Cysts

Question 1

What is dental lamina?

Answer 1

Oral epithelium that gives rise to enamel organ of developing tooth

Question 2

Where are remnants of dental lamina found?

Answer 2

Often angle of mandible

Question 3

What is a follicle?

Answer 3

Odonogenic mesenchyme that surrounds unerupted tooth

Question 4

How is follicle formed?

Answer 4

Formed from external and internal epithelium of enamel organ

Question 5

What are rests of malassez?

Answer 5

Remnants of Hertwig’s root sheath and normal components of PDL

Question 6

What is reduced enamel epithelium?

Answer 6

Residual epithelium of enamel organ - attached ACJ

Question 7

What expect to see radiograph radicular cyst?

Answer 7

Large well defined radiolucency
Can be corticated
Continuity w/ PDL

Question 8

What can be differential of radicular cyst?

Answer 8

Periapical granuloma

Question 9

What look for on histology of radicular cyst if root present?

Answer 9

Look root canal system for viable pulp cells - likely to see necrotic

Question 10

What is main components of cyst?

Answer 10

Wall, lining and lumen

Question 11

What is wall of radicular cyst?

Answer 11

Fibrous connective tissue - may see chronic inflammatory cells

Question 12

What is lining of radicular cyst?

Answer 12

Non-keratinised stratified squamous epithelium

Question 13

Where does radicular cyst originate from?

Answer 13

Rest cells of mallassez - remnants of Hertwigs root sheath

Question 14

What can see in lumen of radicular cyst?

Answer 14

Debris

Cholesterol clefts

Question 15

Why do cholerstoral crystals from?

Answer 15

Due extensive cell destruction

Question 16

Why do radicular cysts form?

Answer 16

Non-vital pulp = periapical granuloma
Ongoing inflammation = tissue destruction = granulation tissue formation
Cause proliferation odontogenic epithelium

Question 17

Likely source of epithelium in radicular cyst?

Answer 17

Cell rests of malassez - arise in PDL

Question 18

How does epithelium proliferation occur in cyst?

Answer 18

Inflammatory infiltrate acts upon epithelium = stimulate grow

Question 19

How goes radicular cyst grow?

Answer 19

Accumulation of fluid - hypertonic so draws fluid - this causes pressure in cyst causing expansion

Question 20

Treatment options for radicular cyst?

Answer 20

Unrestorable - XLA and enucleatre

Restorable - endodontic and peri-radicular surgery

Question 21

What note when describing radiograph?

Answer 21

General overview inc caries
Radiolucency 
- Definition
- Size
- Extension
- Associated displacement - teeth/ ID
- Associated resorption 
- Corticated
- Expansion

Question 22

Different types of follicular cyst?

Answer 22

Dentigerous - associated w/ impacted tooth

Eruption

Question 23

On histology where does follicular cyst attached tooth?

Answer 23

ACJ

Question 24

Is any inflammation wall of dentigerous cyst?

Answer 24

No

Developmental odontogenic cyst

Question 25

What is wall and lining of dentigerous cyst?

Answer 25

``` Wall = fibrous connective tissue, no inflammation Lining = thin non-keratinised SSE ```

Question 26

Source of lining for dentigerous cyst?

Answer 26

Reduced enamel epithelium

Question 27

What teeth are commonly affected by dentigerous cysts?

Answer 27

Lower third molars Maxillary canines Second mandibular premolars

Question 28

What appearance is common for odontogenic keratocyst on X-ray?

Answer 28

Scalloped egden

Question 29

Differential diagnosis for odontogenic keratocyst?

Answer 29

Radicular cyst | Odonotgenic tumour

Question 30

Where is most likely site for odontogenic keratocyst?

Answer 30

Posterior mandible - most common site of dental lamina

Question 31

What is the epithelial lining of odontogenic keratocyst?

Answer 31

Para-keratinised SSE | See nuclei parallel - nuclear palisading

Question 32

Source of epithelium in odontogenic keratocyst?

Answer 32

Dental lamina

Question 33

What clinical tests can help establish diagnosis of odontogenic keratocyst?

Answer 33

Sensibility testing - rules out radicular cyst Imaging - if any expansion Aspiration cyst content

Question 34

Do see expansion with odontgenic keratocyst?

Answer 34

No | More likely to see in tumour

Question 35

Why do odontogenic keratocyst recur?

Answer 35

Thin fragile lining | Daughter cells

Question 36

What condition is odontgoenic keratocyst often seen in?

Answer 36

Gorlin goltz

Question 37

Differential diagnosis for radiolucency in anterior maxilla?

Answer 37

Radicualr cyst | Nasopalatine duct cyst

Question 38

What is epithelium on nasopalatine duct cyst?

Answer 38

Columnar pseudostatified epithelium (respiratory)

Question 39

Source of epithelium for nasopalatine duct cyst?

Answer 39

Remnants of epithelium from fusing of palatine shelf and pre-maxilla