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Questions and Answers
What is a key characteristic that distinguishes a ranula from a mucocele?
What is a key characteristic that distinguishes a ranula from a mucocele?
Which type of cyst is characterized by a true epithelium and is less frequent than mucoceles?
Which type of cyst is characterized by a true epithelium and is less frequent than mucoceles?
Which treatment method is specifically mentioned for a ranula?
Which treatment method is specifically mentioned for a ranula?
What common symptom can indicate that a branchial cyst has become infected?
What common symptom can indicate that a branchial cyst has become infected?
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What happens to the minor salivary gland ducts during the formation of a mucosel?
What happens to the minor salivary gland ducts during the formation of a mucosel?
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What is a characteristic feature of the cyst described in the content?
What is a characteristic feature of the cyst described in the content?
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Which statement accurately describes the treatment approach for the lesion outlined?
Which statement accurately describes the treatment approach for the lesion outlined?
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What is a distinguishing feature of an aneurysmal bone cyst compared to other types of cysts?
What is a distinguishing feature of an aneurysmal bone cyst compared to other types of cysts?
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Which type of lesion is characterized as being asymptomatic and needing no treatment, merely monitored?
Which type of lesion is characterized as being asymptomatic and needing no treatment, merely monitored?
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What type of teeth have been reported in the area affected by the lesion?
What type of teeth have been reported in the area affected by the lesion?
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Which of the following is NOT listed as a differential diagnosis for the lesion?
Which of the following is NOT listed as a differential diagnosis for the lesion?
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What might the needle aspiration of the cyst yield?
What might the needle aspiration of the cyst yield?
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Which feature is commonly associated with cysts in young patients, based on the provided information?
Which feature is commonly associated with cysts in young patients, based on the provided information?
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What is the origin of the nasopalatine duct cyst?
What is the origin of the nasopalatine duct cyst?
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Which cyst is most commonly found in patients aged 40 to 60 years and can occasionally be bilateral?
Which cyst is most commonly found in patients aged 40 to 60 years and can occasionally be bilateral?
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What is a characteristic feature of the incisive duct cyst?
What is a characteristic feature of the incisive duct cyst?
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Which cyst does not typically appear on a radiograph?
Which cyst does not typically appear on a radiograph?
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When examining a nasopalatine duct cyst radiographically, what shape is typically observed?
When examining a nasopalatine duct cyst radiographically, what shape is typically observed?
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What is a contributing factor to the development of a radicular cyst?
What is a contributing factor to the development of a radicular cyst?
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In which region are radicular cysts most commonly found?
In which region are radicular cysts most commonly found?
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How does a nasolabial cyst primarily present in a clinical examination?
How does a nasolabial cyst primarily present in a clinical examination?
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What characteristic distinguishes a radicular cyst on a radiograph?
What characteristic distinguishes a radicular cyst on a radiograph?
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Which histological feature is NOT associated with a radicular cyst?
Which histological feature is NOT associated with a radicular cyst?
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What is the recommended treatment for a large radicular cyst?
What is the recommended treatment for a large radicular cyst?
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Which cyst is specifically associated with the buccal surface of erupted molars?
Which cyst is specifically associated with the buccal surface of erupted molars?
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What is a common differential diagnosis for a radicular cyst?
What is a common differential diagnosis for a radicular cyst?
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In which scenario might a traumatic bone cyst commonly present?
In which scenario might a traumatic bone cyst commonly present?
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Which condition is characterized by a cyst remaining at the site of a previously extracted tooth?
Which condition is characterized by a cyst remaining at the site of a previously extracted tooth?
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Which histological finding is characteristic of traumatic bone cysts?
Which histological finding is characteristic of traumatic bone cysts?
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What is the primary treatment method for dermoid cysts?
What is the primary treatment method for dermoid cysts?
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Where are dermoid cysts most commonly localized?
Where are dermoid cysts most commonly localized?
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Which imaging techniques can be utilized to determine the boundaries of a dermoid cyst?
Which imaging techniques can be utilized to determine the boundaries of a dermoid cyst?
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What is a distinguishing feature of thyroglossal duct cysts during clinical presentation?
What is a distinguishing feature of thyroglossal duct cysts during clinical presentation?
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What complication may occur if a thyroglossal duct cyst becomes infected?
What complication may occur if a thyroglossal duct cyst becomes infected?
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What anatomical structure is often removed during the surgical excision of a thyroglossal duct cyst to prevent recurrence?
