Cysts of the Oral and Paraoral Regions
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Questions and Answers

What constitutes a cyst?

  • A solid mass of tissue without any cavity
  • A normal anatomical structure filled with air
  • A pathological cavity lined by muscle
  • A pathological cavity lined by epithelium containing fluid or semi-fluid material (correct)

Which type of cyst arises from odontogenic epithelial cells?

  • Nasopalatine cysts
  • Fissural cysts
  • Odontogenic cysts (correct)
  • Soft tissue cysts

Which of the following is a characteristic of apical cysts?

  • They are associated solely with dental caries
  • They are primarily caused by trauma
  • They develop from inflammatory hyperplasia following pulp death (correct)
  • They occur only in the mandibular region

Which of the following is a non-odontogenic cyst?

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

What is the primary etiology of a periapical cyst?

<p>Inflammatory hyperplasia following the death of pulp (B)</p> Signup and view all the answers

Which cyst is NOT classified under odontogenic cysts?

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

What percentage of all cysts do apical cysts represent?

<p>65% (C)</p> Signup and view all the answers

How are cysts like the nasopalatine cyst primarily classified?

<p>Non-Odontogenic cysts (A)</p> Signup and view all the answers

What is observed in the connective tissue lining of fully formed cysts?

<p>Well-defined collagen fibers and few inflammatory cells (D)</p> Signup and view all the answers

Which type of cells are typically found in the connective tissue lining of apical periodontal cysts?

<p>Eosinophilic Hyaline bodies (A)</p> Signup and view all the answers

What fluid components are commonly found in cystic fluid?

<p>Serum albumin, globulin, cholesterol, and nucleoproteins (C)</p> Signup and view all the answers

What is the recommended treatment for large cysts?

<p>Surgical removal with reconstruction using bone chips (B)</p> Signup and view all the answers

What characterizes inflammatory lateral periodontal cysts?

<p>They develop at the side of a pulpless tooth due to lateral root canal irritation (B)</p> Signup and view all the answers

Which condition could be diagnosed if a radiolucency is small?

<p>Periapical granuloma (A)</p> Signup and view all the answers

A residual cyst may cause which of the following issues?

<p>Jaw weakening with risk of fracture (B)</p> Signup and view all the answers

Which of the following is a common feature in the treatment of medium-sized cysts?

<p>Enucleation of the cyst along with tooth extraction (A)</p> Signup and view all the answers

What is the primary cause of a mucocele, also known as a mucous extravasation cyst?

<p>Mechanical trauma to the minor salivary gland excretory duct (D)</p> Signup and view all the answers

Where is a ranula typically located?

<p>Ventral surface of the tongue (B)</p> Signup and view all the answers

What is the appearance of a mucocele when it is clinically examined?

<p>Soft, painless swelling with a smooth, translucent surface (C)</p> Signup and view all the answers

What histopathological feature is associated with a mucous extravasation cyst?

<p>Presence of acinic degeneration and ductal dilatation (D)</p> Signup and view all the answers

What is the recommended treatment for a mucocele?

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

What is the most common age range for individuals with the cyst described?

<p>Below 40 years of age (C)</p> Signup and view all the answers

What is a key radiographic feature of the cyst mentioned?

<p>It appears as a well demarcated unilocular cavity (D)</p> Signup and view all the answers

Which site is most commonly affected by the cyst associated with mild trauma?

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

What is the expected histopathological finding within the cyst cavity?

<p>Remnants of blood or blood-stained fluid (D)</p> Signup and view all the answers

What clinical feature is common for the cyst described?

<p>Vital teeth associated with the lesion (B)</p> Signup and view all the answers

Which of the following statements is true regarding the treatment of the cyst?

<p>The cavity is irrigated and then closed after establishing bleeding (C)</p> Signup and view all the answers

What is a distinguishing feature of an aneurysmal bone cyst?

<p>Resembles a blood-soaked sponge upon operation (D)</p> Signup and view all the answers

What is believed to contribute to the pathogenesis of an aneurysmal bone cyst?

<p>Increased venous pressure in the bone area (B)</p> Signup and view all the answers

What does the term 'dentigerous' refer to?

<p>A cyst that surrounds a tooth that has not erupted (A)</p> Signup and view all the answers

Which age group is more commonly affected by dentigerous cysts?

<p>Individuals in their second and third decades (B)</p> Signup and view all the answers

Which anatomical site is most frequently associated with the occurrence of dentigerous cysts?

