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Odontogenic

cyst
INTRO

CYST: A cyst can be defined as a


pathological cavity lined by
epithelium having fluid semi-
fluid or gaseous contents
but not created by accumu-
lation of pus.
CYST

True cyst Pseudo cyst


Cyst with epith- Cyst without
elial lining. Epithelial
EX: *radicular cyst lining.
*dentigerou EX: *aneurysmal
cyst bone cyst
*traumatic
bone cyst
ODONTOGENIC CYST
DEF : Odontogenic cyst can be defined as a cyst
in which lining of lumen is derived from epi-
thelium produced during tooth development.

CLASSIFICATION :
A)Histogenic Classification of Odontoge-
nic Cyst:-
1.Cyst derived from rest cell of
malassez
*periapical cyst
*residual cyst
2. Cyst derived from reduced enamel
epithelium
*dentigerous cyst
*erruption cyst
3. Cyst derived from dental lamina
(Rest of serrae)
*dental lamina cyst of new born
*odontogenic keratocyst
*lateral periodontal
*glandular cyst
4. Unclassified
*paradental cyst
B) Classification of cyst and cyst like
lesions by kramer pindborg and
shears (1992)

ODONTOGENIC NONODONTOGENIC
1> Developmental 1> Developmental
*Primodial *nasopalatine
*dentigerous .incisive canal cyst
*lateral periodontal .cyst of palatine
*botryoid papillae
*glandular *median palatal
*nasolabial
*odontogenic *dermoid & epidermoid
keratocyst
*gingival cyst 2>Non develop-
*dental lamina cyst -mental
of infants *traumatic
(bohns nodules, bone cyst
epstein pearls,) *rannula
*aneurysmal
2>Inflammatory bone cyst
*radicular *mucous rete-
.apical -ntion cyst
.residual *mucocele
*paradental
2> Others
*globulomaxillary
*median mandibular
PERIAPICAL/APICAL/RADICULAR/

APICAL PERIODONTAL CYST


DEF: Periapical cyst is defined as cyst

occuring at the apex of a tooth & is most

frequently the result of infection via


pulp chamber & root canal through
carious involvement of tooth.
Pathogenesis :

*Epithelium of origion
epithelial rests of malassez
*Initiation of epithelial proliferation & cyst formation
*Cyst growth & enlargement
^ mural growth
^ hydrostatic growth
^ bone resorption
C / F:
* non vital tooth (apex)
* involves carious tooth
* males > females
* maxilla > mandible
* 3 – 4 decade of life
* small cyst- asymptomatic
* large cyst- “ swelling & mild sensitivity
“ mobility of adjacent tooth
Radiograph:
*well circumscribed
radiolucency
associated with
apex of tooth
*loss of lamina dura
Histopath:

Treatment: Prognosis :
1) extraction 13 to 60 % reoccurence
2) curretage of apical zone with in 5 years
3) RCT foiiowed by enucleation
& then apicoectomy
Reason for high reoccurence:
1) incomplete removal of cystic lining
& capsule
2) persistance of satellite cysts
3) high proliferation rate (high mitotic
activity)
4) intrinsic multilocular nature of some
cysts
5)budding of basal cell layer
RESIDUAL CYST

* Cyst which develops subsequent to extraction


or after it due to left periapical tissue after
removal of toth
* radiograph:
* treatment: enucleation
DENTIGEROUS CYST/
FOLLICULAR CYST

DEF: Dentigerous cyst is defined as an odonto-

-genic cyst that surrounds the crown of


an impacted tooth caused by fluid accu-
-mulation b/w the reduced enamel epith’
& enamel surface resulting in a cyst in
which the crown is located with in the
lumen & roots outside.
PATHOGENESIS:

unknown

C / F:
* cyst attachment at C.E.J
* encloses crown of an unerrupted tooth
* mand 3 molar > max canines > max 3 molar
* males > females
* 1 & 3 decade of life
* initially bony hard consistency…………
egg shell crackling.
RADIOGRAPH:
Unilocular , well defined radiolucency with
sclerotic margins around the crown of an
unerrupted tooth.
* 3 types of cyst to crown relation:
HISTOPATH:

TREATMENT: PROGNOSIS:
1) marsupialisation *reoccurence rare unless
in children due to fragmentation of cyst
2) enucleation in adults Lining remnants allowed to
remain
ERRUPTION CYST

*Soft tissue counterpart of dentigerous cyst


* Soft ,translucent swelling in the gingival
mucosa over crown of an errupted tooth
* Age - >10 yrs
* Site – 1 permanent molar & max incisor
* No treatment
ODONTOGENIC KERATOCYST/

PRIMODIAL CYST
DEF: A cyst derived from remnants of
dental lamina ,with a biological
behaviour similar to bening neoplasm
with a distinctive lining of 6-10 cells
in thickness & that exhibits a basal
cell layer of palisaded cells & a
surface of corrugated parakeratin.
C / F:
1) 2-3 decade of life
2) males > females
3) mandible > maxilla
4) vincent’’s sign:
* large cyst with secondary infection
* paresthesia in lower lip
5) associated with :
^ MARFAN’S SYNDROME
^ GORLIN GOLTZ SYNDROME /
NEVOID BASAL CELL CARCINOMA SYN’
CLASSIFICATION:

RADIOGRAPH:
unilocular or multilocular
radiolucency with well defined
sclerotic margins.
HISTOPATH:

TREATMENT: PROGNOSIS:
1) enucleation with use
of chemical cauterisation
(carnoy’s solution)
2) peripheral ostectomy
3) recall after 5 years
LATERAL PERIODONTAL CYST

* Origion – cell rest of malassez


*situated on side of root
*Uncommon
*Radiograph – well defined ,round, oval,
unilocular radiolucency b/w roots of tooth
*Histopath – ^1 to 3 cell thick non keratinized
epithelium
^ glycogen rich clear cells


GINGIVAL CYST OF ADULTS

* Soft tissue counterpart of lateral periodontal


cyst
* Origion – remnant of dental lamina
* Site – crest of maxillary & mandibular alveolar
ridge

* Treatment – surgical enucleation

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