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5th yr- CMS2- Facial trauma > Cyst Management > Flashcards

Cyst Management Flashcards

(72 cards)

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1
Q

Define cyst

A

A pathological cavity containing fluid or gas and which is not created by the accumulation of pus
Most cysts are lined by epithelium

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2
Q

What is pus an indication for

A

Infection

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3
Q

Talk through the mechanism of cyst growth

A

Inflammation causes epithelial proliferation
Cells in the cyst centrally break down
There is an increase in osmotic pressure leading to water being drawn in which increases the size of the cyst

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4
Q

List some key features of cysts

A
  1. Sharp defined radiolucencies
  2. Grow slowly displacing than resorbing teeth
  3. Usually symptomless and more radiographic findings
  4. Can appear bluish when close the mucosal surface
  5. Form compressible and fluctuant swellings if extending into soft tissues
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5
Q

How can cysts affect bone

A

Can lead to thinning of the bone and in very rare cases pathological fractures

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6
Q

How can we classify cysts

A
  1. Odontogenic
  2. Non odontogenic
  3. Non epithelial lined bone cyst
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7
Q

What can odontogenic cysts be further classified into

A

Inflammatory
Developmental

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8
Q

Give examples of inflammatory odontogenic cysts

A
  1. Radicular cysts
  2. Paradental cysts
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9
Q

Give examples of developmental odontogenic cysts

A
  1. Dentigerous cysts
  2. Odontogenic keratocysts
  3. Eruption cyst
  4. Lateral periodontal cyst
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10
Q

Give examples of developmental non odontgenic cysts

A
  1. Nasopalatine cysts
  2. Nasolabial cyst
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11
Q

Give examples of no epithelial lined bone cysts

A
  1. Solitary bone cyst
  2. Aneurysmal bone cyst
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12
Q

Give examples of soft tissue cysts

A
  1. Salivary gland cyst
  2. Dermoid cyst
  3. Epidermoid cyst
  4. Thyroglossal duct cyst
  5. Cystic hygroma
  6. Anterior midline lingual cyst
  7. Nasolabial cyst
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13
Q

Name the most common odontogenic cyst

A

Radicular cysts

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14
Q

Describe the epidemiology of cysts

A

More common in males than females
More commonly found in the maxilla than mandible
Usually affects 20-60 yr olds

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15
Q

What do radicular cysts arise due to

A

Chronic inflammation around apex of non vital tooth

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16
Q

Describe radicular cysts

A

They are a slow painless swelling (unless infected)
Sometimes bluish in colour
Always associated with a non vital tooth
can cause bone resorption

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17
Q

What are radicular cysts derived from

A

Epithelial cell remnants of the mallasez within the PDL

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18
Q

How do we manage a small radicular cyst

A

RCT and monitor the tooth associated with the cyst

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19
Q

How do we manage larger radicular cysts

A

Enucleation, histopathology and primary closure

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20
Q

What is a residual cyst

A

A radicular cysts which persists after XLA of the associated tooth

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21
Q

In whom are residual cysts more common

A

In the elderly to those with edentulous jaws

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22
Q

Describe lateral periodontal cysts

A

Often asymptomatic
Commonly afec the canine and premolar
Found adjacent to a vital tooth

