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Periodontology Cyst
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Periodontology Cyst

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  • a)Histologic slide showing stratified squamous epithelium with areas of focal thickening b) Higher magnification showing corrugated parakeratin surface and palisaded basal cell layer.
  • a)  Intrabony osseous defect before cyst enucleation. b) Following debridement, decortication and allograft placement. C) Collagen membrane adaptation. D)  Primary flap closure using 5.0 Dacron suture.
  • (a) Exposure of the cyst, (b) Enucleation and curettage, (c) Soaking of the saline pack placed in the cystic cavity within seconds, (d) Achieving optimal hemostasis for retrograde filling
  • Transcript

    • 1. PRESENTED BY:FASAHAT AHMED BUTTCYST
    • 2. OBJECTIVESWhat is cyst?Types of cystsa. Clinical featuresb. Radiographicfindingsc. Histology Diagnosis Treatment
    • 3. A cyst is a pathological fluid filledcavity lined by epithelium.CYST
    • 4. TYPES OF CYSTSGingival cyst Periodontalcyst
    • 5. GINGIVAL CYST LOCATION: Lingual surface of mandibularcanine and premolars. COLOR: Bluish gray. APPEARANCE: Nodular and resembles mucocele CONTOUR Localized enlargement. PAINLESS ATTACHED or MARGINALGINGIVA
    • 6.  ORIGIN Develop from odontogenic epithelium orfrom surface or sulcular epithelium
    • 7. RADIOGRAPHIC FINDINGS No radiographic findings because the usuallyinvolve the soft tissues
    • 8. HISTOLOGY Gingival cyst cavity is lined by a thin , flattenedepithelium with or without localized areas ofthickening. Types of epithelium Non keratinized stratified squamous epithelium Keratinized stratified squamous epithelium Parakeratinized epithelium with palisading basal cells
    • 9. PERIODONTAL CYST(Lateral Periodontal Cyst) Uncommon lesion. Localized destruction of periodontal tissues. Lateral root surface. LOCATIONMandibular canine-premolar area.ORIGIN Derived from rests of Malassez.CONTOUR Localized enlargementASYMPTOMATICPAINFUL
    • 10. RADIOGRAPHIC FINDINGS Interproximal periodontal cyst appears on theside of the root as a radiolucent area borderedby a radiopaque line. Periodontal abscess is difficult to differentiatefrom periodontal cyst, radiographically
    • 11. `Cyst Abscess Filled with fluid <1.5cm Gingiva appearsbluish gray Filled with puss 2-10cm Gingiva appears red
    • 12. HISTOLOGY Cystic lining may be a loosely arranged , thin,nonkeratinized epithelium, sometimes withthicker proliferating areas.
    • 13. DIAGNOSIS CLINICAL FINDINGS RADIOGRAPH BIOPSY
    • 14. TREATMENT Treatment is surgical excision and histopathologicexamination for a conclusive diagnosis. ENUCLEATION MARSUPIALIZATION COMBINATION ENUCLEATION WITH CURETTAGE
    • 15. ENUCLEATION Enucleation means shelling out the entire cystic lesionwithout rupture.INDICATION: Small cyst, which can be done when the vital structures arenot involved.
    • 16. Local AnesthesiaFlap design ismadeIncision madeaccording to thedesignTooth extractionBur andforcepIntraosseouswindowIrrigation toclean the cavityClosure bysuture (6-12months)
    • 17. MARSUPIALIZATION Marsupialization refers to creating a surgical window inthe wall of the cyst, excavating the contents of the cystand maintaining continuity between the cyst wall and theoral cavity. This process decreases the pressure inside the cyst, andpromotes shrinkage of the cyst as well as bone fill.INDICATIONS: If surgical access is difficult Unerupted tooth involved Small cyst
    • 18. ProphylacticantibioticAnesthesiaMarsupializationOthersAspirationThin boneCavityIncisionCircular orElepticalLargewindowThick bone BurSuturedPt instructedfor cleansingof cavityContents areevacuatedIrrigation vianormal saline
    • 19. COMBINATION Combined approach morbidity and completehealing of the defect. In this technique marsupialization is done firstand the enucleation is done at a later date. The advantage is that as marsupialization isdone first, it spares the vital structures. The sizeof the cystic cavity also becomes small and afterhealing the cystic lining becomes thick, makingenucleation easier at this stage.
    • 20. ENUCLEATION WITHCURETTAGE After enucleation is done, a curette or bur is used toremove 1 to 2 millimeter of bone around the entireperiphery of cystic cavity.INDICATIONS For cysts reported to have high recurrence rate, forexample odontogenic keratocystAdvantages If enucleation leaves any remnants, curettage may removethem thereby decreasing the likelihood of recurrence.Disadvantage Curettage is more destructive to adjacent bone, blood
    • 21. REFERRENCES CARRANZA EOP GOOGLE

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