Oral Surgery: Benign Cystic Lesions Quiz

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Questions and Answers

What is the primary characteristic of Stafne's bone cavity?

  • It typically occurs in females.
  • It is a cyst.
  • It always causes pain.
  • It is a symptomless lesion. (correct)

What is the usual age and gender demographic for Stafne's bone cavity?

  • Females over 50 years old
  • Males over 40 years old (correct)
  • Males under 30 years old
  • Both genders equally across all ages

Where is Stafne's bone cavity typically located?

  • In the anterior maxilla
  • Below the inferior alveolar canal (correct)
  • On the palatine bone
  • Above the inferior alveolar canal

What defines the Gingival Cyst of the Adult?

<p>It arises from remnants of the dental lamina. (B)</p> Signup and view all the answers

What is the typical treatment for a Gingival Cyst of the Adult?

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

What are Epstein's pearls associated with?

<p>Gingival cysts of infants (C)</p> Signup and view all the answers

What is NOT a clinical feature of a Gingival Cyst of the Adult?

<p>Bluish coloration (C)</p> Signup and view all the answers

What is the recommendation for Stafne's bone cavity management?

<p>Regular radiological follow-up (D)</p> Signup and view all the answers

Which type of cyst is commonly associated with impacted third molars?

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

What does percussion of the teeth over a solitary bone cyst produce?

<p>A dull or hollow sound (C)</p> Signup and view all the answers

What indicates the presence of an apical periodontal cyst?

<p>Presence of a fractured tooth (C)</p> Signup and view all the answers

What is true about teeth adjoining an odontogenic keratocyst?

<p>They typically have vital pulps. (A)</p> Signup and view all the answers

What is the significance of performing vitality tests on teeth related to a cyst?

<p>It is essential for preoperative and postoperative assessment. (D)</p> Signup and view all the answers

What primarily causes the formation of a ranula?

<p>Extravasation of mucous due to trauma (C)</p> Signup and view all the answers

What is indicated by the expansion of both cortical plates?

<p>A lesion other than a cyst (C)</p> Signup and view all the answers

What radiographic examination is best for visualizing a cyst in the maxillary sinus?

<p>Occipitomental projection (C)</p> Signup and view all the answers

Which clinical feature is NOT associated with a superficial ranula?

<p>Painless hard mass in the neck (B)</p> Signup and view all the answers

Which treatment option is recommended to avoid recurrence of a ranula?

<p>Surgical removal of the sublingual gland (A)</p> Signup and view all the answers

How can fluctuation be elicited in relation to a cyst?

<p>When the cystic lining lies beneath the mucosa (A)</p> Signup and view all the answers

Where are dermoid cysts commonly located in the mouth?

<p>In the midline in the floor of the mouth (C)</p> Signup and view all the answers

What is a potential complication of dermoid cysts located above the geniohyoid muscle?

<p>Difficulty with mastication and speech (D)</p> Signup and view all the answers

What characterizes an epidermoid cyst compared to a dermoid cyst?

<p>Absence of skin appendages (B)</p> Signup and view all the answers

What is an important diagnostic feature suggesting the presence of a cyst in the jaw?

<p>Absence of teeth from their normal position (A)</p> Signup and view all the answers

What is the most effective treatment approach for large dermoid cysts located inferior to the geniohyoid muscle?

<p>Surgical excision via an extraoral approach (C)</p> Signup and view all the answers

What sound is produced when percussion is applied to teeth overlying a cyst?

<p>A dull sound (C)</p> Signup and view all the answers

What is the recurrence rate of keratocysts within the first 5 years?

<p>5-60% (A)</p> Signup and view all the answers

Which of the following treatment methods is incorrect for keratocysts?

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

Which feature of keratocysts increases the chance of recurrence?

<p>Presence of satellite cysts (A)</p> Signup and view all the answers

What term describes the syndrome associated with multiple keratocysts?

<p>Gorlin-Goltz syndrome (B)</p> Signup and view all the answers

In which demographic is dentigerous cysts most commonly found?

<p>Adults in their first to third decades (C)</p> Signup and view all the answers

What characteristic does a dentigerous cyst have?

<p>Formed by the enlargement of the follicular space (C)</p> Signup and view all the answers

How is the defect closed after surgical management of larger cysts?

