Cyst

Question 1

What are the clinical signs and symptoms of a cyst?

Answer 1

1. Increase in size of jaw or alveolar bone
2. Salty taste
3. Unable to wear dentures
4. Loose teeth
5. Occlusal changes
6. Delayed eruption
7. Occasional pain and dysaesthesia
8. Bluish swelling on alveolus, fluctuant, egg-shell cracking/ pingpong feeling

Question 1

Radiographic feature of a cyst

Answer 1

Generally well-circumscribed/ovoid radiolucent area with a radiopaque margin

Question 2

List some Developmental Cysts

Answer 2

1. Dentigerous cyst
2. Eruption cyst
3. Odontogenic keratocyst
4. Ortho-keratinised odontogenic cyst

Question 3

List some Inflammatory cyst?

Answer 3

1. Periapical radicular cyst
2. Residual cyst

Question 4

List a gingival cyst

Answer 4

Lateral periodontal cyst

Question 5

List some non-odontogenic cysts

Answer 5

1. Nasopalatine duct cyst
2. Dermoid cyst
3. Simple bone cyst
4. Stafne bone cyst
5. Mucous extravasation
6. Mucous retention cyst

Question 6

Etiology of a Periapical Cyst

Answer 6

Inflammation in the PA area increases keratinocyte growth factor leads to the proliferation of epithelium

Question 7

Periapical cyst is always associated with?

Answer 7

a non-vital tooth

Question 8

What are the components of a cyst?

Answer 8

Thick fibrous CT wall lined by epithelium. Wall sometimes show cholesterol clefts

Protein content of cyst high in cyst fluid

Question 9

Etiology of buccal bifurcation cyst?

Answer 9

Buccal enamel extensions in the bifurcation area, predispose to pocket formation form which inflammation could lead to cystic formation

Question 10

Buccal bifurcation cyst/Paradental cyst are usually seen in what age and teeth?

Answer 10

6-11 years, lower 6s

Question 11

What is a residual cyst?

Answer 11

Inflammatory cyst that has persisted after its associated tooth has been lost.

Growth from a remnant of a periapical cyst

Question 12

Lateral Periodontal Cyst is usually seen in what age and teeth?

Answer 12

50-70 years, mandibular premolar region

Question 13

How do you treat a lateral periodontal cyst?

Answer 13

Careful enucleation

Question 14

Etiology of a Dentigerous Cyst

Answer 14

Separation of follicle from the crown of an unerupted tooth

Most common developmental odontogenic cyst

Question 15

What is an Odontogenic Keratocyst?

Answer 15

Aggressive cyst known for its rapid growth and tendency to invade adjacent tissue

Question 16

What is the age prevalence of Odontogenic Keratocyst?

Answer 16

10-40 years

Question 17

Where does the Odontogenic Keratocyst originate from?

Answer 17

Dental lamina

Question 18

Why is it difficult to enucleate an Odontogenic Keratocyst?

Answer 18

Thin friable lining and daughter cysts

Recurrence rate is 5-62%

Question 19

What are the components of an Odontogenic Keratocyst

Answer 19

1. Stratified squamous epithelium 6-8 layers thick
2. Cyst fluid creamy yellowish or serous-like

Question 20

How does an Odontogenic Keratocyst grow?

Answer 20

Grow in anterior-posterior direction within medulla

Question 21

What is a naso-labial cyst?

Answer 21

Rare developmental soft tissue cyst made of pseudo stratified columnar epithelium

Question 22

Nasolabial cyst can cause?

Answer 22

Nasal obstruction and denture wearing

Question 23

What is a nasopalatine cyst?

Answer 23

Most common non-odontogenic cyst that arise from remnants of nasopalatine duct

Made of cuboidal-columnar epithelium

Question 24

Nasopalatine duct cyst usually presents in which age?

Answer 24

40-60 years old

Question 25

What is a simple bone cyst?

Answer 25

Benign cyst is generally empty or some fluid. No epithelium

Question 26

What are the diagnostic tests done for a cyst?

Answer 26

1. Aspiration of cyst fluid 2. Biopsy of cyst lining

Question 27

How to do biopsy for a cyst?

Answer 27

1. Determine whether lesion is solid or cystic 2. If cyst is near the surface, excise an ellipse of tissue of oral mucosa + cyst lining 3. If cyst in infra-bony, raise flap, remove window of bone take an ellipse of cyst lining 4. If bone is thin, take wedge of bone and cyst lining

Question 28

Treatment of Cyst

Answer 28

1. Surgical enucleation 2. Enucleation with Carnoy's solution 3. Marsupialisation 4. Marsupialisation followed by enucleation 5. Osseous resection 6. Endodontic management of periapical cyst

Question 29

What is surgical enucleation?

Answer 29

Total removal of a cystic lesion

Question 30

What are the grafting materials?

Answer 30

1. Demineralised bone chips 2. Mineralised bone chips 3. Tri calcium phosphate 4. Bovine hydroxyapatite

Question 31

What is the endodontic management for periapical cyst?

Answer 31

Followed up for at least 2 years. If no improvement, lesion must be biopsied

Question 32

What is Carnoy Solution made of?

Answer 32

1. 3ml chloroform 2. 6ml absolute alcohol 3. 1ml glacial acetic acid 4. 1gm ferric chloride

Question 33

What is the use of Carnoy Solution?

Answer 33

Complementary treatment after the conservative excision of OKC. Promotes a superficial chemical necrosis and is intended to reduce recurrence rates.

Question 34

When is marsupialisation indicated?

Answer 34

Large cysts when enucleation will injure adjacent structures

Question 35

Management of Ameloblastoma?

Answer 35

Treatment by enucleation gives a recurrence rate of 30%

Question 36

Difference between cysts and odontogenic tumour

Answer 36

1. Speed of growth 2. Expansion of buccal and lingual cortical plates 3. Erosion through cortical bone 4. Erosion of adjacent teeth 5. Radiographic patterns