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5th Oral Disease - Other > Cyst of Jaw - Classification > Flashcards

Cyst of Jaw - Classification Flashcards

1
Q

What is a cyst?

A

A pathological cavity filled with fluid, semi-fluid or gaseous content and which is usually, but not always lined by epithelium

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2
Q

Can a cyst ever be filled with pus?

A

No - not created by accumulation of pus

If pus this would be abscess

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3
Q

What’s the most common cyst found in the jaw ?

A

Odontogenic cyst

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4
Q

How do odontogenic cyst arise?

A

From tooth forming tissue

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5
Q

What are different types of odontogenic cysts?

A

Inflammatory or developmental

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6
Q

Example of inflammatory odontogenic cysts?

A

RPR

Radicular
Residual
Paradental

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7
Q

Examples of developmental odontogenic cysts?

A

FLOCK GG

Folicular 
Lateral periodontal 
Orthokeratinised o.c
Calcifying odontogenic 
odontogenic Keratocyst

Gingival cyst
Glandular odontogenic

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8
Q

Most common odontogenic jaw cyst?

A

Radicular - 65%

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9
Q

Second most common odontogenic jaw cyst?

A

Follicular

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10
Q

How does cyst grow?

A

Need a source of epithelium - give lining
Stimulus for proliferation and growth
Way resorb bone

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11
Q

Epithelial source for radicular cyst?

A

Remnants Hertwigs root sheath - remnants round PDL follow root shape

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12
Q

Epithelial source for follicular cyst?

A

Reduced enamel epithelium

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13
Q

Epithelial source for odontogenic keratocyst?

A

Remnant dental lamina

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14
Q

What is apical granuloma?

A

Ball of granulation tissue - lots of inflammatory cells and mediators

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15
Q

Can apical granuloma turn into cyst?

A

Yes can become radicular cyst - if acts upon epithelium will provoke proliferation

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16
Q

3 ways cysts can grow and expand?

A
  1. Osmosis and hydrostatic pressures
  2. Proliferation of lining
  3. Bone resorption
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17
Q

Where does dental lamina develop from?

A

Enamel organ

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18
Q

What does peridontal ligament contain?

A

Remnants of Hertwig’s root sheath - rest cells of malassez

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19
Q

What is radicular cyst?

A

Inflammatory odontogenic cyst which is associated w/ non-vital tooth

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20
Q

How does radicular cyst arise?

A

Arise from periodontal ligament from epithelial rests of Malassez as result of inflammation following death of pulp

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21
Q

Epidemiology of radicular cyst?

A

Male > female

Tend young- middle aged pt

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22
Q

Where most likely to see radicular cyst?

A

Anterior maxilla teeth most common

Always non-vital

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23
Q

3 types of radicular cyst?

A
  1. Apical - at apex of tooth associated w/ opening canal
  2. Lateral - at side associated w/ lateral branch of canal
  3. Residual
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24
Q

What is a residual cyst?

