Odontogenic Cysts Quiz
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Questions and Answers

What defines a true cyst?

  • A pathological cavity lined with epithelium and containing solid contents
  • A pathological cavity lined with epithelium and having fluid or semi-solid contents (correct)
  • A pathological cavity lined with connective tissue
  • A pathological cavity without any lining
  • Pseudocysts are true cysts lined with epithelium.

    False (B)

    Name one type of odontogenic cyst.

    Dentigerous cyst

    A cyst that arises from odontogenic epithelial remnants is called an __________ cyst.

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

    Match the following types of cysts with their correct classification:

    <p>Incisive Canal Cyst = Cysts of vestigial ducts Keratinized Odontogenic Cyst = Odontogenic cysts Globulomaxillary Cyst = Fissural Cysts Aneurysmal Bone Cyst = Pseudocysts</p> Signup and view all the answers

    Which of the following is NOT classified as an odontogenic cyst?

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

    What is one clinical feature that could help recognize an odontogenic cyst?

    <p>Swelling or pain in the jaw</p> Signup and view all the answers

    What is the primary reason for the formation of inflammatory lateral periodontal cysts?

    <p>Opening of a lateral root canal (C)</p> Signup and view all the answers

    Residual cysts can develop after the extraction of a pulpless tooth.

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

    What type of cyst arises on the distal surface of a partially erupted lower third molar?

    <p>Paradental cyst</p> Signup and view all the answers

    A __________ cyst can interfere with the fit of dentures and may enlarge to weaken the jaw.

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

    Match the types of inflammatory collateral cysts to their descriptions:

    <p>Paradental cyst = A cyst arising on the distal surface of a partially erupted lower third molar Mandibular buccal bifurcation cyst = A cyst arising subgingivally on the buccal aspect of lower first or second molars</p> Signup and view all the answers

    Which type of cyst is the most common type of odontogenic cyst?

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

    The epithelial lining of radicular cysts is derived from the enamel organ.

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

    What phase describes the process where a cavity becomes lined by proliferating epithelium?

    <p>Phase of Cyst Formation</p> Signup and view all the answers

    The cysts which are present at the root apex are called ________ cysts.

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

    Match the following types of cysts with their descriptions:

    <p>Apical cyst = Present at root apex Lateral radicular cyst = Present at the opening of lateral accessory root canals Residual cyst = Remains after extraction of the offending tooth Inflammatory periodontal cyst = Most common type of odontogenic cyst</p> Signup and view all the answers

    Which source does the epithelium associated with odontogenic cysts primarily come from?

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

    Residual cysts can occur after total removal of the offending tooth.

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

    What is the primary cause of the stimulation leading to radicular cyst formation?

    <p>Inflammation in periapical granuloma</p> Signup and view all the answers

    Mucous retention and mucous extravasation cysts are examples of ________ cysts in the floor of the mouth.

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

    What primarily contributes to the presence of cholesterol in the cyst lumen?

    <p>Local tissue damage (D)</p> Signup and view all the answers

    The cyst lumen typically contains serous fluid that stains basophilic.

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

    What type of epithelium lines a periapical cyst?

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

    Cystic fluid contains serum albumin, globulin, cholesterol, and ________.

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

    Match the following diagnoses with their characteristics:

    <p>Periapical granuloma = Small radiolucency Periapical scar = Previously treated area Periapical cemental dysplasia = Vital related teeth Maxillary periapical cyst = Involves the maxillary sinus</p> Signup and view all the answers

    What is the treatment for large cysts?

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

    Hyaline bodies or Rushton bodies are considered to have a definitive odontogenic origin.

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

    Name a type of epithelial lining that may be found in periapical cysts.

    <p>Pseudo-stratified ciliated columnar epithelium</p> Signup and view all the answers

    Cholesterol clefts are present in the cyst wall with chronic ________ infiltrate.

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

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

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

    What indicates that a cyst may be actively enlarging?

    <p>Absence of a visible margin (A)</p> Signup and view all the answers

    Root resorption may occur in the offending tooth or adjacent teeth.

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

    What histopathologic feature is primarily observed in the epithelial lining of apical periodontal cysts?

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

    The diameter of a cyst can range from _____ to several centimeters.

    <p>5mm</p> Signup and view all the answers

    Match the following cyst characteristics with their descriptions:

    <p>Epithelial lining = Acanthosis with hyperplasia Connective tissue = Parallel bundles of collagen fibers Inflammation = Presence of inflammatory cells Cyst size = Ranges from 5mm to several centimeters</p> Signup and view all the answers

    Which of the following is a feature of fully formed, old cysts?

    <p>Regular and flattened epithelium (B)</p> Signup and view all the answers

    Presence of cholestrol clefts and giant cells is rare in the connective tissue wall of the cyst.

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

    What type of leucocytes predominate towards the epithelial lining of the cyst?

    <p>Polymorphonuclear leucocytes</p> Signup and view all the answers

    The radiolucency associated with the maxillary central incisor displays significant root _____ .

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

    What makes it difficult to distinguish between a small radicular cyst and a periapical granuloma?

