This document summarizes and classifies different types of cysts. It begins by defining a cyst and outlining the stages of cyst formation. It then separates cysts into two main categories: odontogenic cysts, which are derived from tooth germ remnants, and non-odontogenic cysts, which arise from epithelial remnants of embryonic structures. Several examples of developmental, inflammatory, and miscellaneous cysts are provided within each category. Specific cysts like the nasopalatine duct cyst, median palatal cyst, and antral pseudocyst are then discussed in more detail, covering their clinical features, histology, treatment and differential diagnosis.

2. Dr.Aafiya Reshma
Post graduate student

3. • Definition of cyst
• Classification of cyst
• Non Odontogenic cyst
• Conclusion

4. • CYST:
A cyst is a pathological cavity having fluid,
semifluid or gaseous contents and which is
not created by the accumulation of pus.
Most cyst, but not all are lined by
epithelium.
Kramer,1974

5. STAGES OF CYST FORMATION:
1. INITIATION
2. CYST FORMATION
3. CYST ENLARGEMENT OR EXPANSION

6. • The odontogenic cyst are derived from epithelium associated
with the development of the dental apparatus.
Non odontogenic cyst
Non odontogenic cyst develop in the same biologic
manner as odontogenic cysts.
These cysts, however, typically arise not from tooth germ
remnants. But from the epithelial remnants of embryonic
structures that are required for the development of the
maxillofacial skeleton or various organs in the head and
neck region.

7. • DEVELOPMENTAL
INTRAOSSEOUS:
 Odontogenic keratocyst
 Orthokeratinized odontogenic cyst
 Dentigerous cyst
 Lateral periodontal cyst
 Glandular odontogenic cyst
 Calcifying odontogenic cyst
EXTRAOSSEOUS:
• Eruption cyst
• Botryoid odontogenic cyst
• Gingival cyst of newborn
• Gingival cyst of adult
• INFLAMMATORY
• Apical periodontal cyst
• Inflammatory periodontal cyst
• Residual cyst
• Paradental cyst
• Buccal bifurcation cyst
ODONTOGENIC CYSTS
Acc. to Shafer’s,

8. • DEVELOPMENTAL
INTRAOSSEOUS
 Nasopalatine duct cyst
 Median palatal cyst
 Globulomaxillary cyst
 Median Mandibular cyst
EXTRAOSSEOUS
• Palatal cyst of newborn
• Nasolabial cyst
• Thyroglossal duct cyst
• Oral lymphoepithelial cyst
• Epidermoid cyst
• Dermoid cyst
• INFLAMMATORY
TRAUMATIC
 Salivary cyst
 Antral cyst
 Traumatic bone cyst
 Aneurysmal bone cyst
INFECTIOUS
• Parasitic cyst
MISCELLANEOUS
CYST
• Oral cyst of gastric epithelium
• Stafne bone cyst
NON - ODONTOGENIC CYSTS

9. INTRAOSSEOUS

10. • Also called as Incisive canal cyst.
• Most common non-odontogenic cyst, occurring in 1% of
population.
• First described by MEYER in 1914

11. • Trauma
• Infection
• Mucous retention with associated salivary gland ducts
• Spontaneous cystic degeneration of residual ductal
epithelium

12. • Males>Females,ratio-3:1
• Age-3rd to 6th decade
• Most commonly swelling seen in
anterior region of the midline of the
palate.
• Asymptomatic swelling
• A salty taste in mouth, because of
mucoid like discharge and foul
taste and purulent.
• Devitalization of pulp associated
with teeth have been reported.

13. • The cyst may produce bulging of the floor of the nose.
• Discolouration is due to the accumulation of the fluid
content within the cyst.
• NPDC has slow and progressive growth
• It presents as translucent or bluish coloured dome
shaped swelling within the soft tissue 0f incisive
papillae area of the anterior hard palate.
• Tooth displacement is more common than bony
expansions.

14. • Small cysts- frequently
asymptomatic
• Large cysts- swelling, discharge,
pain,and about 70% experience
combination of these symptoms.
• Large and destructive cyst -
perforation of the labial and
palatal bony plates and may cause
expansion with a fluctuant
swelling of the anterior palate.

15. • Radiographs usually demonstrate a
well-circumscribed radiolucency in
or near the midline of the anterior
maxilla, between the apical to the
central incisor teeth.
• The lesion is round or oval with
sclerotic border
• Root resorption-rarely noticed
• The lesions are round or ovoid and
some may appear heart-shaped.

