Cysts of the Oral and Paraoral Regions
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Questions and Answers

What causes a mucocele to form in the oral cavity?

  • Metabolic disorders affecting salivary production
  • Congenital malformations of the salivary system
  • Trauma to the minor salivary gland excretory duct (correct)
  • Inflammation of the minor salivary glands
  • Which site is specifically associated with a ranula?

  • Palate
  • Posterior molar area
  • Upper lip
  • Ventral surface of the tongue (correct)
  • What is a characteristic feature of a mucocele upon aspiration?

  • It increases in size
  • The color changes to red
  • It decreases in size (correct)
  • It becomes painful
  • What type of tissue surrounds the mucin pool in a mucocele?

    <p>Granulation tissue and fibrous tissue</p> Signup and view all the answers

    What is the primary treatment for a mucous extravasation cyst?

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

    What does the connective tissue lining of apical periodontal cysts primarily consist of?

    <p>Collagen fibers, fibroblasts, and capillaries</p> Signup and view all the answers

    What characteristic changes occur in the epithelium of cysts as they mature?

    <p>It becomes regular and flattened</p> Signup and view all the answers

    Which of the following components is NOT typically found in cystic fluid?

    <p>Amylase</p> Signup and view all the answers

    What treatment is suggested for a large cyst to avoid damaging important structures like the inferior dental nerve?

    <p>Marsupialization</p> Signup and view all the answers

    Inflammatory lateral periodontal cysts typically form due to irritation of which tissue?

    <p>Periodontal tissue</p> Signup and view all the answers

    What is a significant potential issue with residual cysts in the jaw bone?

    <p>They may cause trouble with dentures</p> Signup and view all the answers

    Which of the following is a characteristic of the epithelium found in newly formed cysts?

    <p>It is hyper-plastic</p> Signup and view all the answers

    What is a likely characteristic of a periapical granuloma compared to other cysts?

    <p>It typically appears as small radiolucency</p> Signup and view all the answers

    What happens to the central cells of the epithelial mass as they become separated from their nutrient source?

    <p>They degenerate and become necrotic.</p> Signup and view all the answers

    Which of the following conditions is primarily associated with the formation of an apical periodontal cyst?

    <p>Proliferation of epithelium in a pre-existing cavity.</p> Signup and view all the answers

    At which age range are apical periodontal cysts most commonly discovered?

    <p>Adults in their thirties to sixties.</p> Signup and view all the answers

    What is a common characteristic of the radiographic appearance of an apical periodontal cyst?

    <p>Well-defined radiolucency with thin opaque margin.</p> Signup and view all the answers

    What is the initial clinical feature of an apical periodontal cyst when it starts to swell?

    <p>It appears as a rounded and hard swelling.</p> Signup and view all the answers

    What typically occurs to the swelling of an apical periodontal cyst if infection develops?

    <p>It becomes painful and may increase in size.</p> Signup and view all the answers

    What type of epithelium lines the apical periodontal cysts?

    <p>Stratified squamous epithelium.</p> Signup and view all the answers

    When examining a cyst radiographically, which feature indicates the presence of infection?

    <p>A hazy outline.</p> Signup and view all the answers

    What is the characteristic radiographic appearance of a multilocular radiolucency associated with certain bone lesions?

    <p>Honeycomb or soap-bubble appearance</p> Signup and view all the answers

    What histopathologic feature is NOT associated with certain bone lesions?

    <p>Epithelial lining</p> Signup and view all the answers

    What is the primary treatment method for the static bone cyst?

    <p>Curettage or excision</p> Signup and view all the answers

    How is a soft tissue cyst in the jaw typically characterized?

    <p>Painless and lowly growing</p> Signup and view all the answers

    Which imaging technique confirms the diagnosis of a static bone cyst?

    <p>Sialogram</p> Signup and view all the answers

    What distinguishes a dermoid cyst from an epidermoid cyst histologically?

    <p>Presence of sebaceous glands</p> Signup and view all the answers

    What is a common characteristic of the static bone cyst on radiographic examination?

    <p>Sharply circumscribed radiolucency</p> Signup and view all the answers

    In which age group are dermoid and epidermoid cysts most commonly found?