<p>Suture closed primarily (C)</p> Signup and view all the answers

What is one of the primary uses of aspiration in the diagnosis of cysts?

<p>To distinguish cysts from solid tumors (A)</p> Signup and view all the answers

Which of the following is an indication for choosing marsupialization over enucleation?

<p>The patient is a young child with developing tooth germs (D)</p> Signup and view all the answers

What is the primary purpose of injecting radiopaque dye into a cyst?

<p>To assess the size and relations of the cyst (A)</p> Signup and view all the answers

What might be the consequence of failing to aspirate liquid from a cyst?

<p>Suggests the possibility of a solid tumor (B)</p> Signup and view all the answers

Which is a recognized advantage of marsupialization?

<p>It preserves vital structures and reduces operating time (D)</p> Signup and view all the answers

What does enucleation commonly involve in the treatment of jaw cysts?

<p>Removing the entire cyst along with surrounding tissues (B)</p> Signup and view all the answers

Under what condition is marsupialization considered a reasonable alternative to enucleation?

<p>In elderly and debilitated patients to minimize stress (C)</p> Signup and view all the answers

Which circumstance can complicate the decision for surgical intervention in cysts?

<p>Proximity of the cyst to vital structures (A)</p> Signup and view all the answers

What is commonly used to treat nonvital teeth associated with radicular cysts?

<p>Extraction (A), Apicoectomy (C), Enucleation (D)</p> Signup and view all the answers

Which type of cyst is characterized by being asymptomatic and discovered on radiographic examination?

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

What type of cyst arises from epithelial inclusions during fusion of the palatine processes?

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

What is a typical clinical feature of a globulomaxillary cyst?

<p>Presence between maxillary lateral incisor and canine (D)</p> Signup and view all the answers

What is a key radiological feature of radicular cysts?

<p>Ovoid shaped radiolucency with a narrow radio-opaque margin (B)</p> Signup and view all the answers

What is a treatment option for a median palatal cyst?

<p>Enucleation with primary closure (A)</p> Signup and view all the answers

What occurs when a periapical granuloma is incompletely enucleated?

<p>Formation of a residual cyst (A)</p> Signup and view all the answers

In which location is a median palatal cyst typically seen?

<p>Hard palate (C)</p> Signup and view all the answers

Flashcards

Stafne's Bone Cavity

Benign, non-cancerous cavity in the jawbone, often found below the inferior alveolar canal, typically in males over 40. It's not a cyst, but a developmental anomaly.

Gingival Cyst of the Adult

Arise from remnants of the dental lamina, often seen in adults in their 50s or 60s. They occur mainly in the mandible, often in the canine and premolar region.

What is Stafne's Bone Cavity?

Benign, non-cancerous cavity found below the inferior alveolar canal, often noticed during routine X-rays.

Gingival Cyst of Infants

Arise from epithelial remnants of the dental lamina, often found on the gums of newborn infants. They usually disappear within a few months.

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What are Bohn's nodules and Epstein's pearls?

Arise from epithelial remnants of the dental lamina, seen in newborns.

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What are the clinical features of a Gingival Cyst of the Adult?

Arise from remnants of the dental lamina, often seen in the attached gingiva or the interdental papilla. They are painless, slow-growing swellings, and often have a bluish hue.

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Where are Epstein's pearls found?

Arise from epithelial remnants of the dental lamina, often seen along the mid-palatine raphe.

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Where are Bohn's nodules found?

Arise from epithelial remnants of the dental lamina, often found on the buccal or lingual aspects of the dental ridges.

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What is a Ranula?

A fluid-filled swelling in the floor of the mouth, often caused by a blockage in the sublingual salivary gland.

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What is a plunging ranula?

A type of ranula that extends through the mylohyoid muscle into the submandibular region.

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What is a dermoid cyst?

A type of cyst that forms from the epithelium and contains skin appendages like hair, sebaceous glands, and sweat glands.

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What is an epidermoid cyst?

A cyst lined by epithelium but doesn't have any skin appendages (like hair or glands).

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How do you treat a ranula?

The best treatment for a ranula is?

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What can a dermoid cyst above the geniohyoid muscle cause?

A common symptom of a dermoid cyst above the geniohyoid muscle is difficulty speaking and chewing.

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What happens to a dermoid cyst below the geniohyoid muscle?

A dermoid cyst below the geniohyoid muscle can cause a noticeable swelling in the area of the double chin.

