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cysts Flashcards

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1
Q

what are the two types of cysts of the jaws?

what are the differences?

A

odontgenic cysts

  • elithelial lining derived from epithelial residues the the tooth forming organ
  • have epithelial linings

non-odontogenic cysts

  • epithelial lining, if present, derived from sources other than tooth forming organ
  • may not have epithelial lining
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2
Q

what are the groups of odontogenic cysts?

A
  • developmental
  • inflammatory
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3
Q

name developmental odontogenic cysts?

A
  • dentigerous cyst (eruption cyst)
  • odontogenic keratocyst
  • developmental lateral periodontal cyst
  • gingival cyst
  • glandular odontogenic cyst
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4
Q

name inflammatory odontogenic cysts

A
  • radicular cyst
    • apical periodontal cyst
      • associated with apex of tooth of nonvital tooth
    • lateral periodontal cyst
      • associated with lateral root canals in non vital tooth
    • residual cyst
      • remain in jaw after extraction of associated tooth
  • paradental cyst
    • uncommon
    • associated with partially erupted lower 3rd molars with a history of repeated pericoronitis
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5
Q

what is the prevelance of cysts of the jaws?

A
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6
Q

which odontogenic cysts are derived from dental lamina and glands of serres

A
  • odontogenic keratocyst
  • developmental lateral periodontal cyst
  • gingival cyst
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7
Q

which odontogenic cysts are derived from the enamel organ and reduced enamel epithelium?

A
  • dentigerous cyst
  • eruption cyst
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8
Q

which odontogenic cysts are derived from the root sheath of hertwig and rests of malassez?

A
  • radicular cysts
    • apical
    • lateral
    • residual
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9
Q

in a table, summarise the origin of epithelial lining of the odontogenic cysts

A
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10
Q

what is the definition of a radicular cyst?

where do the majority arise?

A
  • definition
    • cyst arising from epithelial rests of malassez in the PDL
    • as a consequence of inflammation
      • usually following death of dental pulp
  • majority arise in
    • apical region
      • apical periodontal / radicular cyst
  • some arise in lateral root canals
    • inflammatory lateral periodontal cyst
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11
Q

what are the symptoms of an apical periodontal (radicular) cyst?

A
  • can be symptomless
  • larger cysts - slowly enlarging swellings
  • may be acute inflammation signs due to infection
  • related to tooth with non-vital pulp
  • may be more than 1 cyst
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12
Q

what are the signs of an apical periodonta (radicular) cyst?

A
  • labial or buccal sweeling
  • may be palatal swelling but rarely lingual swelling
  • small cysts
    • bony hard swellings
  • larger cysts
    • springy swellings with eggshell crackling
    • may erode the bone and be fluctuant
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13
Q

identify this

what radiological features are present?

A

apical periodontal (radicular) cyst

  • radiolucent round or oval lesion
  • at apex of tooth root
  • well demarcated periphery
  • surrounded by narrow radiopaque margin which extends from the lamina sura of the involved tooth
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14
Q

what is the management for an apical periodontal cyst?

A
  • extraction
  • endodontic treatment - RCT
  • enucleation
    • removal of cyst wall from bony cavity
  • marsupialisation
    • for large cysts
    • decompression of cyst by opening into oral cavity to allow gradual infilling of bony cavity
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15
Q

what is the definition for a paradental cyst?

A
  • occuring near to cervical margin of the lateral aspect of a root
  • as a consequence of inflammatory process in the periodontal pocket
    • usually pericoronitis
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16
Q

what are the clinical features of a paradental cyst?

site and presentation?

A
  • site
    • mandibular third molars
    • usually bucally or distobuccally placed
  • presentation
    • usually identified on radiograph
    • usually small so no clinical swelling
    • history of pericoronitis
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17
Q

identify this

what features present?

A

paradental cyst

  • well defined radiolucency
  • related to neck of the rooth and coronal third of the root
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18
Q

what is the management for a paradental cyst?

A

remove with impacted tooth usually

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19
Q

what is a dentigerous cyst?

A
  • cyst ensloing part or all of crown of an unerupted tooth
  • attached to the amelocemental junction
  • arises in follicular tissues
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20
Q

what is an eruption cyst?

A

a dentigerous cyst which arises in an extra-alveolar location

after erupting tooth has penetrated alveolar bone to enter soft tissues

uncommon cysts

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21
Q

whom do dentigerous cysts more commonly occur in?