16. The epithelium consists of either,
• Stratified squamous epithelium
• Pseudostratified columnar epithelium
• Simple columnar epithelium
• Simple cuboidal epithelium
Surrounded by connective tissue wall, consisting of chronic
inflammatory cells of lymphocytes, and plasma cells.

17. Ciliated epithelium
Showing nv bundles
Pseudostratified
clilated epithelium

19.  The cyst fluid is straw coloured and contain erythrocytes,
leukocytes, desquamative epithelial cells , tissue debris and
bacteria.
 The contents of the cyst wall can be a helpful diagnostic aid.
Differential diagnosis:
Any odontogenic cyst (lateral periodontal cyst and periapical
cyst/granuloma)
Enlarged incisive fossa
Central giant cell granuloma
Treatment:
Treated by surgical enucleation through a palatal or buccal approach.
Recurrence is rare.

20. • The median palatal cyst arises from
epithelium entrapped along the line of
fusion of the palatal processes of the
maxilla.
Clinical features:
• Firm or fluctuant swelling of the
midline of the hard palate posterior to
the palatine papilla.
• Most frequently in young adults
• Non tender
• They can be central or unilateral.
• Often Asymptomatic, but some
complaints of pain or expansion.

21. • Hadi et al,in 2001 published an article describing specific
criteria for the diagnosis of midpalatal cyst.
1. Cyst must be present posterior to the palatine papilla
2. Cyst must be grossly symmetrical in the midline of palate
3. Cyst must not have any communication with incisive canal or
associated with nonvital tooth
4. Radiographically, it should be round or ovoid
5. And histologically, it should not have hyaline cartilage, large
vascular spaces or salivary glands in the cyst wall.

22. • Occlusal radiographs demonstrate a well-
circumscribed radiolucency in the midline
of the hard palate, frequently bordered by
a sclerotic layer of bone.
DIFFERENTIAL DIAGNOSIS:
• Radicular cyst
• Nasopalatine cyst

23. • The lining epithelium is of
stratified squamous epithelium or
pseudostartified ciliated
columanr epithelium overlying a
relatively dense fibrous
connective tissue band which
may show chronic inflammatory
cell infiltration.
Treatment:
• The median palatal cyst is treated by surgical removal.
• Recurrence is not to be expected.

24. • Globulomaxillary cyst has been first
ascribed by Thoma (1937).
• They were fissural cysts arising from
non-odontogenic epithelium included at
the site of fusion of the globular process
of the medial nasal (frontonasal) process
and the maxillary process,usually the
maxillary lateral incisor and cuspid teeth
• According to Ferenzcy(1958), they
should be called as premaxillary
maxillary cyst.

25. • Nearly every recorded case has
been discovered accidentally
during routine radiographic
examination.
• On the intraoral radiograph,
characteristically appears as an inverted,
pear-shaped radiolucent area between the
roots of the lateral incisor and cuspid,
usually causing divergence of the roots of
these teeth .

26. • Lined by either stratified squamous
epithelium or ciliated columnar epithelium
or pseudostratified ciliated columnar
epithelium.
• The wall is made up of fibrous connective
tissue, usually showing inflammatory cell
infiltrate.
• Treatment is by surgical
excision,preserving the
adjacent tooth if possible.

27. • Developmental non odontogenic cyst
• extremely rare lesion occurring in the midline of the mandible.
Clinical Features:
• Clinically asymptomatic and discovered during routine
radiographic examinations.

28. • Unilocular, well-circumscribed
radiolucency, although it may also
appear multilocular.
HISTOLOGIC FEATURES
• A thin, stratified squamous epithelium, often with many
folds and projections, lining a central lumen.
• In some cases, the cyst has been lined by a
pseudostratified ciliated columnar epithelium.
TREATMENT
Conservative surgical excision with preservation of the
associated teeth

30. • Arises from epithelial remnants of the deeply budding dental lamina
during tooth development, after the fourth month in utero,
• Also called as Epstein pearls as it occur along the median palatal
raphe and Bohn’s nodules, believed to be derived from the palatal
minor salivary glands.
• Most common near the midline at the junction of the hard and soft
palate.
Clinical features
• Present as multiple 1–4 mm yellowwhite,
sessile mucosal papules of the posterior hard
palate, and occasionally of the anterior soft
palate.
• Seen in 55% to 85% of neonates.

31. • Thin, stratified squamous epithelium cyst lining with a
fibrovascular connective tissue stroma, usually without an
inflammatory cell infiltrate.
• The cystic lumen is filled with degenerated keratin, usually
formed into concentric layers or onion rings and the epithelium
lacks rete processes.
• No treatment required and self healing lesion.