What anatomical structure is often removed during the surgical excision of a thyroglossal duct cyst to prevent recurrence?
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At what stage of intrauterine life does the ductus thyroglossus typically disappear?
At what stage of intrauterine life does the ductus thyroglossus typically disappear?
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In children, when do dermoid cysts typically present?
In children, when do dermoid cysts typically present?
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What is a significant disadvantage of marsupialisation?
What is a significant disadvantage of marsupialisation?
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In which situation is marsupialisation indicated?
In which situation is marsupialisation indicated?
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What is required for a successful post-surgical outcome following cyst removal?
What is required for a successful post-surgical outcome following cyst removal?
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What potential issue can arise from improper flap shape during cyst surgery?
What potential issue can arise from improper flap shape during cyst surgery?
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Which statement correctly describes the implications of keratocysts during treatment?
Which statement correctly describes the implications of keratocysts during treatment?
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What is a key consideration to ensure the safety of neighboring structures during cyst surgery?
What is a key consideration to ensure the safety of neighboring structures during cyst surgery?
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Which statement reflects a misconception about the closure of the cyst after marsupialisation?
Which statement reflects a misconception about the closure of the cyst after marsupialisation?
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What is a notable risk associated with insufficient removal of cyst structures?
What is a notable risk associated with insufficient removal of cyst structures?
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Study Notes
Non-Odontogenic Cysts
- These cysts are derived from ectodermal remnants, lacking the potential to form teeth.
- Examples include nasopalatine duct cyst (incisive duct cyst) and nasolabial cyst.
Nasopalatine Duct Cyst (Incisive Duct Cyst)
- Develops from epithelial remnants of the nasopalatine duct in the embryo.
- It's the most common cyst in this group.
- More prevalent in the 5th decade.
- An incisive papilla cyst develops without bone involvement.
- It exhibits a radiolucent area between central tooth roots, appearing round or oval (sometimes heart-shaped).
- The foramen incisivum (6mm widest diameter) can be confused with a small cyst.
- Symptoms typically include a lack of large dimensions, posterior mucosal swelling of central teeth, and vital teeth.
- A sense of a salty taste is sometimes observed.
Nasolabial Cyst (Nasal-Alveolar Cyst)
- Thought to originate from epithelial remnants of the medial and lateral nasal extensions or the nasolacrimal duct.
- It's a soft tissue cyst, not always apparent on radiographs, sometimes visible as a depression in the bone.
- Common age range is 40-60 years old and occasionally bilateral.
Inflammatory Cysts
- These cysts are categorized as inflammatory and odontogenic.
- Examples include radicular cysts (apical and lateral) and residual cysts.
Radicular Cyst
- Develops in the apical or lateral area of non-vital teeth's roots.
- Includes Malassez epithelial remnants.
- Factors driving cyst development include epithelium proliferation, fluid hydrostatic pressure and surrounding bone resorption (prostoglandinII-I).
- Common amongst age groups between 20 and 60 years old with a male/female ratio of 2:1.
- Frequently observed in the maxilla (3/1) or mandible (1/1).
- Occurs in anterior and posterior regions.
- Typically asymptomatic, presenting symptoms only during infection.
Radicular Cyst - Radiology
- Appears as a round radiolucency at the tooth apex with a fine radiopaque border.
- Small lesions can be indistinguishable from periapical granulomas.
- Root resorption is possible in large cysts.
Radicular Cyst - Differential Diagnosis
- Periapical granuloma
- Periapical scar
- Periapical cemento-osseous dysplasia
Radicular Cyst - Histology
- Lined with multilayered squamous epithelium.
- Walls contain hyperplastic connective tissue with multiple blood vessels.
- Includes PMN leucocytes, lymphocytes, plasma cells, and Russell bodies.
- Cyst fluid might contain cholesterol crystals.
Radicular Cyst - Treatment
- Small cysts and anterior teeth treatments involve apical resection and enucleation.
- Large cysts are better treated with tooth extraction followed by enucleation, with emphasis on complete removal to prevent residual cysts.
Collateral Inflammatory Cyst
- A subset of inflammatory cysts excluding radicular cysts.
- "Paradental cysts" are found among younger people (under 20).
- Buccal bifurcation cysts are collateral inflammatory cysts found on the buccal surface of first and second molars.
Residual Cysts
- A cyst remaining at the site of a previously extracted tooth.
- Potential differential diagnoses include haemangioma, unicystic ameloblastoma, adenomatoid odontogenic tumour, and neurilemmoma.
- Treated by enucleation.
