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Mandible > Jaw Cysts > Flashcards

Jaw Cysts Flashcards

1
Q

Cyst

A

Epithelial-lined pathologic cavity

May contain fluid or semisolid material

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2
Q

Pseudocyst

A

Cystic lesion devoid of an epithelial lining

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3
Q

Jaw cysts

A

Well-defined, totally or predominantly radiolucent, and sometimes expansile lesions
Usu slow growing and benign
Initially Asx unless long-standing w/ significant enlargement or secondary infxn
Usu initially discovered on routine dental xrays
Requires histopathologic exam for Dx

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4
Q

Classification of Jaw cysts

A
  1. Odontogenic cysts
  2. Nonodontogenic cysts
  3. Pseudocysts
  4. Ganglion cyst (presents in the TMJ)
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5
Q

Jaw cyst imaging

A

Well-defined
Round-to-oval
Unilocular or multilocular
Radiolucent
Circumscribed by a dense periphery of reactive bone
Small to medium cysts imaged w/ periapical and panoramic xrays
Large cysts w/ CT

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6
Q

Development Odontogenic Cysts

A
  1. Dentigerous (follicular) cysts
  2. Eruption cysts
  3. Odontogenic keratocysts
  4. Gingival (alveolar) cysts of newborns
  5. Lateral periodontal cysts and variant, The Botyroid odontogenic cyst
  6. Calcifying odontogenic cysts (gorlin cysts)
  7. Glandular odontogenic cysts
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7
Q

Odontogenic Inflammatory Cysts

A
  1. Radicular cysts (periapical cysts)
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8
Q

Nonodontogenic Cysts

A
  1. Nasolabial cysts (nasoalveolar cysts)

2. Nasopalatine cysts (incisive canal cysts)

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9
Q

Pseudocysts

A
  1. Aneurysmal bone cysts
  2. Traumatic bone cysts
  3. Static bone cysts
  4. Ganglion cysts
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10
Q

Dentigerous (follicular) cysts

A

Epithelial-line, developmental, odontogenic
2nd m/c type of jaw cyst; a/w crown of an impacted, unerupted, or developing tooth
Well-defined, radiolucen, sometimes expansile lesion
Usu slow growing and benign
Initially Asx unless long-standing w/ significant enlargement or secondary infxn
Usu discovered on routine dental x-rays
Requires histopath exam for Dx (light straw-colored aspirated fluid; thin, nonkeratinized cyst lining)
Tx: enucleation of cyst and removal of tooth

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11
Q

Eruption Cysts

A

A variant of the dentigerous cyst
P/w bluish swelling on alveolar ridge crest @ site of an erupting tooth
M/c in molar region in kid < 10 yo
Periapical or panerex confirms erupting tooth
Clinical presentation is pathognomonic
Tx: Most rupture spontaneously vs relief with excision of overlying mucosa

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12
Q

Odontogenic keratocysts (OKC)

A

Developmental odontogenic cyst vs neoplasm
Parakeratinized epithelial lining
May be component of basal cell nevus syndrome (Gorlin-Goltz synd)
Aggressive clinical behavior
High recurrence
Aspiration: whitish or pale yellow, inspissated, cheese-like material (liquid-containing masses of desquamated keratinized cells)
IHC: + for cytokeratin 10
Tx: enucleation or decompression and marsupialization

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13
Q

Gorlin-Goltz Syndrome

A 
Genetic disorder, auto dom
Mutation of PATCHED tsg
1. Multiple OKCs
2. Multiple BCCs
3. Enlarged occipitofrontal circumference
4. Mild ocular hypertelorism
5. Epidermal cysts
6. Palmar or plantar cysts
7. Calcified ovarian cysts
8. Calcified falx cerebri
9. Rib abnormalities
10. Spina bifida
11. Short 4th metacarpals
12. Vertebral abnlities
13. Pectus excavatum
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14
Q

Gingival (alveolar) cysts of newborns

A

Superficial, keratin-filled cyst found on alveolar mucosa of infants (pathognomonic)
Present at birth
Similar to Epstein pearls and Bohn nodules found on newborn palates
Form from remnants of dental lamina
Asx
No tx since resolve spontaneously