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What is the best treatment for a dermoid cyst?

The preferred treatment for dermoid cysts is?

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How are cysts most often found?

Most cysts are discovered accidentally on radiographs before they become noticeably large.

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Apical Periodontal Cyst

A type of cyst that develops at the root of a tooth, often associated with a non-vital tooth.

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Egg-shell Crackling

A thin, fragile layer of bone that results from a cyst expanding and weakening the bone.

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Dentigerous Cyst

A cyst that develops around the crown of an impacted tooth, most commonly third molars.

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Lesion Expanding Both Cortical Plates

A cystic lesion that is generally associated with expanding both cortical plates of the bone.

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Fluctuation

A cyst that lies close to the oral mucosa, causing a soft, fluid-filled sensation.

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Occipitomental Projection

A type of radiographic image used to visualize cystic lesions in the maxillary sinus.

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CBCT (Cone Beam Computed Tomography)

A radiographic method that provides a detailed 3-D image, useful for assessing large or complex cystic lesions.

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What is marsupialization?

A surgical procedure that creates a window in the cyst's wall, evacuates its contents, and reduces pressure, promoting shrinkage.

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When is marsupialization preferred?

Performed in young children with developing teeth to avoid damage, elderly and weakened patients to reduce stress, and when proximity to vital structures is a concern.

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What is enucleation?

A surgical technique that involves removing the entire cyst sac along with its contents.

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Why might enucleation not be the best option?

Enucleation may harm developing teeth, pose a risk to vital structures, require extensive bone removal, and potentially affect tooth vitality.

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What is the key difference between marsupialization and enucleation?

Enucleation involves completely removing the cyst sac, while marsupialization just creates an opening for drainage.

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What are the advantages of marsupialization?

Marsupialization provides a safer approach for larger cysts, prevents extensive bone removal, and does not risk jeopardizing tooth vitality.

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When is marsupialization a better alternative to enucleation?

Marsupialization is less invasive and preserves vital structures, making it a suitable option when enucleation is too risky.

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What are the limitations of marsupialization?

Marsupialization may not fully eliminate the cyst and requires regular follow-up to monitor its progress.

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Dentigerous (Follicular) Cyst

An enlarging, non-cancerous sac-like structure developing from the dental follicle surrounding an impacted tooth.

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What is the development of a dentigerous cyst?

Enlargement of the follicular space surrounding an impacted tooth, often affecting the whole or part of the tooth's crown.

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How common are dentigerous cysts?

More common than keratocysts, but less frequent than inflammatory cysts.

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What is the usual age range for dentigerous cysts?

Usually affects individuals between the ages of 10 and 30.

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Who gets dentigerous cysts more often?

Slightly more prevalent in males.

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Where are dentigerous cysts more common?

They occur more frequently in the lower jawbone (mandible) than the upper jawbone (maxilla).

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How are dentigerous cysts treated?

Surgical removal, often involving enucleation (removing the cyst from its surrounding tissue) or, for more complex cases, a marginal resection (partial removal) of the bone.

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What should patients do after a dentigerous cyst is removed?

Regular follow-up with a dentist is necessary to ensure the cyst does not return.

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Median Palatal Cyst

A type of cyst that arises from epithelial remnants trapped during the fusion of the palatine processes of the maxilla. Affects adults, mainly found in the hard palate, and can cause bone expansion if it grows large.

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Globulomaxillary Cyst

A cyst that forms from epithelial inclusions at the site where the maxillary process and globular process fuse. Often found between the lateral incisor and canine teeth in adults.

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Residual Cyst

A cyst that develops as a result of incomplete enucleation of a periapical granuloma or cyst. It may enlarge after the tooth associated with it is extracted. Often seen in elderly patients.

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Radicular Cyst

A common type of cyst that occurs at the root of a tooth. Arises from inflammation at the apex of a nonvital tooth, usually causing radiolucency.

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Periapical Cyst

A cyst that expands from the lamina dura of the tooth, typically appearing as a round or ovoid radiolucency on X-rays. May be associated with pain, suppuration, and a discharging sinus tract.

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What is found when a periapical cyst is aspirated?

A straw-colored or brownish fluid may be aspirated from this cyst, and cholesterol crystals may be present.

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How are periapical cysts treated?

Removal of the cyst through surgical enucleation. Small cysts can be removed through the extraction socket.