A

A radicular cyst which persist after extraction of tooth - left in alveolus

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25
What expect to see radiograph radicular cyst?
Radiolucent lesion which is corticated Continuity with PDL Well defined
26
Pathogenesis of radicular cyst?
1. Caries, extension bacteria into pulp = non-vital tooth 2. Periapical granuloma - ongoing inflammation = tissue destruction = granulation tissue form 3. Proliferation odontogenic epithelium 4. Cyst form
27
Key features of radicular cyst on histology?
Cyst wall Lining Lumen cyst Non-keratinised epithelium!
28
Why important to look at epithelium on histology radicular cyst?
Won't be keratinised - differentiate from odontogenic keratocyst
29
What are some histological features could see in radicular cyst?
``` Keratin - very rare CIllia - like seen respiratory epitheium Hyaline bodies - Ruston bodies within epithelium Mucous cells - goblet cells Cholesterol/ cholesterol clefts ```
30
How to differentiate radicular cyst and apical granuloma?
Cysts tend to be larger, more radiolucent, well-defined, corticated and painlesss
31
What size would indicate apical granuloma or radicular cyst?
If less 1cm likely granuloma | If >1cm likely radicular cyst
32
Another word for paradental cyst?
Collateral cyst
33
What is a paradental cyst?
Inflammatory odontogenic cyst which develops alongside developing teeth
34
Definition of paradental cyst?
Cyst arise on lateral aspect of tooth as a result of inflammation in periodontal pocket
35
Common tooth to get paradental/ collateral cyst?
PE 8s - classically in disto-buccal corner
36
What expect to see on histology of paradental cyst?
``` To be attached on/around ACJ Similar radicular cyst Wall - fibrous connective tissue/ chronic inflammation cells Non-keratinised epithelium Arcaded proliferation pattern ```
37
What is a follicular cyst?
Developmental odontogenic cyst | A cyst which surrounds crown on unerupted tooth arising from reduced enamel epithelium
38
Two types of follicular cyst?
Dentigerous - associated impacted tooth | Eruption - associated erupting tooth
39
What radiographic features expect to see of follicular cyst?
Radiolucency surrounding crown of unerupted tooth Well defined and corticated Looks to be attached ACJ
40
What histology expect follicular cyst?
``` Cyst - wall, lining and lumen Attached tooth ACJ No inflammation Lining - thin non-keratinised epithelium lining Wall - fibrous wall ```
41
What expect see clinically on eruption cyst?
Lesion lying beneath oral mucosa w/ colouration of fluid
42
How treat eruption cyst?
Open/ excise to allow eruption
43
How to eruption cyst form?
Retention of primary teeth can impede eruption of permanent teeth = eruption cyst
44
What is odontogenic keratocyst?
Cyst arising in tooth bearing area characteristics by thin lining of parakeratinised epithelium
45
What type of cyst is odontogenic keratocyst?
Developmental odontogenic cyst
46
Where does odontogenic keratocyst arise form?
Dental lamina
47
What expect to see histology odontogenic keratocyst?
Lining = thin parakeratinised SSE | Nuclear palisading on basal layer
48
What does parakeratinised mean
Has nuclei
49
Why is diagnosis harder if odontogenic keratocyst becomes inflamed?
Loses characteristic epithelium lining
50
Most common area to see odontogenic keratocyst?
Posterior mandible
51
What expect to see radiograph odotogenic keratocyst?
Large radiolucent lesion Scalloped outline = multilocular Well defined and corticated
52
What radiographic feature is useful to note of odontogenic keratocyst?
Little expansion - useful diff from tumour
53
Why do odontogenic keratocyst recur?
Lining fragile - can be left behind as break easily during surgery Daughter cysts
54
In what syndrome can see odontogenic keratocyst?
Gorlin goltz - basal cell nevus syndrome
55
What features see gorlin goltz?
``` Multiple/ recurrent odontogenic keratocyst Basal cell carcinoma Frontal bossing Skeletal abnormality- bifid ribs Cranial abnormalities ```
56
Why is it suggests o. keratocyst is a benign neoplasm?
High rate of proliferation in epithelial lining High rate recurrent Aggressive and infiltrative growth
57
What is lateral periodontal cyst?
Occur lateral aspect of roots between vital teeth
58
Where do lateral periodontal cyst arise from?
Rests of Serres
59
What expect to see radiographically lateral periodontal cyst?
Radiolucency between vital teeth | Well-defined and corticular
60
What is a botryoid odontogenic cyst?
Multilocular lateral periodontal cyst
61
Histological feature lateral periodontal cyst?
Focal thickening in walls = plaque
62
Where do gingival cyst arise form in infants?
Dental lamina of alveolar mucous - lies over crown of tooth before erupted
63
Where do gingival cyst arise from in adults?
Dental lamina in attached gingiva
64
Difference of lining in gingival cyst in infants and adults?
Infants - parakeratinised | Adults - non-keratinised
65
Where expect see gingival cyst in adult?
Buccal surface
66
What is glandular odontogenic cyst?
Cyst characterised by cuboidal or column epithelium with mucous production - forms duct/ gland like structure
67
What expect see histology glandular odontogenic cyst?
Focal thickening Goblet cell - mucous production Duct like structure
68
What see radiograph calcifying odonogenic cyst?
Well defined but uncorticated lesion | Calcified material in cyst
69
Histology of calcifying odontogenic cyst?
Lined by ameloblastoma - ghost cells and dentine in wall
70
Example of non-odontogenic cyst?
Nasopalatine cyst | Nasolabial cyst
71
Where do non-odontogenic cyst arise?
From epithelium other than that from tooth developing strucutres Due different fusion in embryological process
72
Where does nasopalatine duct cyst arise?
In nasopalatine (incisive) canal from epithelial residue to nasopalatine duct
73
What are nasopalatine duct cyst lined with?
Respiratory epithelium or SSE
74
What see clinically in nasopalatine duct cyst?
Palatal swelling behind incisors
75
Histology see for nasopalatine duct cyst?
Respiratory type lining - columnar pseudostatified Can see mucosa cells Can see filial Lining mixed - respiratory and squamous
76
How confirm nasopalatine cyst?
Needs to have come from nasopalatine canal - see neurovascular bundles
77
What see radiograph nasopalatine cyst?
Midline anterior maxilla Well-defined, oval shape Sometimes corticated Above root tips central incisor
78
Differential nasopalatine cyst and how to decide?
See if teeth vital | Trace PDL radiograph - if can likely separate from teeth
79
What is nasolabial cyst?
Arise in soft tissue overlying alveolar process at base of nostril
80
Where does nasolabial cyst arise?
Remnant of nasolacrimal duct
81
What lines nasolabial cyst?
Pseudostartified columnar epithelium
82
What is a cyst like lesion?
Cyst in jaw w/o epitheliumm lining
83
Example of cyst like lesion
Stafne bone cavity
84
How expect Stafne bone cavity look?
Well defined Cortciated Radiolucency Angle of mandible - deep to inferior nerve
85
What can be associated w/ stafne bone cavity?
Due to defect lingual side mandible = depression | Salivary gland tissue can extend into defect

5th Oral Disease - Other (13 decks)

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