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Oral Radiology and Pathology Midterm I > Lectures 11 & 12 - Cysts of the Jaw > Flashcards

Lectures 11 & 12 - Cysts of the Jaw Flashcards

(95 cards)

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1
Q

Inflammatory Tumors

A

Radicular
Residual
Buccal Bifurcation

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2
Q

Radicular Cyst Pathology

A

Non-vital tooth

inflammatory process

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3
Q

Radicular Cyst Clinical Appearance

A

MOST COMMON CYST
Apex of tooth
Sometimes lateral root

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4
Q

Radicular Cyst Clinical Symptoms

A

Asymptomatic (unless exacerbated)

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5
Q

Radicular Cyst Radiographic Appearance

A 
Well circumscribed radiolucency
Round
Not corticated
Does not cross midline
LOST lamina dura and PDL
Root resorption
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6
Q

Radicular Cyst Histologic Appearance

A

Hyperplastic stratified squamous epithelium
Fluid filled
Inflamed CT wall

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7
Q

Radicular Cyst Treatment

A

Root canal

Extraction

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8
Q

Residual Cyst Pathology

A

Radicular or dentigerous cyst left after tooth extraction

Associated w/ becoming carcinoma

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9
Q

Buccal Bifurcation Cyst Pathology

A

Often associated with proliferative periostitis of buccal cortex
Rare
Age 5-11
Bilateral 33%

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10
Q

Buccal Bifurcation Clinical Appearance

A

Usually mandible, 1st molar
Bulge on buccal side tips tooth
Roots point lingually, cusp points buccally

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11
Q

Buccal Bifurcation Clinical Symptoms

A

Buccal tenderness
Swelling
Foul taste

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12
Q

Buccal Bifurcation Radiographic Appearance

A

Well circumscribed
Unilocular
Involves buccal furcation area and root
Occlusal film most helpful

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13
Q

Buccal Bifurcation Histologic Appearance

A

Non-keratinizing stratified squamous epithelium
Hyperplastic areas
Chronic inflammation

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14
Q

Buccal Bifurcation Treatment

A

Enucleation

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15
Q

Dentigerous Cyst Pathology

A 
Associated with crown of UNERUPTED tooth
Fluid build up surrounding enamel (hyperplastic follicle)
Can resorb roots, enter sinus
Common
Age 10-30
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16
Q

Dentigerous Cyst Clinical Appearance

A

Most commonly 3rd molar

then Max. canine

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17
Q

Dentigerous Cyst Clincal Symptoms

A

No pain unless infected

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18
Q

Dentigerous Cyst Radiographic Appearance

A

Unilocular radiolucency around crown of unerupted tooth
Cyst wraps from CEJ to CEJ
Can be central (symmetrical over enamel) or lateral (asymmetrical)

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19
Q

Dentigerous Cyst Histological Appearance

A

Non-inflamed: thin non, keratinized, flat epithelium-CT interface
OR
Inflamed: hyperplastic lining, rete ridges, squamous features

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20
Q

Dentigerous Cyst Treatment

A

Enucleation
Marsupialize
Good prognosis

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21
Q

Eruption Cyst Pathology

A

Soft tissue analogue of dentigerous cyst

Develops when follicle separates from crown of erupting tooth within the gingival tissue

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22
Q

Eruption Cyst Clinical Appearance

A

Soft, translucent swelling in the mucosa overlying the crown of an erupting tooth
Usually Max. incisors and Mand. 1st molars

