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43 Cards in this Set
- Front
- Back
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Cyst |
A pathological, epithelium lined, cavity within connective tissue |
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Pseudocysts |
Lesions within connective tissues characterized by empty spaces or cavities which are not lined by epithelium |
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Cyst formation |
1. Remnants of epithelium proliferate in a necrotic mass forming a hypertonic soup - cells shed to promote hypertonicity 2. An epithelium lined space which is normally is present enlarges (gland duct, crown of unerupted tooth) 3. Epithelium proliferates and migrates to line a cavity which developed in connective tissue as a result of some other pathologic process - such as an abscess |
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Factors determining type of cyst: |
1. Type of epithelium that generated the cyst 2. Pathologic process which resulted in cyst formation (inflammatory stimulus, genetic or environmental factors acting during development) 3. Tissue structure in which the cyst develops
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Sources of odontogenic epithelium |
formed during tooth histogenesis 1. Enamel organ 2. Rests of Serres (dental lamina) 3. Cell rests of Malassez (Hertwig's root sheath) 4. Reduced enamel epithelium
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Sources of non-odontogenic epithelium |
formed from embryonic processes which give rise to the maxillo-facial complex 1. maxillary sinus (respiratory) epithelium 2. hair follicles and other adnexal structures 3. implanted epidermis 4. salivary gland epithelium 5. thyroid gland 6. Rests of GI epithelium |
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Clinical management considerations |
1. Removal of cyst 2. Wait and see - resolve on their own 3. Odontogenic keratocyst and the glandular odontogenic cyst are aggressive - careful follow up 4. Dentigerous or follicular cyst can lead to ameloblastoma and very rarely malignancy (SCC, MCC) 5. Examination of cysts is indicated to determine the cyst type |
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Odontogenic keratocyst |
Derived from dental lamina Parakeratinization Palisading of basal epithelial cells, nuclear hyperchromatism, clefting from sub adjacent fibrous connective tissue and corrugation of the keratin are the diagnostic features Small satellite cysts noted near main cyst Marked expansion through bone as a late feature Mand 3rd molar and ramus 20-30 yrs old, male Reccurence 10-60% Satellite cysts left behind after surgery Fragility of epithelium from epithelial fragments left at the surgery site |
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Primordial cyst |
Cyst found in the place of a missing tooth Usually is an odontogenic keratocyst |
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Treatment of an odontogenic keratocyst |
Excision Carnoy's solution Cryotherapy |
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Gorlin Goltz syndrome |
Basal cell nevus Bifid rib syndrome AD trait causes multiple odontogenic keratocysts prognathism rib abnormalities hypertelorism wide nasal bridge internal strabismus basal cell carcinomas plantar and palmar pitting dermal calcinosis mental retardation hydrocephalus hypogonadism in males ovarian tumours in females |
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Lateral periodontal cyst |
Derived from lamina dura Squamous or cuboidal epithelial layer with clear cells Botryoid = grape like Mandibular bicuspid and canine area 50 years old male small radiolucency along lateral aspect of the vital tooth no reoccurrence |
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Gingival cyst of the adult |
Same histologically as a periodontal cyst occurs in the gingiva fluid filled swelling |
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Gingival cyst of infants (or newborn) |
<3 months old discrete white swellings, keratin filled epithelium lined cavities Spontaneous resolution |
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Dental lamina cyst of newborn |
on alveolar ridge derived from lamina dura |
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Epstein's pearls |
On palatal raphe derived from fusion of palatal shelves |
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Bohn's nodules |
Where hard and soft palate meet Derived from salivary gland epithelium |
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Dentigerous cyst (follicular cyst) |
Derived from reduced enamel epithelium Histologic appearance is not pathognomic Stratified squamous epithelium Ameloblastoma can develop within a cyst wall 30 years old male Always associated with an impacted tooth (3rd molar or canines) Smooth unilocular radiolucency around an unerupted tooth |
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Eruption cyst |
Derived from reduced enamel epithelium Bluish soft tissue swelling over a non-exposed erupting tooth Resolves when the erupting tooth breaks into the oral cavity |
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Glandular odontogenic cyst |
Anterior mandible of adults Stratified squamous or columnar lining, containing mucous cells Duct like micro cystic spaces or focal thickening multi or unilocular Aggressive growth potential - esp. in posterior maxilla Potential to recur Clinical follow up necessary |
