OP Exam 1

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aka Radicular cyst - Most common cyst of jaws more commonly an

terior maxilla due to trauma - Tooth is nonvital and nonresponsive H
Periapical cyst characteristics, histology, istology - Shows chronic inammatory cells in the brous connectiv
e tissue with nonspecic signs of inammation - Rushton bodies, Ru
ssel bodies, Cholesterol clefts

Residual cells of cystic lining and inammatory cells continue to pro

Residual cyst
liferate

Radiolucent area along distal aspect of impacted or partially erupte

Paradental Cyst
d 3rd molar

Similar to Paradental cyst but located on buccal of mandibular 1st

Buccal Bifurcation Cyst
molars - Best seen with occlusal radiograph
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Inammatory - Periapical - Residual periapical - Paradental - Buccal

bifurcation Developmental - Dentigerous - Eruption - Gingival cyst o
Odontogenic Cysts f Newborn/Adult - Lateral periodontal - Glandular odontogenic - Odo
ntogenic keratocyst - Orthokeratinized odontogenic - Calcifying odo
ntogenic

aka Follicular cyst - Most common type of developmental odontoge

Dentigerous Cyst characteristics, radiograph, d/d with Hyperplastic
follicle, histology
nic cyst - Occurs in young adults - Attached to the tooth at CEJ Radi
ograph - Shows well dened unilocular radiolucency with sclerotic b
order. May appear multilocular due to residual bone trabeculae. - M
ust be greater than 4-5mm to call an area a dentigerous cyst Histol
ogy - Epithelial lined space surrounded by brous connective tissue
- Usually at interface but may demonstrate anastomosis of rete p
egs during inamation

MACHO - Myxoma - Ameloblastoma - Central giant cell granuloma -

Multilocular radiolucency Mnemonic
Hemangioma - Odontogenic keratocyst

Soft tissue counterpart of a dentigerous cyst - Not in bone - Results

from accumulation of uid in follicular space after tooth as erupted
Eruption cyst
through bone - Usually seen in young children and involves 1st mol
ar and maxillary incisors
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Palatal cysts - Bohn's nodules scattered over hard palate - Epstein's

pearls along median palatal raphe - Ruptures and resolves spontan
Cysts of Newborn
eously Gingival - Dental Lamina cysts - Also not in bone - Spontage
ously resolves

Soft tissue counterpart of periodontal cysts - Derived from dental la

Gingival Cyst of the Adult
mina rests - Appears in older adults as a mucocele on the gingiva

Developmental cyst that arise from dental lamina rests - Intrabony

counterpart of gingival cyst of adult - Not inammatory and reserv
Lateral periodontal cyst characteristics, histology ed for once odontogenic keratocyst has been excluded - Often foun
d in mandibular canine/premolar area - Teeth are vital - Foci of plaq
ue-like thickenings and glycogen-rich clear cells

Botryoid Odontogenic Cyst - Show a grape-like cluster of small indiv

idual cysts Glandular Odontogenic Cyst - Shows glandular dierenti
Variants of lateral periodontal cyst ation within the epithelium - Well dened radiolucency with a sclerot
ic border - Epithelium shows cyst-like spaces lined by cuboidal cells
- Can be mucoepidermoid carcinoma
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Primordial Cyst Probably were all OKCs

aka Keratocystic Odontogenic Tumor - Distinct histological pattern a

nd aggressive biologic behavior - Growth due to osmotic eects and
unusual gene expressions - Solitary OKCs have 10% recurrence rate
. Multiple have 30% recurrence rate. Syndrome OKC has highest rec
urrence Histology - Basal cells are uniform, palisaded, and hyperchr
Odontogenic Keratocyst characteristics, Recurrence, Histology, Trea
omatic - Surface epithelium is parakeratinized - 1/4th have satellite
tment, factors
or daughter cysts in the connective tissue wall which increases recu
rrence Treatment - Marsupialization to shrink the cyst and carnoy s
olution to cauterize the area - PTCH gene mutation - Overexpress Ki
-87 for cell proliferation - Overexpress BCL-2 for antiapoptotic - Ove
rexpression of MMP 2 and 9 to allow tissue growth

aka Gorlin's syndrome - Multiple odontogenic keratocysts - Multiple

Nevoid Basal Cell carcinoma Syndrome basal cell carcinomas of skin - Calcication of falx cerebri - Rib ano
malies - Palmar/plantar pitting - Medulloblastoma

Odontogenic cyst with orthokeratinized epithelium - No increased ris

Orthokeratinized Odontogenic cyst k for recurrence like in OKC - May be associated with an impacted t
ooth
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20% extraosseous and associated with unerupted teeth. Histology -

Fibrous connective tissue lined by palisading Ameloblastic-like epith
elium - Contains ghost cells which are altered epithelial cells that ha
Calcifying odontogenic cyst characteristics, histology, treatment
ve lost their nuclei Treatment - Enucleation with peripheral ostecto
my - Long term followup because some tumors are more aggressiv
e - Ghost cells may calcify and show radiopacities

aka Nasoalveolar cyst - Rare soft tissue cyst of upper lip not in bon
e - Comes from epithelial remnants from nasolacrimal duct or after
Nasolabial cyst characteristics, histology,
fusion of processes Histology - Show pseudostratied columnar epit
helium. Respiratory epithelium