Epithelial Jaw Cysts (Pseudocysts/False Cysts)
- Classified as solitary bone cysts (traumatic bone cysts, simple bone cysts, hemorrhagic bone cysts), Stafne bone cysts, and aneurysmal bone cysts.
Traumatic Bone Cysts
- Though trauma is suspected, the precise cause isn't known.
- It involves a level of trauma below the threshold for fractures.
- Normally painless and asymptomatic.
- Aspiration reveals air.
- A radiolucent area between the roots is observed, and there's no tooth root resorption.
- Treatment involves ventilation.
- It's not a true cyst but mimics one due to haemorrhage accumulation and clot organization after trauma, causing a cavity.
Soft Tissue Cysts Around the Mouth
- Includes eruption, gingival, nasolabial cysts, dermoid cysts, thyroglossal cysts, and branchial cysts, and salivary gland cysts.
Dermoid Cysts
- Embryonic skin (epidermis or dermis) elements are positioned between tissues.
- The cyst wall consists of skin tissue folds and is filled with yellowish, sludge-like material.
- Usually located on the cheek or under the chin (between the genioglossus, geniohyoid, and mylohyoid muscles).
- Typically characterized by slow growth and unilateral occurrence, sometimes appearing in patients over 40.
- In children, it can be easily detected by a painless, movable, rubbery swelling inside the mouth and under the jaw.
- Treatment involves extirpation through extraoral incisions.
Thyroglossal Duct Cysts and Fistulas
- Originates from remnants of the ductus thyroglossus which forms part of the thyroid gland.
- Located in the midline of the neck, between the foramen cecum and the sternum (occasionally off-center).
- Typically present at birth as a single mass.
- May move during swallowing and often causes difficulties in swallowing when the cyst is closely associated with the tongue.
- Possible infection and pain.
- Frequent treatment method is surgical excision of the cyst and fistula and removal of part of the hyoid bone to prevent recurrence.
- Thyroid tissue is maintained during surgery to prevent myxoedema.
Branchial Cysts
- Arises from branchial arch epithelium during embryonic development.
- Located under the angle of the jaw and along the sternocleidomastoid muscle.
- May cause a soft, fluctuating swelling.
- Can become infected after an upper respiratory tract infection, developing pain.
- Typically requires surgical treatment.
Salivary Gland Cysts: Mucous Extravasation Cysts
- Includes mucocele/ranula subtypes.
- Result from minor salivary gland duct ruptures.
- No epithelial lining.
- Located on the lower lip, tongue, or cheek.
- Primarily found in children and younger adults.
- Treatment depends on the specific cyst.
Salivary Gland Cysts: Mucous Retention Cysts
- Characterized by an epithelial lining (true cyst).
- Develops from duct dilation, caused by obstruction or cystic changes in the duct epithelium.
- Impacts minor and major salivary gland ducts.
- Predominantly occurs in adults.
- Less common than mucoceles.
- Treated by cyst removal.
Cyst Treatment: Enucleation
- Advantages include microscopic examination of the entire cyst and no postoperative monitoring required.
- Disadvantages include clot infection in the cavity, recurrence if complete removal is not performed, and potential trauma to neighboring structures (teeth, blood vessels, nerves, sinus, or jaw).
Cyst Treatment: Marsupialization
- Combining cyst and oral cavity through a window opening along the cyst's equator.
- Cyst epithelium is not completely removed.
- Indications include situations needing to preserve neighboring tissues, large cysts, elderly patients, complications from jaw fractures or anatomical structures, and surgical transport difficulties.
- Disadvantages include continuous physician visits, inability to examine the complete cyst microscopically, and needing a second surgical procedure for keratocysts.
Cyst Treatment: Fenestration
- Initiates bone regeneration by opening and maintaining a cyst-opening to reduce cyst size.
- Non-definitive auxiliary treatment.
- Preserves neighboring teeth and mandibular canals via new bone formation.
- Requires a second surgical procedure.
Follow-up After Cyst Surgery
- Post-operative examination, typically after 6 months or until complete bone regeneration, is needed for enucleation surgeries.
- Keratocysts require a 6-to-10-year follow-up.
- Fixed prostheses should be delayed until confirmed bone healing.
- Need for long-term patient follow-up should be discussed.
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Description
Test your knowledge on non-odontogenic cysts including nasopalatine duct cysts and nasolabial cysts. This quiz covers their origins, characteristics, and symptoms. Understand key concepts related to these common cysts found in dental practices.