    <p>Young adults</p> Signup and view all the answers

    What type of keratocyst has a high recurrence rate?

    <p>Parakeratotic type</p> Signup and view all the answers

    Which of the following is a reason for recurrence in parakeratinized keratocysts?

    <p>Daughter cysts may be left behind</p> Signup and view all the answers

    What is the common age range for patients with nasopalatine canal cysts?

    <p>40 to 60 years</p> Signup and view all the answers

    Which radiographic feature is commonly associated with nasopalatine cysts?

    <p>Heart-shaped radiolucency</p> Signup and view all the answers

    What type of epithelium lines the oral portion of a nasopalatine canal cyst?

    <p>Stratified squamous epithelium</p> Signup and view all the answers

    Which of the following conditions is included in the differential diagnosis for cysts?

    <p>Ameloblastoma</p> Signup and view all the answers

    What symptom may occur if a nasopalatine canal cyst becomes infected?

    <p>Rapid swelling with radiating pain</p> Signup and view all the answers

    What characteristic feature is often observed in the histopathology of parakeratinized keratocysts?

    <p>Presence of mucous glands</p> Signup and view all the answers

    What is the primary characteristic of a dentigerous cyst?

    <p>It is attached to the neck of an unerupted tooth.</p> Signup and view all the answers

    Which age group is most commonly affected by dentigerous cysts?

    <p>Second and third decades of life</p> Signup and view all the answers

    What radiographic feature is typical of a dentigerous cyst?

    <p>Well defined unilocular radiolucency</p> Signup and view all the answers

    Which of these symptoms is NOT associated with small dentigerous cysts?

    <p>Facial asymmetry</p> Signup and view all the answers

    How do dentigerous cysts affect adjacent teeth?

    <p>They may cause resorption of roots</p> Signup and view all the answers

    What type of epithelium typically lines an uninflamed dentigerous cyst?

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

    What is a significant consequence of a dentigerous cyst becoming infected?

    <p>Pain and increased swelling occur.</p> Signup and view all the answers

    What role does osmolarity of cystic fluid play in dentigerous cysts?

    <p>Causes degeneration of epithelial cells</p> Signup and view all the answers

    ما هو تعريف الخراج؟

    <p>الخرّاج هو تجويف مرضي مُبطّن بنسيج ظهاري و يحتوي ... سائل أو مادة شبه سائلة.</p> Signup and view all the answers

    ما هو نوع الخراجات التي تنشأ من الخلايا الظهارية المولدة للأسنان؟

    <p>خَراجات مُولدة للأسنان</p> Signup and view all the answers

    ما هي ______ التي تنشأ نتيجة التهاب؟

    <p>خراجات حول سنية</p> Signup and view all the answers

    ما هي الأنواع الفرعية لخراجات حول سنية التي تنتج من النمو؟

    <p>خراج جانبي نموي</p> Signup and view all the answers

    ما هو اسم خراج اللثة حديثي الولادة ؟

    <p>عقد بوهن</p> Signup and view all the answers

    ما هو مرادف مصطلح خراج حامل السن ؟

    <p>خراج الجُرثومة</p> Signup and view all the answers

    ما هو تعريف خَراجات الشقوق ؟

    <p>خَراجات الشقوق هي</p> Signup and view all the answers

    رَبط أشكال الخراجات مع مواقعها:

    <p>خراج القناة الشقوقية = الحنك<br /> خراج اللثة التنموي = الفك السفلي<br /> خراج بقايا السن الذي ... جرى ... خَلعه = عظم الفك بعد خلْع السن<br /> خراج جانبي حول سين التهابي = المنطقة السنية الأمامية للفك العلوي خراج اللثة التنموي = جنب اللثة في السن الغير متطور<br /> خراج الشفاه = الشفاه و اللثة و الشفة العليا و الفك الأمامي</p> Signup and view all the answers

