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oral path 2, exam 3 > odontogenic cysts 1 & 2 > Flashcards

odontogenic cysts 1 & 2 Flashcards

1
Q

what is the most common cyst of the jaw?

A

Periapical cysts

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2
Q

Periapical cysts develop due to inflammatory stimulation of _________________

A

the epithelial rests of Malassez

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3
Q

T/F: Periapical cysts are associated with NON-vital teeth

A

true

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4
Q

General characteristics of periapical cysts

A

1) Round-ovoid radiolucency at apex

2) Inflammation through lateral canals may lead to lateral radicular cyst

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5
Q

what are the microscopic features of periapical cysts?

A

inflamed granulation tissue or fibrous connective tissue

lined by non-keratinized stratified squamous epithelium

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6
Q

what is the treatment/prognosis for periapical cysts?

A

1) Tx: endodontic therapy +/- apicoectomy, or extraction with curettage
2) Prognosis: Excellent, but routine follow-up is warranted

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7
Q

what is a residual periapical cyst?

A

a persisting periapical lesion AFTER tooth is removed

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8
Q

__________ are the most common developmental odontogenic cysts

A

Dentigerous Cysts

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9
Q

what causes Dentigerous cysts to form?

A

Fluid accumulates between the crown of the tooth and the reduced enamel epithelium, leading to gradual enlargement of the cyst

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10
Q

Dentigerous Cysts are associated with the ________ of an unerupted tooth

A

crown

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11
Q

When lucent space around the crown is > _____mm, it is considered a dentigerous cyst

A

greater or equal to 3-4mm

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12
Q

T/F: Radiographic findings for Dentigerous cysts are mimicked by many odontogenic cysts and tumors

A

True

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13
Q

where are most dentigerous cysts found? what population groups are at the highest risk for developing them?

A

Most common site: mand. 3rd molar region, followed by max. canines, max. 3rd molars

Most present in the 2nd and 3rd decades

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14
Q

what are the symptoms of Dentigerous cysts?

A

A) May produce swelling or resorption of adjacent tooth roots

B) Symptoms are usually due to SECONDARY INFECTION

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15
Q

what are the histological characteristics of Dentigerous cysts?

A

uninflamed fibrous connective tissue lined by a thin non-keratinized stratified squamous epithelium

Some cysts will have a few scattered mucous cells in the lining

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16
Q

what is the treatment for dentigerous cysts?

A

Removal of the tooth and enucleation of the cyst, decompression of large cysts

Excellent prognosis

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17
Q

A _____________ is a dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth

A

Eruption Cyst

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18
Q

why are eruption cycts referred to as “eruption hematomas”?

A

Bluish swelling common (bleeding), thus the term “eruption hematoma”

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19
Q

________ cysts are rare lesion, thought to be derived from degenerating tooth bud epithelium

A

Primordial Cyst

20
Q

when do primordial cysts develop?

A

Develops in place of a tooth, before any mineralized material is deposited

21
Q

T/F: the Clinical/radiographic diagnosis of primordial cysts are based on no history of extraction or surgery in the area

A

True

22
Q

Characteristics of primordial cysts:

A

May arise from any tooth in the dentition

Usually detected as a unilocular radiolucency in the area of a missing tooth, usually a 3rd molar

23
Q

The majority of primordial cysts have the microscopic features of what other condition?

A

odontogenic keratocyst (OKC)

24
Q

What is the treatment/prognosis for primordial cysts?

A

Tx: Enucleation
Prognosis: Good

25
Q

when would radiographic follow-up be needed for primordial cysts?

A

when there is a histologic diagnosis of OKC (odontogenic keratocyst) upon enucleation

26
Q

T/F: Odontogenic Keratocysts are relatively common, slow growing cysts

A

FALSE

they are Relatively common, but locally aggressive cyst
keratocystic odontogenic tumor

27
Q

Odontogenic Keratocysts are associated with what other condition?

A

nevoid basal cell carcinoma syndrome

28
Q

what groups are at risk for Odontogenic Keratocysts? what areas of the mouth are most susceptible?

