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Module 7 > ORAL PATH odontogenic cysts > Flashcards

ORAL PATH odontogenic cysts Flashcards

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1
Q

What is a cyst?

A

a pathological cavity having fluid or semi-fluid content

lined wholly or in part by epithelium

NOT due to accumulation of pus

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2
Q

what is an accumulation of pus called?

A

an abscess

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3
Q

what are the 2 main classifications of cysts of the jaws?

A

odontogenic
non-odontogenic

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4
Q

where are odontogenic cysts derived from?

A

epithelial residues of tooth-forming organ

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5
Q

what are the 2 categories of odontogenic cysts?

A

inflammatory
developmental

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6
Q

what do teeth develop from?

A

odontogenic epithelium and neural crest derived ectomesenchyme

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7
Q

what becomes the enamel organ?

A

dental lamina budding down from the ectoderm

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8
Q

what are the 4 layers of the enamel organ?

A

inner enamel epithelium
outer enamel epithelium
stellate reticulum
stratum intermedium

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9
Q

what layer of the enamel organ forms ameloblasts?

A

inner enamel epithelium

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10
Q

what cells develop into the pulp?

A

ectomesenchyme

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11
Q

how is dentine laid down?

A

by odontoblasts which are differentiating pulpal cells

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12
Q

at what point is the enamel matrix laid down?

A

after dentine is laid down

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13
Q

how is root formation mapped out?

A

after crown formation, the enamel organ reduces to form the root sheath of hertwig

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14
Q

what are remnants of the dental lamina known as?

A

glands of serres

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15
Q

what are remnants of the root sheath of hertwig known as?

A

cell rests of malassez

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16
Q

what are the types of inflammatory odontogenic cysts?

A

radicular cysts (apical, lateral, residual)
inflammatory collateral cysts (paradental, mandibular buccal bifurcation)

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17
Q

what is the most common type of jaw cyst?

A

radicular cyst (55%)

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18
Q

where do radicular cysts arise from?

A

epithelial proliferation and cyst formation within some periapical granulomas

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19
Q

where is the most frequent location of radicular cysts?

A

anterior maxilla

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20
Q

do radicular cysts come with symptoms?

A

often none
slow growing swelling

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21
Q

what is the one diagnostic criteria for a radicular cyst?

A

must be associated with a non-vital tooth

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22
Q

radiographic features of radicular cyst?

A

usually at the apex (unless associated with a lateral canal)
well-circumscribed unilocular radiolucent lesion

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23
Q

what is the pathogenesis of a radicular cyst?

A

proliferation of epithelium in response to inflammation
cysts enlarges due to osmotic pressure
local bone resorption

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24
Q

what are the key histopathological features of radicular cysts?