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23
Q

Eruption Cyst Radiographic Appearance

A

Soft tissue, duh

No radiographic evidence

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24
Q

Eruption Cyst Histologic Appearance

A

Oral epithelium w/ subadjacent inflammatory cell infiltrate

Think layer of non-keratinizing epithelium

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25
Primordial Cyst Pathology
Cyst forms instead of tooth Enamel organ degenerates before hard tissue develops Often develops into a keratocystic odontogenic tumor (KCOT)
26
Primordial Cyst Radiographic Appearance
Round radiolucency under primary tooth
27
Gingival Cyst of the Newborn Treatment
Generally rupture on their own w/in 3mo of age
28
Gingival Cyst of the Newborn Histological Appearance
Thin, flattened lining with parakerototic (retained nuclei) surface Lumen of cyst contains keratinaceous debris
29
Gingival Cyst of the Newborn Clinical Appearance
2-3mm white papules on alveolar mucosa Usually multiples Max more common than Mand
30
Gingival Cyst of Newborn Pathology
Small, superficial keratin-filled cyst arise from remnants of dental lamina Similar to Epstein Pearls or Bohn nodules
31
Epstein Pearl
Inclusion cyst found in midline of palate
32
Bohn Nodules
Inclusion cyst found laterally on hard and/or soft palate
33
Gingival Cyst of Adult Pathology
Derived from rests of dental lamina | "Soft tissue counterpart to lateral periodontal cyst"
34
Gingival Cyst of Adult Clinical Appearance
``` <0.5cm papule Dome-like swelling Blue-gray Usually on facial gingiva or alveolar mucosa Most common on Mand. canine or premolars Age 40-60 Painless ```
35
Gingival Cyst of Adult Histological Appearance
Thin, flattened epithelial lining | Focal plaques may contain glycogen-rich clear cells
36
Gingival Cyst of Adult Treatment
Excision to confirm Dx Will not resolve on own, deeper than newborn cyst Excellent prognosis Usually do not reoccur or become malignant
37
Lateral Periodontal Cyst Pathology
``` Rare Age 40-70 Botryoidal subtype Usually VITAL tooth Arise from rests of dental lamina ```
38
Lateral Periodontal Cyst Clinical Appearance
Commonly anterior to mandibular premolars
39
Lateral Periodontal Cyst Clinical Symptoms
Asymptomatic
40
Lateral Periodontal Cyst Radiographic Appearance
Well circumscribed, round, corticated Radiolucent Lateral to mid-root VITAL tooth, intact PDL and lamina dura
41
Lateral Periodontal Cyst Histologic Appearance
Non-inflamed, thin epithelium Flattened or cuboidal cells Clear cells Plaque-like thickening
42
Lateral Periodontal Cyst Treatment
Enucleate
43
Orthokeratinized Odontogenic Cyst Pathology
Orthokeratinized (NO nuclei) epithelial lining | NOT associated w/ Gorlin Synd.
44
Orthokeratinized Odontogenic Cyst Treatment
Enucleation w/ curettage | 2% recurrance rate
45
Orthokeratinized Odontogenic Cyst Histologic Appearance
Orthokeratotic epithelium w/ keratohyaline granules | No prominent palisaded basal layer
46
Orthokeratinized Odontogenic Cyst Radiographic Appearance
Usually unilocular
47
Orthokeratinized Odontogenic Cyst Clinical Appearance
Typically young adult males Most common Mand. 3rd molar On Ddx w/ dentigenous cyst
48
Keratocystic Odontogentic Tumor (KCOT) Pathology
Aggressive odontogenic tumor | MOST RECURRENT odontogenic cyst (epithelial lined)
49
Keratocystic Odontogentic Tumor (KCOT) Clinical Appearance
``` Peripheral lesion in gingiva Usually interosseous, sometimes in soft tissue Post. Mandible Cheesy filling Age 10-30 M>F ```
50
Developmental Cysts
``` Dentigerous Eruption Primordial Gingival Cyst of the Newborn Gingival Cyst of the Adult Lateral Periodontal Orthokeratinized odontogenic Keratocystic odontogenic tumor (KCOT) Calcifying odontogenic (Gorlin) cyst Glandular odontogenic cyst ```
51
Calcifying Odontogenic (Gorlin) Cyst Pathology
Calcification within cyst | Approx. 20% of calcifying odontogenic cysts are associated with odontomas
52
Calcifying Odontogenic (Gorlin) Cyst Clinical Appearance
Appears as an obliteration of the vestibule Often anterior, Max. or Mand. Often unerupted teeth
53
Calcifying Odontogenic (Gorlin) Cyst Radiographic Appearance
Unilocular lucency w/ flecks of opaque calcification 33% with mixed appearance? 33% associated w/ unerupted tooth
54
Calcifying Odontogenic (Gorlin) Cyst Histologic Appearance
GHOST cells (eosinophilic epithelial cells w/o nuclei Thick epithelium Basal cells resemble ameloblasts
55
Cacifying Odontogenic (Gorlin) Cyst Treatment
Enucleate | Recurance is uncommon
56
Glandular Odontogenic Cyst Treatment
Enucleation or curettage | 30% recurrence
57
Glandular Odontogenic Cyst Histologic Appearance
Thin epithelial lining | Mucous cells & duct-like structures in the lining