    خراجات الفكين و الرقبة هي خراجات تقع في الأنسجة الناعمة

    <p>True</p> Signup and view all the answers

    Study Notes

    Cysts of the Oral and Paraoral Regions

    • Definition: A cyst is a pathological cavity lined by epithelium, containing fluid or semi-fluid material. Pseudocysts are cysts not lined by epithelium.
    • Classification: Odontogenic or Non-Odontogenic cysts.
      • Odontogenic Cysts: Arise from odontogenic epithelial cells.
        • Periodontal Cysts:
          • Inflammatory: 1) apical, 2) lateral, 3) residual
          • Developmental: 1) lateral developmental, 2) gingival cyst of adults, 3) gingival cyst of newborn (Bohn's nodules)
        • Dentigerous Cyst: (Central, lateral, circumferential)
        • Primordial Cyst, Odontogenic Keratocyst.
      • Non-Odontogenic Cysts:
        • Nasopalatine Cysts: 1) Incisive Canal Cyst, 2) Cyst of palatine papilla
        • Fissural Cysts: 1) Globulomaxillary, 2) Nasolabial, 3) Median (maxilla: median palatal, mandible: median mandibular)
        • Pseudocysts: 1) Traumatic bone cyst, 2) Aneurysmal bone cyst, 3) Static bone cyst
        • Soft tissue cysts of the jaw and neck: 1) Dermoid and epidermoid cysts, 2) Thyroglossal tract cyst, 3) Benign lymphoepithelial cyst (branchial-cleft cyst), 4) Mucous retention and mucous extravasation cysts

    Epithelium and Odontogenic Cysts

    • Origin of epithelium: Epithelium associated with odontogenic cysts originates from enamel organ, reduced enamel epithelium, epithelial rests of Malassez, and epithelial rests of Serres.
      • Periodontal Cysts: 65% of all cysts, result from inflammatory hyperplasia of epithelial rests of Malassez in periodontal ligament.
      • Periapical Cysts: Develop from periapical granulomas due to inflammatory hyperplasia within the granuloma. Cells in the central portion can be separated from nutrients within capillaries, resulting in necrosis and liquefaction.

    Mechanism of Enlargement

    • Breakdown of complex proteins: Remnants of cellular debris break down complex tissue proteins into simpler molecules, increasing the osmotic pressure of cystic fluid.
    • Fluid transport: Resulting in fluid transport across the semipermeable epithelial lining into the lumen, leading to cyst enlargement.

    Clinical Features (Apical Periodontal Cysts)

    • Age: Adult (third to sixth decades), more common in men
    • Site: Maxilla, especially the anterior region
    • Symptoms: Usually asymptomatic, discovered during routine x-ray. Slowly progressive painless swelling, painful swelling if infected. Swelling hard at first, eggshell crackling of bone later.
    • Radiographic Findings: Well-defined unilocular radiolucency, thin opaque margin, varying dimeter from 5 mm to several centimeters. May show infection which causes outline to be hazy, small radicular cyst and periapical granuloma may appear radiographically similar.

    Microscopic Variations in Cyst Walls

    • Epithelial Lining: Can include stratified squamous epithelium, respiratory or pseudostratified ciliated columnar epithelium (maxillary sinus cysts), or embryonic epithelium.

    Cyst Wall Connective Tissue

    • Composition: Contains collagen fibers, fibroblasts, capillaries, inflammatory cells (acute and chronic), foci of dystrophic calcification as haematoxylin masses, cholesterol clefts, Degenerated plasma cells (Russel bodies), eosinophilic Hyaline bodies or Rushton bodies.

    Cyst contents and differential diagnosis

    • Cyst fluid: Contains serum albumin, globulin, cholesterol, and nucleoproteins.
      • Infected: May be purulent
    • Differential Diagnoses: 1) Periapical granuloma, 2)Periapical scar, 3) Early phase of periapical cemental dysplasia

    Cysts of the Palatine Papilla and Fissural Cysts

    • Etiology and Pathogenesis: Develop from dental lamina remnants in soft tissue between oral epithelium and periosteum.
    • Clinical appearance: Soft, painless swelling less than 1 cm in diameter, same color as adjacent normal mucosa.
    • Radiographic features: Dental x-ray film is negative.
    • Histopathologic features: Thin, flattened squamous epithelial lining.

