Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

A- BDS4 Radiology > Cysts of the Jaws > Flashcards

Cysts of the Jaws Flashcards

(67 cards)

Start Studying
1
Q

What is a cyst?

A

a pathological cavity having fluid, semi-fluid or gaseous contents and which is not created by the accumulation of pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cysts - features

A

diverse group of lesions
symptomatic or asymptomatic
slow or fast growing
indolent or destructive
almost all benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cysts - signs and symptoms

A

often asymptomatic unless infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cysts - initial radiographs that can be taken to investigate

A

periapical
occlusal
panoramic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

supplemental radiographs that can be taken to investigate cysts

A

CBCT
facial radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Radiographic features of cysts

A

shape
- often spherical or egg-shaped
- most grow by hydrostatic pressure

margins
- often well defined
- often corticated

locularity
- ofren unilocular

multiplicity
- can be single, bilateral or multiple
- multiple cysts may indicate a syndrome

inclusion of unerupted teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cysts - effect on surrounding anatomy

A

displacement of cortical plates, adjacent teeth, maxillary sinus, inferior alveolar canal
- variable degree and pattern of growth
- root resorption may occur with chronic cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cysts - radiographic signs of secondary infection

A

may lose definition and cortication
typically associated with clinical signs and symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Classification of cysts

A

structure
- epithelium lined vs no epithelial lining

origin
- odontogenic vs non odontogenic

pathogenesis
- developmental vs inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

give examples of developmental odontogenic cysts

A

dentigerous cyst and eruption cysts
odontogenic keratocyst
lateral periodontal cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

give examples of odontogenic inflammatory cysts

A

radicular cyst and residual cyst
inflammatory collateral cysts
- paradental cyst
- buccal bifurcation cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

give an example of a non-odontogenic developmental cyst

A

nasopalatine duct cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

give examples of non-devleopmenal non-odontogenic cysts

A

solitary bone cysts
aneurysmal bone cysts

*no epithelial lining = not true cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

features of odontogenic cysts

A

occur in tooth bearing areas
most common cause of bony swelling in the jaws
- >90% of all cysts in oral and maxillofacial region
all lined with epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

odontogenic sources of epithelium

A

rests of malaseez
- remnants of Hertwig’s epithelial root sheath
rests of Serres
- remnants of the dental lamina
reduced enamel epithelium
- remnants of the enamel organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common odontogenic cysts

A

radicular cyst (and residual cyst)
- 60% of odontogenic cysts
dentigerous cyst (and eruption cyst)
- 18%
odontogenic keratocyst
- 12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

radicular cysts features

A

inflammatory odontogenic cyst
- always associated with a non-vital tooth
- initiated by chronic inflammation at apex of tooth due to pulp necrosis
sometimes called dental cysts or periapical cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

radicular cysts - incidence

A

most common in 4th and 5th decades
60% maxilla, 40% mandible
can involve any tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

radicular cyst - presentation

A

often asymptomatic
may become infected
- pain
typically slow growing with limited expansion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

radicular cysts vs periapical granulomas

A

difficult to differentiate radiographically
radicular cysts typically larger
if radiolucency diameter >15mm = 2/3 cases will be radicular cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

radicular cysts radiographic features

A

well defined, round/oval radiolucency
corticated margin continuous with lamina dura of non-vital tooth
larger lesions may cause displace adjacent structures
long-standing lesions may cause external root resorption and/or contain dystrophic calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

radicular cyst histology

A

epithelial lining - often incomplete
connective tissue capsule
inflammation in capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how may radicular cysts form ?

A

proliferating epithelium with central necrosis
or
epithelium surrounds fluid areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how do radicular cysts grow?

