8/19/2019 jaw cyst

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Jaw Cyst à»ç¹¶Ø§¹éÓ¾ºà©¾ÒÐã¹¢Ò¡ÃÃä¡Ã ¨ÐäÁ辺·ÕèµÓá˹è§Í×蹢ͧÃèÒ§¡Ò áºè§à»ç¹ true cyst áÅÐ pseudocyst True cyst ¤×Ͷا¹éÓ·ÕèÁÕ epitheliumºØÅéÍÁÃͺ Pseudocyst à»ç¹¶Ø§¹éÓáµèäÁèÁÕ epithelium ÅéÍÁÃͺ True cyst 㹡Ãд١¢Ò¡ÃÃä¡Ã áºè§à»ç¹ 2 »ÃÐàÀ· ¤×Í 1. Odontogenic cyst ¤×Ͷا¹éÓ·ÕèÁÕ cell ·Õèà¡ÕèÂÇ¢éͧ¡Ñº¿Ñ¹ÍÂÙè 2. NonOdontogenic cyst ¨ÐäÁèÁÕ cell ·Õèà¡ÕèÂÇ¢éͧ¡Ñº¿Ñ¹

 Odontogenic cyst áºè§à»ç¹ 2 »ÃÐàÀ· µÒÁ¡ÒÃà¡Ô´ ä´éá¡è 1. Developmental ¤×Íà»ç¹¶Ø§¹éÓ·ÕèÁÕ¤ÇÒÁÊÑÁ¾Ñ¹¸ì¡Ñº¡ÒþѲ¹Ò¢Í§¿Ñ¹ 2. Inflammatory ¤×Í ÁÕ¡ÒÃÍÑ¡àʺà¡Ô´¢Ö鹡è͹¡ÒÃà¡Ô´à»ç¹¶Ø§¹éÓ

 ¡ÅØèÁ Developmental ÁÕ·Ñé§ËÁ´ 7 ÍÂèÒ§ ä´éá¡è

 1.Dentigerous cyst à»ç¹¶Ø§¹éÓ·Õ辺ÁÒ¡à»ç¹Íѹ´Ñº·Õè 2 ¢Í§¶Ø§¹éÓã¹¢Ò¡ÃÃä¡Ã ÊÑÁ¾Ñ¹¸ì¡Ñº¿Ñ ÀÒ¾¶èÒÂÃѧÊըоº well demarcated, unilocular radiolucent áµè¶éÒ¢¹Ò´ãË-è¢ÍºÍÒ¨à»ç¹ scal Differential diagnosis  Unicystic ameloblastoma  Odontogenic keratocyst áµè㹿ÔÅìÁ¢ÍºÁÑ¡à»ç¹ scallop border ¡ÒÃÃÑ¡ÉÒ  Enucleation  Marsupialization with artificial eruption ¡Òà recurrent µèÓ áµè¡ç¾ºà»ÅÕè¹á»Å§ä»à»ç¹ Ameloblastoma, Mucoepidermoid carcinoma ä´é

 2.Odontogenic keratocyst (OKC) ¤è͹¢éÒ§ aggressive áÅÐ recurrent ºèÍ ºÒ§¤ÃÑ駨ѴÍÂÙèã ÀÒ¾ÃѧÊըоº well define unilocular/multilocular radilucent/ scallop border ÍÒ¨¾º¿Ñ¹·Õ Nevoid basal cell carcinoma syndrome (Gorlin syndrome) ¨Ð¾º multiple OKC Orthokeratinized Odontogenic cyst (OOC) à»ç¹ OKC ·ÕèÁÕ Orthokeratinized epithelium rec ¡ÒÃÃÑ¡ÉÒ  Enucleation &Curettage à¾ÃÒСÒà recurrent ÊÙ§  ãªé Carnoys solution  ÍÒ¨·Ó Marsupialization ¡è͹à¾×èÍÅ´¢¹Ò´  Resection

 3.Eruption cyst (Eruption Hematoma) à˧×Í¡ºÃÔàdz¿Ñ¹·Õè¨Ð¢Ö鹺ÇÁ ¶éÒÁÕ trauma ¡ç¨ÐÁÕ bl ¨Ð treat ËÃ×ÍäÁè¡çä´é ÍÒ¨ÃÍãËé¿Ñ¹¢Öé¹àͧä´é

