developmental and odontogenic cysts day 2 Flashcards

1
Q

“Globulomaxillary Cyst”
location?
why is this odd?

A
  • The globulomaxillary position is located at the junction of maxilla with premaxilla, between maxillary lateral incisor and canine
  • No developmental fissural cyst in this position
  • A developmental “globulomaxillary cyst” does not exist
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2
Q

Globulomaxillary Position

A
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3
Q

globulomaxillary cyst radio

A

presents as a well enscribed lucency in C/LI region, may be at apex or lateral

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4
Q

cyst in globularmaxillary region can cause what?

A

root divergence

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5
Q

Globulomaxillary Lesions likely dx’s

A
  • Periapical cyst 50%
  • Periapical granuloma 15%
  • Lateral periodontal cyst 10%
  • Odontogenic keratocyst 10%
  • Giant cell tumor 7%
  • Other lesions 3%
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6
Q

central vs perihperal lesions

A

central: arise in bone
peripheral: arise outside the bone

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7
Q

other lesions that can also present as globulomaxillary findings

A

combined 3% probability for these
* Gorlin cyst
* Odontogenic myxoma
* Adenomatoid odontogenic tumor
* Neurofibroma
* Hemangioma

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8
Q

types of DENTAL LAMINA CYSTS

A

Lateral Periodontal Cyst
Botryoid Odontogenic Cyst
Gingiva Cyst of Adult
Dental Lamina Cyst of Newborn

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9
Q

Lateral Periodontal Cyst
arises from?
teeth? predominant demo?
common areas?

A
  • A developmental cyst that arises from dental lamina rests (rests of Serres)
  • Vital teeth of adult males (3:1)
  • Mandibular premolar area most commonly
  • Maxillary incisor-canine area
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10
Q

dev cyst and inflamm

A

usually none unless infected

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11
Q

epi lining of lat perio cyst

A

alternating thin and thick strat squamous lining

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12
Q

lateral periodontal cyst radiograph

A

well circumscribed, unilocular radiolucency at lateral aspect at most often vital man PM

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13
Q

Botryoid Odontogenic Cyst
usually presents as?

A
  • Polycystic variant of the lateral periodontal cyst
  • A developmental odontogenic cyst that presents as a multilocular lucency associated with the vital mandibular premolars of adults
  • usually found in same areas as lat perio cyst
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14
Q

botryoid vs lat perio cyst

A

multi vs unilocular lucencies

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15
Q

Botryoid Odontogenic Cyst radio

A

multilocular lucency

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16
Q

Gingival Cysts
* arises from?
* teeth/demo?
* locations?

A
  • Soft tissue counterpart of the lateral periodontal cyst
  • A developmental cyst that arises from dental lamina rests
    (rests of Serres)
  • Vital teeth of adult males (3:1)
  • Mandibular premolar area and maxillary incisor-canine area
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17
Q

gingival cyst radio

A

not present, entirely in soft tissue

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18
Q

coloration gingival cyst?

A

bluish possible

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19
Q

bone with gingival cyst

A

can have pressure resorbtion

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20
Q

gingival cyst histo

A

alt patterns of thin thick epi, also oral mucosa opposite of lumen

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21
Q

Dental Lamina
Cyst of Newborn

A

small gingival/alveolar bumps, app whitish

22
Q

dental lamina cyst of newborn tx

A

no need, usually subside

23
Q

dental lamina cyst of new born histo

A

many cystic areas filled with keratin with thin epi lining

24
Q

palatal cyst of newborns

A

bohns nodules and epstein pearls

25
Q

Cyst of Newborn types

A
  • Dental lamina cysts - epithelial remnants of dental lamina from odontogenesis, occur on alveolar ridge= Odontogenic cysts
  • Epstein’s pearls - epithelial remnants from palatal shelf fusion at midline = Non-odontogenic cysts
  • Bohn’s nodules - epithelial remnants from minor salivary gland formation, all over palate =Non-odontogenic cysts
26
Q

palatal cyst of newborns histo

A

all identical, class based on location

27
Q

Primordial Cyst
likely to be?

