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TUMOURS AND CYSTS OF JAW.pptx
- 1. TUMOURS AND CYSTS OF JAW BY Dr.Tarunikaa G Page 1
- 2. According To The Title, PART 1- CYSTS PART 2- TUMOURS Page 2
- 3. CYSTS OF THE JAW PART 1 • Odontogenic • Nonodontogenic Page 3
- 4. Rests of Malassez Reduced enamel epithelium Rests of Serres Unclassified Periapical cyst Residual cyst OKC Gingival cyst of newborn & adult Lateral periodontal cyst Glandular odontogenic cyst Paradental cyst Calcifying odontogenic cyst Dentigerous cyst Eruption cyst CLASSIFICATION Page 4
- 5. Developmental Inflammatory Dentigerous cyst Eruption cyst Odontogenic keratocyst Gingival cyst of newborn Gingival cyst of adult Lateral periodontal cyst Calcifying odontogenic cyst Glandular odontogenic cyst Periapical cyst Residual cyst Paradental cyst CLASSIFICATION Page 5
- 6. • One of the most common cyst • Impacted teeth Scene 1 Page 6
- 8. Accumulation of fluid between the REE and enamel surface What are the syndromes associated with this condition? Page 8 HOLLOWING OUT
- 9. How much is the normal follicular space? Page 9
- 10. What are the 3 radiographic types seen? Page 10
- 11. Page 10 1 3 2
- 12. Potential Complications Epidermoid carcinoma Ameloblastoma Mucoepidermoid carcinoma Page 11
- 13. Fluctuant, often translucent swelling of the alveolar ridge SCENE 2 Page 12
- 15. SCENE 3 Clue 1: Philipsen in 1956 Page 14
- 16. SCENE 3 Clue 2 : Nevoid basal cell carcinoma syndrome Page 14
- 17. SCENE 3 Clue 3 :PTCH 9q22.3 – q31 Page 14
- 18. SCENE 3 Clue 4: Two hit mechanism Page 14
- 19. Odontogenic keratocyst But why ? OrthovsPara keratinized OKC EPITHELIAL MEMBRANE ANTIGEN (EMA) AND CARCINOEMBRYONIC ANTIGEN (CEA) Page 15
- 20. Aggressive Behavior Histopathology: Basal epithelial layer shows proliferation and budding. Mitotic figures Recurrence Two hit mechanism Reclassification of OKC: Keratocystic Odontogenic Tumor (KOT) 1967, Toller Page 16
- 21. Unilocular well-defined peripheral rim Scalloping of the border 1 2 3 WHY ? Multilocularity with satelite cells Page 17
- 22. Parakeratinized 6-10cells thick Picket fence or thombstone appearance keratin and cholestrol in lumen HISTOPATHOLOGY
- 24. Dental Lamina Cyst of Newborn Epstein’ s pearls junction of the hard and soft palate midpalatine raphe, Bohn’s nodules
- 25. 2 1
- 26. Gingival Cyst of Adult Traumatic implantation Rests of Serres
- 27. Radiolucent area seldom over 1 cm in diameter Mandibular bicuspid area Botryoid odontogenic cyst Lateral periodontal cyst
- 28. Ghost cells and spherical calcificatiion Resembles follicular ameloblastoma . Gorlins cyst Guess me yet ?
- 29. Sialo-odontogenic cyst, mucoepidermoid odontogenic cyst GLANDULAR ODONTOGENIC CYST FEATURES Anterior mandible 1 Multilocular radiolucency 2 Nonkeratinized stratified epithelium 3 Goblet cells 4 Microcysts 5 1 2
- 30. Which is the most common odontogenic cyst?
- 31. Cyst arising from infected tooth leading to periapical inflammation stimulating epithelial rests of Malassez?
- 32. Nonkeratinized epithelium Rushtons bodies Arcading pattern of epithelium Cholestrol clefts Inflammation of capsule
- 34. PA R A D E N TA L C Y S T Non widening of periodontal ligament space Lesion was superimposed on the buccal root face Distal or facial aspect of a vital mandibular third molar
- 35. • Marsupialization • Enucleation and primary closure • Enucleation and packing open Treatment for cyst
- 39. ORIGIN Cell rests of the enamel organ Epithelium of odontogenic cysts Disturbances of the developing enamel organ Basal cells of the surface epithelium of the jaw Heterotopic epithelium Before we start ...
- 40. FOLLICULAR HISTOLOGIC TYPES GRANULAR CELL ACANTHOMATOUS PLEXIFORM BASAL CELL DESMOPLASTIC
- 43. 01 Pindborgs tumour 03 Mandibular molar region 02 Stratum intermedium 04 Radiographic feature?