<p>Mandibular third molars and maxillary canines (D)</p> Signup and view all the answers

What radiographic feature is typically observed in dentigerous cysts?

<p>Well-defined unilocular radiolucency (A)</p> Signup and view all the answers

What is a possible consequence if a dentigerous cyst becomes infected?

<p>Resorption of adjacent teeth roots (A)</p> Signup and view all the answers

What histopathological feature characterizes the lining of a dentigerous cyst?

<p>Thin non-keratinized stratified squamous epithelium (C)</p> Signup and view all the answers

What is not a known potential outcome of a dentigerous cyst?

<p>Development of periodontal disease (A)</p> Signup and view all the answers

How does the expansion of a dentigerous cyst relate to cystic fluid osmolarity?

<p>Increasing osmolarity leads to increased cystic fluid accumulation (D)</p> Signup and view all the answers

What is the primary origin of the globulomaxillary cyst?

<p>Non-odontogenic epithelium (C)</p> Signup and view all the answers

Which cyst does NOT involve the alveolus?

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

Which clinical feature is associated with the nasolabial cyst?

<p>Soft tissue swelling of the upper lip (B)</p> Signup and view all the answers

What is a common radiographic feature of the globulomaxillary cyst?

<p>Well-defined radiolucency (C)</p> Signup and view all the answers

What type of epithelium lines the cysts described in the content?

<p>Simple cuboidal or ciliated columnar epithelium (B)</p> Signup and view all the answers

What is the typical age demographic for the nasolabial cyst?

<p>Fourth and fifth decades (D)</p> Signup and view all the answers

Which of the following cysts arises from the fusion of the palatal processes?

<p>Median palatal cyst (C)</p> Signup and view all the answers

What characterizes a traumatic bone cyst?

<p>A bony cavity with no epithelial lining (D)</p> Signup and view all the answers

What is a cyst in the context of oral and paraoral regions?

<p>A cyst is a pathological cavity lined by epithelium and contains fluid or semi-fluid material.</p> Signup and view all the answers

Lateral developmental cysts are a type of inflammatory periodontal cyst.

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

What is the cause of lateral developmental cysts?

<p>They are caused by the proliferation of rests of dental lamina.</p> Signup and view all the answers

What are the typical radiographic features of a lateral developmental cyst?

<p>A small radiolucent area, seldom over 1 cm in diameter, may have an opaque margin.</p> Signup and view all the answers

Which of the following is NOT a common characteristic of developmental gingival cysts of adulthood?

<p>Usually associated with significant pain (B)</p> Signup and view all the answers

What are the radiographic features of developmental gingival cysts of adulthood?

<p>Usually, they appear as a negative image on dental x-ray films.</p> Signup and view all the answers

What does the term "dentigerous" refer to in the context of cysts?

<p>It means the cyst contains an unerupted tooth.</p> Signup and view all the answers

Dentigerous cysts typically cause pain and swelling.

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

What is a common radiographic finding associated with a dentigerous cyst?

<p>It appears as a unilocular radiolucency associated with the crown of an unerupted tooth, sometimes surrounded by a sclerotic line.</p> Signup and view all the answers

What is the typical histological feature of a dentigerous cyst?

<p>It is lined by a thin, non-keratinized stratified squamous epithelium.</p> Signup and view all the answers

Odontogenic keratocysts are the most common type of odontogenic cyst.

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

What is a distinctive characteristic of odontogenic keratocysts?

<p>They contain keratin and have a dirty white or yellowish cheesy material that resembles pus but lacks an offensive odor.</p> Signup and view all the answers

Which of the following histological variations of a parakeratinized keratocyst is associated with a higher recurrence rate?

<p>Both A and B (A)</p> Signup and view all the answers

What is the common location of an incisive canal cyst?

<p>It is located within the nasopalatine canal.</p> Signup and view all the answers

Nasopalatine cysts account for a majority of oral cysts.

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

Describe the typical radiographic appearance of a nasopalatine cyst.

<p>They show a round or heart-shaped radiolucency in the midline between the roots of the maxillary central incisors.</p> Signup and view all the answers

What other name is used for a globulomaxillary cyst?

<p>It is also known as an inclusion cyst.</p> Signup and view all the answers

What is the primary characteristic that defines a pseudocyst?

<p>It lacks an epithelial lining.</p> Signup and view all the answers

What is the most likely cause of a traumatic bone cyst?

