1. Dr. Shahzadi Tayyaba Hashmi
DNT 243
ORAL PATHOLOGY
Cysts of jaws
Dr. Shahzadi Tayyaba Hashmi

2. CYSTS OF JAWS DEFINITION:
Cysts are pathological fluid-filled cavities lined by epithelium
Cysts are the most common cause of chronic swellings of the jaws. They are more common in jaws than in any other bone because of many rests of odontogenic epithelium remaining in the tissues.

3. ODONTOGENIC CYSTS DENTIGEROUS cyst(follicular cyst)
ODONTOGENIC KERATOCYST(OKC)
DENTIGEROUS cyst(follicular cyst)
Eruption cyst
Lateral periodontal cyst
Gingival cysts of Adults
Gingival cysts of Infants

4. NON-ODONTOGENIC CYSTS
Nasopalatine duct cysts
Nasolabial duct cyst

5. INFLAMMATORY ODONTOGENIC CYSTS
RADICULAR CYSTS
Residual
Lateral
PARADENTAL CYSTS

6. Developmental
Odontogenic
cysts

7. ODONTOGENIC KERATOCYST (OKC)
Pathology:
Odontogenic Keratocyst is derived from remnants of dental lamina
Dental lamina:
The bands of epithelium that originates from oral epithelium and remain in the tissues after inducing tooth development

8. CLINICAL FEATURES OF ODONTOGENIC KERATOCYST
Peak incidence during second or third decade of life
Mandible is usually affected, primarily posterior body of mandible and ramus area
Unilocular or Multilocular
Multilocular OKC’s are consistent features of nevoid basal cell carcinoma syndrome( Gorlin Goltz Syndrome )
Exhibits 25% to 60% of recurrence

9. RADIOGRAPHIC FEATURES
Odontogenic Keratocyst appear as well-defined radiolucent areas with a more or less rounded margins
Some are Unilocular, but majority are Multiloculated

10. HISTOPATHOLOGY Microscopic appearance has four major characteristics
A thin, uniform lining of Parakeratinized Squamous epithelium, 6 to 10 cell thick
A palisaded layer of columnar or cuboidal basal cells
Corrugated layer of
parakeratin
4. Lack of rete pegs

11. TREATMENT
Unilocular and small Multilocular cysts can be treated by Enucleation and bony cavity curetted
Large cysts have high rate of recurrence that’s why they need surgical resection and reconstruction with a bone graft

12. DENTIGEROUS CYST
An Odontogenic cyst that surrounds the crown of an impacted tooth.
It is usually derived
from Reduced enamel
Epithelium (residual
Epithelium that
surrounds the crown of
tooth after enamel
formation is complete)

13. CLINICAL FEATURES RADIOGRAPHIC APPEARANCE
Usually remain asymptomatic, but produce swelling or pain ,If it is large or INFLAMMED
More common in males as compared to females
Uncommon in children
RADIOGRAPHIC APPEARANCE
Appear as well defined radiolucency surrounding the crown of an unerupted tooth
In mandible, cyst may displace the associated tooth inferiorly into ascending ramus
In maxilla, it displaces associated tooth posteriorly

14. RADIOGRAPHIC APPEARANCE

15. TREATMENT Surgical ENUCLEATION
In case of a molar teeth, the associated tooth is usually extracted at the time when cyst is enucleated
In case of maxillary CUSPID tooth, cyst may be excised by MARSUPILIZATION (surgical curettage of cyst by creating a surgical window in cyst area)

16. ERUPTION CYST
An Odontogenic cyst with the histologic features of a Dentigerous cyst that surrounds a tooth’s crown that has erupted through bone but not soft tissue and is clinically visible as a soft fluctuant mass on the alveolar ridge

17. CLINICAL FEATURES AND TREATMENT
Affects children and involve teeth that have no predecessors (deciduous teeth)
Cyst lies superficially in gingiva overlying the unerupted tooth
Appears as a soft, rounded, bluish swelling
MANAGEMENT:
Cyst roof may be removed to allow the tooth to erupt, but most eruption cysts burst spontaneously and require no treatment

18. Eruption cyst ( bluish appearance)