 4.Lateral periodontal cyst à¡Ô´·Õè¢éÒ§æÃÒ¡¿Ñ¹ áµè¿Ñ¹äÁèµÒ ÁÑ¡¾ºâ´ÂºÑ§àÍÔ-¨Ò¡¡ÒöèÒ x 5.Gingival cyst of newborn ¾ºã¹à´ç¡ááà¡Ô´ à»ç¹ dental lamina ÁÕËŧàËÅ×ÍÍÂÙè àËç¹à»ç¹µ

 6.Calcifying Odontogenic cyst (COC) 1/3 ¢Í§à¤Ê·Õèà¨Í¨Ð¾ºÃèÇÁ¡Ñº¿Ñ¹äÁè¢Öé¹ ÀÒ¾ÃѧÊÕ well define uniloccular radiolucent with or without calcify ÁÑ¡ Diff Dx ¡Ñº Adenomatoid Odontogenic Tumor (AOT)

 7.Glandular Odontogenic cyst ÅѡɳФÅéÒ tumor ·ÓãËéà¡Ô´ bone expansion, perforation Á ÀÒ¾ÃѧÊÕ¾º Multilocular radiolucentcy

 ¡ÅØèÁ Inflammatocy cyst ÁÕ 3 ÍÂèÒ§ä´éá¡è

 1.Radicular cyst ¾ººèÍ·ÕèÊش㹡ÅØèÁ cyst µéͧÁտѹµÒ cystic content ÁÑ¡à»ç¹ÊÕàËÅ×ͧã ÀÒ¾ÃѧÊÕ well define unilocular radiolucent ÍÒ¨äÁèÁÕ sclerotic border à¾ÃÒÐÁÕ¡ÒÃÍÑ¡àʺ ¡ÒÃÃÑ¡ÉÒ RCT  Marsupilization Enucleation

 2.Residual cyst ¤×Í radicular cyst ·ÕèàÍÒÍÍ¡äÁèËÁ´

 3.Paradental cyst (Buccal bifurcation cyst) ÁÑ¡¾ººèÍÂ㹿ѹ 3rd molar ·ÕèÁÕ pericoronit

8/19/2019 jaw cyst

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 Benign nonodontogenic tumor and tumorlike lesion ÍÒ¡ÒÃÊÓ¤Ñ-¢Í§¼Ùé»èÇ·ÕèÁÕ Jaw bone pathology ¤×Í »Ç´ ÁÕ¡ÒúÇÁËÃ×ÍÃÙ»ÃèÒ§¼Ô´ÃÙ»ä» ¡ÒÃËÑ Differential diagnosis approach to jaw lesion 1. Inflammatory jaw lesions 2. Cyst and benign tumor 3. Malignant of jaw lesion 4. Metabolic and genetic disease 5. Developmental and congenital

 Benign nonodontogenic tumor áºè§µÒÁµé¹¡Óà¹Ô´¢Í§ÃÍÂâää´é 7 ¡ÅØèÁ ä´éá¡è 1. Osteogenic : Osteoma, Osteoidosteoma, Osteoblastoma 2. Chrondogenic : Chrondroma, Osteochrondroma 3. Fibroosseous : Fibrous dysplasia, Cementoosseous dysplasia, Ossifying fibroma 4. Ginat cell : Central giant cell granuloma, Giant cell tumor, Cherubism, Aneurysmal bone cyst, 5. Fibrogenic : Desmoplatic fibroma 6. Hematologic : 7. Vascular lesion :

 1. ¡ÅØèÁ odontogenic

 1.1 Osteoma à»ç¹ benign osteogenic lesion, ¨ÐÁÕ¡ÒÃà¾ÔèÁ¨Ó¹Ç¹¢Í§ cancellous ËÃ×Í compac ÍÒ¡Òà ÃÍÂâä⵪éÒ äÁèÁÕÍÒ¡ÒûǴ ÁÑ¡¾ºâ´ÂºÑ§àÍÔ-¨Ò¡ÀÒ¾ÃѧÊÕ â´Â¨ÐàËç¹à»ç¹ Well define r Gardners syndrome à»ç¹ autosomal dominant¨Ð¾º intestinal polyposis, multiple osteoma, f skin, epidermal and trichilemmal cyst, impacted permanent and supernumerary teeth, odentoma

