Cysts Flashcards
Define a cyst
Pathological cavity with fluid/semifluid/gaseous contents not created by accumulation of pus
Define an abscess
Pathological cavity containing fluid and pus
Clinical signs and symptoms of cysts
Pain
Slow swelling (abscess = fast)
Numbness/tingling
Tenderness
Sensitivity
Mobility
Spacing
Blueish discolouration
Displacement of teeth
Failed eruption
Why does eggshell cracking occur?
Thinning of bone
First lining imaging for a suspected cystic lesion
PA
Occlusal
OPT
Indications for PA for cysts
Most detail
Small lesions
Indications for Occlusal for cysts
Larger lesion
Not seen on PA
Indications for OPT for cysts
Posterior mandible: larger lesions
Disadvantage of OPT for cysts
Not good for anteriors (cervical spine blurs image)
Supplemental imaging for cysts
CBCT
Facial radiographs: PA mandible/occipitomental view
Limitations of OPT
Nose/soft tissues can create radiopacity and obstruct view
Cervical spine can blur anteriors
Hard palate can obstruct and create a white line
If tongue not at root of mouth = air shadow created so can’t see roots of upper teeth
Don’t know buccolingual dimension
One feature of ALL odontogenic cysts
They dont go below the IA canal
Important radiographic features to determine cysts (7)
- Location
- Shape
- Margins
- Locularity
- Multiplicity
- Effect on surrounding anatomy
- Include UE teeth?
3 ways cysts can be classified
Structure
Origin
Pathogenesis
Most common way to classify cysts
Origin:
Odontogenic epithelium
Non odontogenic epithelium
Main branches of odontogenic cysts and examples
Developmental
- Dentigerous
- OK
- Lateral periodontal
Inflammatory
- Radicular + residual
- Inflammatory collateral:
Paradental cyst
Buccal bifurcation cyst
Main branches of non odontogenic cysts and examples
Developmental
- Nasopalatine
Other
- Solitary bone cyst
- Aneurysmal bone cyst
What 2 cysts have no epithelial lining
Solitary bone cyst
Aneurysmal bone cyst
Both non odontogenic others
Histological findings of a radicular cyst
Cholesterol clefts
Hyaline bodies
Compare dentigerous cyst and enlarged follicle
Large follicle = no island of odontogenic epithelium
Dentigerous cyst >4mm
Normal dental follicle up to 3mm around crown
What are multiple OK’s related to?
Basal cell naves syndrome
Nasopalatine cyst vs incisive fossa
<6mm = incisive fossa
Unless clinical swelling /salty discharge
6-10mm = monitor
> 10mm = suspect cyst
Type of fluid for radicular cyst
Yellow straw like fluid
Type of fluid for OK cyst
White or creamy semi solid