    Gingival Cyst of Newborn (Bohn's Nodules)

    • Multiple small white nodules: On alveolar ridge, less than a few mm, asymptomatic.
    • Origin: Remnants of dental lamina, forming small keratinized cysts.
    • Spontaneous resolution: Ruptures and resolves spontaneously in most cases.

    Dentigerous Cysts (Follicular Cysts)

    • Definition/Characteristics: Contains unerupted tooth, attached to the neck of the tooth (15-17% of all jaw cysts)
    • Etiology and Pathogenesis: Cystic change from reduced enamel epithelium, after complete enamel formation, in the space between reduced enamel epithelium and the tooth crown.
    • Clinical Features: No symptoms in small cysts, possible pain and infection in larger cysts
    • Radiographic Features: Well-defined unilateral radiolucency associated with the crown of an unerupted tooth; may be surrounded by a thin sclerotic layer.
    • Histopathologic Features: Lined by a thin, regular, non-keratinized, stratified squamous epithelium, Inflammatory cells are absent in the connective tissue wall, Cholesterol clefts and foreign body giant cells may also be present.

    Other Cysts (Incisive Canal Cyst, Nasopalatine Cyst, etc)

    • Etiology: Originates from the remainder of epithelium tissue remnants from the embryonic nasopalatine ducts that are present inside Nasopalatine canal,
    • Clinical Features: Asymptomatic, discovered in routine x-ray. Pain, salty taste, numbness of anterior palate, and swelling if infected.
    • Radiographic Features: Round/ovoid well-defined radiolucency in midline between the roots of the maxillary central incisors. May not exceed 6mm in diameter
    • Histopathologic Features: Pseudostratified ciliated columnar epithelium in some cases, stratified squamous epithelium, and combinations. The connective tissue wall shows signs of inflammation.

    Eruption Cysts

    • Description: Uncommon superficial dentigerous cyst occurring in the soft tissue of the gum or alveolar mucosa over an erupting tooth.
    • Clinical Features: Soft, rounded swelling, same color as adjacent normal mucosa; possibly filled with blood ("eruption hematoma").
    • Treatment: No treatment needed; typically disappears spontaneously.

    Odontogenic Keratocyst (Primordial Cyst)

    • Least Common: 7% of odontogenic cysts
    • Age: 2nd and 3rd decades
    • Location: Usually in the mandible, followed by maxilla
    • Symptoms: Asymptomatic unless infected
    • Radiographic Features: Unilocular radiolucency, smooth margins; seldom larger than 1 cm in diameter, but may be larger in infected cases.
    • Histopathologic Features: Thin, regular, stratified squamous epithelium; parakeratosis (high recurrence rate) or orthokeratosis (lower recurrence rate)

    Benign Cervical Lymphoepithelial Cyst

    • Location: Lateral neck, anterior to sternomastoid muscle.
    • Origin: Remnants of epithelial cells of branchial grooves, entrapped in cervical lymph nodes
    • Symptoms: Asymptomatic; movable mass
    • Histopathology: Lined by stratified squamous epithelium (sometimes pseudostratified columnar epithelium), with lymphoid follicles.

    Mucous Extravasation Cyst

    • Etiology and Pathogenesis: Mechanical trauma to minor salivary gland excretory duct, resulting in extravasated mucous inducing inflammatory reaction in connective tissue surrounding.
    • Clinical Features: Painless swelling, smooth surface, translucent; varies from mm to cm in size
    • Site: Lower lip, buccal mucosa, ventral surface of the tongue, floor of the mouth (Ranula).
    • Histopathology: Mucous pool surrounded by fibrous/granulation tissue, with neutrophils, macrophages, lymphocytes, and possibly plasma cells.
    • Treatment: Surgical excision

    Other Cysts (Aneurysmal Bone Cysts, Static Bone Cysts)

    • These descriptions are incomplete in the provided context and require further information from the original texts.

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    Description

    Explore the classification and characteristics of cysts found in the oral and paraoral regions. This quiz covers both odontogenic and non-odontogenic cysts, detailing their definitions, types, and relevant examples. Test your knowledge on this important topic in oral pathology!

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