58
Glandular Odontogenic Cyst Radiographic Appearance
Usually multilocular Well-defined margins Sclerotic rim
59
Glandular Odontogenic Cyst Clincal Appearance
Anterior Mandible (85%)
60
Glandular Odontogenic Cyst Pathology
Also called Sialo-odontogenic cyst | Odontogenic cyst with glandular or salivary features
61
Cysts of Bone
Nasopalatine duct / Incisive canal cyst Surgical ciliated cyst of the maxilla Controversial: Medial palatal cyst (more posterior nasopalatine) Globulomaxillary (probably KCOT) Median mandibular (doesn't exist?)
62
Nasopalatine Duct / Incisive Canal Cyst Pathology
Left behind from nasopalatine duct formation | Unrelated to tooth vitality
63
Nasopalatine Duct / Incisive Canal Cyst Clinical Appearance
``` Most common NON-odontogenic cyst M=F age 30-60 Palatal swelling (rare) can push incisors anteriorly Can erode floor of sinus ```
64
Nasopalatine Duct / Incisive Canal Cyst Clinical Symptoms
Typically non-symptomatic | Salty taste = established communication w/ oral cavity
65
Nasopalatine Duct / Incisive Canal Cyst Radiographic Appearance
Heart-shaped | Crosses midline
66
Nasopalatine Duct / Incisive Canal Cyst Histologic Appearance
Stratifies squamous and/or respiratory epithelium | Wall with blood vessels and nerve trunks
67
Nasopalatine Duct / Incisive Canal Cyst Treatment
Small cyst: No tx Large cyst: Ennucleate, low recurrance
68
Surgical Ciliated Cyst of the Maxilla Pathology
Derived from lining of the sinus entrapped during surgical closure
69
Surgical Ciliated Cyst of the Maxilla Clinical Appearance
Typically maxillary sinus | M>F
70
Surgical Ciliated Cyst of the Maxilla Radiographic Appearance
Well defined lucency | Unilocular OR multilocular
71
Surgical Ciliated Cyst of the Maxilla Histologic Appearance
Lined w/ RESPIRATORY epithelium | May show squamous metaplasia
72
Globulomaxillary Cyst
Usually KCOT Pear-shaped radiolucency b/t lateral incisor and canine Adjacent teeth are vital
73
Cysts of Soft Tissue
Lymphoepitheilial Nasolabial / Nasoalveolar Dermoid and Epidermoid Thyroglossal
74
Pseudocysts
Not lined with epithelium ``` Traumatic bone cyst Stafne bone cyst Mucocele Aneurysmal bone cyst Periapical granuloma ```
75
Lymphoepithelial Cyst Clinical Appearance
Cervical, Oral, OR Parotid Yellow color Cervical: Occurs along anterior border of SCM Left (66%) > Right Age 20-40 Oral: Along Waldeyer ring
76
Lymphoepithelial Cyst Histologic Appearance
Stratified squamous epithelium with lymphoid tissue in cyst wall Keratin in lumen (gives cyst yellow color)
77
Lymphoepithelial Cyst Treatment
Excision | 0% recurrance
78
Nasolabial / Nasoalveolar Cyst Treatment
Enucleation
79
Dermoid and Epidermoid Cyst Treatment
Complete surgical excision
80
Dermoid and Epidermoid Cyst Histologic Appearance
Lined by stratified squamous epithelium Dermoid - W/ skin appendages Epidermoid - W/O skin appendages
81
Dermoid and Epidermoid Cyst Clinical Appearance
Slow-growing rubbery or doughy masses May be yellow color Intraoral lesions are usually midline of floor of mouth
82
Dermoid and Epidermoid Cyst Pathology
Derived from epithelial rests from entrapped embryonic cells
83
Thyroglossal Duct Cyst Pathology
Derived from remnants of thyroglossal duct after migration of thyroid gland from the base of the tongue
84
Thyroglossal Duct Cyst Clinical Appearance
Swelling at midline of neck below hyoid bone F>M 50% of pts < 30 yo
85
Thyroglossal Duct Cyst Histological Appearance
Lined by Respiratory and/or stratified squamous epithelium | 50% - thyroid tissue in wall of cyst
86
Thyroglossal Duct Cyst Treatment
Excision
87
Traumatic Bone Cyst Histologic Appearance
Empty lumen | Distinguished from KCOT b/c not filled w/ cheese
88
Traumatic Bone Cyst Radiographic Appearance
Scallops b/t roots of teeth | No cortication
89
Stafne Bone Cyst Pathology
Developmental defect containing portion of salivary gland
90
Stafne Bone Cyst Clinical Appearance
Focal concavity of cortical bone on lingual surface | M>>F
91
Mucocele Pathology
Ranula - when on floor of mouth
92
Mucocele Treatment
May be self-limiting or require local excision | Local gland should be excised to prevent recurrence
93
Mucocele Histologic Appearance
Mucin surrounded by granulation tissue | Numerous foamy histiocytes
94
Mucocele Clinical Appearance
``` Dome-shaped mucosal nodule Swelling increases & decreases in size Normal to blue color Most common: -younger age -lower lip ```
95
Aneurysmal Bone Cyst Clinical Appearance
Blood-filled cavities 30% associated w/ another lesion w/i the same bone Not a true cyst, not lined with epithelium

Oral Radiology and Pathology Midterm I (10 decks)

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