32. • Also known as Nasoalveolar cyst, Klesadt’s cyst
• It is an extraosseous slow growing lesion of soft tissue that
present as a locally growth below the nasal ala and medial
nasal labial fold.
• Commonly they are the soft tissue cysts of the upper lip.
• Comprises 0.7% of all jaw cysts.
• The cyst is found in the upper lip, lateral to the midline or in
the region of the lateral and canine teeth

33. • Common in adults
• 4th-5th decade of life(30-50years of life)
• Women predilection, 3:1 ratio
• Usually Asymptomatic, unless it
becomes secondarily infected.
• Mostly unilateral.
• The cysts grow slowly, producing a
swelling of the lip. They fill out the
nasolabial fold and often lift the ala
nasi, distort the nostril and produce a
swelling of the floor of the nose.

34. • By Seward(1962)
• Localised increase in radiolucency of the
alveolar process above the apices of the
incisor teeth.
• CT scan shows, soft tissue cyst that is oval,
well circumscribed and clearly
extraosseous.
• Although nasolabial cysts do not typically
involve bone, they may cause underlying
bony destruction because of pressure.
• When lesions are injected with a contrast
agent for better visualizations, they will
generally be seen as an egg-shaped
radiopaque mass.

35. • Most nasolabial cysts grossly present as an oval, rubbery, firm
mass that when sectioned will reveal a central cystic cavity.
• The cyst lumen will frequently contain mucinous or viscous
material along with hemorrhage.

36. • The nasoalveolar cyst may be lined by pseudostratified
columnar epithelium which is sometimes ciliated, often with
goblet cells, or by stratified squamous epithelium
• The cyst wall is composed of fibrous connective tissue with
adjacent skeletal muscle.
• Inflammation may be seen if the lesion is secondarily infected.

38. • Nasolabial cysts are typically treated by complete excision
using a transoral, sublabial approach, or by transnasal
marsupialization.
• Recurrence is rare.
Differential Diagnosis:
• Radicular cyst
• Periapical abscess
• Nasopalatine duct cyst
• Epidermoid cyst
• Mucous retention cyst
• Benign mesenchymal tumors
• Minor salivary gland tumors

39. • Occurs before the age of 20years.
• No sex predilection
• The cyst usually presents as a painless,
fluctuant, movable swelling which is
asymptomatic unless it is complicated
by secondary infection.
• Associated with neck or throat pain or
dysphagia.
• The thyroglossal duct cyst is the most common of the
developmental cysts of the neck.
• The cyst is usually located at the midline of the neck.

40. • The thyroglossal tract cyst may be lined by
stratified squamous epithelium, ciliated
columnar epithelium, or intermediate transition
type.
• The connective tissue wall of the cyst will
frequently contain small patches of lymphoid
tissue, thyroid tissue, and mucous glands.
• Surgical excision is usually advised for the
treatment of thyroglossal duct cysts,by
Sistrunk procedure.
• Antibiotics are indicated if there is infection.
• Thyroid scans and thyroid function studies
are ordered preoperatively.

41. • The oral lymphoepithelial cyst is an
uncommon lesion of the mouth that
develops within oral lymphoid tissue
• The age range was 15–65 years.
• Oral lymphoepithelial cyst presents as a
movable, painless submucosal nodule
with a yellow or yellow-white
discoloration.
• Occasional superficial cysts rupture to
release a foul-tasting, cheesy,
keratinaceous material.
• The most frequently reported locations
are the floor of the mouth, ventral
tongue, posterior lateral border of the
tongue, palatine tonsil, and soft
palate.

42. • The lymphoepithelial cyst is lined by atrophic and often
degenerated stratified squamous epithelium, usually lacking
rete processes and usually demonstrating a minimal granular
cell layer.
• The cyst is entrapped within a well-demarcated aggregate of
mature lymphocytes.
• The most striking feature is the presence of lymphoid tissue in
the cyst wall.
TREATMENT:
• Complete surgical
excision.

43. • 80% of follicular cyst of the skin
• Most common in the acne prone areas of the
head ,neck,back and scalp.
• Males are affected more frequently than
females.
• Most common in the third and fourth
decades of life.
• They may present as nodular, fluctuant
subcutaneous lesions that may or may not be
associated with inflammation.
• Discharge of a foul-smelling cheese-like
material is a common complaint.
• Epidermoid cysts appear as firm, round,
mobile, flesh-colored to yellow or white
subcutaneous nodules of variable size.