A
  • Radiographic term for a cyst that develops in place of a tooth, tooth not present (congenitally missing)
  • Likely to be an Odontogenic Keratocyst (OKC)
28
Q

primordial cyst radio

A

typically a well defined unilocular lucency at posterior mandible

29
Q

Odontogenic Keratocyst
(OKC)
demo? location? growth? recurrence? radio?

A
  • Posterior jaws (mandible) of teenagers, young adults
  • Aggressive growth with 30% recurrence (high)
  • A unilocular or multilocular radiolucency; imitates other lucencies
30
Q

OKC distribution

A
31
Q

Radiographic Presentations
OKC, %

A
  • Primordial cysts 50%
  • Lateral periodontal 25%
  • Dentigerous 10%
  • Globulomaxillary 10%
32
Q

assume tooth is vital, what could this be?

A

OKC
lat perio cyst
odontogenic fibroma

33
Q

what could this be? describe it?

A

well defined, multilocular lucency
dentigerous cyst
OKC
ameloblastic fibroma
odontogenic fibroma

34
Q

what could this be, describe it?

A

well defined, unilocular radioluceny
OKC
residual cyst
primordial cyst

35
Q

what could this lesion be? tooth is vital

A

lateral periodontal cyst
OKC

36
Q

Extra-Osseous (peripheral) Odontogenic Keratocyst (OKC)

A

can also occur outside bone as a soft tissue lesion (bump on gum)

37
Q

Extra-Osseous (peripheral) Odontogenic Keratocyst (OKC) radio

A

none, soft tissue involved only

38
Q

Odontogenic Keratocyst
Histology

A
  • Compact epithelium, no rete ridges, 8 to 10 cell layers thick
  • Corrugated surface parakeratin
    * Prominent, palisaded, hyperchromatic basal layer
    lots of keratin in lumen
39
Q

bipsy from posterior mandible cyst, what could this be? what would high power of the basale layer show to confirm?

A

OKC: keratin in lumen with a hyperchromic palisaded basale layer

40
Q

why do OKC recur often?

A

daughter cysts present, usually locasted in conn tissue wall of the main cyst that is excised

41
Q

Significance of the Odontogenic Keratocyst
* behavior?
* Recurrence rate?
* associated Syndrome?

A
  • Aggressive behavior
  • Recurrence - 30%
  • Nevoid Basal Cell Carcinoma Syndrome
42
Q

Clinical Settings Odontogenic Keratocyst

A
  • Non-syndrome-associated OKC - idiopathic
  • Syndrome-associated OKC –multiple OKCs common in the nevoid basal cell carcinoma syndrome
43
Q

Nevoid Basal Cell
Carcinoma Syndrome additional names

A
  • Basal cell nevus syndrome
  • Gorlin-Goltz syndrome
  • Gorlin syndrome
44
Q

gorlin syndrome inheritence/genetic behavior

A

AD- highly penetrant and varible expression

45
Q

basal cell nevus syndrome mutation

A
  • Mutation in PTCH (PATCHED) tumor supressor gene at
    9q22.3
46
Q

Nevoid Basal Cell Carcinoma Syndrome signs

A
  • Skeletal anomalies: Bifid ribs
  • Jaw cysts: Multiple OKCs
  • Skin tumors: Multiple, early onset basal cell carcinomas
  • Neoplasms: CNS –Medulloblastoma
47
Q

multiple OKCs ID’d what could this be?

A

nevoid basal cell carcinoma syndrome

48
Q

an individual present with multiple BCCa’s and this image, what is possible?

A

gorlin syndrome

49
Q

BCCa’s of gorlin-goltz syndrome

A

multiple possible early in life

50
Q

palms of gorlin syndrome pts

A

may have indentations

51
Q

falx cerebri with gorlin syndrome

A

can become calcified

52
Q

Early Recognition and
Diagnosis of Nevoid Basal Cell
Carcinoma Syndrome

A
  • OKCs present early
  • Prevent disfiguring basal cell carcinomas
  • Evaluate for medulloblastoma