A
  • age
    • wide
    • many in adolescents and young adults
  • sex
    • twice as common in males
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22
Q

where do dentigerous cysts occur more commonly?

A
  • twice as common in mandible
  • majority mandibular third molars
    • ​then
      • ​maxillary canines
      • maxillary third molars
      • mandibular premolars
  • occasionally associated with supernumerary teeth and odontomes
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23
Q

describe the presentation of a dentigerous cyst

A

tooth missing from arch

expansion of jaw

retained deciduous tooth

routine radiographic examination

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24
Q

identify

what features

A

dentigerous cyst

  • well defined radiolucency
  • associated with crown of unertuped tooth
  • tooth may be displaced
  • unilocular
  • from cementoamelo junction
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25
describe the presentation of an eruption cyst
extra-alveolar location so present as fluctuant swellin gon alveolar mucosa often bluish in colour
26
how do dentigerous cysts expand?
expansion due to raised hydrostatic pressure
27
what is the management for a dentigerous cyst?
* enucleation of cyst * with extraction of associated tooth * marsupialisation of cyst * esp in children - to allow tooth to erupt *
28
whom are odontogenic keratocysts more common in?
* age * peak in second and third decades * more common in males * more common in mandigble * posterior to first premolar
29
what are the clinical features of an odontogenic keratocyst symptoms?
* few symptoms unless secondarily infected * enlarge in antero-posterior direction * can reach large size without causing marked bone expansion * majority solitary * multiple cysts associated with basal cell naevus syndome
30
identify this
**odontogenic keratocyst** * well defined radiolucency * can be unilocular or multilocular * not involving crowns of tooth * extension into ramus of the mandible
31
what does the cyst fluid of a odontogenic keratocyst contain?
* desquamated epithelial cells and keratin * lower soluble protein concentration than other odontogenic cysts properative diagnosis can be made
32
what is the management for an odontogenic keratocyst?
* histological confirmation before definitive treatment * complete enucleation * difficult to remove all of thin lining * partiaicular from multilocaulated cysts * use Carnoy's solution and liquid nitrogen to ensure destruction of epithelial lining * marupialisation * resection if large high tendency to recur
33
what are the main manifestations of basal cell naevus syndrome?
* multiple odontogenic keratocysts * multple naevoid BCC on skin * can occur anywhere * commonly around puberty * skeletal abnormalities * particularly rib * vertebral deformities
34
what groups can u classify non-odontogenic cysts into?
1. inclusion cysts * formed by epithelium trapped in process of jaw and face fused during embryonic development 2. congenital cysts * result of developmental abnormalities 3. cysts without epithelial lining 4. epidermoid cyst * skin cysts
35
where do inclusion cysts arise? name inclusion cysts
arise at sites of fusion of facial processes during embryonic development * nasopalatine cyst * incisive canal cyst * cyst of incisive papilla * nasoalveolar cyst * occurs in upper lip * medial palatal cyst * along midline of palate
36
name congenital cysts
* thyroglossal duct cyst * lymphoepithelial cyst * dermoid cyst
37
name cysts without epithelial lining
* bone cysts * solitary bone cyst * aneurysmal bone cyst * stafne's idiopathic bone cavity * salivary gand cysts * stromal cysts in neoplasms
38
what is a nasopalatine duct cyst what are the clinical features
aka incisive canal cyst a cyst arising from epithelial residues in the nasopalatine (incisive) canal * clinical features * 40% asymptomatic * remainder present when infected
39
identify this what are the radiographic features common?
* ovoid or heart shaped radiolucent lesion * bilaterally symmetrical in midline of maxilla * behind the central incisors * can see the PDL around incisors - therefore not an apical cyst ## Footnote **nasopalatine cyst**
40
what is the treatment for a nasopalatine cyst?
enucleation
41
what is a thyroglossal duct cyst? what are the clinical features what is the treatment?
cyst arising from remnants of the thryoglossal duct * firm, cystic midline mass, 2-4mm diameter * around the hyoid * treatment * enucleation with excision of thyroglossal tract
42
what is a lymphoepithelial cyst? what are the clinical features what is the treatment?
cyst lined by squamous epithelium with lymphoid tissue forming the capsule * clinical features * asymptomatic * soft mass * usually lat aspect of neck, along anterior border of sternomastoid * treatment * excision
43
what is a dermoid cyst? what are the clinical features what is the treatment?
* sublingual or submental swellin in the midline of the floor of mouth above or below mylohyoid muscle * lined by keratinising squamous epithelium * treatment * enucleation
44
identify this
traumatic bone cyst * unilocular * in posterior mandible * **upper border arches up between teeth** * moderately well defined * lightly corticated * no effect on adjacent structures