44. • Stratified squamous epithelium with glandular
differentiation and is filled with desquamated keratin
disposed in a laminar pattern.
• Dystrophic calcification and reactive foreign body
reaction are seen associated with the cystic capsule.
• Pigmented epidermoid cysts may demonstrate melanin
pigment in the wall and a keratin mass.
• Surgical excision

45. • Most common on face,neck or scalp.
• No gender predilection
• Dermoid cysts occur on the floor of the
mouth or elsewhere in the mouth.
• Cysts that occur below the geniohyoid
muscle often produce a submental swelling,
with a “double-chin” appearance.
• The lesion is usually slow growing and
painless, presenting as a doughy or rubbery
mass that frequently retains pitting after
application of pressure
• Dermoid cysts are developmental cysts arising from entrapped
midline ectodermal tissue lined by epidermis with skin
appendages present in the fibrous.

46. • Lined by orthokeratinized stratified squamous epithelium with a
prominent granular cell layer
• Abundant keratin often is found within the cyst lumen
• The cyst wall is composed of fibrous connective tissue that contains
one or more skin appendages, such as sebaceous glands, hair
follicles, or sweat glands

48. • The lesion appears as a dome-shaped, faintly
radiopaque lesion often arising from the floor of the
maxillary sinus.
• The antral pseudocyst develops due to an
accumulation of an inflammatory exudate (serum,
not mucus) beneath the maxillary sinus mucosa,
causing a sessile elevation.
• Asymptomatic
• Rare symptoms-headache, facial sinus
pain, nasal obstruction, postnasal drip, and
nasal discharge.
• Radiographically,uniform and spherical or
dome-shaped radiodensity arising from the
floor of the maxillary sinus

49. • Covered by sinus epithelium
and demonstrate a
subepithelial inflammatory
exudate that consists of
serum, occasionally
intermixed with
inflammatory cells.
• Collections of cholesterol
clefts and scattered small
dystrophic calcifications
may be seen.
• Harmless and no treatment
is necessary.

50. • 1%of all jaw cysts
• Trauma-hemorrhage theory, trauma that
is insufficient to cause a bone fracture
results in an intraosseous hematoma.
Clinical and Radiographic features:
• Young persons
• Males >Females
• More common- posterior portion of
the mandible,incisor region
• The lesion typically appears as a
well-delineated, unilocular radiolucency.
• The radiolucent defect shows domelike
projections that scalloped upward
between the roots of adjacent teeth.

51. • No epithelial lining
• The walls of the defect are lined by a
thin band of vascular fibrous
connective tissue or a thickened
myxofibromatous proliferation with
reactive bone.
• There may be presence of few red
blood cells, blood pigments, or giant
cells adhering to the bone surface.
Treatment:
Surgical exploration.

52. • Cysts associated with salivary glands are of 2 types:
• Extravasation cyst
• Mucocele
• Ranula
• Retention Cyst

53. • Most common benign lesions of salivary gland .
• Occurs due to rupture of salivary gland or their ducts leading to
spillage of mucin in surrounding soft tissue.
Mucocele-
1. Rupture of minor salivary gland or ducts
2. Smaller than ranula
Ranula-
1. Rupture of ducts of submandibular of sublingual salivary
gland
2. larger

54. • Traumatic- produced by biting lip,cheek leading to its
development
MUCOCELE:
Clinical Features:
• Common site-lower lip
• Other sites-upper lip,palate, cheek,tongue and floor of the
mouth
• The superficial lesion appears as a raised, circumscribed
vesicle, several millimeters to a centimeter or more in diameter,
with a bluish, translucent cast.
• The lesion appears deep,painless and appears as normal
mucosa.

55. • Not lined by epithelium,It is not a true
cyst.
• Wall is made up of a lining of
compressed fibrous connective tissue and
fibroblasts.
• Usually shows infiltration by abundant
numbers of polymorphonuclear
leukocytes, lymphocytes, and plasma
cells.
• The lumen of the cyst like cavity is filled
with an eosinophilic coagulum
containing variable numbers of cells,
chiefly leukocytes and mononuclear
phagocytes.
Treatment:
• Excision with removal of the projecting
salivary gland.

56. • Latin word-rana-Frog
Clinical features
• Slowly developing painless mass on
one side of floor of the mouth
• Blue dome shaped
• Elevates the tongue
• Lesion-deep seated lesions(with normal
appearingmucosa)
• -superficial lesion(with translucent bluish
mucosa)
• Most frequently in children and young adults
Treatment:
Either marsupilaization or excision of the entire
sublingual gland.

