Lecture on Cysts.power point presentation

Etiology pathophysiology clinical feature diagnosis and management of dental cyst

1. 1a

2. 1b

3. 1c

4. 1 Dentigerous Cyst
•Associated w/ the crown of a normal tooth or
supernumerary tooth
•Comes from reduced enamel epithelium after crown
has formed
•Most common site = Mn 3
rd
molars & Mx canines
•Must be assoc. w/ an unerupted tooth to be called
dentigerous cyst
•Unilocular
•Lined w/ stratified squamous epithelium

5. 2a

6. 2b

7. 2c

8. 2 Eruption Cyst
•Found in teeth very close to eruption. Tissue swells
over erupting tooth
•Called “eruption hematoma”
•Diagnosed clinically & not by x-rays
•Common in children and infants

9. 3

10. 3 Primordial Cyst
•A cyst that develops in place of a tooth
•Comes from remnants of enamel organ
•Nearly all are odontogenic keratocysts
•Most common site = 3
rd
molar area
•Usually asymptomatic
•Affect young adults mostly
•Unilocular/multilocular
•Lined by stratified squamous epithelium

11. 4a

12. 4b

13. 4c

14. Tortuous Parakeratin
Layer
Highly basophilic basal layer
4d

15. 4e

16. 4 Odontogenic Keratocyst
•An odontogenic cyst showing keratinization
•Differential Dx: primordial, lateral periodontal,
dentigerous, and rarely periapical cysts
•Common in Mn molar area 65-80%
•These are expansive and aggressive
•Usually unilocular, but may be multilocular
•Might be assoc. w/unerupted tooth
•Have keratotic epithelial lining & lumen has keratin
debris

17. Odontogenic Keratocyst
•Has high recurrence rate
•When they recur, they usually recur late (ie 5 – 10
years)
•Histo shows: 6 – 10 cells in thickness with tortuous
parakeratin layer and highly basophilic basal layer
•Difficult to enucleate b/c of above thinness (accounts
for high recurrence rate)

18. 5

19. 5 Gingival Cyst of the Newborn
•These are fairly common lesions in newborns that
look like whitish papules
•They are filled with keratin and found on the
alveolar mucosa of infants
•Thought to be remnants of the dental lamina
•Tx = none. They disappear spontaneously as they
rupture

20. 6a

21. 6b

22. 6 Gingival Cyst of the Adult
•Fairly uncommon lesion
•Occur on attached gingiva only (or interdental
gingiva)
•Occur in area of Mn premolar, canine, & incisors
•Thought to be the soft tissue manifestation of a lateral
periodontal cyst
•Will look semi translucent in light
•Tx = surgical removal
•Differential Dx = lymphoma

23. 7a

24. 7b

25. 7c

26. 7 Lateral Periodontal Cyst
•Found between the roots of vital teeth (radicular
cysts are assoc w/non-vital teeth)
•Common site = Mn premolar & canine area
•Histo show no inflammation (radicular cysts DO
show inflammation)
•Polycystic appearance = botnyoid odontogenic cyst
•Tx = surgical removal
•Do not tend to recur

27. 8a

28. 8b

29. 8c

30. 8d

31. 8 Calcifying Odontogenic Cyst
(Gorlan’s Cyst)
•Mostly a bony cyst that occurs in the Mx & Mn in the
anterior region (65%)
•May be assoc w/odontomas
•Unilocular with radiopaque areas in 50% of cases
•Histo shows: Ghost cells (swollen pink epithelial
cells)
•Tx = enucleation (complete, intact removal)

32. 9a

33. 9b

34. 9c

35. 9 Glandular Odontogenic Cyst

36. 10

37. 10 Palatal Cyst of the Newborn
•These occur along the midline palatal suture (middle
of junction of the hard & soft palate)
•Thought to be entrapped ectoderm or remnants of
palatal salivary glands
•Tx = none. They rupture and go away

38. 11a

39. 11b

40. Pseudostratified
Columnar Epithelium

41. 11 Nasolabial Cyst
•A soft tissue cyst that has no bone involvement
•Occur in the lower part of the nasolacrimal duct
•Mucolabial fold swells up and/or the floor of the
nose
•Histo shows: pseudostratified columnar epithelium
(respiratory epithelium)
•Tx = removal

42. 12a

43. 12b

44. 12 Globulomaxillary Cyst
•A DESCRIPTIVE TERM ONLY – should be called
“Globulomaxillary Radiolucency”
•Found only between roots of Mx lateral & canine
(sometimes bilaterally)
•Don’t use this as a Dx; use either radicular cyst,
periapical, odontogenic keratocyst, etc…
•Presents as a pear shaped radiolucency
•Adjacent teeth should be vital

45. 13a

46. 13b

47. 13c

48. Blood Vessels
Nerve bundles
Salivary Glands
13d

49. 13 Nasopalatine Cyst
•A cyst of the incisive canal area
•Can look like a radicular cyst (if teeth vital = not
radicular)
•If cyst = < 6mm then it is normal canal contents
> 6mm then it is a cyst
•Histo shows: large nerve and blood vessels (required
for definitive Dx)
•Lining may be simple strat, cuboidal, or ciliated
pseudostrat colum epithelium

50. 14a

51. 14b

52. 14 Median Palatal Cyst
•Found in midline of hard palate
•Caused by trapped epithelium during fusion of Mx
•Lucency of palate opposite premolar/molar area
•Tx = surgical removal

53. 15a

54. 15b
Hair Follicle
Sebaceous Gland

55. 15c

56. 15 Dermoid Cyst
•Occurs in floor of mouth, submand & subling areas
•The bulge elevates the tongue and causes difficulty
eating/talking
•If above mylohyoid musc = bulges out floor of mouth
•If below mylohyoid musc = bulges out submental
area
•Sometimes has oral or skin tracts that drain
•Is like a teratoma (hair, bone, muscle, GI derivatives)

57. 16a

58. 16b

59. 16 Epidermoid Cyst
•Has thin, usually keratinized stratified squamous
epithelium

60. 17a

61. 17b

62. 17 Thyroglossal Duct Cyst
•This forms between foramen caecum and the thyroid
•It is the remnants of the thyroglossal duct
•Always occurs along the midline
•May have draining fistula tract
•Histo shows thyroid tissue
•Tx = surgical excision

63. 18a

64. 18b

65. 18 Cervical Lymphoepithelial Cyst
•Due to epithelium trapped in lymph nodes
•Found on lateral aspect of neck
•Slow progression
•Histo shows: Thin epithelial lining with lymphoid
tissue

66. 19a

67. 19b

68. 19c

69. 19 Oral Lymphoepithelial Cyst
•A cyst developing from oral lymphoid tissue
•Usually found on the floor of the mouth
•Found in Waldeyer’s Ring area
•The cavity is lined by stratified squamous epithelium
•Tx = surgical excision
•Poor recurrence rate

70. 20a

71. 20b

72. 20 Surgical Ciliated Cyst of Maxilla

73. 21a

74. 21b

75. 21c

76. 21 Traumatic Bone Cyst
(Simple Bone Cyst)
•A pseudocyst = has a cavity but no epithelial lining
•This cyst has no epith & no lining. It goes from bone
to cavity!
•Cavity is empty
•Almost never has a corticated border
•Distinguishing factor = scalloped border between
roots
•Common in the posterior Mn

77. 22a

78. 22b

79. 22 Lingual Mandibular Salivary Gland
Depression

80. 23a

81. 23b

82. 23 Aneurysmal Bone Cyst