A term used to describe an anatomic location and is not a diagnosis

Globullomaxillary Cyst - Presents as an inverted pear shaped in between the maxillary late
ral and canines

Nasopalatine cyst - Arise from epithelial remnants of nasopalatine d

Most common non-odontogenic cyst of oral cavity source, radiogra uct Radio - Superimposition with nasal septum shows classic heart s
ph, histology hape Varying histology ranging from pseudostratied columnar to si
mple columnar to cuboidal
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Soft tissue Nasopalatine cyst with no bone involvement - Found in s

Incisive papilla cyst
ame area

Median palatine cyst More posteriorly placed nasopalatine duct cyst

Describes a cyst in the particular location - In between two halves o

Median mandibular cyst
f the mandible

Occurs after trauma or iatrogenic sinus surgery - Portion of the sinu

Surgical ciliated cyst of the Maxilla s lining is separated from the sinus and forms epithelial lined cavity
in the bone
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Intraosseous blood lled sinuses not lined by endothelium - Histolog

y shows multinucleated giant cells with extravasated RBC - So can
Aneurysmal bone cyst characteristic, d/d, treatment have similar histology to CGCG, Cherubism, Brown tumors Treatme
nt - Vascularity is low ow unlike central hemangioma - Irradiation i
s contraindicated and may cause angiosarcoma

Not epithelial lined - Forms between sinus epithelial lining and the b
Antral Pseudocyst
one - Appears as dome shaped elevation of oor of sinus

- Empty uid lled cavity in bone that does not have epithelial lining
Traumatic Bone cyst characteristics and radio - Teeth are vital and responsive - Shows scalloping around and betw
een roots - Associated with Florid COD

- Asymptomatic focal concavity on the lingual aspect of the mandibl

Stafne Bone cyst
e below the canal
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Usually found in anterior oor of mouth - Feels doughy or rubbery -

Dermoid cyst characteristics, histology Contains skin appendages. Adnexal structures such as sebaceous gl
ands and hair follicles

Abundant in Gardner's syndrome but unlike dermoid cysts, does no

Epidermoid cyst
t show adnexal structures

The most common developmental cyst of neck Thyroglossal duct cyst - Classic cyst at midline

aka Cervical lymphoepithelial cysts - Presents as a soft swelling loc

Branchial cleft cyst ated on lateral aspect of the neck - Multiple lymphoepithelial cysts
bilaterally indicates HIV
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Eosinophil - Purple nucleus with red granules Monocyte - One U sha

ped nucleus Neutrophil - Multilobed nucleus Plasma cells - Eccentric
White blood cells
Soccer ball shaped ncleus Histiocyte - Foamy looking cell Basophil P
urple nucleus with besophilic granules

Acute: Vascular and Exudative Chronic: Proliferative phase and Gra

Major components of Acute inammation and Chronic inammation
nulation tissue

Area of chronic inammation at the apex of a nonvital/nonresponsi

ve tooth - Appears rst as widening of PDL space then radiolucency
Periapical granuloma
- Radiographically indistinguishable from other unilocular radiolucen
t lesions

Abscess - With or without epithelial lining. Lumen lled with WBC an

d necrotic tissue. Predominantly Acute inammatory cells Cyst - Epi
Abscess, Cyst, Granuloma thelial lined. Lumen lled with cellular debris. Contains chronic ina
mmatory cells Granuloma - No epithelium. No lumen, just granulati
on tissue. Filled with Chronic inammatory cells
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Excessive growth of chronically inammed pulp - Most common in d

Chronic hyperplastic pulpitis eciduous molars and composed of granulation tissue and surface e
xposure into the oral cavity

- Dentin dysplasia type 2 - Pulpal dysplasia - Ehler-Danlos syndrome

Pulp calcications
type 1 - Tumoral Calcinosis - Calcinosis Universalis

Epithelial - Ameloblastoma - Calcifying epithelial odontogenic tumor

- Adenomatoid odontogenic tumor - Squamous odontogenic tumor -
Clear cell odontogenic tumor Mesenchymal - Odontogenic broma -
Odontogenic tumors
Odontogenic myxoma - Granular cell odontogenic tumor - Cementif
ying broma - Cementoblastoma Mixed - Ameloblastic Fibroma/Fibro
sarcoma - Ameloblastic bro-odontoma - Odontoma

Cyst: Male > Female except Nasolabial Everything else: Female >M
Sexes
ale except Osteosarcoma and Pagets
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Most odontogenic cysts & AACO, AAO, CCC Ameloblastoma unicysti

Associated with Impacted or unerupted teeth c AOT CEOT Ossifying broma AF AFO Odontoma COC Cleidocranial
Cherubism

Capsulated AF AFO Adenoid odontogenic tumor Dermoid cyst Ossifying broma

Inductive COC AOT AF AFO Odontoma

Coc, AAC, AO, OF, PCOD - COC - Ameloblastoma desmoplastic - AO

Mixed RL/RO T - CEOT - AFO: Due to odontomas - Odontoma - Ossifying broma -
Periapical COD