57. • True developmental cyst lined by epithelium
• Occurs due to the obstruction or constriction of salivary gland duct
leading to retention of saliva within duct.
Etiology and pathogenesis:
 Due to partial obstruction or total obstruction of salivary duct by
salivary calculi
 Mucous plug
 Continuous use of mouth washes leading to constriction of ductal
orifice

58. • Mainly involves major glands such as parotid
• Slowly growing,fluctuant and painless swelling
• Deeper lesions appears normal, nodular and firm.
Histopathological features:
• cuboidal, columnar, or atrophic squamous epithelium surrounding
thin or mucoid secretions in the lumen.
• This epithelium often demonstrates papillary folds into the cystic lumen

59. • Lesion of young persons
• No gender predilection
• Lesions are also seen frequently in the clavicle, rib, innominate
bone, skull and bones of the hands and feet as well as other
sites.
• Painful or tender,swelling.
• Gross findings- excessive bleeding is encountered, the blood
‘welling up’ from the tissue.
Oral Manifestations:
• Posterior segments of the jaw, mandible
• Rapid enlarging swelling.

60. • Unilocular or multilocular radiolucency, often
with marked cortical expansion and thinning.
• a ballooning or “blow-out” distention of the
affected bone.
• MRI-Honey comb or soap bubble appearance
HISTOPATHOLOGIC FEATURES
• A fibrous connective tissue stroma
containing many cavernous or
sinusoidal blood-filled spaces.
• Young fibroblast and numerous
multinucleated giant cells,osteoid
and woven bone.
TREATMENT
Surgical curettage or excision.

61. • First recognized by Stafne in 1942,
• Other names- static bone cavity, defect of
the mandible, lingual mandibular bone
cavity, static bone cyst, latent bone cyst,
and Stafne bone defect.
• Males>females
• Radiographically, the lesion usually appears
as an ovoid radiolucency located between the
inferior alveolar canal and the inferior border
of the mandible in the region of the second or
third molars.
• The lesion is typically well circumscribed and
has a sclerotic border.
• Unilateral

62. • Biopsy is not usually necessary to establish the diagnosis of
Stafne defects.
Treatment:
• No treatment is necessary for patients with Stafne defects, and
the prognosis is excellent.

63. • Usually echinococcal as part of desseminated hydatid disease
• Primary hydatid cyst of the adrenal gland is extremenly rare.
• Accounts for 6-7% of all adrenal cysts
CLINICAL FEATURES:
 Asymtomatic,occasionally with abdominal pain
HISTOPATHOLOGY:
• Walls contain many eosinophils,also evidence of parasite.
TREATMENT:
• Surgical excision
• Anti helminthic agents.

64. 1. Oral and Maxillofacial Pathology Neville 4th Edition
2. Shafers textbook of Oral Pathology
3. Cysts of the Oral and Maxillofacial Regions,Mervyn Shear,Paul Speight
4. Nonodontogenic Cysts Rawle Fabian Philbert, DDS*, Navraj Singh Sandhu, BSc, DMD
5. Odontogenic and Non-Odontogenic Cysts Robert O. Greer and Robert E. Marx.
6. Non-Odontogenic CystsReed McKinney; Heather Olmo.
7. True median palatal cyst; a rare case report Shruthi Rangaswamy, Madhumati Singh, Ranjeeta Yumnum,
Journal of Oral and Maxillofacial Pathology | Volume 22 | Issue 2 | May - August 2018.
8. Median Palatal Cyst: Case Report and Review of Literature Steve Manzon, DMD,* Michael Graffeo,
DDS, and Rawle Philbert, DDS, J Oral Maxillofac Surg 67:926-930, 2009
9. Sharma BB, Sharma S, Jha A, Sharma KD, Sharma JD, Sharma CB. Non-odontogenic hard palate cysts
with special reference to globulomaxillary cyst. Plast Aesthet Res 2016;3:302-5.
10. Globulomaxillary cyst: does it still exist? A CASE REPORT eleni PANAGOULI1, gregory
TSOUCALAS2 , anastasios VASILOPOULOS2, vasilios THOMAIDIS2, aliki FISKA2,
alexandroupolis, greece received 07 apr 2019, accepted 23 may 2019
https://doi.org/10.31688/ABMU.2019.54.2.28
11. Globulomaxillary non- odontogenic cyst: A case report Ashok Gupta, Simran Kaur Pawar, Priya
Ghanghas , Harsimranjeet singh, Indian Journal of Orthodontics and Dentofacial Research, October-
December 2017;3(4):247-248
12. Menditti, Dardo et al. “Cysts and Pseudocysts of the Oral Cavity: Revision of the Literature and a New
Proposed Classification.” In vivo (Athens, Greece) vol. 32,5 (2018): 999-1007.
doi:10.21873/invivo.11340
13. Internet