 1.2 Osteoid osteoma ¢¹Ò´àÅç¡ < 2 «Á. ÁÑ¡¾ºã¹¤¹ÍÒÂØ < 30 ÁÕÍÒ¡ÒûǴ áµèµÍºÊ¹Í§µèÍ ASA 1.3 Osteoblastoma ¢¹Ò´ > 2 «Á. ÍÒÂØ < 30 well/illdefine mixed lesion, ÍÒ¨à»ÅÕè¹á»Å§ä

2. Fibroosseous lesion of the jaws : à»ç¹ÃÍÂâä·Õè¡Ãд١»¡µÔ¶Ù¡á·¹·Õè´éÇ à¹×éÍàÂ×èÍ 2.1 Fibrous dysplasia à»ç¹ÃÍÂâä·Õèà¡Ô´ÃÐËÇèÒ§¡ÒÃà¨ÃÔ-àµÔºâµ¢Í§¡Ãд١ áÅÐ ¡ÒÃremodelinªèǧÍÒÂØ 1st áÅÐ 2nd decade, Max>Mand, ÃÍÂâä¨ÐËÂØ´âµàͧ áÅШÐËÒÂ㹪èǧÇÑÂÃØè¹ äÁèµéͧMonostotic FD ¾ºµÓá˹è§à´ÕÂÇ ÁÑ¡¾ºã¹ body of mandible, premolarmolar of maxilla

 Polyostotic FD multiple bone+Caf? au lait (Jaffe Lichtenstein syndrome) multiple bone+Caf? au lait+multiple endocrinopathy (MaCuneAlbright syndrome) Craniofacial FD ¾ºã¹ skull áÅÐ facial bone

 2.2 Ossifying fibroma : ªèǧÍÒÂØ 3rd áÅÐ 4th decade ¾ºã¹ Mand>Max, premolarmolar area ÀÒ¾ÃѧÊըоº well defined unilocular radiolucent ËÃ×Í radiopaque ¡çä´é

 2.3 Cementoosseous dysplasia (COD) COD Location Sex Age Periapical COD Ant mand < 1cm. Female black 3050 yrs Focal COD Post mand< 1.5cm. Female white Mean 38 yrs Florid COD Bilateral of 4 qudrant Female black Middle age to older

 3. Giant cell lesion 3.1 Central giant cell granuloma (CGCG) : non aggressive lesion ¨Ð⵪éÒ ÁÑ¡äÁèÁÕÍÒ¡Òà áÅÐäÁè·ÓãËéà¡Ô´¡Ãд١·ÐÅØ ËÃ×ÍÃÒ¡¿Ñ¹ÅÐÅÒ aggressive lesion ¨ÐâµàÃçÇ ÁÕÍÒ¡ÒûǴ ¡Ãд١·ÐÅØáÅÐÃÒ¡¿Ñ¹ÅÐÅÒ ÁÑ¡¾ºÍÒÂØ < 30 »Õ, Mand >Max, ÁÑ¡¨Ð¾ºã¹ anterior mandible áÅÐ cross midline

 3.2 Cherubism âä¶èÒ·ʹ·Ò§¾Ñ¹¸Ø¡ÃÃÁ ¼èÒ¹ÂÕ¹à´è¹ ÁÑ¡¾ºã¹à´ç¡ÍÒÂØ 25 »Õ ÃÍÂâä¨Ð⵨¹¶Ö ÍÒ¡Òà bilateral symmetrical bony expansion, tooth displacement, eruption failure, Erupn failure, impaired function and speech

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 3.3Aneurysmal bone cyst ¡ÒÃà¡Ô´âäÍÒ¨ÁÕ¤ÇÒÁà¡ÕèÂÇ¢éͧ¡Ñº¡ÒÃà»ÅÕè¹á»Å§ hemodynamics ËàÍÒ¡Ò÷ҧ¤ÅÔ¹Ô¡ ÁÑ¡¾ºã¹ªèǧÇÑÂÃØè¹ËÃ×ͪèǧÍÒÂعéÍÂ