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4 - oral surgery > cyst - basics > Flashcards

cyst - basics Flashcards

1
Q

What is a cyst?

A

A pathological cavity containing, fluid, semi-fluid or gaseous contents which has not been created by accumulation of pus

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2
Q

What are the different epithelial cysts?

A

Odontogenic - inflammatory and developmental
Non-odontogenic

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3
Q

What are the different inflammatory odontogenic cysts?

A

Radicular cyst - and residual cyst
Inflammatory collateral cysts:
- paradental cyst
- mandibular buccal bifurcation cyst

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4
Q

What are the different odontogenic developmental cysts?

A

Dentigerous cyst - and eruption cyst
OKC
Lateral periodontal cyst
Gingival cysts

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5
Q

What are the different non-odontogenic epithelial cysts?

A

Nasolabial cyst
Nasopalatine cyst

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6
Q

what are the different non-epithelial cysts?

A

Solitary bone cyst
Aneurysmal bone cyst
Stafne’s bone cavity

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7
Q

How do radicular cysts present clinically?

A

4-5th decade (IC)
60% maxilla, frequent lateral incisors
Non-vital teeth
Often asymptomatic
Can produce alveolar bone expansion

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8
Q

How do radicular cysts present radiographically?

A

Round or ovoid radiolucency at apex
Unilocular
Well defined
Uniform radiolucency

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9
Q

How to radicular cysts present histopathologically?

A

Regular lining of non-keratinised squamous epithelium
Deposits of cholesterol
Vascular capsule

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10
Q

What is the content of radicular cysts?

A

Varies from watery, straw coloured fluid to semi-solid brownish material

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11
Q

What are paradental cysts?

A

60% of inflammatory collateral cysts
Associated with PE M3M, inflamed through pericoronitis
Well defined radiolucency related to neck and coronal 1/3 of tooth
Pathology resembled radicular cyst

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12
Q

What are mandibular buccal bifurcation cysts?

A

> 35% of inflammatory colateral cysts
Occur in children
Usually buccal of erupting FPM

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13
Q

What lines dentigerous cysts?

A

Epithelium derived from REE from enamel organ

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14
Q

What is the clinical presentation of dentigerous cysts?

A

Males > females
2-3 decade - M3M and upper 3s
Asymptomatic - incidental finding
Tooth missing from arch

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15
Q

What is the radiographic presentation of dentigerous cysts?

A

Round/ovoid
Well-defined
Unilocular
Uniform radiolucency
Usually attach at the CEJ

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16
Q

How do dentigerous cysts present histopathologically?

A

Thin, regular layer of non-keratinising stratified squamous epithelium

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17
Q

What are the contents of dentigerous cysts?

A

Proteinaceous, yellowish fluid
Cholesterol crystals common

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18
Q

What are eruption cysts?

A

Odontogenic developmental
Overlying an erupting tooth
Histopathologically same as dentigerous
Tooth often erupts
Most commonly deciduous incisors or FPM

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19
Q

How common are dentigerous cysts?

A

20% of all odontogenic cysts

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20
Q

How common are OKCs?

A

3rd most common odontogenic cyst after radicular and dentigerous

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21
Q

What lines OKCs?

A

Cell rests of Serres - originates from remnants of dental lamina

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22
Q

What is the clinical presentation of OKCs?

A

Males > females
Wide age range
70-80% mandible - esp 3 molar region
Usually asymptomatic

23
Q

How do OKC’s present radiographically?

A

Oval
Well defined
May have scalloped margins
Uni or multilocular
Large mesio-distal expansion without buccal-lingual expansion

24
Q

How do OKCs appear histopathologically?

A

Thin connective tissue wall
Uninflamed
Lined by parakeratinised stratified squamous epithelium

25
Q

What are the contents of OKCs?

A

Thick, grey/white cheesy material with keratinous debris

26
Q

What is seen in basal cell naevus syndrome?

A

GORLIN-GOLTZ
Multiple OKCs
Multiple basal cell carcinomas
Palmar and plantar pitting
Calcification of intracranial dura mater

27
Q

What are the symptoms of cysts?