A

osmotic effect with semi-permeable wall
cytokine mediated growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
name 2 variants of radicular cysts
residual cysts lateral radicular cysts
26
what is a residual cyst?
when a radicular cyst persists after loss of tooth - or after tooth is successfully root canal treated
27
what is a lateral radicular cyst?
a radicular cyst associated with an accessory canal - located at side of tooth instead of apex
28
inflammatory collateral cysts - features
associated with a vital tooth collective term for - paradental cyst - buccal bifurcation cyst
29
paradental cysts typically occur...
at distal aspect of partially erupted mandibular third molar
30
buccal bifurcation cysts typically occur...
at buccal aspect of mandibular first molar
31
dentigerous cyst features
developmental odontogenic cyst associated with crown of unerupted (and usually impacted) tooth - e.g. mandibular 3rd molars, maxillary canines cystic change of dental follicle
32
dentigerous cyst incidence
more common in 2nd-4th decades male > female mandible > maxilla
33
Dentigerous cyst radiological features
corticated margins attached to cemento-enamel junction of tooth - larger cysts may begin to envelop root of tooth may displace involved tooth tend to be symmetrical initially - larger cysts may begin to unilaterally expand - variable displacement of cortical bone/bony expansion
34
dentigerous cyst - histology
thin non-keratinised stratified squamous epithelium - may resemble radicular cyst if inflamed
35
how to tell the difference between a dentigerous cyst and an enlarged follicle
consider cyst if follicular space 5mm or more - measure from surface of crown to edge of follicle - normal follicular space typically 2-3mm - assume cyst if >10mm consider cyst if radiolucency is asymmetrical
36
eruption cyst features
variant of dentigerous cyst - continued within soft tissue rather than bone associated with an erupting tooth - more commonly incisors - almost exclusively affects children
37
odontogenic keratocyst features
developmental odontogenic cyst no specific relationship to teeth - high recurrence rate
38
odontogenic keratocyst incidence
more common in 2nd and 3rd decades male>female mandible>maxilla (3:1) posterior >anterior
39
odontogenic keratocyst radiographic features
often have scalloped margins 25% are multilocular often cause displacement of adjacent teeth - root resorption uncommon characteristic expansion - can have significant mesio-distal expansion without bucco-lingual expansion
40
odontogenic keratocyst pre operative diagnostic test
cyst aspirate - containes squames - low soluble protein content
41
odontogenic keratocyst histology
basal palisading parakeratosis loss of keratin if inflamed
42
basal cell naeuvus syndrome - presentation
multiple odontogenic keratocysts multiple basal cell carcinomas calcification of inter cranial dura mater cysts histologically identical to non-syndromic form but often occur as a younger age e.g. 15 years
43
give examples of non-odontogenic cysts
nasopalatine duct cyst - most common solitary bone cyst aneurysmal bone cyst
44
nasopalatine duct cyst features
developmental non-odontogenic cyst arises from nasopalitine duct epithelial remnants occurs in anterior maxilla aka incisive canal cyst
45
nasopalatine duct cyst incidence
more common in 4th to 6th decades male > female
46
nasopalatine duct cyst presentation
often asymptomatic patients may note 'salty' discharge larger cysts may displace teeth or cause swelling in palate always involves midline but not always symmetrical
47
naspalatine duct cyst - histology
variable epithelial lining - non-keratinised stratified squamous and modified respiratory
48
nasopalatine duct cyst; radiographic features
periapical or/and standard maxillary occlusal - corticated radiolucency between/over roots of central incisors - often unilocular - may appear 'heart shaped' due to superimposition of anterior nasal spine CBCT may be indicated if better visualisation of cyst required for surgical planning
49
Nasopalatine Cyst vs incisive fossa
incisive fossa - may or may not be visible radiographically - midline, oval shaped radiolucency - typically not visibly corticated transverse diameter can be considered in absence of clinical issues: <6mm assume incisive fossa 6-10mm consider monitoring >10mm = suspect cyst
50
What is a solitary bone cyst?
non-odontogenic cyst without an epithelial lining aka simple/traumatic/haemorrhagic bone cyst
51
solitary bone cyst incidence
most common in 2nd decade male>female mandible>>maxilla can occur in association with other bone pathology - e.g. fibre-osseous lesions
52
solitary bone cyst - clinical presentation
- usually asymptomatic - incidental finding - rarely pain or swelling
53
solitary bone cyst - radiological features
majority in premolar/molar region of mandible - can also occur in non-tooth bearing areas variable definition and cortication may have scalloped margins giving a pseudooculuar appearance may project up between the roots of adjacent teeth
54
what is a stafne cavity?
not a cyst but commonly mistaken as one - depression in the bone - only occur in mandible, almost exclusively lingual - contains salivary or fatty tissue
55
stafne cavity presentation
more common in 5th and 6th decades often in angle or posterior body of mandible often inferior to inferior alveolar canal asymptomatic well-defined, often corticated radiolucency rarely displaces adjacent structures
56
Cysts - how to obtain material for histology
aspiration biopsy - drainage of contents incisional biopsy - partial removal excisional biopsy - complete removal
57
What is required for an aspiration biopsy
wide bore needle 5-10ml syringe
58
How cyst fluid may determine the type of cyst
clear or straw coloured fluid found in inflammatory or developmental cysts white or cream semi-solid may indicate keratocyst
59
purpose of an incisional biopsy
to obtain a sample of the lining for histological analysis
60
incisional biopsy method
usually under LA select region where lesion appears superficial raise mucoperiosteal flap remove bone as required - using round bur incise and remove section of lining may be combined with marsupialisation
61
Cysts - outline surgical options
enucleation - removal of all cystic lesion marsupialisation - creation of a surgical window in the wall of the cyst, removing the contents and suturing the cyst wall to the surrounding epithelium - encourages the cyst to decrease in size and may be followed up by enucleation at a later date
62
enucleation is the treatment of choice for most cysts, what are the advantages?
whole lining can be examined pathologically primary closure little aftercare needed
63
enucleation disadvantages
risk of mandible fracture with very large cysts for dentigerous cyst - may wish to preserve tooth old age/ill health clot filled cavity may become infected incomplete removal of lining may lead to recurrence damage to adjacent structures
64
marsupialisation indications
if enucleation would damage surrounding structures - e.g. ID nerve difficult access to area may allow eruption of teeth affected by dentigerous cyst elderly or medically compromised patient very large cysts would risk jaw fracture if enucleation was performed
65
marsupialisation advantages
simple to perform may spare vital structures can combine with enucleation at later procedure
66
marsupialisation disadvantages
opening may close and cyst may reform complete lining not available for histology difficult to keep clean lots of aftercare needed long time to fill in
67
function of an obturator in marsupialisation
used to keep marsupialisation window open

A- BDS4 Radiology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions