Cysts in and around the Jaws
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Questions and Answers

What is the primary method of treatment for residual radicular cysts?

  • Curettage
  • Antibiotics and drainage
  • Marsupialisation
  • Enucleation and primary closure (correct)

What type of outline is typically found in a conditioning radiograph of a residual radicular cyst?

  • Rounded and radiolucent (correct)
  • Bubbly and diffuse
  • Irregular and poorly defined
  • Elongated and calcified

Which treatment was once common but has seen a decrease in use for odontogenic keratocysts?

  • Marsupialisation (correct)
  • Enucleation
  • Curettage
  • Antibiotics

What is the result of performing curettage after enucleation?

<p>It scrapes the bony cavity. (C)</p> Signup and view all the answers

What condition is indicated by adjacent teeth being tilted or displaced?

<p>Presence of a carious cavity (B)</p> Signup and view all the answers

What percentage of jaw cysts are odontogenic in nature?

<p>90% (C)</p> Signup and view all the answers

Which type of cyst is the most common, accounting for 70% of inflammatory cysts?

<p>Radicular cyst (B)</p> Signup and view all the answers

What is the primary growth pattern of cysts?

<p>They grow like a balloon by resorbing medullary bone. (A)</p> Signup and view all the answers

What is a common structural effect of cysts on surrounding anatomy?

<p>They resorb the cortex and displace the inferior dental canal. (B)</p> Signup and view all the answers

What type of cyst accounts for 15% of odontogenic cysts?

<p>Dentigerous cyst (D)</p> Signup and view all the answers

What type of epithelial cells are typically found in odontogenic cysts?

<p>Cells resembling ameloblasts (B)</p> Signup and view all the answers

What is one example of a developmental cyst?

<p>Incisive canal cyst (A)</p> Signup and view all the answers

Which of the following does NOT typically characterize cysts?

<p>Solid masses of tissue (B)</p> Signup and view all the answers

What is the first stage in the pathogenesis of a cyst?

<p>Cyst Initiation (C)</p> Signup and view all the answers

Which mechanism contributes to cyst enlargement due to hydrostatic pressure?

<p>Fluid accumulation (C)</p> Signup and view all the answers

Which factor is NOT associated with poor lymphatic drainage in a cyst?

<p>Active transport (D)</p> Signup and view all the answers

What is the expected timeframe for a cyst in the mandible to enlarge to a few centimeters in diameter in an adult?

<p>5 years (C)</p> Signup and view all the answers

Which aspect contributes to the mitotic rate of the cyst's epithelial lining?

<p>High mitotic activity (B)</p> Signup and view all the answers

Which of the following is a characteristic of keratocysts?

<p>High mitotic rate of the lining (D)</p> Signup and view all the answers

What role does the cyst lumen filled with keratin play in the expansion of a cyst?

<p>Exerts little osmotic pressure (A)</p> Signup and view all the answers

Which of the following statements does NOT accurately describe the growth of cysts?

<p>Cysts grow uniformly throughout their walls (D)</p> Signup and view all the answers

What is the primary characteristic of a cyst as described?

<p>A wall of fibrous tissue with a central lumen lined by epithelium (B)</p> Signup and view all the answers

Which type of cyst is categorized under nonodontogenic cysts?

<p>Nasolabial cyst (A)</p> Signup and view all the answers

Which percentage represents the apical position of cysts described?

<p>75% (B)</p> Signup and view all the answers

What is a characteristic feature of pseudocysts?

<p>They do not have epithelial lining (D)</p> Signup and view all the answers

What does the term 'residual cyst' refer to?

<p>A cyst that persists after tooth extraction (A)</p> Signup and view all the answers

Which of the following cysts is classified under odontogenic cysts?

<p>Glandular Odontogenic cyst (C)</p> Signup and view all the answers

What type of cyst is most commonly associated with infants?

<p>Gingival cyst of infants (A)</p> Signup and view all the answers

Which cyst is characterized as being found in the soft tissue of the neck?