A

Often asymptomatic
Mobility of teeth
Numbness/altered sensation
Egg shell cracking feeling
Loss of vitality

28
Q

How common are lateral periodontal cysts?

A

0.4%

29
Q

How do lateral periodontal cysts present clinically?

A

Middle aged
May present with expansion
Canine and premolar region of mandible, then anterior maxilla
Vital tooth
Usually asymptomatic and incidental finding

30
Q

How do lateral periodontal cysts present radiographically?

A

Well-demarcated radiolucent area

31
Q

How do lateral periodontal cysts present histopathologically?

A

Thin lining stratified squamous epithelium
Similar to gingival cysts

32
Q

What are gingival cysts and what are they derived from?

A

Rests of Serres - remnants of dental lamina
Also called Bohn’s nodules
Small yellow/cream nodules on edentulous alveolar mucosa
No tx required - naturally degenerate

33
Q

How common are nasopalatine duct cysts and what do they originate from?

A

5-10% of non-odontogenic cyst - most common one
Epithelial remnants of naso-palatine duct

34
Q

How do nasopalatine duct cysts present clinically?

A

Males >females
5th-6th decade (OP)
Slowly enlarged swelling anterior palate

35
Q

How do nasopalatine duct cysts present radiographically?

A

Well defined
Round or ovoid or heart shaped
Sclerotic margin
Always involve midline

36
Q

How to nasopalatine duct cysts present histopathologically?

A

Lined by stratified squamous and respiratory epithelium
Neurovascular bundle found in capsule

37
Q

How do solitary bone cysts present clinically?

A

Children and adults, no sex more than the other
Premolar/molar region of mandible
Asymptomatic, incidental finding
Bony expansion often seen

38
Q

How do solitary bone cysts present radiographically?

A

Radiolucency of variable size, irregular outline, moderately well defined
Scalloped margins

39
Q

What is a Stafne’s bone cavity?

A

Developmental anomaly of mandible
Asymptomatic - incidental finding

40
Q

How do Stafne’s bone cavities present radiographically?

A

Round or oval, well demarcated radiolucency
Between premolar region and angle of mandible
Usually below inferior dental canal

41
Q

List 4 odontogenic tumours

A

Ameloblastoma
Ameloblast if fibroma
Malignant ameloblastoma
Odontogenic myxoma

42
Q

List 3 giant cell lesions

A

Peripheral and central giant cell granulomas
Brown tumours of hyperparathyroidism
Cherubism

43
Q

List 2 fibro cemento-osseous lesions

A

Periapical cemento-osseous dysplasia
Fibrous dysplasia

44
Q

List 4 radiolucent non-odontogenic tumours

A

Chondroma
Osteosarcoma
SCC
Central haemangioma

45
Q

When is enucleation useful?

A

Radicular and residual cysts
Dentigerous cysts
OKCs

46
Q

When is enucleation avoided specifically?

A

Ameloblastomas

47
Q

What are the risks of enucleation?

A

Damage to IAN
OAC
Pathological fracture of mandible
Recurrance risk if whole lining not removed

48
Q

What is segmental resection and when is it carried out?

A

Removal of cyst with margin of normal bone
Ameloblastoma
Sarcoma

49
Q

What are the risks of marsupialisation?

A

Lining not available for histopathology
Chance of re-infection
Needs further surgery for cyst removal
Uncomfortable for patient

50
Q

What is enucleation?

A

All of the cystic lesion is removed

51
Q

What is marsupialisation?

A

Creation of a surgical window in wall of cyst
Remove cyst contents
Suture cyst wall to the surrounding epithelium
Encourages cyst to decrease in size and can be followed by enucleation

52
Q

What are the advantages of enucleation?

A

Whole lining can be examined histopathologically
Primary closure
Little aftercare needed

53
Q

What are the indications of marsupialisation?

A

If enucleation would damage surrounding structures
Difficult to access area
May allow eruption of teeth affected by dentigerous cyst
Elderly or medically compromised - can withstand surgery
If large cyst would risk jaw fracture

4 - oral surgery (19 decks)

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