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23
Q

How does a lateral periodontal cyst present on a radiograph

A

As a unilocular radiolucent on the side of the tooth

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24
Q

What to lateral periodontal cysts arise from

A

Epithelial cell rests of malassez

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25
How do we treat lateral periodontal cysts
Enucleation Rare occasions we may extract the adjacent tooth if there was evidence of it being involved in the cyst
26
In whom are dentigerous cysts commonly found in
More males than females Usually in pts around the age of 20-50
27
Describe dentigfeorus cysts
asymptomatic incidental findings on a radiograph surrounds the crown of the an unerupted or partially erupted tooth
28
What are dentigerous cysts associated with
Unerupted third molars and Canines
29
What can dentigerous cysts associated with
Unerutped or partially erupted teeth that can prevent their eruption or displace the tooth
30
Describe how a dentigerous cyst may present on a radiogrpah
1. Well circumscribed 2. Rounded 3. Unilocular 4. Contains crown of a tooth which is displaced from its natural position
31
How do we treat dentigerous cysts
1. marsupialisation 2. Enucleation and XLA of tooth
32
What is marsupialisation
the surgical technique of cutting a slit into a cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst
33
What are eruption cysts
Benign cysts that appear on the mucosa of the tooth prior to eruption
34
How do we manage eruption cyst
Usually first on their own spontaneous May need to remove cyst roof in rare cases of infection
35
What do odontogenic keratocysts prudes from
Remnants of the dental lamina
36
Describe odotngenic keratocysts
1. Lined by thin parakeratinised stratified squamous epithelium 2. Characteristic corrugated surface 3. Basal cell layer is well defined
37
In whom are odontogenic keratocysts more commonly seen in
20-30 yr old is peak age (can be seen in 50-70s) More commonly found in the mandible usually the angle of the mandible
38
Describe odontogenic keratocysts
Often asymptomatic until swelling Low pressure Present late
39
Describe how odotogenic keratocysts present radiographically
Well defined radiolucency Round/ scalloped margins Can envelop a tooth or displace adjacent teeth can be unilocular or multilocular
40
What are odotongenic keratocysts associated with
Gorlin Goltz syndrome
41
How do we trat odotnogenic keratocysts
Enucleation
42
What is a risk after treating odotogenic keratocysts
Risk of recurrence is 5-60% due to the presence of satellite cysts which may not be removed
43
In whom re ameloblastomas seen
Usually between 30-60 year olds More Riley in the mandible at the ramus
44
Describe an ameloblastoma
Symptomless until swelling
45
Describe how an ameloblastoma may present on a radiograph
1. Rounded 2. Cyst like 3. Radiolucent 4. Moderately well defined margins 5. Typically mupltilocualr but can be uni cystic 6. Honey comb pattern
46
What is a calcifying epithelial odontogenic tumour also known as
Pindborg tumour
47
Describe a calcifying epithelial odontogenic tumour
Asymptomatic until swelling occurs found commonly t the posterior body of the mandible Common in those around the age of 40
48
Describe how a calcifying epithelial odontogenic tumour may appear on a radiograph
Radiolucent area with poorly defined margins Can be complete radiolucent or develop radiopacity as it develops
49
How do we treat calcifying epithelial odontogenic tumour
Excise with small clear margins
50
What is a stafne bone cyst
A developmental inclusion of salivary glands in the mandible leadign to cyst formation
51
Where are stafne bone cysts found
Below the Inferior alveolar nerve canal
52
How do we treat stafne bone cysts
Conservative management
53
Describe aneurysmam bone cysts
Slowly expands and can be aggressive Typically Contain blood filled spaces interspersed with giant cells and fibroblasts They are non epithelial line lesions (not true cysts) More commonly fount in the mandible than maxilla
54
How do we treat aneurysmam bone cysts
Enucleation
55
Describe solitary boen cysts
Often an incidental finding Non epithelial lined (psydocyst) Teeth usually vital Aetiology unknown Cyst can contain blood stained serous fluid or gas
56
How do we manage solitary bone cysts
Enucleation
57
Where are nasoplatine duct cysts found
At the nasoplatine duct/ canal formed due to the remnants of the nasopalatine duct
58
What are naso palatine duct cyst formed
Epithelial remnants of the nasopalatine duct
59
What are naso palatine duct cyst formed
Epithelial remnants of theH nasopalatine duct
60
How are naso palatine duct cyst treated
Enucleation but recurrence is high due to poor technique
61
What assessments do we need to carry put before coming to a treatment plan for a cyst
1. History 2. Examination 3. Radiogrpahs 4. Special tests: vitality testing and biopsy
62
List some cyst red flags
1. Altered sensation 2. Neurological disorder 3. Sudden mobility of teeth 4. Sudden onset of swelling
63
Go through potential treatment options for a cyst from least to most invasive
1. Conservative 2. Decompression 3. Enucleation 4. Enucleation and curretage 5. Resection and margin
64
In whom would we consider a conservative treatment option approach
1. Patient unfit for surgery 2. Pt at high risk of complication 3. Smaller cysts
65
What is conservative managemetn
Wait and watch
66
What is decompressions
Marupialisation: opening a window into the cavity ti allow pressure to reduce Reduces size fo cyst to then enucleate
67
What are the advantages of decompression
Simple protect vital structures Preserve teeth
68
What are the disadvantages of decompression
Hygiene Compliance Can be lengthy Takes 2 procedures
69
What are the advantages of enuclaetion
Entire specimen is removed Is curative
70
What are the disadvantages of enuclation
1. Technically challenging 2. Can damage the vital structures 3. There's a risk of fracture with large cysts
71
What is enucleation
Removing the whole cyst
72
What is resection
Excision of lesion with margin of clinically nroaml looking tissue

5th yr- CMS2- Facial trauma (5 decks)

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