Aggressive lesions can be expansive
simple bone cyst
simple bone cyst
What age/gender is the simple bone cyst prevelant?
- age: second decade (usually <25 years)
- gender: no predilection
What site is a simple bone cyst most common?
Body and ramus of mandible
What is the management for the simple bone cyst?
- Initiate bleeding
- Recurrence is rare
What is a posterior lingual mandibular salivary gland depression (stafne cyst)?
be very familar with this… easy to tell what it is
Asymptomatic, usually found in routine radiographic examinations
What does the posterior lingual mandibular salivary gland depression (stafne cyst) look like radiographically?
Well circumscribed posterior radiolucency in molar region between mandibular canal and inferior border
posterior lingual mandibular salivary gland depression (stafne cyst)
posterior lingual mandibular salivary gland depression (stafne cyst)
What age/gender is the posterior lingual mandibular salivary gland depression prevelant?
- adults; prominent over 50 years
- almost exclusively male predilection
What site is most common to have a posterior lingual mandibular salivary gland depression?
Between the mandibular canal and inferior border
What is the management for a posterior lingual mandibular salivary gland depression?
Positive diagnosis based on clincial and radiologic history negates the need for biopsy and histologic examination
What is a focal osteoporotic bone marrow defect of the jaws?
- Asymptomatic
What does the focal osteoporotic bone marrow defect of the jaws look like radiographically?
- Unilocular, faint radiolucency
- Not ragged but difficult to discern as a separate entity
What age/gender is the focal osteoporotic bone marrow defect of the jaws prevelant?
- all age
- slightly higher in females but no predominant gender
What site is focal osteoporotic bone marrow defect of the jaws most commonly found?
Mandible
What is the treatment for a focal osteoporotic bone marrow defect of the jaws?
No treatment
What is the pathophysiology for a residual/recurrent cyst?
- Results from incomplete removal or residual viable epithelial cystic lining following treatment of a cyst
- Previous history of periapical disease
What is a residual cyst?
- Asymptomatic, normally found on radiographic examinations of edentulous areas
- Tooth or root may or may not be present
What does a residual cyst look like radiographically?
- Well defined radiolucency with smooth, round, corticated borders
- Usually 5mm or less in diameter
- May not be any root present if tooth was previously extracted
What age/gender is the residual cyst prevelant?
- middle age or older
- more common in males
What site is more common to find a residual cyst?
more common in maxilla
What is the management for a residual/recurrent cyst?
- Requires removal of the cyst lining
- Enucleation if a large cyst
- same as a PA cyst
What is the pathophysiology of a fibrous healing defect (apical scar)?
- Develops after inflammation that affects the integrity of the periosteum
- Once disease is eradicated, the bone heals without a mineralized bony matrix
- Due to the loss of the periosteum, only fibrous connective tissue fills the site of the previous disease
What is a fibrous healing defect (apical scar)?
- Asymptomatic
- Noted in areas with a previous history of disease or trauma
What does a fibrous healing defect (apical scar) look like radiographically?
- Well circumscribed radiolucent lesion at site of previous surgery
- “punched out” or “see through” appearance
- May resemble residual cysts in edentulous areas but lack cortication
What is the managment for a fibrous healing defect (apical scar)?
- No treatment indicated
- A previous history of disease is critical in establishing the diagnosis
What is a neuroma/neurofibroma?
- Expansion, pain, or paresthesia
- Symptoms include complaints of burning, tingling, and aching sensations
What does a neuroma/neurofibroma look like radiographically?
- Well circumscribed radiolucency of various shapes
- In the mandible it usually forms in the mandibular canal
What is the management for a neuroma/neurofibroma?
Excision, recurrence is rare
Many other odontogenic and non-odontogenic lesions may manifest as solitary “cyst-like” radiolucencies such as…
Odontogenic
*Amelobastoma
*Central giant cell granuloma
*Ossifying fibroma (early stage)
Non-odontogenic
*Chronic localized Langerhans’ cell disease
*Myeloma
