Odontogenic Cysts - part I Flashcards
(88 cards)
1
Q
inflammatory cysts
A
- periapical (radicular) cyst
- residual periapical (radicular) cyst
- buccal bifurcation cyst
2
Q
developmental cyst
A
- dentigerous cyst
- eruption cyst
- primordial cyst
- odontogenic keratocyst (OKC)
- gingival (alveolar) cyst of the newborn
- gingival cyst of the adult
- lateral periodontal cyst
- calcifying odontogenic cyst (COD)
3
Q
what is the most common cyst of the jaws?
A
periapical cyst
4
Q
what is periapical cyst also known as?
A
- radicular cyst
2. apical periodontal cyst
5
Q
what causes periapical cyst?
A
inflammatory stimulation of epithelial rests of Malassez
6
Q
epithelial rests of Malassez
A
- PDL
2. clusters of residual cells of Hertwig’s epithelial root sheath
7
Q
T/F: periapical cyst is asymptomatic
A
true
8
Q
what is a a periapical cyst associated with?
A
non-vital tooth - pulp test!
9
Q
what happens if periapical cyst is secondarily infected or if large?
A
may get swelling, pain
10
Q
radiographic features of periapical cyst
A
- round to ovoid radiolucency at apex
- loss of lamina dura
- may develop on lateral aspect of root
11
Q
why might a periapical cyst develop on the lateral aspect of the root?
A
due to presence of lateral canal in the area “lateral radicular cyst”
12
Q
histopathologic features of periapical cyst
A
- inflamed granulation tissue or fibrous CT lined by non-keratinized stratified squamous epithelium
13
Q
if no cyst lining is seen histopathologically in a periapical cyst, what is it called?
A
periapical granuloma
14
Q
tx of periapical cyst
A
- endo
- apicoectomy
- extraction w curettage
15
Q
what should be done to confirm healing from periapical cyst?
A
radiographic follow-up
16
Q
prognosis of periapical cyst
A
excellent
17
Q
what may happen if the periapical cyst is not completely removed?
A
may persist as a residual cyst
18
Q
what does residual cyst often represent?
A
periapical cyst which had not been removed with the extraction or resolved with endo
19
Q
what is seen in the site of a residual cyst due to previous extraction or endo treated tooth?
A
well-defined radiolucency
20
Q
tx of residual cyst
A
enucleation
21
Q
prognosis of residual cyst
A
excellent
22
Q
who is normally affected by buccal bifurcation cyst?
A
children
23
Q
which tooth is typically involved with a buccal bifurcation cyst?
A
mandibular molars
24
Q
clinical features of buccal bifurcation cyst
A
- localized swelling buccal aspect of alveolar process
- ± pain
- possible foul taste
25
T/F: buccal bifurcation cyst may be hard to detect radiographically
true
26
radiographic features of buccal bifurcation cyst
1. may have well-defined radiolucency in the furcation, superimposed over the roots
2. apices typically tipped to lingual cortex
3. may see proliferative periostitis
27
proliferative periostitis
single or multiple subperiosteal layers of bone formation
28
histopathologic features of buccal bifurcation cyst
inflamed granulation tissue or fibrous CT lined by non-keratinzed stratified squamous epithelium (like periapical cyst)
29
tx of buccal bifurcation cyst
1. enucleation
| 2. may heal spontaneously
30
T/F: tooth involved in buccal bifurcation cyst needs to be extracted
false, tooth does not require extraction
31
prognosis of buccal bifurcation cyst
good
32
how long does it take for bone to fill in and have normal perio probe depths after tx'ing buccal bifurcation cyst?
~1 year
33
what may need to be done after tx'ing buccal bifurcation cyst?
recontouring of furcation or periodontal surgery
34
T/F: involved tooth with buccal bifurcation cyst may be lost due to bone destruction
true
35
what is the most common DEVELOPMENTAL odontogenic cyst?
dentigerous cyst
36
what is the 2nd most common cyst overall?
dentigerous cyst
37
what is the most common cyst overall?
periapical cyst
38
how does a dentigerous cyst develop?
due to accumulation of fluid between the crown and the reduced enamel epithelium, which eventually forms the epithelial lining of cyst
39
T/F: dentigerous cyst is usually asymptomatic
true
40
clinical features of dentigerous cyst
1. may have swelling
| 2. can cause root resorption adjacent tooth
41
radiographic features of dentigerous cyst is associated with what?
