Odontogenic Cysts (3)

Question 1

What is the most common cyst of the jaws?

Answer 1

Periapical cyst

Question 2

What is the origination of a periapical cysts?

Answer 2

Due to inflammatory stimulation of the epithelial rests of Malassez

Question 3

T/F: Periapical cysts are associated with vital teeth.

Answer 3

False

Periapical cysts = non-vital tooth

Question 4

T/F: Periapical cysts are symptomatic.

Answer 4

False

Asymptomatic unless secondarily infected or very large

Question 5

T/F: Loss of lamina dura is seen with a Periapical cyst.

Answer 5

True

Question 6

What are the histopathological features of a periapical cysts?

Answer 6

Granulation tissue lined by non-keratinized stratified squamous epithelium

*if no epithelial lining -> periapical granuloma

Question 7

What is the treatment/prognosis for a periapical cysts?

Answer 7

Endodontic therapy/apicoectomy/extraction

Excellent

Question 8

T/F: Buccal bifurcation cysts are usually seen in lower molars of children.

Answer 8

True

Question 9

Flat v-shaped extension of enamel into the buccal bifurcation of a mandibular molar can cause what?

Answer 9

Buccal bifurcation cysts

Question 10

In a buccal bifurcation cyst, which way will the apices of the tooth appear to be leaning?

Answer 10

Toward the lingual

Question 11

T/F: A buccal bifurcation cyst has the same histopathological features as a periapical cyst.

Answer 11

True

Question 12

T/F: Treatment for buccal bifurcation cyst is extraction of the tooth.

Answer 12

False

Enucleation

Good prognosis

Question 13

What is the most common developmental odontogenic cyst?

Answer 13

Dentigerous cyst

*2nd most common cyst overall after periapical

Question 14

What is the cause of a dentigerous cyst?

Answer 14

Fluid accumulation between crown and reduced enamel epithelium

Question 15

_____________ are associated with the crown of an unerupted tooth.

Answer 15

Dentigerous cysts

Question 16

If the radiolucency is greater than ________, it is probably a cyst.

Answer 16

5mm

Question 17

Which tooth is the most common to have a dentigerous cyst?

Answer 17

Mandibular 3rd molars

Question 18

What is the treatment/prognosis for dentigerous cyst?

Answer 18

Removal of tooth and cyst

Excellent

Question 19

What type of cyst is sometimes called an “eruption hematoma”?

Answer 19

Eruption cyst

Dentigerous cyst that forms in the soft tissue

Bluish swelling

Question 20

T/F: Eruption cysts must always be unroofed.

Answer 20

False

Only if causing problems

Question 21

What is a primordial cyst?

Answer 21

Rare lesion that develops in place of a tooth

*to diagnose there must have never been extraction in that area

Question 22

Which lesion is thought to possibly be the same as a primordial cyst?

Answer 22

Odontogenic keratocyst (OKC)

Question 23

What is the treatment/prognosis of a primordial cyst?

Answer 23

Enucleation

Good

Question 24

What syndrome can an OKC be associated with if multiple are seen?

Answer 24

Nevoid basal cell carcinoma syndrome (NBCCS)

Question 25

T/F: OKCs are benign, but more aggressive than other odontogenic cysts.

Answer 25

True

Question 26

When is someone most likely to develop an OKC?

Answer 26

3rd decade *anterior maxilla after 70 y.o.

Question 27

T/F: The majority of OKCs are multilocular and develop in the posterior mandible.

Answer 27

False Unilocular and in posterior mandible

Question 28

What are the three histopathological criteria for an OKC?

Answer 28

1. Thin epithelial lining 2. Corrugated parakeratin surface 3. Palisaded basal cell layer

Question 29

What is the treatment for an OKC?

Answer 29

Smaller - enucleate in one piece Larger - marsupialization followed by enucleation

Question 30

What is the prognosis for an OKC?

Answer 30

Guarded

Question 31

What is a condition that involves multiple odontogenic keratocysts (OKCs) arising at an early age?

Answer 31

Nevoid basal cell carcinoma syndrome (NBCCS) *Gorlin syndrome

Question 32

Which three cysts are inflammatory?

Answer 32

1. Periapical cyst 2. Residual periapical cyst 3. Buccal bifurcation cyst *the rest are developmental

Question 33

What are some clinical features of NBCCS?

Answer 33

OKCs in jaws, hypertelorism, large head, frontal bossing, milia and epidermal cysts, and multiple BCCs

Question 34

What might you see in a radiograph of a patient with NBCCS?

Answer 34

Calcification of falx cerebri, hypoplastic/bifid rips, multiple OKCs

Question 35

What is also called a dental lamina cyst?

Answer 35

Gingival cyst of the newborn

Question 36

What is the average recurrence rate of an OKC?

Answer 36

30% Most will happen within 5 years Need annual follow up for 7 years

Question 37

What is the treatment and prognosis for gingival cysts of the newborn?

Answer 37

No treatment. Excellent prognosis.

Question 38

Where are gingival cysts of the adult most likely to be seen?

Answer 38

Facial surfaces in anterior segments of the jaws just below mucogingival junction

Question 39

T/F: No treatment is needed for patients with gingival cysts of the adult.

Answer 39

False Conservative excision; prognosis is excellent

Question 40

T/F: Calcifying odontogenic cysts are more likely to be seen in the mandible.

Answer 40

False Equal in max and mand

Question 41

Where on the jaw do most calcifying odontogenic cysts occur?

Answer 41

Incisor-canine region

Question 42

T/F: The majority of calcifying odontogenic cysts are intrabony.

Answer 42

True

Question 43

What features are associated with some calcifying odontogenic cysts?

Answer 43

``` Scattered radiopacities (50%) Impacted teeth (30%) Odontomas (20%) ```

Question 44

What is another term for a calcifying odontogenic cyst?

Answer 44

Gorlin cyst

Question 45

In a _____________ cyst, some lesional cells undergo “ghost cell” change then may calcify.

Answer 45

Calcifying odontogenic cysts

Question 46

What is the treatment/prognosis for calcifying odontogenic cysts?

Answer 46

Enucleation w/ curettage Good

Question 47

What is the definition of a lateral periodontal cyst?

Answer 47

Defined as a non-keratinized developmental cyst occurring adjacent or lateral to the root of a tooth

Question 48

What is the treatment/prognosis of lateral periodontal cysts?

Answer 48

Curettage Excellent