This document discusses various types of cysts found in the oral cavity and jaws. It defines odontogenic cysts as those lined by epithelium from tooth development and non-odontogenic cysts as those arising from epithelial inclusions during facial development. Specific cysts discussed include nasolabial cysts arising from the nasolacrimal duct, nasopalatine duct cysts from remnants of the nasopalatine duct, and globulomaxillary cysts between the maxilla and premaxilla. Clinical features, radiographic appearance, histopathology and treatment are described for each. The document provides an overview of developmental cysts of the oral region.
2. A cyst is a pathological cavity having fluid,
semifluid or gaseous contents and which is not
created by the accumulation of pus. Most cysts, but
not all, are lined by epithelium..
( Kramer 1974)
3. Odontogenic cyst -- Is a cyst in which lining of
lumen is derived from epthelium produced
during tooth development
Non odontogenic cyst – a cyst that arise from
epithelial inlusion or entrapments in the lines of
closure of developing facial process during
embryonic period of life…
4. Types of fissural cysts:
Nasolabial cysts (nasoalveolar cysts
(located in soft tissue, not in the jaw!)
Nasopalatine duct cysts
Globulomaxillary cyst
5. Definition - a type of developmental cysts that
actually arises in the bone suture between
maxilla and premaxilla
6. Earlier concept -- develops from as a result of
proliferation of the epithelium , entrapped along
the line of fusion between maxilla and premaxilla
Nowdays --- acc. To christ
variant of primordial cyst or lateral
periodontal cyst
7. Site – between lateral incisir and canine teeth
-- usually asymptomatic
-- cause pain and discomfort only when it is
secondarily infected.
--lateral maxillary and cupsid teeth will be found
to be tilted coronally with root divergence
-- vitality test is normal for both teeth
-- small swelling in between upper lateral incisor
and canine with elevation of lip is rare case
8. Well circumscribed unilocular radiolucency (
inverted pear between apices of teeth)
Roots reveals divergence
9. Cystic cavity – lined by either by a
stratified/pseudostratified ciliated columnar
epithelium or thin squamous epithelium
chronic inflammatory cell inflitration present
in capsule
10. The clinical and pathohistological evidence
overwhelmingly shows that a "cyst" in the so-
called globulomaxillary region may be one of the
following lesions : Radicular cyst
Lateral periodontal cyst
Keratocystic odontogenic tumour
Odontogenic tumour
Ameloblastoma
Central giant cell granuloma
Apical infection
11. Careful enucleation without damage to
adjoining roots ot the teeth, followed by
primary closure
12. Definition – entirely soft tissue cyst , which
arises in the nasolabial fold, just below the ala
of nose…
13. From remnant of nasolacrimal duct/ epithelial
lining of FOM
14. Age – peak incidence in 4th and 5th decade of life
Sex– more in female
Site – soft tissue of anterior maxillary vestibule
below the ala of nose and deep in nasolabial area
Usually unilateral
Commonest complain – slowly growing and
occassionally, pain and difficult in nasal breathing
Intraorally – bulge in labial sulcus
Extraorally – filling out of nasolabial fold and may
lift ala nasi
Flutuant lesion
15. Seen as localized increase lucency of alveolar
process above apices of incisors ( appears as
spherical , kidney shaped lesion)
Lucency results from presure resorption on
labial surfaces of maxilla
16. Cyst lined by non ciliated pseudo stratified columnar
epithelium
Goblet cells seen in some cases
Occasionally, part of lining may be cuboidal / flat
sqamous
Connective tissue wall is fibrous , relatively acellular
with fibers arranged loosely or compactly
18. Although the nasolabial cyst are extra-osseous
they lie subperiosteally and careful surgical
enucleation should be done
19. Definition -- Nasopalatine duct cysts (NPDC) are
cysts that originate from epithelial remnants of
the nasopalatine duct, which become entrapped
during fusion of the palate plates
20. This lesion is considered as a true
developmental cyst and it arises usually due to
the proliferation and subsequent cystic
degeneration of the epithelial remnants
remaining after closure of the embryonic
nasopalatine duct.. The initiating factors to the
development of the cyst may be trauma,
inflamMation and bacterial infection, etc.
21. Age – 4th , 5th and 6th decade
Sex – male > female ( 4:1)
Site – usually in anterior region of mid palate near
opening of the incisive foramen
Small, painful swelling
often extends onto the labial aspect of upper alveolar
ridge
Causes pressure sensation on the floor of the nose and
displacement of roots of upper central incisors
Occasionally, there can be purulent or salty discharge
frpm the lesion
Some patient complain of episodic swelling in the soft
tissue between the upper central incisor
Regional teeth are always vital
22. A sharply demarcated symmetrical radiolucency
in the midline of anterior maxilla
Small round or heart shaped between the roots of
the upper central incisor in the midline with
cortical border
Displacement of roots of the upper central incisor
are commonly seen
23. Cystic cavity – lined by the ciliated columnar or non
keratinized stratified squamous epithelium and is backed by
a connective tissue capsule
mucous secretory cells seen
Sometimes presence of pigments in the lining
Lining may be thin or thick and there may or may not be
formation of rete pegs in the lining
Presence of large nerve and vascular bundle in connective
tissue wall
24. Radicular cyst , if it is associated with a
pulpally involved tooth
Large incisive canal
26. Shafer, et al: A text book of oral pathology, 3rd
edition
Essential of oral pathology - swapan kumar
purkait– 2nd edition
Google.com
Neville, et al:oral and maxillofacial pathology
3rd edition
- And various websites