Cysts of the Jaws & oral soft tissues Classification of non-odontogenic cysts of the jaws: Non-odontogenic cysts (10%)

%) o Developmental
Nasopalatine duct (incisive canal) cyst (5-10%) Nasolabial (nasoalveolar) cyst Median cyst

o Pseudocysts (non-epithelialized primary bone cysts) Solitary bone cyst (simple, traumatic, hemorrhagic bone cyst) Aneurysmal bone cyst Stafnes idiopathic bone cavity

Nasopalatine duct cyst (incisive canal cyst): o Clinical features: o Nasopalatine duct cyst is the most common non-odontogenic cyst o Nasopalatine duct cyst is epithelialized non-odontogenic developmental cyst o Origin of lining epithelium is non-odontogenic (epithelial remnants of the Nasopalatine duct which connects the oral and nasal cavities in the embryo) o Nasopalatine duct cysts are developmental in origin because they have no specific cause
behind their formation ** Nasopalatine duct cysts are intra-bony developmental cysts o Nasopalatine duct cyst is often asymptomatic and discovered on routine radiographic examination o Nasopalatine duct cyst may present as a slowly

enlarging swelling in the anterior region of the midline of the palate o Nasopalatine duct cyst can produce swelling, drainage of pus into the mouth and pain (if secondarily infected) o Nasopalatine duct cyst can be associated with vital or non-vital teeth

Cyst of the Incisive Papilla (cyst of papilla palatine):

o Nasopalatine duct cyst may arise at any point along the Nasopalatine canal (near the oral or nasal parts or in between) and some arise entirely within the soft tissue of the incisive

papilla
o Cyst of the incisive papilla (cyst of papilla palatine) = extra-bony Nasopalatine duct cyst

arising in the soft tissue of the incisive papilla

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Median cyst of the palate:

o Median cysts may occur in the palate or the mandible o Some median cysts of the palate may represent a displaced Nasopalatine duct

cyst to the area between the maxillary lateral incisor and the canine
o Radiographic features: o Present as a round, ovoid or heart-shaped

radiolucency near the midline of the anterior maxilla between roots of maxillary incisors o The lesion is often well-circumscribed with peripheral radiopaque (corticated) margin o The lesion is usually symmetrical about the midline o The Nasopalatine duct cyst must be distinguished from the normal incisive fossa ** If the width of the incisive fossa is greater than 6 mm then this is considered to be a cyst
Microscopic features: o The Nasopalatine cyst has variable epithelial

lining but mostly ciliated pseudostratified columnar epithelium with mucous cells (respiratory epithelium)
o The epithelium is supported by connective tissue capsule which includes prominent

neurovascular bundles o Cyst wall contains small muscular arteries, veins and moderate-sized nerves
Pathogenesis: o Nasopalatine duct cysts arise from epithelial remnants of Nasopalatine duct found in

incisive canal
o The stimulus for Cystic change is unknown Treatment and Prognosis: o Surgical enucleation of the cyst o Little tendency to recur o Routine clinical and radiographic follow up is necessary o No neoplastic potential Differential diagnosis of Nasopalatine duct cyst:

1. Normal incisive fossa (if radiolucency is less than 6 mm in diameter) 2. Apical radicular cyst 3. Odontogenic keratocyst
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 Nasolabial cyst: Clinical features:

o Nasolabial cyst is epithelialized non-odontogenic developmental cyst o Origin of lining epithelium is non-odontogenic (epithelial remnants of the

Nasolacrimal duct) o Nasolabial cysts are developmental in origin because they have no specific cause behind
their formation ** Nasolabial cysts are extra-bony developmental

cysts (soft tissue cysts arising in the soft tissue of the upper lip just below the ala of the nose)
o Nasolabial cysts present as a slowly enlarging soft tissue swelling obliterating the Nasolabial fold o Nasolabial cysts have strong female predilection

Treatment:
o Surgical excision of the cyst

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