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Cysts of the jaws  /certified fixed orthodontic courses by Indian dental academy
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Cysts of the jaws /certified fixed orthodontic courses by Indian dental academy

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Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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  • 1. Cysts of the jaws INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Cysts of the jaws Significance for a general practitioner Often encountered in practice Though benign increase in size Likely to get infected, lead to fracture of the mandible Surgical treatment is simple Recurrences are rare except keratocysts www.indiandentalacademy.com odontogenic
  • 3. Cysts of the jaws Definition: Conventional “ It is an epithelial-lined sac filled with fluid of semi fluid material” Appropriate “It is an abnormal cavity in hard or soft tissues which contains fluid, semi fluid or gas and is often encapsulated and lined by epithelium” www.indiandentalacademy.com
  • 4. Cysts of the jaws Classification Robinson’s classification (1945) A From odontogenic tissues 1. Periodontal cyst 2. Dentigerous cyst 3. Primordial cyst B From Non dental tissues 1. Median cyst 2. Incisive canal cyst 3. Globulo-maxillary cyst www.indiandentalacademy.com
  • 5. Cysts of the jaws Lucas classification (1964) Odontogenic Periodontal Dentigerous Primordial Fissural Nasopalatine Globulo maxillary Naso labial Median cysts Bone cysts Solitary bone cyst Aneurysmal bone cyst Stafne’s bone cavity www.indiandentalacademy.com
  • 6. Cysts of the jaws Odontogenic cysts Cyst Epithelial source Periodontal cell rests of malassez Dentigerous reduced enamel epithelium Keratocysts cell rests of serre www.indiandentalacademy.com
  • 7. Cysts of the jaws Clinical features Radiological examination Aspiration biopsy Histopathology www.indiandentalacademy.com Diagnosis
  • 8. Cysts of the jaws Diagnosis Symptoms If small asymptomatic Pain & swelling if infected Missing tooth Non-vital tooth Displacement & irregularity of the teeth Displacement of the denture Pathological fracture Salty taste www.indiandentalacademy.com
  • 9. Cysts of the jaws Diagnosis Signs •If small no physical signs •Hard, smooth painless bulging of outer cortical plate •Thinning of outer cortical plate •Fragmentation of the outer cortical plate •Resorbtion of the fragments •Fluctuation www.indiandentalacademy.com
  • 10. Cysts of the jaws Significance of location or site Fissural cysts have definite location Dentigerous cyst more common in mandibular third molar and maxillary canine areas Periodontal more in maxillary anterior region Odontogenic keratocyst more in mandible Solitary bone cyst & aneursymal bone cyst occur only in mandible Stafne’s only in mandible www.indiandentalacademy.com
  • 11. Cysts of the jaws Relationship with teeth Non vital teeth Periodontal cyst Impacted teeth Dentigerous cyst Missing teeth Occassionally odontogenic keratocyst if developed from enamel organ www.indiandentalacademy.com
  • 12. Cysts of the jaws Diagnosis Radiographic examination Radiographs required Intra oral peri apical Occlusal films Orthopantomogram www.indiandentalacademy.com
  • 13. Cysts of the jaws Diagnosis Radiographic examination Round or oval area of radiolucency Surrounded by a sharp radio opaque margin www.indiandentalacademy.com
  • 14. Cysts of the jaws Diagnosis Use of radio opaque medium Useful to demonstrate the relationship of naso labial cyst to the surface of the maxilla and to the nasal cavity www.indiandentalacademy.com
  • 15. Cysts of the jaws Diagnosis Aspiration Biopsy Light straw coloured fluid rich in cholesterol indicates periodontal, dentigerous, fissural cysts Light yellow cheese like odontogenic keratocyst material indicates Presence of blood under pressure indicates aneurysmal bone cyst Minute amount of serous fluid indicates solitary bone cyst www.indiandentalacademy.com
  • 16. Cysts of the jaws Diagnosis Aspiration Biopsy Odontogenic Keratocyst Electrophoresis :The protein content of the cystic fluid is less than 4 grams per 100 ml. Identification of Keratin under microscope www.indiandentalacademy.com
  • 17. Cysts of the jaws Management Reasons for treatment 1. Progressive increase in size 2. Likely to get infected 3. Constitute an area of weakness 4. May result in pathological fracture 5. To confirm the benign nature 6. Encroachment on neighbouring structures www.indiandentalacademy.com
  • 18. Cysts of the jaws Treatment Operative procedures a. Enucleation Removal of the entire cystic lining with primary closure or cavity packed open b. Marsupialisation  Decompression of the cystic cavity by making a small opening and evacuating the cystic contents www.indiandentalacademy.com
  • 19. Cysts of the jaws Enucleation Treatment contra indications Large cyst where surgical access would further weaken the jaw Involving apices of one or more teeth where stripping of lining may make them non vital A dentigerous cyst in a young person where the tooth is likely to erupt. www.indiandentalacademy.com
  • 20. Cysts of the jaws Treatment Marsupialisation operative procedure A window is created surgically to relieve intra cystic tension The aperture should be large An acrylic bung is constructed www.indiandentalacademy.com
  • 21. Cysts of the jaws Enucleation Treatment surgical procedure Anaesthesia Incision & reflection of mucoperiosteal flap Making bony window to gain access to the cyst Removal of cystic lining Preparation of the wound for closure Haemostasis Closure of the wound Post operative www.indiandentalacademy.com care
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  • 27. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com