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Questions and Answers
What is the mechanism by which water is attracted into a cyst to raise the internal pressure?
Which factor stimulates the proliferation of cells in a cyst to form arcades of epithelium?
What contributes to the unremitting growth of the epithelial lining in keratocysts?
Which process enlarges a bony cavity by the release of bone resorbing factors from the capsule?
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How does increased internal pressure within a cyst affect the adjacent bone?
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What prevents attracted fluid from diffusing out of a cyst?
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Which factor increases the surface area of cyst lining by cell multiplication?
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What stimulates cells known as cell rests of Malassez to proliferate and form arcades of epithelium?
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Study Notes
Residual Cysts
- Histopathological features are similar to conventional radicular cysts, but may become less inflamed over time
- Cyst wall may eventually be composed of uninflamed collagenous fibrous tissue
- Radiographic appearance: a large residual cyst left behind after extraction of a tooth (e.g. 1st mandibular molar)
Differential Diagnosis
- Lesions to be distinguished from periapical radiolucencies include:
- Periapical granuloma
- Peripaical cemento-osseous dysplasia (early lesions)
Lateral Periodontal Cysts
- An uncommon but well-recognized type of odontogenic cyst
- Occur in the lateral periodontal position
- Inflammatory etiology and diagnosis of collateral OKC are excluded on clinical and histological grounds
- Clinical features:
- Age: 20-60 years, peak in 6th decade
- Sex: Male predilection
Frequency of Epithelial Cysts of Jaws
- Radicular cyst: 5.60%
- Dentigerous cyst: 8%
- Odontogenic keratocyst: 11.60%
- Residual cyst: 4.20%
- Paradental cyst: 18.10%
- Unclassified odontogenic cysts: 52.30%
Radicular Cysts
- Also called apical periodontal cyst
- Most common inflammatory cysts, arising from epithelial residues in the periodontal ligament
- Result from periapical periodontitis following death and necrosis of the pulp
- Can remain behind in the jaws after removal of the offending tooth (residual cyst)
Pathogenesis of Radicular Cysts
- Phase of initiation: rests of Malassez proliferate to form the lining of radicular cyst
- Phase of cyst formation: epithelium proliferates and covers the bare connective tissue surface of the abscess cavity
- Water from the tissue fluid is attracted into the cyst to raise the internal pressure
- Hydrostatic pressure is transmitted to the adjacent bone, leading to bone resorption
- Retention of fluid within the cavity: semi-permeable membrane governs access into the cyst, preventing the escape of certain substances from the contents
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Description
Test your knowledge on dental lesions and residual cysts. Identify the distinct features of a residual cyst compared to other lesions based on histopathological characteristics and radiographic appearances.
