Cysts In The Oral Cavity
By: Naz Noori Burhan
Cyst is defined as pathologic cavity having fluid,
semifluid, or gaseous contents and which is not created
by accumulation of pus.
Cysts are a reaction of the body to a condition and are
usually relatively slow growing. They can be sterile or
TYPES OF CYSTS
TRUE CYSTS: that which is lined by epithelium e.g dentigerous
cyst, radicular cyst etc.
PSEUDO CYSTS: not lined by epithelium, e.g. Solitary bone cyst,
Aneurismal bone cyst etc
Cysts of oral
Frequency Of Epithelial Cysts Of Oral Region
4.20% SHEAR 2006 Radicular cyst
Radicular ( Periapical ) cyst
The most common odontogenic cyst of inflammatory origin.
Related to apex of non-vital tooth. More common in anterior
of maxilla , small cyst asymptomatic .
Pain if infected with sinus
Paresthesia and pathological fracture
Periapical abscess .
Traumatic bone cyst .
Residual cyst are retained periapical cysts from teeth that have
Usually asymptomatic, In both jaws but more in the mandible If
residual cyst remains untreated, continued growth can cause
significant bone resorption and weakening of the mandible or
A cyst of inflammatory origin- occurring on lateral aspect of
root of partially erupted mandibular 3rd molar with an
associated history of pericoronitis
Age: 20-40 years
Tooth is vital
Facial sinus in some cases
Odontogenic kerato cyst
OKC is a cyst containing keratin and lined with keratinized
OKC’s arises from cell rests of the dental lamina.
Ocure at any age More frequently in males than in females,.
Mandible: posterior portion of body & ramus.
Maxila: 3rd molar area.
Defined as cyst originating after crown of a tooth is
completely formed, by accumulation of fluid between
reduced dental epithelium and tooth substance.
Encloses crown of impacted / unerupted tooth and is
attached to its neck.
Dentigerous cyst occurring in soft tissues, instead of
Mandibular 3rd molar, maxillary canine and maxillary
Eruption cyst is defined as an odontogenic cyst that
surrounds a tooth crown which has erupted through
bone but not soft tissue and is clinically visible as a
soft fluctuant mass on the alveolar ridges
found in children of different ages, and occasionally
in adults if there is delayed eruption
SITE : most commonly associated with the first permanent, molars
and the maxillary incisors.
A small developmental odontogenic cyst of the gingival soft
tissue derived from the rests of the dental lamina
Slowly enlarging, well circumscribed painless
on facial aspect of free / attached gingiva and
Site: mandibular bicuspid/cuspid/incisor area.
Lateral periodontal cyst.
Lateral periodontal cyst
Uncommon intra-osseous odontogenic cyst similar to gingival
cyst of adult
It’s derived from rest of dental lamina
Lateral to the root surface of erupted tooth
Middle age patient ,Both mandible and maxilla
Canine and premolar of mandible ,Near the crest of ridge
Asymptomatic, May produce bone expansion and pain
Tooth is vital .Cyst less than 1 cm.
Nasopalatine (FISSURAL CYSTS)
Nasopalatine canal usually contains remnants of the
nasopalatine duct, a primitive organ of smell, and the
nasopalatine vessels and nerves. forms in the
nasopalatine canal,, Pressure of cyst on adjacent
nasopalatine nerve may cause burning sensation or
numbness over palatal mucosa.
If extends posteriorly involving hard palate
(MEDIAN PALATAL CYST)
if expands anteriorly between central
incisors,destroying or expanding labial plate of
bone and causing teeth to diverge MEDIAN
ANTERI OR MAXILLARY CYST
Traumatic bone cyst , or hemorrhagic bone cyst.
Children and adolescent, Mandibular premolar and
molar ,rarely in maxilla
Painless swelling ,Round radio-lucent and less
Bony wall lined by thin loose C.T.
Cysts of the jaws are treated in one of the following
four basic methods:
(3) A staged combination of the two procedures, and
(4) Enucleation with curettage.
Enucleation: This technique involves complete removal of
the cystic sac and healing of the wound by primary intention.
This is the most satisfactory method of treatment of a cyst
and is indicated in all cases where cysts are involved, whose
wall may be removed without damaging adjacent teeth and
other anatomic structures.
The surgical procedure for treatment of a cyst
with enucleation includes the following steps:
1. Reflection of a mucoperiosteal flap.
2. Removal of bone and exposure of part of the cyst.
3. Enucleation of the cystic sac.
4. Care of the wound and suturing.
This method is usually employed for the removal of large cysts
by opening a surgical window above the lesion.
A circular incision is made, which includes the mucoperiosteum,
the underlying perforated (usually) bone, and the respective
wall of the cystic sac.
Then the contents of the cyst are evacuated, and interrupted
sutures are placed around the periphery of the cyst , suturing
the mucoperiosteum and the cystic wall together.
Afterwards, the cystic cavity is irrigated with saline solution and
packed with iodoform gauze.
Technique of Marsupiaiization
4) Removal of bone.
5) Removal of cystic lining specimen.
6) Visual examination of residual cystic
7) Irrigation of cystic cavity.
8) Suturing Cystic lining sutured with
the edge of oral mucosa.
Marsupialization method. Circular incision
includes mucosa and periosteum.
Exposure of buccal cortical plate and
removal of portion of bone with round bur
Exposure of cyst
after removal of
Suturing of wound
margins with cystic
Packing of cystic
cavity with iodoform
Cystic cavity after
insertion of gauze