Odontogenic cyst
Encyclopedia
Odontogenic cyst is a closed sac, having a distinct membrane
derived from rests of odontogenic epithelium
. It may contain air, fluids, or semi-solid material. Intra-bony cyst
s are most common in the jaws, because the mandible and maxilla
are the only bone
s with epithelial components. That odontogenic epithelium is critical in normal tooth
development. However, epithelial rests may be the origin for the cyst lining later.
Not all oral cysts are odontogenic cyst. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.
(dysfunctional) tumors, the result of plugged ducts or other natural body outlets for secretions. However sometimes these masses are considered neoplasm:
of the cyst to curettage
to resection
. For example, small radicular cyst may resolved after succsseful endodontic ("root-canal") treatment. Because of high recurrence potential and aggressive behaviour, curettage is recommended for keratocyst. However, the conservative enucleation is the treatmet of choice for most odontogenic cysts. The removed cyst must be evaluated by pathologist to confirm the diagnosis
, and to rule out other neoplastic lesions with similar clinial or radiographic featres (e.g., cystic or solid ameloblastoma
, central mucoepidermoid carcinoma
). There are cysts, e.g. buccal bifurcation cyst
with self-resolation nature, in which close observation can be employed unless the cyst is infected and symptomatic.
Biological membrane
A biological membrane or biomembrane is an enclosing or separatingmembrane that acts as a selective barrier, within or around a cell. It consists of a lipid bilayer with embedded proteins that may constitute close to 50% of membrane content...
derived from rests of odontogenic epithelium
Epithelium
Epithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the cavities and surfaces of structures throughout the body, and also form many glands. Functions of epithelial cells include secretion, selective...
. It may contain air, fluids, or semi-solid material. Intra-bony cyst
Cyst
A cyst is a closed sac, having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst could go away on its own or may have to be removed through surgery.- Locations :* Acne...
s are most common in the jaws, because the mandible and maxilla
Maxilla
The maxilla is a fusion of two bones along the palatal fissure that form the upper jaw. This is similar to the mandible , which is also a fusion of two halves at the mental symphysis. Sometimes The maxilla (plural: maxillae) is a fusion of two bones along the palatal fissure that form the upper...
are the only bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
s with epithelial components. That odontogenic epithelium is critical in normal tooth
Tooth
Teeth are small, calcified, whitish structures found in the jaws of many vertebrates that are used to break down food. Some animals, particularly carnivores, also use teeth for hunting or for defensive purposes. The roots of teeth are embedded in the Mandible bone or the Maxillary bone and are...
development. However, epithelial rests may be the origin for the cyst lining later.
Not all oral cysts are odontogenic cyst. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.
Types
- Buccal bifurcation cystBuccal bifurcation cystBuccal bifurcation cyst is an inflammatory odontogenic cyst, of the paradental cysts family, that typically appears in the buccal bifurcation region of the mandibular first molars in the second half of the first decade of life...
- Calcifying odontogenic cystCalcifying odontogenic cystThe calcifying odotogenic cyst, also known as the Gorlin cyst, is a cyst most likely to affect the anterior areas of the jaws. It is most common in people in their second to third decades but can be seen at almost any age. On radiographs, the calcifying odontogenic cyst appears as a unilocular...
- Dentigerous cystDentigerous CystA dentigerous cyst or Follicular Cyst is an odontogenic cyst - thought to be of developmental origin - associated with the crown of an unerupted tooth. The cyst cavity is lined by epithelial cells derived from the reduced enamel epithelium of the tooth forming organ...
(associated with the crowns of non-erupted teeth) - Glandular odontogenic cystGlandular odontogenic cystThe glandular odontogenic cyst is a rare odontogenic cyst. In 85% of cases, it is found in the mandible, especially in anterior areas. It is more common in adults in their fifth and sixth decades. On radiographs, it can appear as a unilocular or multilocular radiolucency...
- KeratocystOdontogenic keratocystA keratocystic odontogenic tumour , abbreviated KCOT, is a rare and benign but locally aggressive developmental cystic neoplasm. It most often affects the posterior mandible....
(in the jaws, these can appear solitary or associated with the Gorlin-Goltz or Nevoid basal cell carcinoma syndromeNevoid basal cell carcinoma syndromeNevoid basal cell carcinoma syndrome , also known as basal cell nevus syndrome, multiple basal cell carcinoma syndrome, Gorlin syndrome, and Gorlin–Goltz syndrome, is an inherited medical condition involving defects within multiple body systems such as the skin, nervous system, eyes, endocrine...
