ODONTOGENIC CYSTS

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ORAL AND MAXILLOFACIAL SURGERY

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ODONTOGENIC CYSTS

  1. 1. ODONTOGENIC CYSTS CLINICAL FEATURES RADIOGRAPHIC FEATURES DIFFERENTIAL DIAGNOSIS Yasmin Moidin 2008 Batch Al Azhar Dental College Thodupuzha
  2. 2.  Introduction  Classification  Types of odontogenic cysts  Conclusion  Reference
  3. 3.  Cyst is defined as a pathological cavity filled with fluid which is solid semisolid or gaseous form which may or may not be lined by epithelium  Cyst can occur within bone or soft tissues  They may be asymptomatic or associated with swelling and pain
  4. 4.  Cysts are generally slow growing, expansile lesions  They grow by hydraulic expansion  Radiographically , they often appear radiolucency surrounded by thin radioopaque border
  5. 5.  CLASSIFICATION BY ETIOLOGY  DEVELOPMENTAL: Unknown origin but are not the result of an inflammatory reaction  Dentigerous cyst  Eruption cyst  Odontogenic keratocyst  Gingival cyst of newborn
  6. 6.  Gingival cyst of adult  Lateral periodontal cyst  Calcifying odontogenic cyst  Glandular odontogenic cyst  INFLAMMATORY: result of inflammation  periapical cyst  Residual cyst  Paradental cyst
  7. 7.  CLASSIFICATION BY TISSUE OF ORIGIN  DERIVED FROM RESTS OF MALASSEZ  Periapical cyst  Residual cyst  DERIVED FROM DENTAL LAMINA (RESTS OF SERRES)  Odontogenic kertocyst  Gingival cyst of newborn  Gingival cyst of adult
  8. 8.  Lateral periodontal cyst  Glandular odontogenic cyst  UNCLASSIFIED  Paradental cyst  Calcifying odontogenic cyst
  9. 9.  A dentigerous cyst results because of the enlargement of the follicular space of the whole or part of the crown of an impacted or unerupted tooth and is attached to the neck of the tooth
  10. 10.  CLINICAL FEATURES  The cyst is always associated initially with the crown of an impacted, embedded or unerupted tooth  Sites: mandibular and maxillary third molar and maxillary cuspid areas  Most dentigerous cysts are solitary  Expansion of bone with subsequent facial asymmetry, extreme displacement of teeth, sever root resorption of adjacent teeth and pain
  11. 11.  RADIOGRAPHIC FEATURES  Reveal a radiolucent area associated with an unerupted tooth crown  The radiolucent area is surrounded by a thin sclerotic line representing bony reaction
  12. 12.  Three radiological variations:-  Central variety, crown is enveloped symmetrically  Lateral type, results from dilatation of the follicle on one aspect of the crown  Circumferential type, follicle expands and entire tooth is enveloped by cyst  DIFFERENTIAL DIAGNOSIS  Ameloblastoma and ameloblastic fibroma  Adenomatoid odontogenic tumour  Calcifying odontogenic cyst
  13. 13.  Developmental primordial and follicular primordial cyst  Odontogenic keratocyst  Cystic ameloblastoma  Radicular cyst  Hyperplastic follicle
  14. 14.  Eruption cyst is defined as an odontogenic cyst that surrounds a tooth crown that has erupted through bone but not soft tissue and is clinically visible as a soft fluctuant mass on the alveolar ridges
  15. 15.  CLINICAL FEATURES  Found in children and occcasionally in adults  Common site – anterior to first molar  Lesion appear as circumscribed, fluctuant, translucent swelling of the alveolar ridge over the site of the erupting tooth  When the circumcoronal cystic cavity contains blood, swelling appears purple or deep blue; hence the term ERUPTION HAEMATOMA
  16. 16.  RADIOGRAPHIC FEATURES  It may show soft tissue shadow since the cyst is confined within it and there is usually no bone involvement  DIFFERENTIAL DIAGNOSIS  Dentigerous cyst
  17. 17.  A cyst derived from the remnants of the dental lamina, with a distinctive lining of six to ten cells in thickness and exhibits a basal cell layer of palisaded parakeratin cells and a surface of corrugated
  18. 18.  CLINICAL FEATURES  The cyst may occur at any age  Peak incidence is in 2nd and 3rd decades of life  Predilection for occurrence in males  Common site:- third molar area  Other features: pain, soft-tissue swelling and expansion of bone and neurological manifestations – parasthesia of lips
  19. 19.  RADIOGRAPHIC FEATURES  They are unilocular, presenting a well-defined peripheral rim  Scalloping of the border represents variations in the growth pattern of cyst
  20. 20.  DIFFERENTIAL DIAGNOSIS  Dentigerous cyst  Ameloblastoma  Primordial cyst  Residual cyst  Traumatic cyst  Benign odontogenic tumor  Giant cell granuloma  Odontogenic myxoma
  21. 21.  These are multiple , occasionally solitary, superficial raised nodules on edentulous alveolar ridges of infants that resolve without treatment, derived from rests of the dental lamina and lining consisting of keratin-producing epithelial
  22. 22.  CLINICAL FEATURES  Small discrete white swellings of the alveolar ridge  Lesion appear to be asymptomatic and donot produce discomfort in infants
  23. 23.  A small developmental odontogenic cyst of the gingival soft tissue derived from the rests of the dental lamina, containing a lining of embryonic epithelium of cuboidal cells and distinctive focal thickenings
