DISORDERS OF MAXILLA AND MANDIBLE(CYSTS

AND TUMOURS)

DR.SHAHZADI TAYYABA HASHMI

DNT 243

DEVELOPMENTAL ODONTOGENIC CYSTS

GINGIVAL CYST OF ADULT: Usually form after the age 40 Clinically, they form dome-shaped

swellings less than 1cm in diameter. They are lined by very thin, flat, stratified

squamous epithelium. Can be treated by Enucleation

INFLAMMATORY ODONTOGENIC CYST

PERIAPICAL CYST:An Odontogenic cyst derived from rests

of MALASSEZ that proliferate in response to inflammation

Rests of MALASSEZ are the remnants of HERTWIG’S EPETHELIAL root sheath that persist in the periodontal ligament after root formation is complete

PATHOLOGY

Cyst arises from rests of MALASSEZ, which enlarge in response to inflammation elicited by bacterial infection of pulp

Proliferation of epithelial lining and fibrous capsule

Hydrostatic pressure of cyst fluid

RESORPTION of surrounding bone

CLINICAL FEATURES

Develops at the apex of root adjacent to pulp canal opening

Measures less than 1cm in diameter

RADIOGRAPHIC FEATURES:Appears as \rounded, well-circumscribed radiolucency at the apex of a non-vital

tooth

HISTOPATHOLOGY AND TREATMENT

Characterized by a cavity lined with a layer of non-keratinized Squamous epithelium

Cysts are usually inflamed and neutrophils are present within the epithelial lining

TREATMENT:

Surgical enucleation after extraction

If Periapical cyst is not removed, residual cyst may develop A cyst that remains at the site ofpreviously extracted toothIs termed as Residual cyst

NON-ODONTOGENIC CYSTS

Nasopalatine duct cysts

Nasolabial cyst

NASOPALATINE DUCT CYST(INCISIVE CANAL CYST)

CLINICAL FEATURES: Slow growing cysts Occasionally they cause intermittent discharge with a salty

taste May cause swelling in the midline of the anterior part of the

palate near the incisive foramen

RADIOGRAPHIC FEATURES: Oval or heart shaped radiolucency located in the midline of anterior maxilla between the roots of central incisors

TREATMENT: Surgical enucleationusing a palatal approach

NASOLABIAL CYST

A developmental cyst of the soft tissues of the anterior mucobuccal fold beneath the ala of the nose

Also known as Nasoalveolar Cyst

CLINICAL FEATURES: Unilateral or bilateral painless soft tissue

swelling Common in females

TREATMENT Surgical ENUCLEATION

ODONTOGENIC And

NON-ODONTOGENICTUMOURS of

JAWS

IMPORTANT TYPES OF ODONTOGENIC TUMOURS

BENIGN EPITHELIAL NEOPLASMS:1. AMELOBLASTOMA and its variants2. SQUAMOUS ODONTOGENIC TUMOUR (SOT)3. CALCIFYING ODONTOGENIC TUMOUR (COT)4. ADENOMATOID ODONTOGENIC TUMOUR (AOT)5. CALCIFYING ODONTOGENIC CYST

BENIGN MIXED EPITHELIAL AND CONNECTIVE TISSUE NEOPLASMS:

• AMELOBLASTIC FIBROMA

IMPORTANT TYPES OF ODONTOGENIC TUMOURS

BENIGN CONNECTIVE TISSUE NEOPLASMS

ODONTOGENIC FIBROMA ODONTOGENIC MYXOMA CEMENTOBLASTOMA

MALIGNANT EPITHELIAL NEOPLASMS

ODONTOGENIC CARCINOMAS CLEAR CELL ODONTOGENIC CARCINOMA

MALIGNANT CONNECTIVE TISSUE NEOPLASMS ODONTOGENIC SARCOMAS

3) CALCIFYING EPETHELIAL ODONTOGENIC TUMOUR (CEOT)

Also known as PINDBORG TUMOUR Usually present between age 40 and 70 Most commonly forms in posterior

mandible Locally invasive but does not metastasize May be unilocular or multilocular

TREATMENT: Treated by excision with a small margin