Calcifying Odontogenic Cyst Quiz

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Questions and Answers

What is a characteristic feature of the lining of a calcifying odontogenic cyst?

Lined by transitional epithelium

Lined by thin, flat stratified squamous epithelium (correct)

Lined with columnar epithelium

Lined with stratified cuboidal epithelium

Which of the following statements is true regarding the age distribution for calcifying odontogenic cysts?

Commonly found in individuals older than 40

Usually occurs in patients below the age of 40 (correct)

Rarely found before the age of 20

Equally prevalent across all age groups

Which term is classified as a neoplasm associated with calcifying odontogenic cysts?

Dentigerous cyst

Residual periapical cyst

Dentinogenic ghost cell tumor (correct)

Orthokeratinized odontogenic cyst

What clinical feature is most commonly associated with calcifying odontogenic cysts?

Painless dome-like swelling less than 1 cm Signup and view all the answers

What is the common radiographic appearance of calcifying odontogenic cysts?

Well-defined unilocular or multilocular radiolucent area Signup and view all the answers

What effect do cytokines released by inflammatory cells have on fibroblast activity?

Enhance the production of collagenase and prostaglandins Signup and view all the answers

How does the cyst wall function in relation to cyst fluid and osmosis?

Functions as a semipermeable membrane to retain osmotically-active molecules Signup and view all the answers

What type of epithelium predominantly lines radicular cysts?

Non-keratinized stratified squamous epithelium Signup and view all the answers

What presence is commonly associated with radicular cysts in histological sections?

Cholesterol clefts associated with giant cells Signup and view all the answers

What is found in the contents of a cyst that can indicate inflammation?

Serum proteins produced by plasma cells Signup and view all the answers

What change occurs in the epithelial lining of radicular cysts as they become established?

It appears more regular in thickness Signup and view all the answers

Which of the following best describes Rushton bodies?

Curved eosinophilic laminated bodies Signup and view all the answers

What aspect of the fibrous capsule of newly formed cysts is notable?

Richly vascular and infiltrated by inflammatory cells Signup and view all the answers

What defines a residual radicular cyst?

A cyst that persists after tooth extraction Signup and view all the answers

What is the primary origin of radicular cysts?

Fragmentation of the epithelial root sheath of Hertwig Signup and view all the answers

Which clinical feature is NOT commonly associated with apical radicular cysts?

Associated with vital teeth Signup and view all the answers

What mechanism has been proposed for the formation of an epithelial-lined cyst cavity within a granuloma?

Degeneration of central cells within proliferating epithelium Signup and view all the answers

What contributes to the bone resorption associated with radicular cysts?

Release of bone resorbing factors by cyst lining fibroblasts Signup and view all the answers

Which of the following locations is most likely to have radicular cysts in the mandible?

Posterior to the canine Signup and view all the answers

How do radicular cysts typically appear radiographically?

As a round or ovoid radiolucency at the root apex Signup and view all the answers

Which factor is released from cyst lining fibroblasts that promotes osteoclastic activity?

Prostaglandins Signup and view all the answers

What type of epithelium lines the cyst wall of odontogenic keratocyst?

Stratified squamous epithelium Signup and view all the answers

Which statement best describes the histopathological appearance of the odontogenic keratocyst?

Thin, folded cyst wall with areas of parakeratosis Signup and view all the answers

What percentage of odontogenic keratocysts are related to unerupted teeth?

25% to 40% Signup and view all the answers

What is the primary reason for the high recurrence rate of odontogenic keratocysts?

Retention of satellite cysts after enucleation Signup and view all the answers

Which of the following factors is NOT involved in the expansion of odontogenic keratocyst?

Tissue inflammation Signup and view all the answers

What role do prostaglandins play in the odontogenic keratocyst?

Acting as bone resorbing factors Signup and view all the answers

Which characteristic is typically associated with the cyst walls of odontogenic keratocysts?

Well-defined radiolucencies with smooth margins Signup and view all the answers

Which of the following best describes the mitotic activity in odontogenic keratocysts compared to other cysts?

Higher than in other cysts Signup and view all the answers

What type of cells predominantly constitutes the basal layer of the epithelium in odontogenic keratocysts?