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What does the presence of pus in a cyst imply?

A sign of potential infection. It may be a result of the cyst being infected.

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Study Notes

Oral Surgery: Benign Cystic Lesions of the Oral Cavity

  • A cyst is a cavity with a lining of epithelium and filled with fluid, semifluid, or gas.
  • The cyst wall is surrounded by connective tissue.
  • Cysts form due to epithelial proliferation and fluid accumulation.
  • Cysts can enlarge by increasing content volume and resorbing surrounding bone.
  • Cysts can displace vital structures.

Classification of Intraosseous Cysts

I. Epithelial Cysts

  • A. Odontogenic Epithelial Origin
    • i. Developmental:
      • Primordial cyst (keratocyst)
      • Dentigerous cyst (follicular cyst)
      • Lateral periodontal cyst
      • Calcifying odontogenic cyst
    • ii. Inflammatory:
      • Radicular cyst (apical)
      • Residual cyst
  • B. Nonodontogenic Epithelial Origin (fissural cysts)
    • Median mandibular
    • Median palatal
    • Globulomaxillary
    • Incisive canal (nasopalatine duct cyst)

II. Non-Epithelial Cysts

  • Solitary bone cyst (traumatic)
  • Aneurysmal bone cyst
  • Stafne's bone cavity

Primordial Cyst (Keratocyst)

  • A developmental anomaly of odontogenic epithelium.
  • It may arise from the dental lamina or enamel organ remnants.
  • Commonly found in the mandible.
  • Incidence: 5-10% of odontogenic cysts.
  • More prevalent in males.
  • Usually asymptomatic until large.

Dentigerous Cyst

  • Develops from the dental follicle of an impacted tooth, often enlarging the follicular space.
  • Usually found in the mandible.
  • More common than keratocysts.
  • Incidence mostly in males, 1st to 3rd decades of life.
  • Radiographic features: unilocular or multilocular radiolucency, often around an impacted tooth.

Calcifying Epithelial Odontogenic Cyst

  • Also known as odontogenic ghost cell cyst or Gorlin cyst.
  • Often seen in children and young adults.
  • Asymptomatic until large.
  • Radiographic features: unilocular or multilocular radiolucency. May involve cortical perforation or contain calcifications.

Radicular Cysts

  • Inflammatory cysts originating from periapical tissues.
  • Can develop into a periapical or lateral radicular cyst.
  • Associated with infected nonvital teeth.
  • Most prevalent in the 2nd and 3rd decades of life (males).
  • Usually asymptomatic.
  • Radiographic features: radiolucency around affected tooth.

Nasopalatine Duct Cyst

  • Arises from epithelial remnants in the embryonic nasopalatine canal.
  • Found in the maxillary palate.
  • Typically occurs in adults between the fourth and sixth decades.
  • Usually asymptomatic.
  • Radiographic features: well-defined, round or ovoid radiolucency.

Globulomaxillary Cyst

  • Arises from epithelial inclusions at the fusion site of the globular and maxillary processes.
  • Uncommon in adults.
  • Usually asymptomatic.

Stafne's Bone Cavity

  • Not a true cyst.
  • Clinically similar.
  • Usually asymptomatic; found incidentally.
  • May be associated with failure of normal bone deposition from cartilage.

Solitary Bone Cyst

  • Also known as traumatic or hemorrhagic bone cyst.
  • Usually in long bones (rarely maxilla).
  • Commonly in adolescents or children.

Gingival Cyst of Adults

  • Arise from dental lamina remnants.
  • Typically in the canine and premolar regions of the mandible.

Mucocele

  • Retention cysts of salivary glands
  • Typically caused by either obstruction or trauma to a salivary duct.

Ranula

  • A mucocele located in the floor of the mouth.
  • Two types: superficial and plunging.

Dermoid Cysts

  • A developmental cyst.
  • Contains skin-like epidermal tissues.
  • Often located in the neck or floor of the mouth.
  • Typically asymptomatic until large.

Nasolabial Cyst

  • Fissural cyst.
  • Typically in the nasolabial fold between the nose and lip.
  • May be unilateral.
  • Uncommon.

Treatment and Surgical Techniques

  • Treatment methods often vary to include enucleation and marsupialization (depending on the size and location of the lesion).
  • Specific surgical technique details are given for each lesion.

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