    <p>Similar outlines on imaging (C)</p> Signup and view all the answers

    Flashcards

    What is a cyst?

    A pathological cavity lined with epithelium, containing fluid or semi-solid contents, found in hard or soft tissues.

    What is a pseudocyst?

    They are not true cysts because they lack an epithelial lining.

    What are odontogenic cysts?

    Cysts originating from epithelial remnants associated with tooth development.

    What are developmental cysts?

    Cysts arising from the remnants of the dental lamina, the structure that forms teeth.

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    What are inflammatory cysts?

    Cysts arising from inflammation or infection near the tooth root.

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    What are dentigerous cysts?

    Cysts developing around the crown of an unerupted tooth.

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    What are nasopalatine tract cysts?

    Cysts that originate from the remnants of the nasopalatine duct, a structure that connects the nasal cavity to the mouth.

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    Inflammatory Periodonal Cyst

    A common odontogenic cyst that arises from epithelial rests of Malassez in the periodontal ligament, usually occurring after pulp death.

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    Apical or Periapical Cyst

    A type of inflammatory periodontal cyst located at the root apex of a tooth.

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    Lateral Radicular Cyst

    A type of inflammatory periodontal cyst found at the opening of lateral accessory root canals.

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    Residual Cyst

    A type of inflammatory periodontal cyst remaining after tooth extraction.

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    Phase of Initiation (Radicular Cyst)

    The first stage in radicular cyst formation; it involves inflammation in the periapical granuloma which stimulates the epithelial cells to proliferate.

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    Phase of Cyst Formation (Radicular Cyst)

    The second phase in radicular cyst formation; it involves a cavity lined with proliferating epithelium due to multiplication of epithelial rests in the periapical area.

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    Epithelial Rests of Malassez

    Epithelial remnants found in periodontal ligaments, believed to contribute to the formation of inflammatory periodontal cysts.

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    Thyroglossal Tract Cyst

    A soft tissue cyst located in the floor of the mouth or neck, typically caused by a blockage of the thyroglossal duct.

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    Dentigerous Cyst

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

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    Periapical Cyst

    A radiolucent area on a dental X-ray that indicates a cyst near the apex of the tooth root.

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    Why is the cyst margin not clear?

    The radio-opaque margin of a cyst may appear less distinct if the cyst is rapidly growing.

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    How big can a periapical cyst be?

    The size of a periapical cyst can vary, ranging from 5 millimeters to several centimeters.

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    What's the state of the tooth with a cyst?

    The tooth associated with a periapical cyst often exhibits a large cavity caused by decay or a filling.

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    What might happen to the tooth root?

    The root of the affected tooth or adjacent teeth may be resorbed, indicating bone breakdown.

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    What happens to the cyst outline during an infection?

    Inflammation of the cyst causes its outline to become hazy on an X-ray.

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    Challenge of X-ray diagnosis.

    Visually differentiating a small periapical cyst from a periapical granuloma on an X-ray is challenging.

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    What kind of cells form the cyst lining?

    The epithelial lining of the periapical cyst is typically stratified squamous epithelium.

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    How is the cyst lining in a new forming cyst?

    The epithelial lining of a newly formed cyst exhibits an increased number of cells (acanthosis) with over vascularized connective tissue and inflammatory cells.

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    What is the cyst lining like in an old, mature cyst?

    In mature, older cysts, the epithelial lining becomes thinner and more regular, with reduced inflammation and fewer inflammatory cells in the connective tissue.

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    Cystic Fluid

    The fluid inside of a cyst, often containing serum albumin, globulin, cholesterol, and nucleoproteins.

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    Foam Cells

    Clusters of lipid-filled macrophages that are often present in cyst cavities.

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    Rushton Bodies

    Small, thin, curved bodies found within the epithelial lining of some cysts, often eosinophilic in staining.

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    Pseudo-stratified Ciliated Columnar Epithelium

    A type of cyst wall lining that can be found in periapical cysts, characterized by multiple layers of cells with varying shapes and sizes.

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    Dystrophic Calcification

    A type of calcification that can occur in cyst walls, characterized by calcium deposits that stain dark purple.

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    Enucleation

    A type of cyst treatment that involves surgically removing the cyst while preserving the tooth.

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    Tooth Extraction and Enucleation

    A type of cyst treatment that involves surgically removing the tooth and the cyst together.

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    Marsupialization

    A type of cyst treatment that involves creating an opening in the cyst wall to allow for drainage and reduce pressure.

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    Lateral Inflammatory Cyst

    A type of cyst that develops on the lateral aspect of a tooth root, usually after inflammation of the periodontal tissue due to an opened lateral root canal. The affected tooth is often nonvital.

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    Collateral Cyst

    A type of inflammatory cyst that occurs on the buccal or distal side of a tooth, commonly a mandibular molar.

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    Paradental Cyst

    A specific type of collateral cyst that develops on the distal surface of a partially erupted lower third molar, often associated with a history of pericoronitis.

