ODONTOGENIC CYSTS
P RANJITH KUMAR 107
ODONTOGENIC CYSTS
Odontogenic cysts are epithelial lined pathologic cavities derived
from remnants of odontogenic epithelium present within the jaws.
CLASSIFICATION
1.ODONTOGENIC EPITHELIAL CYSTS
A.DEVELOPMENTAL
Gingival cysts:Infants,adults
Odontogenic keratocyst
Dentigerous cyst
Eruption cyst
Lateral periodontal cyst
Glandular odontogenic cyst
B.INFLAMMATORY
Paradental cyst
Radicular/Periapical cyst
Residual cyst
2.NON ODONTOGENIC EPITHELIAL
CYSTS(FISSURAL CYSTS)
• Nasolateral/Nasoalveolar cyst
• Globulomaxillary cyst
• Nasopalatine cyst
• Median palatal cyst
• Median mandibular cyst
3.NON-EPITHEIAL/PSEUDOCYSTS
• Solitary Bone Cyst
• Aneurysmal Bone Cyst
• Stafne’s Bone Cyst
RADICULAR CYST
• Also called apical,periodontal or dental cyst is the most common cyst originating from
the dental tissues.
• Associated with non vital teeth.
• Pathogenesis
• It arises consequent to dental caries.
Bacteria gain entry into pulp inducing inflammation and destruction of dental pulp
producing pulp and periapical abscess(collection of pus at the root of the tooth).
The epithelial cells of malassez which are nests of odontogenic epithelium embedded in
the peridontium,proliferate within apical granuloma under the influence of
inflammation,leading to the formation of an epithelium lined cystic cavity.
Most of the radicular cysts are observed at the apex of an erupted tooth.
HISTOLO
GY
• Radicular cyst is lined by nonkeratinized squamous epithelium
• The cyst wall is fibrous and contains chronic inflammatory
cells(lymphocytes,plasma cells with russell bodies and macrophages)
hyaline bodies and deposits of cholesterol crystals.
SURGICAL CILIATED CYST
• It develops at the site of previous surgery or trauma.Other names
include post operative maxillary cyst,paranasal cyst or implantation
cyst.
• MICROSCOPY
• The cyst is lined by pseudostratified ciliated columnar epithelium.
NASOPALATINE CYST
• Also called invasive canal cyst/median or anterior maxillary cyst.
• Is the most common non-odontogenic cyst and arises from the
epithelial remnants of the nasopalatine duct.
• Occurs due to spontaneous cystic degeneration of the residual ductal
epithelium.
• MICRPSCOPY
• The cyst is lined by stratified squamous epithelium,respiratory
epithelium or both.
GINGIVAL CYST
• It arises from the epithelial rests in the gingiva, is lined by keratinized
squamous epithelium.
• Classified into two types : Adult,Newborn types.
• Newborn type:
• Mulituple, occasionally solitary nodule on the alveolar ridge of new born.
• Appear as small creamish whitish projection on the alveolar ridge.
• HISTOPATHOLOGY:
• Shows stratified squamous parakeratinised cystic epithelium with flattened
or cuboidal epithelium with darkly staining nuclei.
• Central lumen is filled with parakeratin flakes arranged in concentric
laminations.
Mulituple,
occasionally solitary
nodule on the alveolar
ridge of new born.
Appear as small
creamish whitish
projection on the
alveolar ridge
Adult type
• Bluish colour swelling of gingiva is observed which is dome shaped
DENTIGEROUS CYST
• Also called follicular cyst, arises from the enamel of an unerupted tooth, as a
result of fluid accumulation between the developing tooth and the dental
follicle.
• Involves the crown of the tooth.
• Produces root resorption of the surrounding teeth due to expansion.
• RADIOLOGY
• These are unilocular lesions most often associated with impacted third molar
tooth.
• HISTOLOGY
• Lined by thin layer of stratified squamous epithelium, a dense chronic
inflammatory cell infiltrate in the surrounding connective tissue which is mild
that differentiates it from a radicular cyst.
• Treatment is to excise the cyst.
GLOBULOMAXILLARY CYST
• Formed at fusion of maxillary and globular processes or between
lateral incisors and canine.
• Is asymptomatic
• Inverted pear shape radioluency.
KERATOCYSTIC ODONTOGENIC
TUMOR
• Also called primordial cyst, most common in males of 10 to 40 yeas of age,
within the posterior mandible, arise from the cell rests of dental lamina and
basal cell hamartias.
• Spreads in the anteroposterior direction.
• The lesions are well defined unilocular or multilocular with a lining consisting of
keratinized stratified squamous epithelium with a prominent basal cell layer and
a corrugated epithelial surface.
• Recurrence is high, lesions are solitary but patients with multiple cysts should be
evaluated for nevoid basal cell carcinoma syndrome which is associated with
mutations in the tumor suppressor gene PTCH on chromosome 9q.
MICROSCOP
Y
Cyst is lined by a thin layer of
keratinised squamous epithelium
without rete pegs.
Parakeratinisation seen
Basal cells show palisading giving
tombstone or picket fence appearance.
Daughter cysts or satellite cysts are
seen in the connective tissue which are
thought to be one of the reasons for
recurrence.
Corticated scalloped
margin with moderate
expansion of jaw.
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