  24. 24.  CLINICAL FEATURES  Lesion is small, well-cirumscribed , painless, swelling of the gingiva  Lesion is of same color as the adjacent normal mucosa and 1cm in diameter  It occurs in free or attachment gingiva and gingival papilla
  25. 25.  RADIOGRAPHIC FEATURES  It is a soft tissue lesion and if it enlarges to sufficient size, it causes superficial erosion of the cortical plate of bone   DIFFERENTIAL DIAGNOSIS Lateral periodontal cyst
  26. 26.  A slow growing, non expansile developmental odontogenic cyst derived from one or more rests of the dental lamina, containing an embryonic lining of one to three cuboidal cells and distinctive focal thickenings
  27. 27.  CLINICAL FEATURES  Predilection for occurrence in males  Site: mandibular bicuspid/cuspid/incisor area  When the cyst is located on labial surface of the root, there is a slight mass
  28. 28.  RADIOGRAPHIC FEATURES  Radiolucent area in apposition to the lateral surface of a tooth root  Lesion is small, border is definitive and surrounded by thin layer of sclerotic bone
  29. 29.               DIFFERENTIAL DIAGNOSIS Gingival cyst of adult Botryoid cyst Lateral radicular cyst Lateral periodontal abscess Lateral dentigerous cyst Residual cyst Primordial cyst Globullomaxillary cyst Median mandibular cyst Small OKC Mental foramen Small neurofibroma Radicular cyst
  30. 30.  A rare, well circumscribed, solid or cystic lesion derived from odontogenic epithelium that contains ghost cells and spherical calcifications
  31. 31.  CLINICAL FEATURES  It is more common in females  It occurs anterior to first molar  It is a slow growing , painless, non-tender swelling which causes expansion and destruction of cortical plates  The cystic mass may become palpable and discharging
  32. 32.  RADIOGRAPHIC FEATURES  The central lesion may appear as a cyst like radiolucency with variable margins which may be smooth well defined or irregular in shape with poorly defined borders  Perforation of cortical plates can be seen
  33. 33.  DIFFERENTIAL DIAGNOSIS  Fibrous dysplasia  Partially calcified odontoma  Adenomatoid odontogenic tumor  Ossifying fibroma  Odontogenic fibroma  Cementoblastoma  Dentigerous cyst  Ameloblastic fibroadenoma  Calcifying epithelial odontogenic tumor
  34. 34.  A large solitary or multilocular odontogenic cyst derived from rests of dental lamina, consisting of a stratified squamous epithelium numerous mucus-secreting cells containing
  35. 35.  CLINICAL FEATURES  A slight male predilection  Common site is anterior mandible  Lesion shows slow progressive growth, painless and locally destructive
  36. 36.   RADIOGRAPHIC FEATURES The lesions appear well defined with a multilocular pattern  DIFFERENTIAL DIAGNOSIS  Lateral periodontal cyst
  37. 37.  Periapical cysts results when rests of malassez in the periodontal ligament are stimulated to proliferate and undergo cystic degeneration by inflammatory products which are associated with necrosis of the pulp
  38. 38.  CLINICAL FEATURES  The tooth is painful and sensitive to percussion  It represents a chronic inflammatory process and develops over a prolonged period of time  This acute exacerbation leads to abscess, then proceed to a cellulitis and form a draining fistula
  39. 39.  RADIOGRAPHIC FEATURES  A peri or para apical round or oval radiolucency of variable size which is well-delineated and marked with a radioopaque rim
  40. 40.  DIFFERENTIAL DIAGNOSIS  Periapical granuloma  Periapical scar  Surgical defect  Periapical cementoma  Traumatic bone cyst  Periapical abscess  Mandibular infected buccal cyst  Odontogenic keratocyst  Benign tumor  Ossifying fibroma
  41. 41.  Residual cyst are retained periapical cysts from teeth that have been removed  CLINICAL FEATURES  Usually asymptomatic and found radiographic examinations  It is found in tooth bearing area on routine
  42. 42.  RADIOGRAPHIC FEATURES  It may present well defined radiolucency that can vary in size from a few mm to several cm; with thin radioopaque margins  DIFFERENTIAL DIAGNOSIS  Primordial cyst  Keratocyst  Traumatic cyst  Ameloblastoma
  43. 43.  Paradental cyst is an inflammatory cyst which develops on the lateral surface of a tooth root
  44. 44.  CLINICAL FEATURES  It occurs in younger age group  Seen in third decades of life  Male predilection  It is usually associated with third molar on buccal surface and covers the bifurcation  The tooth is usually vital  It may occur bilaterally
  45. 45.  RADIOGRAPHIC FEATURES  These are the non-widening of the periodontal ligamentspace and the lesion was superimposed on the buccal root surface  When there was a distal as well as a buccal radiolucency, the distal element was separate from distinct distal follicular space
  46. 46.  DIFFERENTIAL DIAGNOSIS  Periodontal abscess  Langerhan’s cell histiocytosis  Dentigerous cyst
  47. 47.  S M Balaji – textbook of oral and maxillofacial surgery  Neelima Malik – textbook of oral maxillofacial surgery  Shafers – textbook of oral pathology  Freny Karjodhkar – textbook of radiology and

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