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15
Q

Lateral periodontal cysts

A

Rare type of odontogenic developmental cyst
Occurs lateral to tooth root (m/c in premolar region of mandible - a common location of supernumerary teeth)
Asx, possible expansion of buccal plate of bone
Adjacent teeth usu vital, may have root divergence
Dx usu on dental xray
Lined by nonkeratinized epith
Tx: cyst enucleation
Recurrence is possible

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16
Q

Botryoid odontogenic cyst

A

A more aggressive variant of the lateral periodontal cyst

17
Q

Calcifying odontogenic cysts (gorlin cysts)

A

Rare odontogenic, developmental cyst with occassionally aggressive behavior
Maxilla cases = Mandibular
Most in the incisor or canine regions
Some thinks is a neoplasm
Painless
25% are peripheral to the bone and look sessile or pedunculated
Unilocular or multilocular and well-delineated radiolucency
Radiopacities may appear in the lesion
Histopath: “ghost cell” keratinization of the epithelial lining
Tx: enucleation

18
Q

Glandular odontogenic cysts

A 
Uncommon
Any jaw site but anterior is m/c
Can be locally aggressive
Multilocular radiolucency
Lined by nonkeratinized epithelium with localized areas of mucus and clear cells in a pseudoglandular pattern
19
Q

Radicular cysts (Periapical cysts)

A

Type of odontogenic inflammatory cyst
M/c type of jaw cyst
A/w nonvital tooth (2/2 caries, trauma, surgical devitalization)
Usu p/w radiolucent lesion around apex of tooth root
The epithelium is derived from the epithelial rest of Malassez
Small cysts are Asx
Large cysts may expand the bone, displace tooth roots, and have crepitus
Dental Xrays show cyst at end of root
Tx: Endodontic Rx for small (<5mm); endodontic Rx + periapical surgery and cyst enucleation for large; tooth extraction if not restorable

20
Q

Nasolabial cysts (nasoalveolar cysts)

A 
A rare nonodontogenic developmental cyst
U/l swelling (10% b/l) of upper lip lateral to midline, superficial to maxilla
4th - 6th decade
Females 3:1
Epithelium from remnants of nasolacrimal duct
No radiographic signs
Lined by pseudostratified columnar epith
Tx: transoral excision
21
Q

Nasopalatine cyst (incisive canal cyst)

A

Relatively common nonodontogenic, developmental cyst
Occurs in palatal midline behind maxillary central incisory in region of incisive canal
Epithelium from embryonic remnants of nasopalatine duct
Dx w/ Xray
Tx: enucleation via a palatal flap

22
Q

Aneurysmal bone cysts

A

Rare intraosseous jaw lesion ch. by blood-filled spaces a/w fibroblastic tissue containing multinucleated giant cells and osteoid and woven bone
Mandible > Maxilla
Pts under 30 yo m/c
Considered reactive rather than neoplastic or cystic
Smaller ones are Asx and seen on xray
Larger ones may be painful, nonpulsatile swelling over jaw
Tx: complete excision (not curettage)

23
Q

Traumatic bone cysts

A

An empty or possibly fluid-filled bone cavity that appears to scallop the roots of vital teeth
Rather than an epithelial lining, there is a fibrous or granulation tissue component, or no identifiable lining
Usu seen on routine dental xray
Tooth vitality maintained
Tx: surgical exploration to r/o more aggressive lesion.
Aspiration or curettage of cavity freq induces hemorrhage with subsequent healing of bony cavity in 6-12 months

24
Q

Static bone cysts

A

A mandibular anatomic defect that has a cyst-like appearance on xray
May occur in incisor or in the cuspid or premolar regions of the lingual aspect of the mandible
Usu u/l
80-90% in males
Stable in size (static)
Asx and nonpalpable
Well circumscribed, round-to-oval mass located near the angle of the mandible and below level of mandibular canal
No involvement of tooth roots
Tx: nothing

25
Q

Ganglion cysts

A

Cystic lesions that develop near joints incl TMJ
May be confused for parotid tumor
2 types:
1. Those w/ walls consisting of fibrous connective tissue
2. Those w/ walls lined by synovial cells
Tx: surgical removal w/ histopath exam

Mandible (3 decks)

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