45
describe the radiographic features of a radicular cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site : * apex of non vital tooth * size : * \>1.5cm in diatmeter * shape: * round, unilocular * outline: * well defined corticated outline continuous with lamina suraw of tooth * radiodensity: * uniformly radiolucent * effect on adjacent structures: * teeth displaced * expansion of buccal/lingual bone
46
what type of cyst is shown here
**radicular cyst** * corticated margins * round * unilocular * associated with root apex
47
describe the radiographic features of a residual cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * apical region of edentulous part of jaw * size: * \>1.5cm in diameter * shape: * round unilocular * outline: * well defined corticated outline continuous with lamina dura * radiodensity: * uniformly radiolucent * effect on adjacent structures: * teeth displaced * expansion of buccal / lingual bone
48
what type of cyst is this
**residual cyst** in edentulous area of the jaw similar appearance to radicular cyst
49
describe the radiographic features of an inflammatory collateral cyst (paradental cyst) site: size: shape: outline: radiodensity: effect on adjacent structures:
* **in children and adolescents (first & second molars), age 20-40 (third molars)** * site: * buccal aspect of erupting lower molars * sometimes associated with buccal enamel spur * size: * variable * up to 3cm diameter * shape: * unilocular * outline: * smooth, well defined, corticated * radiodensity: * uniformly * effect on adjacent structures: * tipped tooth * no resorption
50
identify this cyst
**inflammatory collateral cyst (paradental cyst)**
51
describe the radiographic features of a dentigerous cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * surrounding crown of an unerupted tooth * size: * suspect if follicular space \>3mm * shape: * round / oval, unilocular * outline: * well defined, corticated * radiodensity: * uniformaly * effect on adjacent structures: * teeth displaced * expansion of buccal / lingual bone
52
identify this cyst
**dentigerous cyst** has cause expansion of the alveolar crest
53
describe the radiographic features of a odontogenic keratocyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * most common in the posterior mandible * size: * variable * shape: * oval, pseudolocular or multilocular * outline: * well defined corticated * radiodensity: * uniformly * effect on adjacent structures: * teeth not displaced * little if any expansion of buccal / lingual bone
54
identify this cyst
odontogenic keratocyst
55
describe the radiographic features of a lateral periodontal cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * lateral surface of teeth * size: * 1cm * shape: * round, unilocular * outline: * well defined, corticated * radiodensity: * uniformly * effect on adjacent structures: * teeth displaced * expansion of the buccal / lingual bone if large
56
what is a botryoid odontogenic cyst?
a variate of lateral periodontal cyst which is multilocular
57
what is the management for a lateral periodontal cyst ?
enucleation
58
what is glandular odontogenic cyst? radiographic features?
a developmental cyst with epithelial features that simulate salivary gland tissue unilocular or multilocular expansile lesion in anterior mandible displacement but no resorption
59
what is a calcifying odontogenic cyst?
rare cyst in anterior mandible or maxilla * in early stages = radiolucent * in later stages = calcified often associated with unerupted tooth or odontome
60
describe the radiographic features of a nasopalatine duct cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * midline, anterior maxilla posterior to central incisors * size: * variable * shape: * round/oval, unilocular, can be 'heart shaped' * outline: * well defined corticated outline * radiodensity: * uniformly * effect on adjacent structures: * teeth displaced * expansion into palate
61
describe the radiographic features of a simple bone cyst (traumatic bone cyst) site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * posterior mandible in children and young adults * size: * variable * shape: * unilocular * upper border arches up and between teeth * outline: * moderately well defined * lightly corticated * radiodensity: * uniformly * effect on adjacent structures: * no effect on adjacent structures
62
what is an aneurysmal bone cyst? how does it present? what is the treatment?
rare expansile osteolytic lesion presents as painless swelling treatment : curettage
63
describe the radiographic features of an aneurysmal bone cyst site: size: shape: outline: radiodensity: effect on adjacent structures:
* site: * body/posterior manddible of adolescents and young adults * size: * variable may be several cms * shape: * unilocular or multilocular * outline: * moderately well defined * radiodensity: * radiolucent * may have internal trabeculations * effect on adjacent structures: * **ballooning expansion** * displacement of teeth
64
identify this
aneurysmal bone cyst ballooning expansion

z oral surgery / oral diseases (13 decks)

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