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BDS4 Tutorials > Cysts > Flashcards

Cysts Flashcards

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1
Q

What is a cyst?

A

Pathological cavity containing fluid, semi-fluid or gas
-> not created by accumulation of pus

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2
Q

What are the inflammatory types of odontogenic cyst?

A

Radicular
-> residual (subtype)

Collateral
-> Paradental
-> buccal bifurcation

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3
Q

What are the developmental types of odontogenic cysts?

A

Dentigerous
-> eruption

OK

Lateral periodontal

Gingival

Glandular odontogenic

Calcifying odontogenic

Orthokeratinised odontogenic

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4
Q

What are the non-odontogenic epithelial cysts?

A

Nasolabial

Nasopalatine

Globulomaxillary

Median

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5
Q

What are the non-epithelial odontogenic cysts?

A

Solitary bone cyst

Aneurysmal bone cyst

** Stafne’s idiopathic bone cavity

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6
Q

What are the features of Radicular cysts?

A

Associated with non-vital tooth
-> follow on from apical periodontitis due to necrosis of pulp

Can be apical, lateral or residual

May expand bone and cause discharge

Ofren in lateral incisor region

60% maxilla

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7
Q

What is the origin of radicular cysts?

A

Rests of mallassez
-> from HERS (dental follicle)

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8
Q

What are residual cysts?

A

Radicular cysts remaining in jaws following extraction

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9
Q

How are radicular cysts treated?

A

Enucleation

Removal of associated tooth

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10
Q

When do radicular cysts tend to present?

A

4th-5th decades

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11
Q

How do radicular cysts appear radiographically?

A

Round or ovoid radiolucency at root apex

Unilocular

Well defined

Uniform

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12
Q

How do radicular cysts appear histologically?

A

Regular lining- NK squamous epithelium

Cholesterol depsits

Vascular capsule

Presence of inflammatory infiltrate

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13
Q

What are the contents of a radicular cyst?

A

Watery straw coloured fluid

Semi-solid brown material

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14
Q

Where do inflammatory collateral cysts tend to occur?

A

buccal aspect of partially erupted vital tooth

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15
Q

What teeth are paradental cysts usually associated with?

A

Partially erupted 8s
-> inflammatory stimulus is pericoronitis

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16
Q

Where do mandibular bifurcation cysts occur?

A

In children on buccal aspect of erupting FPM

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17
Q

How does a paradental cyst appear radiographically?

A

Well defined radiolucency related to neck and coronal third of root
-> similar to radicular

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18
Q

What are the features of a dnetigerous cyst?

A

Most common of this type

Associated with impacted 8s

M>F

2nd-3rd decades

Incidental finding- asymptomatic

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19
Q

Where do denitgerous cysts arise from?

A

Reduced enamel epithelium (enamel organ)

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20
Q

How do dentigerous cysts present radiographically?

A

Embrace all/part of crown of unerupted tooth- attaches at CEJ

Round/oviod radiolucency

Well-defined/uniform

Unilocular

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21
Q

What are the histopathological features of dentigerous cyst?

A

Thin regular layer of NK stratified squamous epithelium

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22
Q

What are the contents of a dentigerous cyst?

A

Proteinacous yellowish fluid
-> cholesterol crystals common

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23
Q

How are dentigerous cysts treated?

A

Enucleation with associated tooth

Marsupialisation if large

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24
Q

What are the features of an eruption cyst?

