Op Exam 1

Front 1

Periapical cyst characteristics, histology,

Back 1

aka Radicular cyst
- Most common cyst of jaws more commonly anterior maxilla due to trauma
- Tooth is nonvital and nonresponsive

Histology
- Shows chronic inflammatory cells in the fibrous connective tissue with nonspecific signs of inflammation
- Rushton bodies, Russel bodies, Cholesterol clefts

Front 2

Residual cyst

Back 2

Residual cells of cystic lining and inflammatory cells continue to proliferate

Front 3

Paradental Cyst

Back 3

Radiolucent area along distal aspect of impacted or partially erupted 3rd molar

Front 4

Buccal Bifurcation Cyst

Back 4

Similar to Paradental cyst but located on buccal of mandibular 1st molars
- Best seen with occlusal radiograph

Front 5

Odontogenic Cysts

Back 5

Inflammatory
- Periapical
- Residual periapical
- Paradental
- Buccal bifurcation

Developmental
- Dentigerous
- Eruption
- Gingival cyst of Newborn/Adult
- Lateral periodontal
- Glandular odontogenic
- Odontogenic keratocyst
- Orthokeratinized odontogenic
- Calcifying odontogenic

Front 6

Dentigerous Cyst characteristics, radiograph, d/d with Hyperplastic follicle, histology

Back 6

aka Follicular cyst
- Most common type of developmental odontogenic cyst
- Occurs in young adults
- Attached to the tooth at CEJ

Radiograph
- Shows well defined unilocular radiolucency with sclerotic border. May appear multilocular due to residual bone trabeculae.

- Must be greater than 4-5mm to call an area a dentigerous cyst

Histology
- Epithelial lined space surrounded by fibrous connective tissue
- Usually flat interface but may demonstrate anastomosis of rete pegs during inflamation

Front 7

Multilocular radiolucency Mnemonic

Back 7

MACHO
- Myxoma
- Ameloblastoma
- Central giant cell granuloma
- Hemangioma
- Odontogenic keratocyst

Front 8

Eruption cyst

Back 8

Soft tissue counterpart of a dentigerous cyst
- Not in bone
- Results from accumulation of fluid in follicular space after tooth as erupted through bone
- Usually seen in young children and involves 1st molar and maxillary incisors

Front 9

Cysts of Newborn

Back 9

Palatal cysts
- Bohn's nodules scattered over hard palate
- Epstein's pearls along median palatal raphe
- Ruptures and resolves spontaneously

Gingival
- Dental Lamina cysts
- Also not in bone
- Spontageously resolves

Front 10

Gingival Cyst of the Adult

Back 10

Soft tissue counterpart of periodontal cysts
- Derived from dental lamina rests

- Appears in older adults as a mucocele on the gingiva

Front 11

Lateral periodontal cyst characteristics, histology

Back 11

Developmental cyst that arise from dental lamina rests
- Intrabony counterpart of gingival cyst of adult
- Not inflammatory and reserved for once odontogenic keratocyst has been excluded
- Often found in mandibular canine/premolar area
- Teeth are vital

- Foci of plaque-like thickenings and glycogen-rich clear cells

Front 12

Variants of lateral periodontal cyst

Back 12

Botryoid Odontogenic Cyst
- Show a grape-like cluster of small individual cysts

Glandular Odontogenic Cyst
- Shows glandular differentiation within the epithelium
- Well defined radiolucency with a sclerotic border
- Epithelium shows cyst-like spaces lined by cuboidal cells
- Can be mucoepidermoid carcinoma

Front 13

Primordial Cyst

Back 13

Probably were all OKCs

Front 14

Odontogenic Keratocyst characteristics, Recurrence, Histology, Treatment, factors

Back 14

aka Keratocystic Odontogenic Tumor
- Distinct histological pattern and aggressive biologic behavior
- Growth due to osmotic effects and unusual gene expressions
- Solitary OKCs have 10% recurrence rate. Multiple have 30% recurrence rate. Syndrome OKC has highest recurrence

