Cystic Lesions of the Jaws

20 Questions

What is the most common type of cystic lesions of the jaws?

Radicular cysts

What are pseudocysts?

Cysts with no epithelial lining

What do odontogenic cystic lesions of the jaws contain?

Fluid or semi-fluid material

What is the aim of the lecture on cystic lesions of bone?

To detail radiological and histopathological features of odontogenic cystic lesions

Where are cysts more common than in any other bone?

Jaws

What are pseudocysts characterized by?

Absence of epithelial lining

Which cyst may exhibit a blue to purple color due to a considerable amount of blood in the cystic fluid?

Eruption cyst

What is the most common site for the occurrence of lateral periodontal cyst?

Mandible

Which cyst has a greater potential to recur and resembles a cluster of grapes?

Botryoid odontogenic cyst

What is the treatment for gingival cyst of the new born (Bohn's nodules)?

No treatment is required because these cysts rupture spontaneously

What is the histopathologic feature of lateral periodontal cyst?

Thin non keratinized stratified squamous epithelium

Which type of odontogenic cyst arises from dental lamina rests and represents the extraosseus counterpart of the lateral periodontal cyst?

Developmental gingival cyst of adults

What are the radiographic features of gingival cyst of adults?

It's a soft tissue lesion so negative in x-ray

Which type of odontogenic cyst usually ruptures spontaneously, permitting the tooth to erupt?

Eruption cyst

What is the clinical feature associated with Gingival Cyst of Adults?

Small (less than 1cm) well-circumscribed painless swelling of the gingiva

What is the histopathologic feature associated with Gingival Cyst of Adults?

Thin non keratinized stratified squamous epithelium.

What is the most common type of odontogenic cysts?

Paradental cysts

What is the histopathologic feature associated with apical cysts?

Cholesterol clefts and foam cells

Which odontogenic cyst arises from inflammation of pericoronal tissue?

Inflammatory collateral cyst

What is the radiographic appearance of buccal bifurcation cysts?

Unilocular radiolucencies with a narrow opaque margin

Study Notes

Pseudocysts are a type of cysts that arise from epithelial remnants (odontogenic epithelium) associated with the development of teeth and affect the toothbearing region of the jaws.
Odontogenic cysts are further classified into inflammatory and developmental types, with inflammatory cysts being the most common (55% of all cysts).
Inflammatory odontogenic cysts, specifically apical or radicular cysts, result from inflammatory hyperplasia of the epithelial rests of Malassez in the periodontal ligament following death of the pulp.
Clinical features of apical cysts include site in the maxilla, especially the anterior region, non-vital related tooth, and the presence of swelling, which may be hard, later becoming eggshell crackling, and eventually soft and fluctuant as the overlying bone is resorbed.
Radiographically, apical cysts appear as round, well-defined radiolucencies with a narrow opaque margin, a related dead tooth with a large carious cavity or a filling, and root resorption of the offending tooth or adjacent teeth.
Histopathologically, apical cysts have an epithelial lining with hyperplasia, elongated rete pegs, and Rushton bodies or hyaline bodies, which are thin, linear, curved structures found within the epithelial lining. Cholesterol clefts, foam cells, chronic inflammatory cells (lymphocytes, plasma cells, and multinucleated giant cells), and newly and fully formed walls are also present.
Less common than apical cysts are lateral periodontal cysts, which are related to the opening of a lateral root canal of a non-vital tooth and can cause trouble by interfering with the fitness of dentures and sometimes enlarge to the extent of weakening the jaw with possible risk of jaw fracture.
Inflammatory collateral cysts arise on the buccal aspect of roots of partially erupted or recently erupted teeth as a result of inflammation of pericoronal tissue.
Paradental cysts are the most common type of odontogenic cysts (60%) and arise on the buccal bifurcation of lower third molars or the buccal aspect of lower first or second molars. They can be exacerbated by buccal enamel extensions into the by food impaction bifurcation area and may cause pain, swelling, and trismus.
Buccal bifurcation cysts are well-circumscribed, unilocular radiolucencies involving the buccal bifurcation and root area of the involved tooth. They can be treated by enucleation with or without extraction of the involved tooth.
Other types of odontogenic cysts include developmental odontogenic cysts, such as dentigerous cysts, and non-odontogenic cysts. Dentigerous cysts are attached to the cervical region of an impacted tooth and envelop its crown, and they can cause jaw fracture, give rise to ameloblastoma, or undergo malignant transformation into mucoepidermoid or squamous cell carcinoma.
Eruption cysts are the soft tissue counterparts of dentigerous cysts and appear as a soft swelling in the gingival mucosa overlying the crown of an erupting deciduous or permanent tooth.

Learn about the radiological and histopathological features of common odontogenic cystic lesions of the jaws, and gain an understanding of radicular cysts, the most common of all cystic lesions of the jaws.

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