Cysts of the Jaws
Cysts of the Jaws[✎ edit | edit source]
Pathological cavity with fluid or semifluid content, lined by epithelium.
Growth : epithelial proliferation, internal hydraulic pressure, bone resorption.
WHO classification[✎ edit | edit source]
1. Epithelial cysts:
- Developmental odontogenic cysts: odontogenic keratocyst, follicular cyst, eruption cyst, gingival cyst.
- Inflammatory odontogenic cysts: radicular cyst, residual cyst, periodontal cyst.
- Non-odontogenic cyst: nasopalatine cyst, nasolabial cyst.
2. Non-epithelial cysts: solitary bone cyst, aneurismal bone cyst.
3. Other: benign mucosal cyst of max. antrum, post.op.max,cyst, dermoid cyst, cysts of salivary glands.
Odontogenic cysts: lined by epithelium derived from radicular cyst, odontogenic keratocyst; well defined round radiolucencies, well-defined margins; swelling, displacement of teeth, increased mobility of teeth;
Radicular cyst: apical dental cyst of inflammatory origin; well-defined round radiolucency associated with root apex, corrugated margin is continuous with lamina dura at root; cyst lumen lined with simple sq.ep and in parts may be replaced with granulation tissue.
Residual cyst: well-defined round radiolucency in edentulous area; occasional flecks of calcification; lining- simple sq.ep but mature.
Odontogenic keratocyst: well-defined radiolucency with dense corticated margins; multilocular; expansion limited; lining- continuous str.sq.ep with corrugated surface; enucleation, irrigation with chemical fixatives, excision to incl.bone margin around cyst.
Follicular cyst: pericoronal radiolucency >3-4mm; cyst attaches to tooth at amelocementl junction.
Eruption cyst: extrabony position soft tissue mass appears; marsupialialization-to expose erupting tooth.
- Neonates - white keratinous nodules (Epstein pearls); may open into oral cavity forming clefts that exude keratin.
- Adults- found in buccal gingival in mandibular premolar - canine region; soft blue swelling with attached gingival, <5mm diameter.
Nasopalatine cyst: well defined round radiolucency in midline of anterior maxilla, heart-shaped, pseudostratified ciliate columnar epithelium.
Nasolabial cyst: soft tissue lesion so nothing seen on x-ray; lined by non-ciliated pseudostratified columnar ep.
Aneurysmal bone cyst: well defined radiolucency; multilocular; marked expansion curettage.
Solitary bone cyst: well defined non-corticated radiolucency; arches up between roots of teeth; cortical margins of canal may be lost.
Diagnosis[✎ edit | edit source]
Treatment[✎ edit | edit source]
- Enucleation : one stage procedure- 3 side incision or semilunar incision; risk of damage to adjacent structures, leaves cavity prone to infection.
- Marsupialization : one stage procedure; prolonged healing period; protects vitality of teeth and integrity of nerves; sup.part of cyst excised.
Differential Diagnosis[✎ edit | edit source]
- periapical abscess
- malignant tumour