Palisaded columnar or occasionally cuboidal cells Signup and view all the answers

What condition is important to note when discussing the development of odontogenic keratocysts?

Derived from remnants of dental lamina Signup and view all the answers

What is the recommended treatment approach for an odontogenic cyst to minimize recurrence?

Complete enucleation with Carnoy's fluid application Signup and view all the answers

Which characteristic is NOT associated with orthokeratinized odontogenic cysts?

Cyst demonstrates hyperchromatic palisaded basal cell layer Signup and view all the answers

What is the role of polyethylene drainage tubes in the treatment of cystic cavities?

To allow decompression and reduce the cyst size Signup and view all the answers

Which of the following correctly describes one of the clinical features of Basal Cell Nevus Syndrome?

Multiple odontogenic keratocysts are often present Signup and view all the answers

What percentage of keratinizing jaw cysts do orthokeratinized odontogenic cysts represent?

7% to 17% Signup and view all the answers

Which factor contributes to the lower recurrence rate observed when using decompression treatment?

Thickening of the cyst lining post-treatment Signup and view all the answers

What is a distinguishing microscopic feature of orthokeratinized odontogenic cysts?

Presence of keratohyaline granules Signup and view all the answers

In the context of cyst management, what is the primary purpose of Carnoy's fluid?

To chemically cauterize the bony cavity post-removal Signup and view all the answers

What is the inheritance pattern of Basal Cell Nevus Syndrome?

Autosomal dominant Signup and view all the answers

Which of the following statements about the risks associated with odontogenic cysts is accurate?

Complete enucleation minimizes potential for recurrence Signup and view all the answers

Study Notes

Cysts of the Jaws and Oral Cavity

A cyst is a pathological cavity filled with fluid or semi-fluid, not pus. Most are lined wholly or partially by epithelium.
Key features of jaw cysts are sharply defined radiolucencies with smooth borders that may be transilluminated. They grow slowly, displacing teeth, and are often asymptomatic unless infected, rarely causing pathological fractures, and are compressible or fluctuant if they extend into soft tissue. They appear bluish when close to the mucosal surface.
Cysts are grouped by the suspected origin of their lining epithelium: odontogenic or non-odontogenic.

Odontogenic Cysts

Odontogenic cysts originate from epithelial residues of the tooth-forming organ.
They are subdivided into inflammatory and developmental types, depending on their etiology.

Non-Odontogenic Cysts

These cysts originate from sources other than the tooth-forming organ.

Epithelial Cysts

Odontogenic Cysts (A):
- Inflammatory cysts (1) Radicular (apical) cyst, (2) lateral radicular cyst, (3) residual cyst (4) paradental cyst
- Developmental cysts (1) dentigerous(follicular) cyst, (2) eruption cyst, (3) odontogenic keratocyst, (4) gingival cyst (5) lateral periodontal cyst, (6) glandular odontogenic cyst, (7) calcifying odontogenic cyst (Gorlin).
Non-Odontogenic Cysts (II):
- Naso-palatine duct(incisive canal) cyst (1), (2) Nasolabial cyst (Nasoalveolar cyst), (3) Globulomaxillary cyst,(4) median cyst
Non-Epithelialized Primary Bone Cysts (III)
- Solitary bone cyst (Simple, traumatic, haemorrhagic bone cyst).
- Aneurysmal bone cyst.
- Stafne's idiopathic bone cavity.
Soft Tissue Cysts (IV)
- Branchial cyst. (Lymphoepithelial)
- Dermoid cyst.
- Thyroglossal duct cyst.
- Salivary gland cysts

Relative Frequency of Jaw Cysts

Data in table 7.3 indicates the relative frequency of different types of jaw cysts, with figures such as 65-70% for radicular cysts, 15-18% for dentigerous, 3-5% for odontogenic keratocysts, and so on.

Radicular Apical Cysts (Page 4)

Commonly found at the apex of non-vital teeth. Clinically and radiographically typically small and asymptomatic, though may cause expansion of bone, especially related to maxillary anterior teeth, and often posteriorly in the mandible. Radiographically, round or ovoid in form and well-circumscribed, often surrounded by a continuous lamina dura of the affected tooth.

