ORAL AND MAXILLOFACIAL SURGERY

2. ODONTOGENIC CYSTS
CLINICAL FEATURES
RADIOGRAPHIC FEATURES
DIFFERENTIAL DIAGNOSIS
Yasmin Moidin
2008 Batch
Al Azhar Dental College
Thodupuzha

3. 
Introduction

Classification

Types of odontogenic cysts

Conclusion

Reference

4. 
Cyst is defined as a pathological cavity filled with
fluid which is solid semisolid or gaseous form
which may or may not be lined by epithelium

Cyst can occur within bone or soft tissues

They may be asymptomatic or associated with
swelling and pain

5. 
Cysts are generally slow growing, expansile
lesions

They grow by hydraulic expansion

Radiographically
,
they
often
appear
radiolucency surrounded by thin radioopaque
border

6. 
CLASSIFICATION BY ETIOLOGY

DEVELOPMENTAL:
Unknown origin but are not the
result of an inflammatory reaction

Dentigerous cyst

Eruption cyst

Odontogenic keratocyst

Gingival cyst of newborn

7. 
Gingival cyst of adult

Lateral periodontal cyst

Calcifying odontogenic cyst

Glandular odontogenic cyst

INFLAMMATORY: result of inflammation

periapical cyst

Residual cyst

Paradental cyst

8. 
CLASSIFICATION BY TISSUE OF ORIGIN

DERIVED FROM RESTS OF MALASSEZ

Periapical cyst

Residual cyst

DERIVED FROM DENTAL LAMINA (RESTS OF SERRES)

Odontogenic kertocyst

Gingival cyst of newborn

Gingival cyst of adult

9. 
Lateral periodontal cyst

Glandular odontogenic cyst

UNCLASSIFIED

Paradental cyst

Calcifying odontogenic cyst

10. 
A
dentigerous
cyst
results
because
of
the
enlargement of the follicular space of the whole or
part of the crown of an impacted or unerupted
tooth and is attached to the neck of the tooth

11. 
CLINICAL FEATURES

The cyst is always associated initially with the
crown of an impacted, embedded or unerupted
tooth

Sites: mandibular and maxillary third molar and
maxillary cuspid areas

Most dentigerous cysts are solitary

Expansion
of
bone
with
subsequent
facial
asymmetry, extreme displacement of teeth, sever
root resorption of adjacent teeth and pain

12. 
RADIOGRAPHIC FEATURES

Reveal a radiolucent area associated with an
unerupted tooth crown

The radiolucent area is surrounded by a thin
sclerotic line representing bony reaction

13. 
Three radiological variations:-

Central variety, crown is enveloped symmetrically

Lateral type, results from dilatation of the follicle
on one aspect of the crown

Circumferential type, follicle expands and entire
tooth is enveloped by cyst

DIFFERENTIAL DIAGNOSIS

Ameloblastoma and ameloblastic fibroma

Adenomatoid odontogenic tumour

Calcifying odontogenic cyst

14. 
Developmental primordial and follicular primordial
cyst

Odontogenic keratocyst

Cystic ameloblastoma

Radicular cyst

Hyperplastic follicle

15. 
Eruption cyst is defined as an odontogenic cyst that
surrounds a tooth crown that has erupted through
bone but not soft tissue and is clinically visible as a
soft fluctuant mass on the alveolar ridges

16. 
CLINICAL FEATURES

Found in children and occcasionally in adults

Common site – anterior to first molar

Lesion appear as circumscribed, fluctuant, translucent
swelling of the alveolar ridge over the site of the
erupting tooth

When the circumcoronal cystic cavity contains blood,
swelling appears purple or deep blue; hence the term
ERUPTION HAEMATOMA

17. 
RADIOGRAPHIC FEATURES

It may show soft tissue shadow since the cyst is
confined within it and there is usually no bone
involvement

DIFFERENTIAL DIAGNOSIS

Dentigerous cyst

18. 
A cyst derived from the remnants of the dental
lamina, with a distinctive lining of six to ten cells in
thickness and exhibits a basal cell layer of
palisaded
parakeratin
cells
and
a
surface
of
corrugated

19. 
CLINICAL FEATURES

The cyst may occur at any age

Peak incidence is in 2nd and 3rd decades of life

Predilection for occurrence in males

Common site:- third molar area

Other features: pain, soft-tissue swelling and
expansion of bone and neurological manifestations
– parasthesia of lips

20. 
RADIOGRAPHIC FEATURES

They are unilocular, presenting a well-defined
peripheral rim

Scalloping of the border represents variations in
the growth pattern of cyst

21. 
DIFFERENTIAL DIAGNOSIS

Dentigerous cyst

Ameloblastoma

Primordial cyst

Residual cyst

Traumatic cyst

Benign odontogenic tumor

Giant cell granuloma

Odontogenic myxoma

22. 
These
are
multiple
,
occasionally
solitary, superficial raised nodules on edentulous
alveolar ridges of infants that resolve without
treatment, derived from rests of the dental lamina
and
lining
consisting
of
keratin-producing
epithelial

23. 
CLINICAL FEATURES

Small discrete white swellings of the alveolar ridge

Lesion appear to be asymptomatic and donot
produce discomfort in infants

24. 
A small developmental odontogenic cyst of the
gingival soft tissue derived from the rests of the
dental lamina, containing a lining of embryonic
epithelium of cuboidal cells and distinctive focal
thickenings