<p>Thyroglossal duct cyst (C)</p> Signup and view all the answers

What histological feature is characteristic of the glandular odontogenic cyst?

<p>Ameloblast-like basal cells (B)</p> Signup and view all the answers

At what age range are lateral periodontal cysts typically observed?

<p>Approximately 50 years old (B)</p> Signup and view all the answers

What is a common radiographic characteristic of a radicular cyst?

<p>Unilocular radiolucency between roots (B)</p> Signup and view all the answers

Which odontogenic cyst is known for featuring ghost cells?

<p>Sialo-odontogenic cyst (C)</p> Signup and view all the answers

What can be a consequence of the expansion caused by lateral periodontal cysts?

<p>Displacement and resorption of teeth (B)</p> Signup and view all the answers

What type of appearance differentiates the odontogenic keratocyst from other cysts?

<p>Lining resembling ameloblastoma (B)</p> Signup and view all the answers

What is a typical location for lateral periodontal cysts?

<p>Mandibular premolar/canine region (D)</p> Signup and view all the answers

Which of the following cysts is considered rare?

<p>Glandular odontogenic cyst (B)</p> Signup and view all the answers

What is the recommended treatment for large cysts associated with impacted teeth?

<p>Enucleation followed by marsupialization (C)</p> Signup and view all the answers

What is a characteristic feature of botryoid odontogenic cysts?

<p>Multilocular appearance (A)</p> Signup and view all the answers

What is the risk of recurrence associated with enucleation alone for larger cysts?

<p>Greater than 50% (C)</p> Signup and view all the answers

What histological feature is commonly found in gingival cysts?

<p>Mucous cells that secrete mucin (D)</p> Signup and view all the answers

Which of the following is a characteristic of multilocular cysts?

<p>Complex and extensive structure (B)</p> Signup and view all the answers

What is the most appropriate approach when dealing with a multi-rooted tooth within a cyst?

<p>Sacrifice the tooth (B)</p> Signup and view all the answers

What is a common age group for the occurrence of calcifying odontogenic cysts?

<p>Adults over 40 (A)</p> Signup and view all the answers

What is the resolution method for newborn gingival cysts known as Bohn’s Nodules?

<p>Spontaneous rupture (B)</p> Signup and view all the answers

What type of epithelium is typically seen in the histology of odontogenic cysts?

<p>Non-keratinized stratified squamous epithelium (A)</p> Signup and view all the answers

What is the preferred treatment for the calcifying odontogenic cyst?

<p>Surgical excision (C)</p> Signup and view all the answers

Which is a differential diagnosis for gingival cysts?

<p>Solid odontogenic tumor (B)</p> Signup and view all the answers

Recurrence of odontogenic cysts is most commonly observed within which time frame after treatment?

<p>Within the first 5 years (C)</p> Signup and view all the answers

Which feature distinguishes a botryoid odontogenic cyst from other cysts?

<p>Lobular appearance (C)</p> Signup and view all the answers

What type of swelling is typically associated with gingival cysts?

<p>Firm compressible fluid-filled swelling (D)</p> Signup and view all the answers

Which treatment method is least effective for managing odontogenic cysts?

<p>Only monitoring (A)</p> Signup and view all the answers

Flashcards

Cyst Initiation

The first stage in cyst development.

Cyst Formation

The second stage in cyst development, following cyst initiation.

Cyst Enlargement

The final stage of cyst development, involving expansion.

Hydrostatic Pressure

A pressure that drives cyst expansion due to fluid build-up.

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Bone Resorption

Process by which bone is broken down, contributing to cyst enlargement.

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Mural Growth

Growth of the cyst wall contributing to enlargement (especially in keratocysts).

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Keratocyst

A type of cyst with fast epithelial growth in its wall, contributing to its expansion.

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Cyst Enlargement Time

Cysts in the jaw can take 5 years to expand to a few cm in adults, faster in children.

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What are cysts?

