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DENTIGEROUS CYST WITH EMPHASIS ON ITS COMPLICATIONS
- 1. DENTIGEROUS CYST WITH EMPHASIS ON ITS COMPLICATIONS PRESENTER:DR.KRISHNA MOHAN MDS
- 2. SYNOPSIS CYST - 1) DEFINITION 2) CLASSIFICATION 3) PATHOGENESIS DENTIGEROUS CYST - DEFINITION TERMINOLOGY EPIDEMIOLOGY CLASSIFICATION CLINICAL FEATURES RADIOLOGICAL FEATURES HISTOLOGICAL FEATURES INVESTIGATION TREATMENT COMPLICATIONS RECENT ADVANCES
- 3. STAGES OF TOOTH DEVELOPMENT • Bud stage • Cap stage • Bell stage –Early bell stage -Late (or)advanced bell stage
- 8. CYST A cyst is pathologic cavity having fluid, semifluid, or gaseous contents that are not created by the accumulation of pus; frequently, but not always, is lined by epithelium . KRAMER’S(1974)
- 9. TYPES OF CYST TRUE CYSTS : Cysts which are lined by epithelium, E.g. Dentigerous Cyst, Radicular Cyst, etc. PSEUDO CYSTS : Cysts which are not lined by epithelium, E.g. Solitary Bone Cyst, Aneurysmal Bone Cyst,Traumatic bone cyst etc.
- 10. CLASSIFICATION (WHO 1992 )
- 11. WHO 2005
- 12. WHO 2017
- 13. SHEAR CLASSIFICATION According to Shear cysts are classified under three main headings: I ) Cysts of the jaws II) Cysts associated with the maxillary antrum III Cysts of the soft tissues of the mouth, face, neck and salivary glands.
- 14. CYSTS OF THE JAWS EPITHELIAL-LINED CYST NON-EPITHELIAL-LINED CYSTS ODONTOGENIC NON ODONTOGENIC • Gingival cyst of infants • Odontogenic keratocyst • Dentigerous cyst • Eruption cyst • Gingival cyst of adults • llateral • periodontal cyst • Botryoid odontogenic cyst • Glandular odontogenic cyst • Calcifying odontogenic cyst • Midpalatal raphe cyst of infants • Nasopalatine duct cyst • Nasolabial cyst • Inflammatory origin • Radicular cyst, apical and lateral • Residual cyst • Paradental cyst and • juvenile paradental cyst • Inflammatory collateral cyst • Solitary bone cyst • Aneurysmal bone cyst
- 15. CYSTS ASSOCIATED WITH THE MAXILLARYANTRUM • Mucocele • Retention cyst • Pseudocyst • Postoperative maxillary cyst CYSTS OF THE SOFT TISSUES OF THE MOUTH, FACE AND NECK • Dermoid and epidermoid cysts • Lymphoepithelial cyst • Thyroglossal duct cyst • Nasopharyngeal cyst • Thymic cyst
- 16. SHAFERS CLASSIFICATION DEVELOPMENTAL CLASSIFICATION BASED ON ETIOLOGY CLASSIFICATION BY TISSUE OF ORIGIN Dentigerous cyst Eruption cyst Odontogenic keratocyst Gingival (alveolar) cyst of newborn Gingival cyst of adult Lateral Periodontal cyst Calcifying odontogenic cyst Glandular odontogenic cyst. INFLAMMATORY Periapical Residual periapical (radicular) cyst Paradental cyst DERIVED FROM RESTS OF MALASSE DERIVED FROM DENTAL LAMINA ( REST OF SERRES) Periapical cyst Residual cyst Derived from reduced enamel epithelial Dentigerous cyst Eruption cyst Odontogenic keratocyst Gingival (alveolar) cyst of newborn Gingival cyst of adult Lateral Periodontal cyst Calcifying odontogenic cyst Glandular odontogenic cyst.
- 17. PATHOGENESIS OF CYST • INITIATION • CYST FORMATION • ENLARGEMENT
- 18. INITIATION Initiation results in the proliferation of the developing odontogenic epithelial cells and the formation of small cavity • Cell Rests of Malassez • Reduced Enamel Epithelium • Cell Rests of Serres (Dental Lamina)
- 19. CYST ENLARGEMENT Harris (1974) Postulated the theories 1) Mural growth - Peripheral cell division 2) Hydrostatic –Accumulated contents 3) Bone resorbing factor
- 20. DENTIGEROUS CYST • Latin word • Denti -Tooth • Gerous - Bearing or Producing • Also called follicular cyst or pericoronal cyst • Developmental odontogenic cyst of epithelial origin. • Occurs in association with an unerupted tooth
- 21. DEFINITION • An odontogenic cyst that surround the crown of impacted tooth,caused by fluid accumulation between the reduced enamel epithelium and enamel surface ,resulting in a cyst in which the crown is located within the lumen.
- 23. PATHOGENESIS THEORY :TOLLERS ET AL • INTRAFOLLICULAR • EXTRAFOLLICULAR INTRAFOLLICULAR : It may develop by the accumulation of fluid either between the reduced enamel epithelium and the enamel or within enamel organ itself.
- 26. ACCORDING TO AL-TALABANI AND SMITH(1980)
- 28. CLINICAL FEATURE • AGE: first to third decades • SEX: equal in both sex • SITE: maxilla-33%, mandible- 67% • most frequently located in angle of mandible, canine region of maxilla & mandible • maxillary 3rd molar area , rarely at anterior segment • Usually painless , pain arise when secondary infection occurs • If untreated-swelling became large
- 29. • Expansion of bone with subsequent facial asymmerty • Pus may discharge in case of secondary infection
- 30. RADIOLOGICAL FEATURE • Well defined radiolucent area • unilocular or multilocular radiolucency encircle the crown of unerupted tooth
- 31. • Central variety • Lateral variety • Circumferential variety CENTRAL CIRCUMFERENTIAL LATERAL
- 32. EXPANSION
- 33. ASSOCIATED DISEASE Bilateral cysts are found in association with Basal cell nevus syndrome, Cleidocranial dysplasia and a rare form of amelogenesis imperfecta.
- 36. CYST LINED BY THIN KERATINISED EPITHELIUM
- 37. CYST LINED BY NON KERATINISED EPITHELIUM
- 38. CYST LINED BY CILIATED COLUMNAR EPITHELIUM
- 39. MUCOUS CELLS SEEN WIHIN THE EPITHELIAL LINING
- 40. EPITHELIAL LINING CONTAINING RUSHTON BODIES
- 42. DENTIGROUS CYST IN PRIMARY DENTITION • Frequently in children is low • 10 years of age. • Periapical inflammation from a non-vital primary tooth • The spread of periapical inflammation may affect the germ of permanent tooth and may induce the formation of a cyst.
- 43. INVESTIGATION FNAC BIOPSY OPG CT BLOOD TEST
- 44. TREATMENT • Enucleation • Marsupialisation • Removal of associated tooth
- 45. POTENTIAL COMPLICATION OF DENTIGEROUS CYST • Ameloblastoma • Mucoepidermoid carcinoma • Squamous cell carcinoma
- 46. RECENT ADVANCES
- 50. THANK YOU