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Radicular cyst |
periapical reactive lesions |
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Residual cyst |
Occurs at the site of an extracted tooth Regarded as a persistant radicular cyst that does not resolve after tooth removal Excision is curative |
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Inflammatory periodontal cyst |
Derived from the lateral root canals of a non-vital pulp or from deep periodontal pockets Eliminated if irritant is removed (endodontically, periodontically or surgically) |
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Paradental cyst |
Derived from reduced enamel epithelium/epithelial attachment Associated with a partially erupted 3rd molar, usually mand, with pericoronitis Radiolucent cavity in distal pericoronal bone Hyperplastic stratified squamous epithelium Removal of cyst is curative |
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Buccal bifurcation cyst |
From enamel cervical extension Develops along buccal bifurcation and presents as a radiolucency Buccally positioned radiolucency Proliferative periostitis - layers of bone produced by periosteum in response to a low grade inflammatory stimulus |
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Nasopalatine duct cyst |
incisive canal cyst well defined radiolucency in incisive canal area derived from nasopalatine duct remnants asymptomatic 40-60 years old, male Squamous, cuboidal and respiratory epithelium Contains nerves, blood vessels Excision treatment Recurrences rare |
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Nasolabial cyst |
Rare soft tissue cyst soft tissue selling of the lip distort mucobuccal fold in canine area 30 years old female remnants of the nasolacrimal duct Respiratory epithlium Excision treatment recurrences rare
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Surgical ciliated cyst of the maxillary antrum (sinus) |
Implantation of sinus mucosa into bone usually following surgery Excision treatment Recurrences rare |
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Antral pseudocyst |
dome shaped soft tissue swelling of the sinus floor sinus floor does not usually have glandular tissue respiratory epithelium lesions are a reaction to some chronic irritant not usually removed unless they cause symptoms can spontaneously resolve |
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Mucous extravasation cyst |
Mucocele extravasation of mucous into the connective tissue after the rupture of the duct of a minor salivary gland Usually in lower lip Resolution and recurrence Walls formed by compressed granulation tissue which contain mucous in the lumen Often spontaneously resolve |
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Mucous retention cyst |
Dilation of the duct of a minor salivary gland due to obstruction Cuboidal, columnar or squamous epithelium Removal curative |
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Ranula |
Large cystic swelling in the floor of the mouth Represents a mucous extravasation cyst |
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Plunging ranula |
ranula extends through the muscles of the floor of the mouth |
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Dermoid, epidermoid and pilar cysts |
Usually occur on skin, dermoid and epidermoid can occur on the floor of the mouth |
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Epidermoid cyst |
squamous epithelium look like epidermis without adnexal structures |
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Dermoid cyst |
Similar but wall contains adnexal structures |
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Pilar cyst |
occurs on scalp less common |
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Lymphoepithelial cyst |
stratified squamous cell epithelium lined cavity within a well defined mass of lymphoid tissue floor of mouth of foliate papilla |
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Brachial cleft cyst |
lymphoepithelial cyst occurring on lateral neck near anterior of sternocleidomastoid muscle young adults slow growing |
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Thyroglossal duct cyst |
Can form anywhere along the path of the embryonic thyroglossal tract between foramen cecum of tongue to the thyroid glan fistulated, slow growing mass young people stratified squamous or columnar contain lymphoid, thyroid or mucous glandular tissue |
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Pseudocysts |
jaw cysts without an epithelial lining simple bone cyst aneurysmal bone cyst
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Simple bone cyst |
S. H. I. T. solitary, hemorrhagic, idiopathic, traumatic empty cystic cavity in bone lined by a scanty of fibrous connective tissue possibly related to trauma cemento-osseous dysplasia adolescents mandible bone expansion unusual well defined raidolucency between teeth and interradicular spaces Curretage is the solution |
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Aneurysmal bone cyst |
occur in vitally any bone under 20 years multiloculated radiolucency tender swellling associated with other bone lesions (simple bone cyst) change in vascular venous pressure currettage treatment |