Cysts are fluid-filled sacs lined with epithelium.

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Cyst lining

Cysts are lined with epithelial cells, which are the building blocks of skin and tissues.

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Odontogenic cysts

Cysts that arise from dental tissues, accounting for 90% of jaw cysts.

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Non-odontogenic cysts

Cysts that don't originate from dental tissues, only 10% of jaw cysts.

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Radicular cyst

A type of odontogenic cyst commonly caused by infection at the root of a tooth.

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Dentigerous cyst

A type of odontogenic cyst that develops around the crown of an unerupted tooth.

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Incisive canal cyst

A type of developmental cyst found in the incisive canal of the front teeth.

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Rushton bodies

Hyaline bodies found within the lining of some cysts, especially odontogenic cysts.

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What are the three main types of cysts?

Cysts are divided into odontogenic, non-odontogenic, and pseudocysts (without lining).

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Pseudocyst

A cyst-like cavity without an epithelial lining.

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Where are cysts found?

Cysts can be found in and around the jaws, as well as the soft tissues and neck.

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Enucleation

Surgical removal of a cyst, typically a whole cyst intact with a smooth lining. Often used for smaller cysts.

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Marsupialization

Surgical procedure where a large cyst is opened and drained, leaving a flap of tissue to allow gradual healing. Often used for big, problematic cysts.

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Curettage

Scraping out the cyst lining after initial surgery. Often done after enucleation or piecemeal removal of a cyst.

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Residual Radicular Cyst

A type of cyst that often remains after root canal treatment, usually rounded and radiolucent, often with a condensed radiopaque border.

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What can happen to adjacent teeth?

Adjacent teeth to a cyst could be tilted or displaced, meaning they shift or move due to the cyst's pressure on them.

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Lateral Periodontal Cyst

A rare odontogenic cyst that arises from the periodontal ligament, often found in the premolar/canine region of the mandible and maxilla. It typically affects middle-aged individuals.

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Glandular Odontogenic Cyst

An uncommon cyst that is often multilocular, meaning it has multiple compartments, and displays a distinct histology with ameloblast-like basal cells and a thick layer of stellate reticulum.

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Ghost Cells

A characteristic feature of the Glandular Odontogenic Cyst. These are dead cells that have undergone a process called 'ghost cell' formation.

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Appearance of OKC

The Glandular Odontogenic Cyst can have a radiographic appearance similar to an Odontogenic Keratocyst (OKC), often exhibiting a multilocular pattern.

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Histology of Radicular Cyst

A Radicular Cyst, also known as a periapical cyst, is a type of odontogenic cyst that develops at the root of a non-vital tooth.

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Radiographic Features of Glandular Odontogenic Cyst

The Glandular Odontogenic Cyst often exhibits spotty radiopacities, which are areas of increased density, due to calcification within the cyst wall.

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Differential Diagnosis

The process of identifying the most likely diagnosis from a list of potential possibilities. This is particularly important when some cysts share similar appearances.

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Rests of Malassez

These are remnants of Hertwig's epithelial root sheath, a structure that guides the formation of tooth roots, and can sometimes give rise to cysts.

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Unilocular Cyst

A cyst with a single cavity, often smaller in size and less aggressive than multilocular cysts.

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Multilocular Cyst

A cyst with multiple compartments, often larger and more complex, potentially indicating more aggressive behavior.

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Satellite Cysts

Smaller, secondary cysts that develop near a larger primary cyst. May indicate a higher risk of recurrence.

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Botryoid Odontogenic Cyst

A rare type of lateral periodontal cyst characterized by a multilocular appearance, like clusters of grapes.

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Calcifying Odontogenic Cyst (COC)

A rare cyst with radiopaque flecks within its radiolucent structure, often found in the anterior jaw of younger patients.

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Gingival Cyst (Rests of Serres)

A soft, compressible swelling found in the gingiva, usually near erupting teeth, often disappears on its own.