A

Overlies an erupting tooth
-> deciduous teeth/FPM

Similar histopathology to dnetigerous

Surgical excision may be required

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25
What is the third most common odontogenic cyst?
OK
26
What does an OK arise from?
Rests of serres (dental lamina)
27
What are the issues in OKs?
High risk of recurrence Enlarges AP- unusual pattern, can reach large size without causing bony expansion
28
What are the clinical features of OK?
M>F Wide age range 70-80% occur in mandible -> mostly in 8 region Asymptomatic
29
How do OKs present radiographically?
Oval radiolucency Well defined/uniform Uni or multilocular
30
How do OKs appear histopathologically?
Thin connective tissue wall No inflammation Lined by thin- folded parakeratinsied stratified squamous epithelium
31
What is the contents of an OK?
Thick grey/white material with keratinous debris
32
What is Gorlin-Goltz syndrome?
Autosomal dominant syndrome Multiple OKs Multiple Naevoid Basal cell Carcinomas on skin Skeletal abnormalities (abnormal Ca/PO metabolism) -> Ribs/vertebrae affected -> Calcified falx
33
What are the facial characteristics of Gorlin-Goltz?
Frontal, temporal, parietal bossing Hypertolerism Mild mandibular prognathism
34
What is an orthokeratinised odontogenic cyst how is it different from an OK?
Used to be considered variant of OK -> similar presentation but histologically disntinct (orthokeratinisation and flattened basal cell layer) -> unilocular without epithelial proliferations or satellite cells -> No naevoid BCCs -> rarely recur
35
What teeth are lateral periodontal cysts associated with?
Canine and premolar region in mandible Vital teeth -> Asymptomatic/incidental (may present with expansion)
36
How do lateral periodontal cysts appear radiographically?
Well demarcated radiolucent area in lateral periodontium
37
What are the histological features of Lateral periodontal cysts?
Thin Stratified squamous lining Similar to gingival cyst
38
How are Lateral periodontal cysts treated?
Enucleation
39
What is a botryoid odontogenic cyst?
Multi-locular variant of LPC Often larger More likely to recur
40
What is the origin of gingival cysts?
Rests of serres (dental lamina) in gingival or alveolar soft tissues
41
How do gingival cysts present?
As a <1cm pink/blueish sessile swelling in the attached mandibular gingivae
42
What are gingival cysts in infants called, how do they present?
Bohn's nodules -> small yellow nodules on edentulous alveolar mucosa -> degenerate, no tx required
43
What are the features of Glandular odontogenic cysts?
Rare Potentially aggressive, locally invasive -> can cause erosions of cortical plate High recurrence Uni/multilocular radiolucency Uninflamed fibrous wall with cuboidal epithelium (glandular)
44
Where do glandular odontogenic cysts tend to occur?
Anterior mandible- slow growing and painless
45
What is a calcifying odonotogenic cyst?
Member of ghost cell family of odontgenic lesions -> appear as ghost epithelial cells histologically
46
How does calcifying odontogenic cyst present clincially?
Wide age rage- usually <40 Intraosseous Arise anterior to FPM 1-3mm in diameter Rarely recur Benign
47
What are the radiographic features of calcifying odontogenic cysts?
Initially radiolucent- then starts to contain calcified radiopaque material Uni/multilocular Adjacent teeth may be displaced or resorbed by bony expansion
48
What is the origin of nasopalatine duct cyst?
Epithelial remnants of naso-palatine duct
49
How do naso-palatine duct cysts present?
M>F 5-6th decades Asymptomatic/incidental Slowly enlarging swelling in anterior region of palate at midline
50
How do nasopalatine duct cysts appear radiographically?
Round, ovoid, heart-shaped radiolucency Sclerotic margin Well-defined
51
What are the histopathological characteristics of NPDC?
Lined by stratified squamous and respiratory epithelium Neuromuscular bundles found in capsule
52
What is the aetiology of a solitary bone cyst? (known as simple, haemorrhage, traumatic)
Unknown
53
How does a solitary bone cyst present?
Any age/sex Premolar/molar region of mandible Asymptomatic/incidental Bone expansion in 25%
54
How do solitary bone cysts appear radiographically?
Radiolucent Variable size Irregular outline- scalloped -> Moderately well defined
55
What occurs on surgical exploration of solitary bone cysts?
Rough bony walled cavity with no lining -> rapid healing occurs -> spontaeously resolves
56
What is stafne's bone cavity?
Developmental anomaly of mandible -> asymptomatic and incidental
57
What are the radiographic features of Stafne's bone cavity?
Round or oval radiolucency Occurs between premolars and angle of mandible Located below IDC Can be bilateral
58
What is found on surgical exploration of Stafne's?
Saucer shaped depression in lingual aspect of mandible -> contains ectopic salivary tissue
59
What are examples of differential diagnoses for radiolucent lesions that are non-cystic
Odontogenic tumours -> ameloblastoma, ameloblastic fibroma, odontogenic fibroma and myxoma Giant cell lesions -> cherubism, peripheral/central giant cell granuloma, Brown tumour Fibro-cemento-osseus lesions -> Periapical cemento-osseous dysplasia, fibrous dysplasia Non-odontogenic tumours -> chondroma, osteosarcoma, SCC, metastatic bone tumours, central haemangioma
60
What are the treatment options for Cysts?
Enucleation- remove entire lining and contents -> radicular, residual, dentigerous, kerato Marsupialisation- create fenestration with tube or grommet -> larger cysts Surgical resection- removal of cyst with margin of normal bone -> ameloblastoma/sarcoma -> may require secondary surgery
61
What are the complications for enucleation?
Damage to IAN OAC Pathological fracture of mandible Risk of recurrence
62
What are the complications of marsupialisation?
Further surgery required for removal of cyst Long treatment Chance of re-infection of cyst Uncomfortable

BDS4 Tutorials (9 decks)

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