- 47. Eamel and dentin laid down in an abnormal pattern because the organization of odontogenic cells fails to reach a normal state of morphodifferentiation Hamartomatous malformation. Ghost cellls Make a guess
- 48. •Arises from the mesenchymal portion of the tooth. •Tennis racquet pattern •step ladder appearance Page 13
- 49. Surgical resection Treatment for tumours
- 51. Here's to achieving all our goals and dreams, however big or small they may be! Thank you for listening!
Editor's Notes
- WOW I can see a lot of hungry faces rn. Let me make you all a deal. I promise to finish this class as quick as possible but only if you all promise to be as interactive as you can.
- arising from tooth-forming tissues or bcoz of tissues entrapped in the developmental fissures.
- Based on their site of origin Malassez- Hertwiigs epithelial root sheath RER- FORMED by outer and inner enamel epithelium Rest of serres- remnants of dental lamina
- Most cysts do not have any characteristic clinical features. Among the more common features are pain, soft-tissue swelling and expansion of bone, drainage and various neurologic manifestations such as paresthesia of the lip or teeth. To keep things short and to the point I wouldn’t be discussing clinical features unless they are characteristkc.
- Lets see how quickly you all can identify this cyst. It’s a quite easy one. This is the one of the most common odontog cyst assoc with impacted teeth.
- Reduced enamel epithelium MOST DENTIGEROUS CYSTS ARE SOLITARY. cleidocranial dysplasia and Maroteaux–Lamy syndrome. result in a ‘hollowing-out’ of the entire ramus in some cases
- We all knw that the radiographic feature of dentigerious cyst is a a cmooth unilocular radiolucency seen around an impacted tooth. But isnt there a radiolucency evident around all unerupted teeth. This radiolucency is called as follicular space. The only way to differentiate a dentigerous cyst from normal follicular space. This can be done only if you know how much the normal follicular space is? 3–4 mm
- circumferential dentigerous cyst results when the follicle expands in a manner that it covers the entire tooth structure. The lateral type of dentigerous cyst is a radiographic appearance which results from dilatation of the follicle on one aspect of the crown. This type is commonly seen when an impacted mandibular third molar is partially erupted so that its superior aspect is exposed. the crown is enveloped symmetrically. In these instances, pressure is applied to the crown of the tooth and may push it away from its direction of eruption. The so-called
- s. There are no characteristic microscopic features which can be used reliably to distinguish the dentigerous cyst from the other types of odontogenic cysts.
- odontogenic cyst is clinically visible as a soft fluctuant mass on the alveolar ridges. in children of different ages
- This cyst gas similar histologic features of a dentigerous cyst. But can anyone tell me the difference. dentigerous cyst occurring in the soft Whereas the dentigerous cyst develops around the crown of an unerupted tooth lying in the bone. When the circumcoronal cystic cavity contains blood, the swelling appears purple or deep blue; hence the term ‘eruption hematoma’.
- ‘two hit mechanism’ refers to the process by which a tumor suppressor gene is inactivated. The first hit is a mutation in one allele, which, although it can be dominantly inherited, has no phenotypic effect. The second hit refers to loss of the other allele and is known as ‘loss of heterozygosity
- the cyst epithelium produces so much keratin that it fills the cyst lumen cytokeratin
- Variation in the growth pattern
- (Basal cell nevus syndrome, hereditary cutaneomandibular polyoncosis, Gorlin and Goltz syndrome s transmitted as an autosomal dominant trait,
- n are multiple, occasionally solitary, superficial raised nodules on edentulous alveolar ridges of infants that resolve without treatment
- 1 bohns nodule 2 epstein pearl Treatment not required usually.
- Is an uncommon cyst of the gingiva caused either That arising from cystic transformation of dental lamina or rests of Serres. O That arising from traumatic implantation of surface epithelium. a small, well-circumscribed, painless swelling of the gingiva. Local surgical excision of
- r calcifying epithelial odontogenic cyst
- Mucin producing epithelial cells
- commonly, these actually are retained periapical cysts from teeth that have been removed. T
- Which is the rarest type? The most common type
- Confined to luminal surface Projects from cystic lining into lumen Tumour infiltrates fibrous cystic wall
- Radiographically this is chaaracterized by multilocular radiolucency showing soap bubble appearance. Sometimes may also be unilocular radiolucency.
- Snow driven appearance
- Photomicrograph showing apple-green color birefringence of amyloid deposited in fi brous connective tissue stroma (Congo red stain under polarized light sourc
- r calcifying epithelial odontogenic cyst
- Odontogenic myxoma spindle-shaped, stellate, and rounded cells in a loose myxoid stroma
- epithelium can vary with most lesions having stratified squamous but some developmental or fissural cysts in the maxilla may have respiratory epithelium.