2-Residual Radicular cyst (Page 7)

Persists after extraction of the causative tooth, presenting as a common cause of swelling in older patients. The lining is thinner and exhibits mild inflammation.

3-Lateral Inflammatory Periodontal cyst (Page 7)

Develops on the side of a non-vital tooth, often near the lateral branch of the root canal. Differentiate from a lateral developmental periodontal cyst.

4-Paradental Cyst (Page 8)

Related to inflammation around partially erupted teeth, often third molars in the young adult years, with affected teeth most commonly associated with pericoronitis. Treatment usually involves enucleation.

Dentigerous Cyst (Page 8)

A cyst arising from the follicle surrounding a crown of an unerupted tooth. This cyst often prevents tooth eruption, frequently displacing teeth.

Basal Cell Nevus Syndrome (Page 16)

An inherited autosomal dominant trait often associated with multiple odontogenic keratocysts and skin abnormalities.

2-Eruption Cyst (Page 10)

Develops in relation to a tooth erupting or through trauma to the enamel. The appearance on x-ray is superficially like other odontogenic cysts, but histologically it can show characteristics distinctive from the dentigerous cyst.

5-Palatal Cysts of New Born (Page 17)

Arise from the dental lamina epithelium during development. They often resolve spontaneously.

6-Calcifying Odontogenic Cyst (Gorlin Cyst) (Page 18)

Uncommon, possibly a neoplasm or, more accurately, a tumor rather than a simple cyst in the WHO classification. Characteristically shows solid lesions that are aggressive but often responds favorably to enucleation.

1-Nasopalatine Canal Cyst (page 20)

Commonest non-odontogenic cyst, thought to arise from embryonic remnants of nasopalatine duct, commonly seen in the palate.

2-Nasolabial Cyst (Page 21)

A rare cyst thought to arise from embryonic nasal or maxillary processes, usually found below the ala of the nose.

1-Solitary Bone Cyst (Page 23)

A benign, asymptomatic cyst that most commonly seen in young adults, specifically in the premolar/molar area of the mandible. It is radiolucent, with clear borders that appear scalloped at the margins of the tooth roots.

2-Aneurysmal Bone Cysts (Page 24)

Usually discovered due to expansion. They are a complex lesion, usually located in the lower mandible posteriorly, characterized by blood-filled spaces with cellular fibrous tissue and bone, with no epithelial lining.

3-Stafne's Idiopathic Bone Cavity (Page 25)

A radiolucent defect, commonly located in the inferior dental canal, often bilaterally, characterized by benign cystic presentation and well-defined borders.
Important, sometimes overlooked features such as a prominent location related to the mandibular inferior dental canal and a tendency towards a saucer shape must be emphasized.

4- Branchial Cyst (Lymphoepithelial Cyst, Page 26)

A very rare type of soft tissue cyst in the head and neck region, located deep to or along the anterior border of the sternomastoid muscle near the angle of the mandible. Pathogenesis relates to entrapped epithelium during embryologic development.

2- Dermoid Cyst (Page 26)

Located between the hyoid bone and mandible, in the midline of the floor of the mouth (intra- or sub-mentally).

3-Thyroglossal Tract Cyst (Page 27)

A common developmental cyst, typically found in the midline of the neck, arising from thyroglossal duct remnants, and potentially containing thyroid tissue.

Mucous Extravasation Cyst (Page 28)

A common cyst of minor salivary glands, typically located in oral mucosa, usually relating to trauma and inflammation of the excretory duct. Histology features the presence of macrophages, neutrophils and lymphocytes. Differential diagnoses should exclude salivary gland tumors and mucoceles.

Mucous Retention Cyst (Page 29)

Due to obstruction or dilatation of a salivary gland duct. The clinical appearance usually demonstrates soft tissue swelling with a smooth, non-tender surface, and a pale appearance (as mucin).

Ranula (Page 30)

Typically arises in the floor of the mouth(involving a soft tissue cyst) from the sublingual or submandibular gland, and appears as a bluish/pale, painless, fluctuant swelling.

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Test your knowledge on the characteristics, age distribution, and clinical features of calcifying odontogenic cysts. This quiz covers essential aspects such as radiographic appearance and associated neoplasms. Perfect for dental students and professionals interested in oral pathology.