<p>It is associated with trauma or bleeding that causes hematoma formation within the bone.</p> Signup and view all the answers

Under what circumstances does a traumatic bone cyst often become symptomatic?

<p>Although most cases are asymptomatic, pain is possible if the cyst becomes infected.</p> Signup and view all the answers

Aneurysmal bone cysts are characterized by the presence of an epithelial lining.

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

What is the proposed mechanism behind aneurysmal bone cyst development?

<p>It is suggested that increased venous pressure and dilated blood vessels within the bone area contribute to the development of aneurysmal bone cysts.</p> Signup and view all the answers

What is the defining feature of a static bone cyst?

<p>It is a developmental inclusion of submandibular salivary gland tissue within, or adjacent to, the body of the mandible.</p> Signup and view all the answers

Which of the following is NOT a characteristic of a dermoid cyst?

<p>It is located solely in the jaw (B)</p> Signup and view all the answers

Thyroglossal tract cysts are among the most common developmental cysts of the neck.

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

What is the probable cause of thyroglossal tract cyst formation?

<p>These cysts arise from remnants of epithelial tissue that are left behind during the development of the thyroid gland from the tongue to its final location in the neck.</p> Signup and view all the answers

Which of the following is NOT a common location for a thyroglossal tract cyst?

<p>Lateral aspect of the neck (D)</p> Signup and view all the answers

What is the most common treatment for a thyroglossal tract cyst?

<p>The primary treatment is complete surgical excision of the cyst.</p> Signup and view all the answers

What other name is given to a benign cervical lymphoepithelial cyst besides "branchial cleft cyst"?

<p>It is also referred to as a benign cystic lymph node.</p> Signup and view all the answers

Where is a benign cervical lymphoepithelial cyst usually located?

<p>It is commonly found on the lateral aspect of the neck, anterior to the sternocleidomastoid muscle.</p> Signup and view all the answers

What are the microscopic features of the cyst wall in a benign cervical lymphoepithelial cyst?

<p>The wall is primarily composed of lymphoid tissue with well-formed germinal centers and may contain areas of stratified squamous epithelium and pseudostratified columnar epithelium.</p> Signup and view all the answers

What is the most common presenting symptom of a benign cervical lymphoepithelial cyst?

<p>The most common symptom is an asymptomatic movable mass on the lateral aspect of the neck near the anterior border of the sternocleidomastoid muscle.</p> Signup and view all the answers

What are the two main types of mucous extravasation cysts?

<p>Mucous extravasation cysts are often referred to as mucoceles or ranulas.</p> Signup and view all the answers

Mucous extravasation cysts are characterized by a thick, well-defined epithelial lining.

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

What is the most likely mechanism of formation for a mucous extravasation cyst?

<p>Trauma to a minor salivary gland's excretory duct can lead to the leakage of mucus into surrounding tissues, initiating the formation of a mucous extravasation cyst.</p> Signup and view all the answers

What is the typical appearance of a mucous extravasation cyst?

<p>They appear as soft, painless swellings with a smooth surface that may have a translucent appearance.</p> Signup and view all the answers

What histopathological changes are observed in the surrounding tissue of a mucous extravasation cyst?

<p>The surrounding tissue usually shows a collection of neutrophils, macrophages, lymphocytes, and occasionally plasma cells, along with evidence of acinar degeneration and ductal dilatation in the affected salivary gland.</p> Signup and view all the answers

Flashcards

Odontogenic Cysts

Cysts originating from odontogenic (tooth-forming) epithelial cells.

Periodontal Cysts

Odontogenic cysts arising from epithelial remnants (rests) in the periodontal ligament.

Apical Periodontal Cyst

A common periodontal cyst formed from inflammation at the root apex of a tooth.

Dentigerous Cyst

Odontogenic cyst that develops around a developing tooth.

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Incisive Canal Cyst

A non-odontogenic cyst located in the incisive canal.

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Traumatic bone cyst

A pseudocyst,not lined by epithelium, usually filled with a clear fluid or a semi-fluid material.

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Epithelial rests of Malassez

Remnants of embryonic cells that can give rise to cysts in the periodontal ligament.

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Pseudocyst

A pathological cavity that is not lined by epithelium.

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C-embryonic epithelium in cysts

The lining of newly formed cysts; it's hyper-plastic, meaning it's rapidly growing.

