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Questions and Answers
What defines a true cyst?
What defines a true cyst?
Pseudocysts are true cysts lined with epithelium.
Pseudocysts are true cysts lined with epithelium.
False
Name one type of odontogenic cyst.
Name one type of odontogenic cyst.
Dentigerous cyst
A cyst that arises from odontogenic epithelial remnants is called an __________ cyst.
A cyst that arises from odontogenic epithelial remnants is called an __________ cyst.
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Match the following types of cysts with their correct classification:
Match the following types of cysts with their correct classification:
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Which of the following is NOT classified as an odontogenic cyst?
Which of the following is NOT classified as an odontogenic cyst?
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What is one clinical feature that could help recognize an odontogenic cyst?
What is one clinical feature that could help recognize an odontogenic cyst?
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What is the primary reason for the formation of inflammatory lateral periodontal cysts?
What is the primary reason for the formation of inflammatory lateral periodontal cysts?
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Residual cysts can develop after the extraction of a pulpless tooth.
Residual cysts can develop after the extraction of a pulpless tooth.
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What type of cyst arises on the distal surface of a partially erupted lower third molar?
What type of cyst arises on the distal surface of a partially erupted lower third molar?
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A __________ cyst can interfere with the fit of dentures and may enlarge to weaken the jaw.
A __________ cyst can interfere with the fit of dentures and may enlarge to weaken the jaw.
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Match the types of inflammatory collateral cysts to their descriptions:
Match the types of inflammatory collateral cysts to their descriptions:
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Which type of cyst is the most common type of odontogenic cyst?
Which type of cyst is the most common type of odontogenic cyst?
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The epithelial lining of radicular cysts is derived from the enamel organ.
The epithelial lining of radicular cysts is derived from the enamel organ.
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What phase describes the process where a cavity becomes lined by proliferating epithelium?
What phase describes the process where a cavity becomes lined by proliferating epithelium?
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The cysts which are present at the root apex are called ________ cysts.
The cysts which are present at the root apex are called ________ cysts.
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Match the following types of cysts with their descriptions:
Match the following types of cysts with their descriptions:
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Which source does the epithelium associated with odontogenic cysts primarily come from?
Which source does the epithelium associated with odontogenic cysts primarily come from?
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Residual cysts can occur after total removal of the offending tooth.
Residual cysts can occur after total removal of the offending tooth.
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What is the primary cause of the stimulation leading to radicular cyst formation?
What is the primary cause of the stimulation leading to radicular cyst formation?
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Mucous retention and mucous extravasation cysts are examples of ________ cysts in the floor of the mouth.
Mucous retention and mucous extravasation cysts are examples of ________ cysts in the floor of the mouth.
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What primarily contributes to the presence of cholesterol in the cyst lumen?
What primarily contributes to the presence of cholesterol in the cyst lumen?
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The cyst lumen typically contains serous fluid that stains basophilic.
The cyst lumen typically contains serous fluid that stains basophilic.
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What type of epithelium lines a periapical cyst?
What type of epithelium lines a periapical cyst?
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Cystic fluid contains serum albumin, globulin, cholesterol, and ________.
Cystic fluid contains serum albumin, globulin, cholesterol, and ________.
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Match the following diagnoses with their characteristics:
Match the following diagnoses with their characteristics:
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What is the treatment for large cysts?
What is the treatment for large cysts?
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Hyaline bodies or Rushton bodies are considered to have a definitive odontogenic origin.
Hyaline bodies or Rushton bodies are considered to have a definitive odontogenic origin.
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Name a type of epithelial lining that may be found in periapical cysts.
Name a type of epithelial lining that may be found in periapical cysts.
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Cholesterol clefts are present in the cyst wall with chronic ________ infiltrate.
Cholesterol clefts are present in the cyst wall with chronic ________ infiltrate.
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Which of the following is NOT a component typically found in cystic fluid?
Which of the following is NOT a component typically found in cystic fluid?
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What indicates that a cyst may be actively enlarging?
What indicates that a cyst may be actively enlarging?
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Root resorption may occur in the offending tooth or adjacent teeth.
Root resorption may occur in the offending tooth or adjacent teeth.
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What histopathologic feature is primarily observed in the epithelial lining of apical periodontal cysts?
What histopathologic feature is primarily observed in the epithelial lining of apical periodontal cysts?
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The diameter of a cyst can range from _____ to several centimeters.
The diameter of a cyst can range from _____ to several centimeters.
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Match the following cyst characteristics with their descriptions:
Match the following cyst characteristics with their descriptions:
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Which of the following is a feature of fully formed, old cysts?
Which of the following is a feature of fully formed, old cysts?
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Presence of cholestrol clefts and giant cells is rare in the connective tissue wall of the cyst.
Presence of cholestrol clefts and giant cells is rare in the connective tissue wall of the cyst.
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What type of leucocytes predominate towards the epithelial lining of the cyst?
What type of leucocytes predominate towards the epithelial lining of the cyst?
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The radiolucency associated with the maxillary central incisor displays significant root _____ .
The radiolucency associated with the maxillary central incisor displays significant root _____ .
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What makes it difficult to distinguish between a small radicular cyst and a periapical granuloma?
What makes it difficult to distinguish between a small radicular cyst and a periapical granuloma?
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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.