. The latest World Health OrganizationWorld Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
classification considers Keratocysts as tumors rather than cysts) - Paradental cystParadental cystParadental cysts constitute a family of inflammatory odontogenic cyst, that typically appear in relation to crown or root of partially erupted molar tooth...
- Periapical cystPeriapical cystThe periapical cyst is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain...
(The periapical cyst, otherwise known as radicular cyst, is the most common odontogenic cyst.) - Radicular cyst (associated with the roots of non-vital teeth, also known as Periapical cystPeriapical cystThe periapical cyst is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain...
) - Residual cyst
Cystic neoplasm
Most cysts in the body are benignBenign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
(dysfunctional) tumors, the result of plugged ducts or other natural body outlets for secretions. However sometimes these masses are considered neoplasm:
- KeratocystOdontogenic keratocystA keratocystic odontogenic tumour , abbreviated KCOT, is a rare and benign but locally aggressive developmental cystic neoplasm. It most often affects the posterior mandible....
- Calcifying odotogenic cyst
- According to the cuurent (2005) classification of the World Health Organization, both (parakeratizied) odontogenic keratocyst and calcifying odotogenic cyst have neoplastic characteristics, thus renamed as Keratocystic odontogenic tumor and Calcifying odotogenic tumor, respectively.
- Cystic ameloblastomaAmeloblastomaAmeloblastoma is a rare, benign tumor of odontogenic epithelium much more commonly appearing in the lower jaw than the upper jaw. It was recognized in 1827 by Cusack...
- Long standing dentigerous cystDentigerous CystA dentigerous cyst or Follicular Cyst is an odontogenic cyst - thought to be of developmental origin - associated with the crown of an unerupted tooth. The cyst cavity is lined by epithelial cells derived from the reduced enamel epithelium of the tooth forming organ...
, odontogenic keratocyst, and residual cyst may have neoplastic potential converting into the locally aggressive ameloblastomaAmeloblastomaAmeloblastoma is a rare, benign tumor of odontogenic epithelium much more commonly appearing in the lower jaw than the upper jaw. It was recognized in 1827 by Cusack...
, or the malignantCancerCancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
squamous cell carcinomaSquamous cell carcinomaSquamous cell carcinoma , occasionally rendered as "squamous-cell carcinoma", is a histologically distinct form of cancer. It arises from the uncontrolled multiplication of malignant cells deriving from epithelium, or showing particular cytological or tissue architectural characteristics of...
and mucoepidermoid carcinomaMucoepidermoid carcinomaMucoepidermoid carcinoma is the most common type of salivary gland malignancy in children. Mucoepidermoid carcinoma can also be found in other organs, as bronchi, lacrimal sac and thyroid.Mucicarmine staining is one stain used by pathologist for detection....
.
Treatment
Treatment ranges from simple enucleationEnucleation (surgery)
As a general surgical technique, enucleation refers to the surgical removal of a mass without cutting into or dissecting it.-Removal of the eye:Enucleation refers to removal of the eyeball itself, while leaving surrounding tissues intact....
of the cyst to curettage
Curettage
Curettage, in medical procedures, is the use of a curette to remove tissue by scraping or scooping.Curettages are also a declining method of abortion. It has been replaced by vacuum aspiration over the last decade....
to resection
Resection
Resection may refer to:*Segmental resection , the partial removal of an organ or other body structure*Resection , a means of establishing a location...
. For example, small radicular cyst may resolved after succsseful endodontic ("root-canal") treatment. Because of high recurrence potential and aggressive behaviour, curettage is recommended for keratocyst. However, the conservative enucleation is the treatmet of choice for most odontogenic cysts. The removed cyst must be evaluated by pathologist to confirm the diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, and to rule out other neoplastic lesions with similar clinial or radiographic featres (e.g., cystic or solid ameloblastoma
Ameloblastoma
Ameloblastoma is a rare, benign tumor of odontogenic epithelium much more commonly appearing in the lower jaw than the upper jaw. It was recognized in 1827 by Cusack...
, central mucoepidermoid carcinoma
Mucoepidermoid carcinoma
Mucoepidermoid carcinoma is the most common type of salivary gland malignancy in children. Mucoepidermoid carcinoma can also be found in other organs, as bronchi, lacrimal sac and thyroid.Mucicarmine staining is one stain used by pathologist for detection....
). There are cysts, e.g. buccal bifurcation cyst
Buccal bifurcation cyst
Buccal bifurcation cyst is an inflammatory odontogenic cyst, of the paradental cysts family, that typically appears in the buccal bifurcation region of the mandibular first molars in the second half of the first decade of life...
with self-resolation nature, in which close observation can be employed unless the cyst is infected and symptomatic.