Cysts part 1
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The document summarizes different types of cysts that can occur in the oral and paraoral regions. It describes odontogenic cysts that arise from epithelial remnants associated with tooth development, including inflammatory and developmental periodontal cysts. Non-odontogenic cysts such as dermoid and thyroglossal duct cysts in the soft tissues are also mentioned. Key characteristics such as location, histology, clinical features and treatment are provided for different cyst types.
Cysts part 1
- 1. Cysts of The Oral & Paraoral Regions
- 2. Definition of Cyst • A cyst is an epithelial lined pathologic cavity occuring either in hard or soft tissue and may contain a fluid or semi-fluid material (True Cyst). • Some cysts may not be epithelial- lined & therefore are not true cysts (Pseudocysts).
- 3. Cysts Classification Non- Pseudo- Soft Tissue Odontogenic cyst Odontogenic Cysts Naso- Dermoid, Ep periodontal Traumatic Palatine idermoid Bone C. Tract C. Dentigerous Thyro- glossal tract Aneurysmal C. Fissural Bone C. Primordial Benign lympho- Static KCOC, epithelial Bone C. Gorlin’s cyst Mucous Retention ,Extravasat.
- 4. 1- Odontogenic Cysts • Def.: these arise from epithelial remnants associated with the development of teeth odontogenic epithelium. • Site: Affect the tooth bearing region of the jaw. • Origin of epithelium: - Enamel organ. - Reduced enamel epithelium. - Epithelial rests of Malassez. - Epithelial rests of Serres (dental lamina remnants).
- 5. Odontogenic Cysts Classification Keratinized Periodontal Dentigerous Primordial & calcifying odontogenic Odonto- (KCOC) Inflamm. Central genic keratocyst Gorlin’s Development Lateral cyst (OKC) Circumferential
- 6. Periodontal Cysts Inflammatory Developmental Apical Lateral Lateral Gingival C. adults Gingival C. Residual newborn
- 7. Periodontal Inflammatory Cysts • Cause: it results from inflammatory hyperplasia of the epithelial rests of Malassez in the periodontal ligament following death of the pulp. • Types according to its location: - Apical or periapical or radicular : related to root apex. - Lateral: related to lateral root surface & accessory root canal. - Residual: left after extraction in edentulous area of jaw.
- 8. 1-Inflammatory Periodontal Apical (Periapical, Radicular) Cyst Periapical Inflammatory ↑↑epith. granuloma proliferation mass Degeneration Epith. Lined Separation + cavity filled of cells in liquefication with fluid the central of central formed portion cells Apical periodont al cyst
- 9. Mechanism of Cyst Enlargement Tissue ↑osmotic breakdown pressure Fuid Osteoclastic transport to bone cystic cavity resorption Enlarging the bony cavity
- 10. Clinical Features of Inflamm. Apical Cyst • Age: adult (3rd -6th )decade. • Sex: male ˃ female. • Site: maxilla ( anterior area). • Symptoms: - No infection → painless. - Infection occurs → painful. - Rounded swelling • Signs: -non-vital tooth, eggshell crackling sensation under pressure then fluctant swelling.
- 11. X-ray of Inflammatory Apical Cyst •Shape: Round or ovoid • Margin: Well- defined •Radiolucency. •Size : (5mm – several cm). •Related Tooth: may has a large carious cavity or large filling.
- 12. Histology of Inflammatory Apical Cyst 1-C.T wall 2- Epith. lining 3- Cyctic fluid
- 13. Histology of Inflammatory Apical Cyst
- 14. The Epithlium Lining of Apical Cyst • Stratified squamous epith. Acanthosis (20 cell layer). • Newly formed cyst: • -Hyperplasic, forming rings around inflammatory cells. • Fully formed cyst: • - Regular, flattened with few inflammatory cells.
- 15. Connective Tissue Wall of Apical Cyst • Collagen fibers bundles, fibroblasts & B.capillaries. • Acute inflamm. Cells ( PMNL) toward epith. & macrophages. • Chronic inflamm. Cells ( plasma cells & lymphocytes) deeper in CT. • Dystrophic calcification foci. • Cholesterol clefts. • Multinucleated giant cells • Russel bodies. • Rushton bodies. • Hemosidren &foam cells.
- 16. Cholesterol Crystals Cholesterol Clefts Rushton Bodies Russel Bodies
- 17. Lumen Content or Fluid of Apical Cyst •The lumen contains fluid which stains eosinophilic. •Sometimes contains cholesterol in great amount. •Chemically: contains albumin, globulin, cholesterol & nucleoproteins.
- 18. Treatment of Inflammatory Apical Cyst • Enucleation. Small • Apicectomy. • Enucleation. Medium • Extraction of tooth. • Marsupilization to avoid imp. Structures e.g. Large antrum & inf. Alveolar nerve.
- 19. 2- Inflammatory Lateral Periodontal Cyst • Less common ˃ periapical. •Site: at the side of the root of a pulpless tooth. •Cause: a result of opening of a lateral root canal & irritation of periodontal tissue.
- 20. 3- Inflammatory Residual Periodontal Cyst •Cause: -The pulpless tooth from which a periapical cyst may persist in the jaw bone. •Complication: -Interfering with the fittness of dentures. -Enlarge to the extent of weakning of the jaw. -Jaw fructure
- 21. Developmental Lateral Periodontal Cyst •Def.: a non-inflammatory developmental cyst which occurs adjacent or lateral to the root of vital tooth. •Cause: proliferation of rests of odontogenic epithelium at lateral side of adjacent vital tooth.
- 22. Clinical Features of Developmental Lateral Periodontal Cyst • Age: any age. • Sex: male ˃female. • Site: 2 543 • Signs : may cause a slight bulge although the overlying mucosa is normal. • Symptoms: - Asymptomatic - Vital tooth.
- 23. X-ray of Developmental Lateral Periodontal Cyst •Small , rarely over 1 cm. •Radiolucent area. •May or may not well circumscribed with an opaque margin.
- 24. Histology of Developmental Lateral Periodontal Cyst •C.T wall: may have inflammatory cell if the cys get infected. •Epith. Lining: -Stratified squamous . -Thin( 1-2)layers. -Epith. Cells with clear cytoplasm& small deeply stained nuclei. -Parakeratin or orthokeratin.
- 25. Developmental Gingival Cysts Of The New Born Of Adulthood (Bohn’s Nodules) • Origin: from dental • Origin: from dental lamina remnants in the lamina remnants which proliferate to form small ST between the oral cyst. epith.& periosteum. • Shape: • Shape: multiple white wellcircumscribed nodules. swelling of the gingiva. • Size: small ˃1cm. • Size: ˃ few mm. • Site: on the alveolar • Site: free & attached ridge of new born infant gingiva or papilla(adult).
- 26. Developmental Gingival Cysts Of The New Born Of Adulthood (Bohn’s Nodules)
- 27. Developmental Gingival Cysts Of Adulthood Of The New Born • X-ray: (-ve) soft tissue & • X-ray: (-ve) soft tissue. vital tooth. • Histology: • Histology: - Thin epith. - Thin epith., flattened st. - The lumen filled with sq.cells. desqumated keratin. - Non- keratinized. • Treatment: • Treatment: - No treatment & - No treatment. discharge their content into the oral cavity.
- 28. Developmental Gingival Cysts Of Adulthood Of The New Born
- 29. Thanks Presented by: Marwa Assem Salama