A

Peak incidence - 3rd decade

Mandible:maxilla - 2:1 ratio

29
Q

clinical characteristics of Odontogenic Keratocysts:

what locations are favored, what are the symptoms

A

1) Mandibular lesions usually develop in the posterior quadrants or the ramus
2) Anterior maxilla favored after 60 yrs of age
3) Usually asymptomatic, may produce swelling/discomfort with enlargement

30
Q

Odontogenic Keratocysts may mimic what other lesions?

A

dentigerous cyst, residual cyst or lateral periodontal cyst

31
Q

what % of Odontogenic Keratocysts present as unilocular? what % are multilocular?

what causes these 2 forms?

A

A) Majority (up to 80%) present as unilocular radiolucencies with well-demarcated margins and a thin sclerotic border

B) Only 20% exhibit the classic multilocular, expansile radiolucent appearance, which is probably related to the size of the lesion

32
Q

what are the “three histopathological features” of Odontogenic keratocysts?

A
  1. uniformly thin epithelial lining - stratified squamous – 6-8 cells thick
  2. corrugated surface layer of parakeratin
  3. palisaded, dark basal cell layer
33
Q

T/F: The connective tissue wall of odontogenic keratocysts is usually uninflamed

A

True

  • When inflammation is present, the histology of the lining epithelium is markedly altered
34
Q

what is the treatment protocol for Odontogenic Keratocysts?

A

A) Treatment is controversial and depends on size of lesion

B) With smaller lesion, careful enucleation as a single piece is ideal

C) With larger lesion, decompression followed by enucleation

35
Q

what is the prognosis/recurrence for Odontogenic Keratocysts?

A

Prognosis: Guarded. Recurrence rates range from 3-62%

2 recent reports with 5-year minimum follow-up indicated a 40-50% recurrence rate

36
Q

what condition is caused by a mutation of the PTCH gene?

A

Nevoid Basal Cell Carcinoma Syndrome

37
Q

inheritence characteristics of Nevoid basal cell carcinoma syndrome:

A

Autosomal dominant
extremely variable expressivity
40% are new mutations

38
Q

what are the craniofacial features of Nevoid Basal Cell Carcinoma Syndrome?

(hint: theres 4)

A

1) Enlarged occipitofrontal cranial circumference (60 cm or more in adults)
2) Heavy brow ridges
3) Broad nasal root
4) Mild ocular hypertelorism

39
Q

what are the skin/epithelial features of Nevoid Basal Cell Carcinoma Syndrome?

A

A) 1-2 mm shallow pits of the palms and/or soles (65%)

B) Milia and multiple epidermoid cysts (50%)

40
Q

Radiographic findings for Nevoid Basal Cell Carcinoma Syndrome:

A

1) Lamellar calcification of the falx cerebri (85%)

2) Bifid, fused or hypoplastic ribs (60%)

41
Q

Odontogenic keratocysts of the jaws occurs in ____% of people with Nevoid Basal Cell Carcinoma Syndrome.

when does this occur?

A

85%

may develop during 1st decade, but after age 7 years

42
Q

T/F: A patient is more likely to have Nevoid Basal Cell Carcinoma Syndrome if they have MULTIPLE odontogenic Keratocysts

A

True

43
Q

what is the treatment for Nevoid Basal Cell Carcinoma Syndrome?

A
  1. genetic counseling
  2. remove OKCs as needed
  3. remove BCCs as needed
  4. patient should use sunscreen and reduce sun exposure to decrease risk of basal cell Ca
44
Q

what is the Prognosis for Nevoid Basal Cell Carcinoma Syndrome?

A

Prognosis: Guarded

  • Usually the basal cell carcinomas are relatively small and indolent, but this can be variable
  • Periodic radiographic follow-up for OKCs
45
Q

what is another name for odontogenic keratocysts?

A

keratocystic odontogenic tumors

46
Q

what are the features of the Basal cell carcinomas that occur during Nevoid Basal Cell Carcinoma Syndrome?

A
  1. multiple carcinomas
  2. occur in unexposed, as well as exposed, skin
  3. develop at an earlier age (puberty-35 years)
  4. often show melanin pigmentation
  5. are usually quiescent, with a few being aggressive

oral path 2, exam 3 (4 decks)

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