3. Introduction
“A cyst is an epithelium lined sac
containing fluid or semifluid material”
The epithelial cells first proliferate and later undergo
degeneration and liquefaction.
Grow by expansion, causing displacement of adjacent
teeth.
4.
5. On Basis of Origin
• Originate from residues of the tooth-forming organ
Derived from 3 ORIGINS
Dental lamina:
Odontogenic keratocyst
Lateral periodontal cyst
Gingival cysts
11. APICAL CYST
Develops from a preexisting periapical granuloma,
Related to the apex of a non vital tooth
12. Clinical features
• Most common cystic lesions of jaw.
• High incidence in Anterior maxillary teeth.
• Usually symptomless.
• When enlarged cause expansion of the alveolar
arch and may discharge through a sinus
• The rate of expansion 5mm/year in diameter
13. Histopathology
• Lined by non-keratinized stratified squamous
epithelium
• Chronically inflamed fibrous tissue capsule
• Newly formed cysts have irregular epithelial lining with
variable thickness. Becomes regular and even in thickness
14. • The connective tissue capsule becomes
more fibrous, less vascular, and with less
inflammatory cells
• Metaplasia of epithelial lining may
give rise to mucous cells, rarely
ciliated respiratory epithelium
• In some cases the lining contains
hyaline eosinophilic bodies,
Rushton bodies
15. Radiographic features
• Well defined, Round radiolucency at the root apex
surrounded by radiopaque margin
• Root resorption is common
• 40 % of apical radiolucencies are cystic
16.
17. Contents
Hypertonic fluid containing
• breakdown products of epithelial
• inflammatory products
• connective tissue elements
• serum proteins (5-11 g/dl), Immunoglobulin higher
then serum.
• cholesterol crystals
18. CYST EXPANSION
• majority of the radicular cyst do not grow to large
dimension
• Cyst enlarges and causes bone resorption centrally
increments of sub periosteal bone are laid down to
maintain integrity of cortex , producing bony hard
expansion
• The rate of expansion is greater then the rate of periosteal
deposition leading to progressive thinning of cortex
• Clinical sign of OIL-CAN BOTTOMING & EGG
SHELL CRACKLING
22. Management
• Small cyst : Root canal Treatment
• Large Cyst : Enucleation or marsupialiazation
23. Residual cyst
• It is a radicular cyst that is retained after the
extraction of the related tooth
• May continue growth causing significant
bone resorption
24.
25. Lateral Radicular cyst
• An Uncommon type of Radicular cyst
• Arise as a result of pulpal inflammation
into lateral preriodontium.
26. Dentigerous cyst
“Cyst that originates by the separation of follicle
from around the crown of unerupted tooth”
Also called as Follicular Cyst
27. Clinical features
• Twice as common in mandible
• Usually asymptomatic
• Twice as common in males
• Large cyst tends to expand the outer plate
32. Odontogenic keratocyst
• Relatively uncommon
• 2nd to 3rd decades, or fifth decade
• More common in males
• Asymptomatic
• Gain much attention because of its unusual growth
pattern (anterioposterior direction) and tendency recur.
• Multiple cysts are associated with nevoid basal cell
carcinoma syndrome (Gorlin syndrome)
33. Radiographic features
• 3rd molar and ramus of mandible are common sites
• Well-defined radiolucency
• Can displace and resorb teeth
• Uni or multi locular
34.
35. Histopathology
• wall is thin , friable.
• 5-10 cells thick stratified squamous epithelium
• Characteristic folded wall
• Basal cell layer is well defined, contains columnar or
cuboidal cells
• satellite cyst (daughter cysts) usually found, formed by
independent small groups of epithelial cells resembling
dental lamina reside in fibrous capsule
36. • Thin fibrous capsule free from inflammatory
cells
• High recurrence due to rupture
• Cyst contains keratinous debris, white cheesy
material, protein level 4 g/dl
40. Gingival cyst
Neonates
• Common in neonates
• Also knows as Bohn’s nodules or Epstein pearls
• Disappear by 3 months of age
• Arise from remnants of dental lamina, form
keratinizing cysts
43. Developmental lateral
periodontal cyst
• Uncommon
• Canine and premolar region of the mandible
• Derived from either reduced enamel epithelium or rests
of dental lamina
• Occasionally multilocular (Grape like structure) called as
botryoid odontogenic cyst