A

cholesterol clefts
haemosiderin

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25
treatment for radicular cyst?
small cysts may resolve after RCT/XLA/periradicular surgery enucleation marsupialisation for very large lesions
26
what is enucleation?
entire lesion removed
27
what is marsupialisation?
converting cyst into a pouch to let it drain prior to enucleation
28
what is a lateral radicular cyst?
radicular cyst arising from a lateral root canal branch of a non-vital tooth
29
what is a residual cyst?
radicular cyst that persists after xla of the associated non-vital tooth
30
what are the 2 variants of inflammatory collateral cysts and where do you find them?
paradental cyst - lower 3rd molars mandibular buccal bifurcation cyst - lower 1st or 2nd molars
31
aetiology of inflammatory collateral cysts?
inflammation associated with pericoronitis or enamel spur on buccal aspect of involved tooth
32
what exacerbates inflammatory collateral cysts?
food impaction
33
what type of collateral cyst is more common?
paradental
34
what are the clinical features of an inflammatory paradental cyst?
chronic pericoronitis association associated with vital tooth well-demarcated radiolucency
35
what are clinical features of mandibular buccal bifurcation inflammatory cysts?
painless swelling associated with tooth tilted buccally with deep perio pocket well demarcated buccal radiolucency
36
treatment of mandibular buccal bifurcation cysts?
enucleation removal of 8s and paradental cyst
37
list the types of developmental odontogenic cysts?
odontogenic keratocyte dentigerous cyst/ eruption cyst lateral periodontal cyst and botryoid odontogenic cyst glandular odontogenic cyst gingival cysts calcifying odontogenic cyst orthokeratinised odontogenic cyst
38
where do you find most odontogenic keratocysts?
posterior mandible
39
are odontogenic keratocysts symptomatic?
only if they are infection or when cortical bony expansion
40
radiographic features of odontogenic keratocysts?
well-defined radiolucency uni or multi locular lesion
41
aetiology of odontogenic keratocysts?
remnants of the dental lamina (glands of serres) mutation/ inactivation of PTCH1 gene, chromosome 9 activation of SHH signaling pathway = aberrant cell proliferation of epithelium
42
what was the classification for odontogenic keratocysts in 2005?
keratocystic odontogenic tumour
43
why did are odontogenic keratocysts no longer called keratocystic odontogenic tumours?
there isnt enough evidence to support a neoplastic origin
44
what is gorlin syndrome?
naevoid basal cell carcinoma syndrome
45
what syndrome do keratocysts present in?
Gorlin syndrome
46
what is the histopathology of odontogenic keratocysts?
cystic lesion keratinised stratified squamous epithelial lining corrugated parakeratin layer no inflammation (unless secondary infection)
47
what type of cyst is an odontogenic keratocyst?
benign developmental cyst
48
treatment options for odontogenic keratocysts?
marsupialisation enucleation marsupialisation + enucleation enucleation + carnoys solution enucleation + cryotherapy resection
48
what is carnoys solution?
eliminates any cyst/ daughter cysts leftover
49
what is the best tx option for odontogenic keratocysts?
no evidence some evidence to support lower recurrence rate with enucleation + carnoys solution and for resection
50
what is a dentigerous cyst?
developmental cyst encloses all or part of a crown of unerupted tooth attached to the ACJ affects impacted teeth or teeth late to erupt
51
are dentigerous cysts symptomatic?
symptom free until significant swelling or if infected potential ballooning expansion
52
radiographic features of dentigerous cysts?
well-circumscribed unilocular radiolucency associated with crown of unerupted tooth
53
histopathology of dentigerous cyst?
non-keratinised stratified squamous epithelial lining fibrous capsule no inflammation unless secondary infection
54
treatment for dentigerous cysts?
enucleation exposure/ transplantation/ xla of associated tooth
55
what must you include on the pathology request form if suspect a dentigerous cyst?
clinical attachment of lesion to ACJ of unerupted tooth
56
what is an eruption cyst?
dentigerous cyst arising in the extra-alveolar location
57
clinical features of eruption cysts?
typically seen in children deciduous and permanent molars present as bluish swelling
58
treatment options for eruption cysts?
none exposure of erupting tooth
59
clinical features of lateral periodontal cyst?
uncommon arise in adjacent to vital tooth canine and premolar region of mandible usually symptom free, incidental finding well-circumscribed radiolucency in PDL
60
what do lateral periodontal cysts arise from?
cell rests of malassez
61
treatment for lateral periodontal cysts?
enucleation recurrence is rare
62
what is a botryoid odontogenic cyst?
very rare multicystic variant of lateral periodontal cyst botryoid = 'bunch of grapes' - polycystic appearance
63
how do botryoid odontogenic cysts present radiographically?
multilocular radiolucency
64
where do you find botryoid odontogenic cysts?
mandibular premolar, canine region
65
clinical features of glandular odontogenic cysts?
very rare anterior mandible multilocular
66
what malignant condition must glandular odontogenic cysts be differentiated from?
central mucoepidermoid carcinoma
67
treatment for glandular odontogenic cysts?
enucleation but high recurrence rate
68
what are gingival cysts?
developmental cysts which occur in infants superficial keratin-filled cysts in the gingivae of newborns
69
what causes gingival cysts in infants?
proliferation of dental lamina remnants (glands of serres)
70
what do gingival cysts in infants present as?
white nodules
71
treatment for gingival cysts?
none usually disappear in a few weeks
72
do you get gingival cysts in adults?
very rarely
73
treatment for gingival cysts in adults?
simple excision
74
what is a calcifying odontogenic cyst?
painless swelling of the jaw which can present with tooth displacement and resorption
75
aetiology of calcifying odontogenic cysts?
arises from dental lamina
76
what was the 2005 classification for calcifying odontogenic cysts?
neoplasm
77
treatment for calcifying odontogenic cyst?
enucleation recurrence is rare
78
clinical features of orthokeratinised odontogenic cysts?
in the mandible painless swelling of the jaw well-defined unilocular radiolucency
79
aetiology of orthokeratinised odontogenic cysts?
pathogenesis uncertain but likely derives from dental lamina
80
treatment for orthokeratinised odontogenic cysts?
enucleation recurrence is rare
81
in what cases, would an OKC resemble a radicular cyst?
if secondarily inflamed

Module 7 (72 decks)

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