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    Mandibular Buccal Bifurcation Cyst

    A type of collateral cyst that forms on the buccal aspect of lower first or second molars, presenting as a painless swelling that can become painful if infected.

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    Study Notes

    Cysts of the Oral and Para-oral Region

    • A cyst is a pathological cavity lined with epithelium, containing fluid or semi-solid material, found within hard or soft tissues.
    • Pseudocysts are not lined with epithelium.
    • Cysts are more common in the jaws than other bones due to epithelial rests left behind after dental development.
    • Odontogenic cysts originate from odontogenic epithelial remnants associated with tooth development.
    • Periodontal cysts are further classified into inflammatory and developmental types. Inflammatory types include apical/radicular, lateral, and residual cysts. Developmental types include lateral, botryoid odontogenic, gingival (adult/newborn), and dentigerous cysts. Dentigerous cysts are frequently central, lateral, or circumferential, associated with eruption.
    • Odontogenic keratocysts and orthokeratinized odontogenic cysts are types of odontogenic cysts.
    • Non-odontogenic cysts are not associated with the development of teeth, and include cysts of vestigial ducts (e.g., nasopalatine duct cysts), fissural cysts (e.g., median palatal/mandibular cysts), globulomaxillary, and nasolabial cysts.
    • Pseudocysts include simple bone cysts, aneurysmal bone cysts, and static bone cysts.
    • Soft tissue cysts of the floor of the mouth and neck include dermoid/epidermoid cysts, thyroglossal duct cysts, cervical lymphoepithelial cysts, mucous retention/extravasation cysts, and ranulas.
    • Odontogenic cysts are associated with the tooth-bearing regions of the jaws.
    • The epithelium associated with odontogenic cysts arises from enamel organ, reduced enamel epithelium, or epithelial rests of Malassez.

    Inflammatory Periodontal Cyst

    • This is the most common odontogenic cyst (65%).
    • It forms from inflammatory hyperplasia of the epithelial rests of Malassez in the periodontal ligament after pulp death.
    • It develops from a pre-existing periapical granuloma, stimulated by inflammation.
    • Classified as apical (periapical), lateral radicular, or residual cysts.
    • Pathogenesis involves three phases: initiation (epithelial lining from Malassez cells stimulated by inflammation), cyst formation (proliferation of epithelium creates a cavity), and cyst enlargement (osmosis, osteoclast-stimulated bone resorption).

    Clinical Features of Apical Periodontal Cyst

    • Common in adults (30-60 years old); more frequent in men.
    • Usually asymptomatic, discovered during routine dental radiographs.
    • Located primarily in the anterior maxilla.
    • Gradually increasing, painless swelling.
    • May exhibit a crackling sensation, later progressing to a fluctuant, bluish swelling beneath the mucosa.
    • The associated tooth is usually non-vital.
    • Radiographically, a well-defined round/oval radiolucency with a narrow radiopaque margin.

    Histopathologic Features of Periodontal Cyst

    • Epithelial lining is usually stratified squamous.
    • Newly formed cysts show hyperplastic epithelium (increased cell layers), acanthosis, and vascularized connective tissue with many inflammatory cells.
    • In mature cysts, epithelium is more regular, flattened, and inflammatory cells decrease.
    • Intense inflammation may result in discontinuous epithelial lining.

    Connective Tissue of Periodontal Cyst

    • The underlying connective tissue is composed of collagen fibers, fibroblasts, and capillaries.
    • It may contain inflammatory cells, cholesterol clefts, multinucleated giant cells, and degenerated plasma cells (Russell bodies).

    Differential Diagnosis of Periodontal Cyst

    • Periapical granuloma (smaller radiolucency)
    • Periapical scar (surgical defect from previous treatment)
    • Early stage of periapical cemental dysplasia.

    Microscopic Variations of Cysts

    • Pseudo-stratified ciliated columnar epithelium
    • Dystrophic calcification
    • Keratinized or orthokeratinized lining
    • Hyaline bodies (Rushton bodies)

    Treatment of Periodontal Cysts

    • Small cysts: Enucleation and apicectomy (of the involved tooth)
    • Medium cysts: Tooth extraction followed by enucleation
    • Large cysts: Marsupialization (to avoid major structures like nerves), followed by enucleation and filling with bone chips.

    Inflammatory Lateral Periodontal Cysts

    • Less common than apical cysts.
    • Located on the lateral aspect of the root of a pulpless tooth.
    • Usually results from opening of lateral root canals and periodontal tissue irritation.

    Residual Cyst

    • A periapical cyst that may persist after the extraction of the involved tooth.

    Inflammatory Collateral Cysts

    • Arise on the distal aspect of a lower third molar (paradental cysts) or buccal aspect of lower first/second molars (buccal bifurcation cyst)
    • Associated with pericoronitis and/or impacted food; possible tooth tilting.

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    Description

    Test your knowledge on the various types of odontogenic cysts, including their definitions, classifications, and clinical features. This quiz covers cyst origins, characteristics, and associations with dental health. Challenge yourself to identify key terms and concepts related to odontogenic pathology.

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