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Mature cyst epithelium

In fully formed cysts, the epithelial lining becomes regular and flattened. Connective tissue is less active.

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Apical Periodontal Cyst Connective Tissue

Contains collagen fibers, fibroblasts, capillaries, inflammatory cells, and possible calcification.

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Cyst fluid components

Serum albumin, globulin, cholesterol, and nucleoproteins are present in cyst fluid.

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Periapical Granuloma vs. Cyst

A small radiolucency might be a granuloma, whereas a larger one could be a cyst.

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Lateral Periodontal Cysts

These are less common, occurring on the side of a root (often of a pulpless tooth), in comparison with periapical cysts.

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Residual cyst

A cyst that remains after a tooth extraction of a pulpless tooth (with a periapical cyst)

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Cyst treatment (small)

Small cysts are often treated with enucleation and apicectomy.

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What is a Dentigerous cyst?

A cyst that encloses the crown of an unerupted tooth, attached to the neck of the tooth.

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What is the origin of a Dentigerous cyst?

It originates from the reduced enamel epithelium (REE), the layer that forms tooth enamel.

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Why does a Dentigerous cyst form?

Fluid accumulates between the REE and the tooth crown, causing cystic change.

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Where does a Dentigerous cyst attach?

It attaches to the amelocemental junction, where the enamel and cementum meet.

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What are the clinical features of Dentigerous cysts?

They are more common in males, in the second and third decades of life, often affecting the mandibular third molar or maxillary canine.

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How can a Dentigerous cyst affect a tooth?

It can prevent the tooth from erupting and may cause resorption of adjacent tooth roots.

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What are the radiographic features of Dentigerous cysts?

They appear as well-defined, unilocular radiolucencies (dark areas) surrounding the crown of an unerupted tooth.

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How does the cyst lining appear microscopically?

It's lined by non-keratinized stratified squamous epithelium, usually 2-4 cell layers thick.

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What is a Nasolabial Cyst?

A soft tissue cyst located near the upper lip, caused by entrapped epithelium during development.

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Where do Globulomaxillary Cysts form?

Between the maxillary lateral incisor and canine teeth, arising from non-odontogenic epithelium.

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Median Palatal Cyst Origin

From epithelial remnants at the fusion line of the palatal processes, or a posteriorly displaced nasopalatine cyst.

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What is a Median Mandibular Cyst?

It arises from epithelial entrapment in the midline of the mandible.

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Nasolabial Cyst Location

It's a soft tissue cyst that doesn't involve the alveolus.

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What does 'non-odontogenic' mean?

Originating from tissue that is not related to tooth development.

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Globulomaxillary Cyst Appearance

A well-defined radiolucency that diverges the roots of the lateral incisor and canine teeth.

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Mucous Extravasation Cyst

A cyst formed when saliva leaks out of a damaged salivary gland duct and collects in surrounding tissue. This leaked saliva induces an inflammatory response, leading to a wall formation around the mucin pool.

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Mucocele

A common type of mucous extravasation cyst, typically found on the lower lip or inside cheek. It's a small, soft, painless swelling.

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Ranula

A large mucous extravasation cyst found on the floor of the mouth or under the tongue. It can be a soft, translucent swelling that can get quite big.

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What causes a mucocele or ranula?

Injury to a minor salivary gland duct, causing saliva to leak into the surrounding tissue.

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How are mucoceles and ranulas treated?

Surgical removal, usually by excision.

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Traumatic Bone Cyst: Location

Traumatic bone cysts commonly develop in the body and ramus of the mandible, often near the molar and premolar regions.

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Traumatic Bone Cyst: Symptoms

Traumatic bone cysts are often asymptomatic and may be discovered accidentally during routine radiographic examinations. They typically don't cause pain or expansion of the jawbone.

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Traumatic Bone Cyst: Radiographic Features

The cyst appears on X-rays as a well-defined, unilocular (single chamber) cavity that can extend from the mandible body into the ramus. It's situated above the inferior alveolar canal.

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Aneurysmal Bone Cyst: Classification

Aneurysmal bone cysts are considered pseudocysts because, despite appearing cyst-like on X-rays, they lack an epithelial lining under microscopic examination.

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Aneurysmal Bone Cyst: Pathogenesis

The exact cause of aneurysmal bone cysts is unknown, but one theory suggests increased venous pressure leading to dilated blood vessels in the bone. This causes bone resorption and replacement with connective tissue and new bone.