with the crown of an unerupted tooth
42
radiolucency GREATER than 5 mm is probably what?
a cyst
43
radiolucency SMALLER than 5 mm is probably what?
hyperplastic dental follice
44
T/F: a cyst and hyperplastic dental follice are histologically indistinguishable
true
45
radiographic features of dentigerous cyst
1. unilocular
2. attaches to cervical area of tooth
3. well-defined, often corticated border
46
what will the dentigerous cyst appear radiographically if it is infected?
borders may appear ill-defined
47
T/F: any unerupted tooth may have a dentigerous cyst?
true
48
what is the most common unerupted tooth that may have a dentigerous cyst?
mandibular 3rd molar
49
list the order of the most to least common unerupted tooth that may have a dentigerous cyst
mandibular 3rd molar > max canine > max 3rd molar
50
histopathologic features of dentigerous cyst
1. uninflamed fibrous CT wall lined by thin, non-keratinized stratified squamous epithelium
2. may see scattered mucous cells in lining
51
tx of dentigerous cyst
removal of tooth and cyst
52
prognosis of dentigerous cyst
excellent
53
microscopic exam of dentigerous cyst is needed to rule out what?
other cyst or tumor
54
the mucous cells in the lining of dentigerous cyst histopathologically may explain what?
central (intraossesous) mucoepidermoid carcinoma
55
who is affected by eruption cyst?
children
56
eruption cyst
dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth
57
clinical features of eruption cyst
bluish swelling, "eruption hematoma"
58
T/F: primordial cyst is common
false, rare
59
where is primordial cyst thought to be histogenetically derived from?
degenerating tooth bud epithelium
60
primordial cyst develops in place of what?
a tooth, before any mineralized material is deposited
61
which tooth can be affected by primordial cyst?
any tooth, including supernumerary teeth
62
what is mandatory for diagnosis of primordial cyst?
no hx of extraction or surgery in area
63
radiographic features of primordial cyst
unilocular radiolucencu in area of missing tooth
64
the majority of primordial cysts have the microscopic features of what?
odontogenic keratocyst (OKC)
65
histopathologic features of primordial cyst
1. corrugated surface
2. cyst lined by parakeratotic stratified squamous epithelium
3. hyperchromatic and palisaded basal cells
66
tx of primordial cyst
enucleation
67
prognosis of primordial cyst
good
68
what can OKC be associated with?
nevoid basal cell carcinoma syndrome (NBCCS)
69
what might OKC mimic?
1. primordial cyst
2. dentigerous cyst
3. residual cyst
4. lateral periodontal cyst
70
T/F: OKC is uncommon
false, common
71
T/F: OKC is benign but more aggressive compared to other odontogenic cysts
true
72
T/F: OKC is symptomatic
false, asymptomatic
73
where does OKC favor after 70 y.o.?
anterior maxilla
74
T/F: there are no OKC cases under 10 y.o. unless pt has syndrome
true
75
T/F: OKC has a maxilla 2:1
false, mandible 2:1
76
what is noted at time of surgery for OKC?
"cheesy" material
77
areas in the jaw most affected by OKC
1. posterior mand (49%)
2. posterior max (20%)
3. anterior max (13%)
4. anterior mand (9%)
5. mand PM region (7%)
6. max PM region (2%)
78
radiographic features of OKC
majority (80%) unilocular radiolucencies with well-demarcated margins and a thin sclerotic borde
79
T/F: OKC can hollow-out mandible without expansion
true
80
T/F: OKC can be expansile and symptomatic
true
81
a small percent of OKC cases exhibit what radiographically?
multilocular appearance
82
OKC resembles dentigerous cyst radiographically except what?
the lucency for OKC is apical to the CEJ
83
3 histopathologic criteria for OKC
1. uniformly thin epithelial lining of stratified squamous epithelium 8-10 cells thick
2. corrugated parakeratin surface
3. palisaded basal cell layer
84
T/F: OKC histopathologically has CT wall that is not inflammed
true
85
tx for OKC depends on what?
size of lesion
86
tx for smaller OKC
enucleate in one piece
87
tx for larger OKC
marsupialization followed by enucleation
88
prognosis of OKC
guarded
