ODONTOGENIC CYSTS

SEMINARODONTOGENIC CYSTS

CLINICAL FEATURES

RADIOGRAPHIC FEATURES

DIFFERENTIAL DIAGNOSIS

Yasmin Moidin

2008 Batch

Al Azhar Dental College

Thodupuzha

Introduction

Classification

Types of odontogenic cysts

Conclusion

Reference

CONTENTS

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

INTRODUCTION

Cysts are generally slow growing, expansile

lesions

They grow by hydraulic expansion

Radiographically , they often appear

radiolucency surrounded by thin

radioopaque border

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

CLASSIFICATION

Gingival cyst of adult

Lateral periodontal cyst

Calcifying odontogenic cyst

Glandular odontogenic cyst

INFLAMMATORY: result of inflammation

periapical cyst

Residual cyst

Paradental cyst

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


Glandular odontogenic cyst

UNCLASSIFIED

Paradental cyst


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

DENTIGEROUS CYST

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


Reveal a radiolucent area associated with an

unerupted tooth crown

The radiolucent area is surrounded by a thin

sclerotic line representing bony reaction

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


Ameloblastoma and ameloblastic fibroma

Adenomatoid odontogenic tumour


Developmental primordial and follicular

primordial cyst


Cystic ameloblastoma

Radicular cyst

Hyperplastic follicle

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

ERUPTION CYST

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


It may show soft tissue shadow since the cyst is

confined within it and there is usually no bone

involvement


Dentigerous cyst

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 cells and a surface of corrugated

parakeratin

ODONTOGENIC KERATOCYST

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


They are unilocular, presenting a well-defined

peripheral rim

Scalloping of the border represents variations in

the growth pattern of cyst


Dentigerous cyst

Ameloblastoma

Primordial cyst

Residual cyst

Traumatic cyst

Benign odontogenic tumor

Giant cell granuloma

Odontogenic myxoma

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

consisting of keratin-producing epithelial lining

GINGIVAL CYST OF NEWBORN

CLINICAL FEATURES

Small discrete white swellings of the alveolar

ridge

Lesion appear to be asymptomatic and donot

produce discomfort in infants

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

GINGIVAL CYST OF ADULT

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


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

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

LATERAL PERIODONTAL CYST

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


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


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

A rare, well circumscribed, solid or cystic lesion

derived from odontogenic epithelium that

contains ghost cells and spherical calcifications

CALCIFYING ODONTOGENIC CYST

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


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


Fibrous dysplasia

Partially calcified odontoma

Adenomatoid odontogenic tumor

Ossifying fibroma

Odontogenic fibroma

Cementoblastoma

Dentigerous cyst

Ameloblastic fibroadenoma

Calcifying epithelial odontogenic tumor

A large solitary or multilocular odontogenic cyst

derived from rests of dental lamina, consisting of

a stratified squamous epithelium containing

numerous mucus-secreting cells

GLANDULAR ODONTOGENIC CYST

CLINICAL FEATURES

A slight male predilection

Common site is anterior mandible

Lesion shows slow progressive growth, painless

and locally destructive


The lesions appear well defined with a multilocular pattern



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

PERIAPICAL CYST

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


A peri or para apical round or oval radiolucency of

variable size which is well-delineated and marked

with a radioopaque rim


Periapical granuloma

Periapical scar

Surgical defect

Periapical cementoma

Traumatic bone cyst

Periapical abscess

Mandibular infected buccal cyst


Benign tumor

Ossifying fibroma

Residual cyst are retained periapical cysts from

teeth that have been removed

CLINICAL FEATURES

Usually asymptomatic and found on routine

radiographic examinations

It is found in tooth bearing area

RESIDUAL CYST


It may present well defined radiolucency that can

vary in size from a few mm to several cm; with

thin radioopaque margins


Primordial cyst

Keratocyst

Traumatic cyst

Ameloblastoma

Paradental cyst is an inflammatory cyst which

develops on the lateral surface of a tooth root

PARADENTAL CYST

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


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


Periodontal abscess

Langerhan’s cell histiocytosis

Dentigerous cyst

S M Balaji – textbook of oral and

maxillofacial surgery

Neelima Malik – textbook of oral and

maxillofacial surgery

Shafers – textbook of oral pathology

Freny Karjodhkar – textbook of radiology

REFERENCE

ODONTOGENIC CYSTS

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