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Aneurysmal Bone Cyst: Clinical Features

These cysts usually affect patients under 30 years old, with a slight female pre-disposition. They are commonly found in the molar regions of the jaws.

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Aneurysmal Bone Cyst: Symptoms

Aneurysmal bone cysts often present as firm, painful swellings. Surgical intervention leads to excessive bleeding, likened to a blood-soaked sponge.

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What is a cyst?

A pathological cavity lined by epithelium, containing fluid or semi-fluid material.

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What's a pseudocyst?

A cyst-like cavity that lacks an epithelial lining.

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Odontogenic cyst origin

Arise from odontogenic epithelial cells, which are involved in tooth development.

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Periodontal cyst types

Can be inflammatory (caused by infection) or developmental (non-inflammatory).

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Apical periodontal cyst location

Forms at the tip of a tooth's root, often due to pulp death.

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Lateral periodontal cyst location

Forms on the side of a tooth root, usually in response to inflammation from a lateral root canal.

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Dentigerous cyst attachment

Attached to the neck of an unerupted tooth.

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Primordial cyst origin

Develops from the enamel organ before tooth formation or from supernumerary tooth germs.

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Nasopalatine cyst location

Found in the incisive canal, between the maxillary central incisors.

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Globulomaxillary cyst location

Found between the maxillary lateral incisor and canine, caused by entrapped epithelium during development.

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Median mandibular cyst origin

Arises from epithelial entrapment in the midline of the mandible during fusion of the two mandibular arches.

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Traumatic bone cyst cause

Thought to be related to trauma, leading to bleeding and a cavity in the bone.

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Aneurysmal bone cyst appearance

Multilocular (many chambers) on X-rays, with a honeycomb or soap-bubble appearance.

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Static bone cyst nature

Not a true cyst, caused by developmental inclusion of salivary tissue in the mandible.

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Dermoid or epidermoid cyst cause

From epithelial debris during closure of the mandibular arches.

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Thyroglossal tract cyst origin

Remnants of the thyroid gland's developmental pathway.

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Benign cervical lymphoepithelial cyst location

Found on the side of the neck, anterior to the sternomastoid muscle.

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Mucous extravasation cyst cause

Trauma to a minor salivary gland duct, causing saliva to leak into surrounding tissue.

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Mucocele location

Commonly found on the lower lip or inside cheek.

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Ranula location

Found on the floor of the mouth or under the tongue.

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What is the difference between a periapical granuloma and a periapical cyst?

A periapical granuloma is an inflammatory response at the root tip, while a periapical cyst is a fluid-filled cavity lined by epithelium.

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What is a periapical scar?

A scar that forms after a periapical granuloma or cyst has been treated.

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What is periapical cemental dysplasia?

A non-inflammatory condition that affects the root of a tooth, often causing a radiolucency.

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What are the factors that influence what kind of epithelial lining a cyst can have?

The location of the cyst, whether it is newly formed or old, and whether the cyst is infected.

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Study Notes

Cysts of the Oral and Paraoral Regions

  • A cyst is a pathological cavity lined by epithelium, containing fluid or a semi-fluid material.
  • Pseudocysts are cysts not lined by epithelium.

Classification of Cysts

1-Odontogenic Cysts

  • Arise from odontogenic epithelial cells.
  • a. Periodontal Cysts:
    • Inflammatory:
      • Apical
      • Lateral
      • Residual
    • Developmental:
      • Lateral developmental cysts
      • Gingival cyst of adults
      • Gingival cyst of newborn (Bohn's nodules)
  • b. Dentigerous Cysts:
    • Central
    • Lateral
    • Circumferential
  • c. Primordial Cyst, Odontogenic Keratocyst:

2- Non-Odontogenic Cysts

  • (Further classifications and descriptions for Non-Odontogenic cysts are provided in subsequent pages of the document.)

3- Pseudocysts

  • a. Traumatic bone cyst:
  • b. Aneurysmal bone cyst:
  • c. Static bone cyst:

4- Soft tissue cysts of the jaw and neck

  • a. Dermoid and epidermoid cysts:
  • b. Thyroglossal tract cyst:
  • c. Benign lymphoepithelial cyst (branchial-cleft cyst):
  • d. Mucous retention and mucous extravasation cysts:

Further information on specific cyst types (following pages):

(Further details and specific information regarding various types of cysts are documented in the following pages from pages of the document, including their causes, characteristics, and treatments)

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