CYSTS OF JAWS

Dr. Shahzadi Tayyaba Hashmi

shahzadi@inaya.edu.sa

DEFINITION:Cysts are pathological fluid-filled cavities lined by

epithelium

• Cysts are the most common cause of chronic swellings of the jaws. They are more common in jaws than in any other bone because of many rests of odontogenic epithelium remaining in the tissues.

CYSTS OF JAWS

ODONTOGENIC KERATOCYST(OKC)

DENTIGEROUS cyst(follicular cyst)

Eruption cyst

Lateral periodontal cyst

Gingival cysts of Adults

Gingival cysts of Infants

ODONTOGENIC CYSTS

Nasopalatine duct cysts

Nasolabial duct cyst

NON-ODONTOGENIC CYSTS

RADICULAR CYSTS Residual Lateral

INFLAMMATORY ODONTOGENIC CYSTS

DEVELOPMENTALODONTOGENIC

CYSTS

Pathology: • Odontogenic Keratocyst is derived from

remnants of dental lamina

Dental lamina:• The bands of epithelium that originates from oral

epithelium and remain in the tissues after inducing tooth development

ODONTOGENIC KERATOCYST(OKC)

• Peak incidence during second or third decade of life

• Mandible is usually affected, primarily posterior body of mandible and ramus area

• Unilocular or Multilocular• Multilocular OKC’s are consistent features of

nevoid basal cell carcinoma syndrome( Gorlin Goltz Syndrome )

• Exhibits 25% to 60% of recurrence

CLINICAL FEATURES OF ODONTOGENIC KERATOCYST

• Odontogenic Keratocyst appear as well-defined radiolucent areas with a more or less rounded margins

• Some are Unilocular, but majority are Multiloculated

RADIOGRAPHIC FEATURES

Unilocular and small Multilocular cysts can be treated by Enucleation and bony cavity curetted

Surgical resection and reconstruction with a bone graft

TREATMENT

• An Odontogenic cyst that surrounds the crown of an impacted tooth.

It is usually derived

from Reduced enamel

Epithelium (residual

Epithelium that

surrounds the crown of

tooth after enamel

formation is complete)

DENTIGEROUS CYST

• Usually remain asymptomatic, but produce swelling or pain ,If it is large or INFLAMMED

• More common in males as compared to females

RADIOGRAPHIC APPEARANCE Appear as well defined radiolucency surrounding the

crown of an unerupted tooth In mandible, cyst may displace the associated tooth

inferiorly into ascending ramus

In maxilla, it displaces associated tooth posteriorly

CLINICAL FEATURES

RADIOGRAPHIC APPEARANCE

• Surgical ENUCLEATION• In case of a molar teeth, the associated tooth is

usually extracted at the time when cyst is enucleated

• In case of maxillary CUSPID tooth, cyst may be excised by MARSUPILIZATION (surgical curettage of cyst by creating a surgical window in cyst area)

TREATMENT

• An Odontogenic cyst that surrounds a tooth’s crown that has erupted through bone but not soft tissue and is clinically visible as a soft fluctuant mass on the alveolar ridge

ERUPTION CYST

CLINICAL FEATURES: Affects children and involve deciduous teeth Cyst lies superficially in gingiva overlying the unerupted

tooth Appears as a soft, rounded, bluish swelling

MANAGEMENT:• Cyst roof may be removed to allow the tooth to

erupt, but most eruption cysts burst spontaneously and require no treatment

CLINICAL FEATURES AND TREATMENT

Eruption cyst ( bluish appearance)