25. 
CLINICAL FEATURES

Lesion is small,
well-cirumscribed
, painless,
swelling of the gingiva

Lesion is of same color as the adjacent normal
mucosa and 1cm in diameter

It occurs in free or attachment gingiva and gingival
papilla

26. 
RADIOGRAPHIC FEATURES

It is a soft tissue lesion and if it enlarges to
sufficient size, it causes superficial erosion of the
cortical plate of bone


DIFFERENTIAL DIAGNOSIS
Lateral periodontal cyst

27. 
A slow growing, non expansile
developmental
odontogenic cyst derived from one or more rests of
the dental lamina, containing an embryonic lining
of one to three cuboidal cells and distinctive focal
thickenings

28. 
CLINICAL FEATURES

Predilection for occurrence in males

Site: mandibular bicuspid/cuspid/incisor area

When the cyst is located on labial surface of the
root, there is a slight mass

29. 
RADIOGRAPHIC FEATURES

Radiolucent area in apposition to the lateral surface
of a tooth root

Lesion is small, border is definitive and surrounded
by thin layer of sclerotic bone

30. 













DIFFERENTIAL DIAGNOSIS
Gingival cyst of adult
Botryoid cyst
Lateral radicular cyst
Lateral periodontal abscess
Lateral dentigerous cyst
Residual cyst
Primordial cyst
Globullomaxillary cyst
Median mandibular cyst
Small OKC
Mental foramen
Small neurofibroma
Radicular cyst

31. 
A rare, well circumscribed, solid or cystic lesion
derived from odontogenic epithelium that contains
ghost cells and spherical calcifications

32. 
CLINICAL FEATURES

It is more common in females

It occurs anterior to first molar

It is a slow growing , painless, non-tender swelling
which causes expansion and destruction of cortical
plates

The cystic mass may become palpable and discharging

33. 
RADIOGRAPHIC FEATURES

The central lesion may appear as a cyst like
radiolucency with variable margins which may be
smooth well defined or irregular in shape with
poorly defined borders

Perforation of cortical plates can be seen

34. 
DIFFERENTIAL DIAGNOSIS

Fibrous dysplasia

Partially calcified odontoma

Adenomatoid odontogenic tumor

Ossifying fibroma

Odontogenic fibroma

Cementoblastoma

Dentigerous cyst

Ameloblastic fibroadenoma

Calcifying epithelial odontogenic tumor

35. 
A large solitary or multilocular odontogenic cyst
derived from rests of dental lamina, consisting of a
stratified
squamous
epithelium
numerous mucus-secreting cells
containing

36. 
CLINICAL FEATURES

A slight male predilection

Common site is anterior mandible

Lesion shows slow progressive growth, painless
and locally destructive

37. 

RADIOGRAPHIC FEATURES
The lesions appear well defined with a multilocular
pattern

DIFFERENTIAL DIAGNOSIS

Lateral periodontal cyst

38. 
Periapical cysts results when rests of malassez in
the
periodontal
ligament
are
stimulated
to
proliferate and undergo cystic degeneration by
inflammatory products which are associated with
necrosis of the pulp

39. 
CLINICAL FEATURES

The tooth is painful and sensitive to percussion

It represents a chronic inflammatory process and
develops over a prolonged period of time

This acute exacerbation leads to abscess, then
proceed to a cellulitis and form a draining fistula

40. 
RADIOGRAPHIC FEATURES

A peri or para apical round or oval radiolucency of
variable size which is well-delineated and marked
with a radioopaque rim

41. 
DIFFERENTIAL DIAGNOSIS

Periapical granuloma

Periapical scar

Surgical defect

Periapical cementoma

Traumatic bone cyst

Periapical abscess

Mandibular infected buccal cyst

Odontogenic keratocyst

Benign tumor

Ossifying fibroma

42. 
Residual cyst are retained periapical cysts from
teeth that have been removed

CLINICAL FEATURES

Usually
asymptomatic
and
found
radiographic examinations

It is found in tooth bearing area
on
routine

43. 
RADIOGRAPHIC FEATURES

It may present well defined radiolucency that can
vary in size from a few mm to several cm; with thin
radioopaque margins

DIFFERENTIAL DIAGNOSIS

Primordial cyst

Keratocyst

Traumatic cyst

Ameloblastoma

44. 
Paradental cyst is an inflammatory cyst which
develops on the lateral surface of a tooth root

45. 
CLINICAL FEATURES

It occurs in younger age group

Seen in third decades of life

Male predilection

It is usually associated with third molar on buccal
surface and covers the bifurcation

The tooth is usually vital

It may occur bilaterally

46. 
RADIOGRAPHIC FEATURES

These are the non-widening of the periodontal
ligamentspace and the lesion was superimposed on
the buccal root surface

When there was a distal as well as a buccal
radiolucency, the distal element was separate from
distinct distal follicular space

47. 
DIFFERENTIAL DIAGNOSIS

Periodontal abscess

Langerhan’s cell histiocytosis

Dentigerous cyst

48. 
S M Balaji – textbook of oral and maxillofacial
surgery

Neelima
Malik
–
textbook
of
oral
maxillofacial surgery

Shafers – textbook of oral pathology

Freny Karjodhkar – textbook of radiology
and