This document discusses cysts, specifically gingival and periodontal cysts. It defines a cyst as a pathological fluid-filled cavity lined by epithelium. Gingival cysts typically appear as bluish nodules on the gingiva near the mandibular canine and premolars. Periodontal cysts occur on lateral root surfaces and are derived from rests of Malassez. Diagnosis involves clinical and radiographic examination as well as biopsy. Treatment options include surgical excision through enucleation, marsupialization, or a combination approach.

1. PRESENTED BY:
FASAHAT AHMED BUTT
CYST

2. OBJECTIVES
What is cyst?
Types of cysts
a. Clinical features
b. Radiographic
findings
c. Histology
 Diagnosis
 Treatment

3. A cyst is a pathological fluid filled
cavity lined by epithelium.
CYST

4. TYPES OF CYSTS
Gingival cyst Periodontal
cyst

5. GINGIVAL CYST
 LOCATION:
 Lingual surface of mandibular
canine and premolars.
 COLOR:
 Bluish gray.
 APPEARANCE:
 Nodular and resembles mucocele
 CONTOUR
 Localized enlargement.
 PAINLESS
 ATTACHED or MARGINAL
GINGIVA

6.  ORIGIN
 Develop from odontogenic epithelium or
from surface or sulcular epithelium

7. RADIOGRAPHIC FINDINGS
 No radiographic findings because the usually
involve the soft tissues

8. HISTOLOGY
 Gingival cyst cavity is lined by a thin , flattened
epithelium with or without localized areas of
thickening.
 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.
 LOCATION
Mandibular canine-premolar area.
ORIGIN
 Derived from rests of Malassez.
CONTOUR
 Localized enlargement
ASYMPTOMATIC
PAINFUL

10. RADIOGRAPHIC FINDINGS
 Interproximal periodontal cyst appears on the
side of the root as a radiolucent area bordered
by a radiopaque line.
 Periodontal abscess is difficult to differentiate
from periodontal cyst, radiographically

11. `
Cyst Abscess
 Filled with fluid
 <1.5cm
 Gingiva appears
bluish gray
 Filled with puss
 2-10cm
 Gingiva appears red

12. HISTOLOGY
 Cystic lining may be a loosely arranged , thin,
nonkeratinized epithelium, sometimes with
thicker proliferating areas.

13. DIAGNOSIS
 CLINICAL FINDINGS
 RADIOGRAPH
 BIOPSY

14. TREATMENT
 Treatment is surgical excision and histopathologic
examination for a conclusive diagnosis.
 ENUCLEATION
 MARSUPIALIZATION
 COMBINATION
 ENUCLEATION WITH CURETTAGE

15. ENUCLEATION
 Enucleation means shelling out the entire cystic lesion
without rupture.
INDICATION:
 Small cyst, which can be done when the vital structures are
not involved.

16. Local Anesthesia
Flap design is
made
Incision made
according to the
design
Tooth extraction
Bur and
forcep
Intraosseous
window
Irrigation to
clean the cavity
Closure by
suture (6-12
months)

18. MARSUPIALIZATION
 Marsupialization refers to creating a surgical window in
the wall of the cyst, excavating the contents of the cyst
and maintaining continuity between the cyst wall and the
oral cavity.
 This process decreases the pressure inside the cyst, and
promotes shrinkage of the cyst as well as bone fill.
INDICATIONS:
 If surgical access is difficult
 Unerupted tooth involved
 Small cyst

19. Prophylactic
antibiotic
Anesthesia
Marsupializati
on
Others
Aspiration
Thin bone
Cavity
Incision
Circular or
Eleptical
Large
window
Thick bone Bur
Sutured
Pt instructed
for cleansing
of cavity
Contents are
evacuated
Irrigation via
normal saline

20. COMBINATION
 Combined approach morbidity and complete
healing of the defect.
 In this technique marsupialization is done first
and the enucleation is done at a later date.
 The advantage is that as marsupialization is
done first, it spares the vital structures. The size
of the cystic cavity also becomes small and after
healing the cystic lining becomes thick, making
enucleation easier at this stage.

21. ENUCLEATION WITH
CURETTAGE
 After enucleation is done, a curette or bur is used to
remove 1 to 2 millimeter of bone around the entire
periphery of cystic cavity.
INDICATIONS
 For cysts reported to have high recurrence rate, for
example odontogenic keratocyst
Advantages
 If enucleation leaves any remnants, curettage may remove
them thereby decreasing the likelihood of recurrence.
Disadvantage
 Curettage is more destructive to adjacent bone, blood

23. REFERRENCES
 CARRANZA
 EOP
 GOOGLE