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Bohn's Nodules

Tiny, benign cysts found on the gingiva of newborn babies. They usually resolve by 3 months.

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Treatment of a Lateral Periodontal Cyst

Usually involves enucleation and removal of the involved tooth, if present.

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COC Treatment

Usually involves surgical removal (enucleation) of the cyst, with the potential for recurrence.

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Gingival Cyst Treatment

Often resolves spontaneously, but enucleation is also an option.

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Histologic Features of Botryoid Odontogenic Cyst

Microscopically, it shows a multilocular structure lined by epithelium with features similar to a lateral periodontal cyst.

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Calcifying Odontogenic Cyst Histology

Microscopically, it shows calcifications within the cyst wall and a lining of odontogenic epithelium.

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Gingival Cyst Histology

The lining is usually thin and composed of non-keratinized stratified squamous epithelium, resembling the epithelium of the gingiva.

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Study Notes

Cysts in and around the Jaws

  • Cysts are pathological fluid-filled cavities lined by epithelium.
  • They are a common cause of chronic swellings in the jaws.
  • Cysts have a wall of fibrous tissue surrounding a central lumen lined by epithelium.
  • Cysts are categorized as odontogenic or non-odontogenic.

Cyst Classification

  • Odontogenic Cysts (90%): Originate from dental structures.

    • Periapical (Radicular) Cysts (70%): Most common odontogenic cyst. Located at the apex of a non-vital tooth.
    • Dentigerous Cysts (15%): Surround the crown of an unerupted tooth.
    • Keratocysts (5%): Tendency to recur, characterized by parakeratinized lining epithelium.
    • Lateral Periodontal Cysts (3%): Located between roots, often associated with vital teeth.
    • Glandular Odontogenic Cysts: Rare, with a lining resembling ameloblastoma epithelium.
    • Calcifying Odontogenic Cysts: Produce radiopaque flecks in the cyst.
    • Orthokeratinized Odontogenic Cysts

  • Non-Odontogenic Cysts (10%): Originate from non-dental structures.

    • Nasopalatine Canal Cysts: Most common non-odontogenic cyst.
    • Nasolabial Cysts: Rare, form outside the bone.
    • Sublingual Dermoid Cysts: Located beneath the tongue.
    • Thyroglossal Duct Cysts: Embryological remnants, common in neck.
    • Branchial Cysts: Embryological remnants located in the neck region

  • Pseudocysts: Lack epithelial lining, include simple bone cysts or aneurysmal bone cysts.

Cyst Features

  • Growth: Slowly enlarge, either via hydrostatic pressure, wall growth, or resorption of medullary bone.
  • Fluid Content: Typically watery, opalescent, thick and white (keratocyst), viscous, yellowish, or with pus (infected).
  • Radiographic Appearance: Often radiolucent with a rounded shape and sharp outline; may be unilocular (single cavity) or multilocular (multiple cavities).
  • Location: May affect various jaw areas, influencing the expansion direction of the cyst (buccal, lingual).

General Cyst Characteristics

  • Asymptomatic: Initially asymptomatic, symptoms develop if infected or growth is significant.
  • Tooth Vitality: Usually does not affect tooth vitality unless infected.
  • Clinical Presentation: Often a slow, painless swelling, sometimes bluish appearance if expanded beyond the cortex.
  • Diagnosis: Radiographic examination coupled with biopsy. Combination of radiographic appearance, non-vital tooth, and histological examination aid in diagnosis.

Treatment

  • Treatments vary depending on the cyst type and the severity.
  • Common treatments include enucleation, curettage (removal of lining and scrap the cavity) or marsupialization (a surgical procedure to create an opening).
  • Treatment should be supplemented with antibiotics and drainage for infected cysts.

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Cysts in and around the Jaws PDF

Description

This quiz covers the types and classifications of cysts found in and around the jaws, focusing on their characteristics, origins, and specific types such as odontogenic cysts. Test your understanding of the definitions and examples of both odontogenic and non-odontogenic cysts.

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