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CAVITY
Cysts
pathological cavity
possibly in response to
a slightly elevated
hydrostatic luminal
pressure
Cysts of Oral Region
common
bacterial infection
necrosis of dental pulp
following carious involvement of tooth
Pathogenesis
proliferation of epithelial
rest in the periapical
area involved by granuloma
epithelial proliferation
follows an irregular pattern of
growth
Clinical Features
asymptomatic
indicates reaction of
bone to slowly expanding
mass
Radiographic Features
Histologic Features
similar to periapical
granuloma
with apicoectomy
of cystic lesion
1.2) Odontogenic Cyst
(Dentigerous Cyst)
related to epithelial
proliferation
release of bone-resorbing
factors
commonly seen in
association most
with 3rd molars commonly
impacted
maxillary canines teeth
Clinical Features
greater incidence in
males
well-defined
unilocular or ocassionally
mutilocular radiolucency
with coricated margins
mandible
anteriorly + inferiorly
along body of mandible
Radiographic Features
maxilla
exteriorization
marsupialization of cyst
allow for decompression
+ subsequent shrinkage of lesion
reducing extent of surgery at a later date
1.3) Odontogenic Cyst
(Primordial Cyst)
arises from cystic changes in
developing tooth bud
circular radiolucency
unilocular or multilocular
Radical Surgery
curretage of bone
1.4) Odontogenic Cyst
(Odontogenic Keratocyst)
mandible
posterior portion of
body commonly
affected
ramus region
maxilla
well-circumscribed
radiolucency
ostectomy
believed to be related to
proliferation of rests of
dental lamina
Clinical Features
occur in mandibular
premolar + cuspid region
in maxilla
male predilection
asymptomatic
well-delineated
Radiographic Features
round
teardrop-shaped unilocular
(and occasionally multilocular)
radiolucency with opaque
margin along lateral
surface of vital tooth root
Radiographic Features
Radiographic Features
Radiographic Features
Treatment & Prognosis
local excision
lateral to midline
pathogenesis is uncertain
2 theories
maxillary
median nasal
lateral nasal process
2 theories
significant predilection
for women
Radiographic Features
pressure resorption of
underlying bone may
occur
Treatment & Prognosis
sometimes it is necessary
to sacrifice portion of nasal
mucosa to ensure total removal
Treatment & Prognosis
Treatment & Prognosis
(2.3) Non- Odontogenic Cyst
(Median Palatal Cyst)
occlusal radiographs
demonstrate well-
circumscribed radiolucency
in midline of hard palate
surgical removal
embryologic structure
connects oral + nasal cavities in
area of incisive canal
believed to arise from remnants
of nasopalatine duct
well-circumscribed
radiolucency in or near
midline of anterior
maxilla
radiolucency that is 6 cm
or smaller in this area is
usually considered a normal
foramen
surgical enucleation
biopsy is recommended
recurrence is rare
References:
Books
Neville, et. al: Oral and Maxillofacial Pathology
3rd Edition
(pages 25-32)