Histology
- Basal cells are uniform, palisaded, and hyperchromatic
- Surface epithelium is parakeratinized
- 1/4th have satellite or daughter cysts in the connective tissue wall which increases recurrence

Treatment
- Marsupialization to shrink the cyst and carnoy solution to cauterize the area

- PTCH gene mutation
- Overexpress Ki-87 for cell proliferation
- Overexpress BCL-2 for antiapoptotic
- Overexpression of MMP 2 and 9 to allow tissue growth

Front 15

Nevoid Basal Cell carcinoma Syndrome

Back 15

aka Gorlin's syndrome
- Multiple odontogenic keratocysts
- Multiple basal cell carcinomas of skin
- Calcification of falx cerebri
- Rib anomalies
- Palmar/plantar pitting
- Medulloblastoma

Front 16

Orthokeratinized Odontogenic cyst

Back 16

Odontogenic cyst with orthokeratinized epithelium
- No increased risk for recurrence like in OKC
- May be associated with an impacted tooth

Front 17

Calcifying odontogenic cyst characteristics, histology, treatment

Back 17

20% extraosseous and associated with unerupted teeth.

Histology
- Fibrous connective tissue lined by palisading Ameloblastic-like epithelium
- Contains ghost cells which are altered epithelial cells that have lost their nuclei

Treatment
- Enucleation with peripheral ostectomy
- Long term followup because some tumors are more aggressive
- Ghost cells may calcify and show radiopacities

Front 18

Nasolabial cyst characteristics, histology,

Back 18

aka Nasoalveolar cyst
- Rare soft tissue cyst of upper lip not in bone
- Comes from epithelial remnants from nasolacrimal duct or after fusion of processes

Histology
- Show pseudostratified columnar epithelium. Respiratory epithelium

Front 19

Globullomaxillary Cyst

Back 19

A term used to describe an anatomic location and is not a diagnosis
- Presents as an inverted pear shaped in between the maxillary lateral and canines

Front 20

Most common non-odontogenic cyst of oral cavity source, radiograph, histology

Back 20

Nasopalatine cyst
- Arise from epithelial remnants of nasopalatine duct

Radio
- Superimposition with nasal septum shows classic heart shape

Varying histology ranging from pseudostratified columnar to simple columnar to cuboidal

Front 21

Incisive papilla cyst

Back 21

Soft tissue Nasopalatine cyst with no bone involvement
- Found in same area

Front 22

Median palatine cyst

Back 22

More posteriorly placed nasopalatine duct cyst

Front 23

Median mandibular cyst

Back 23

Describes a cyst in the particular location
- In between two halves of the mandible

Front 24

Surgical ciliated cyst of the Maxilla

Back 24

Occurs after trauma or iatrogenic sinus surgery
- Portion of the sinus lining is separated from the sinus and forms epithelial lined cavity in the bone

Front 25

Aneurysmal bone cyst characteristic, d/d, treatment

Back 25

Intraosseous blood filled sinuses not lined by endothelium
- Histology shows multinucleated giant cells with extravasated RBC
- So can have similar histology to CGCG, Cherubism, Brown tumors

Treatment
- Vascularity is low flow unlike central hemangioma
- Irradiation is contraindicated and may cause angiosarcoma

Front 26

Antral Pseudocyst

Back 26

Not epithelial lined
- Forms between sinus epithelial lining and the bone
- Appears as dome shaped elevation of floor of sinus

Front 27

Traumatic Bone cyst characteristics and radio

Back 27

- Empty fluid filled cavity in bone that does not have epithelial lining
- Teeth are vital and responsive

- Shows scalloping around and between roots

- Associated with Florid COD

Front 28

Stafne Bone cyst

Back 28

- Asymptomatic focal concavity on the lingual aspect of the mandible below the canal

Front 29

Dermoid cyst characteristics, histology

Back 29

Usually found in anterior floor of mouth
- Feels doughy or rubbery

- Contains skin appendages. Adnexal structures such as sebaceous glands and hair follicles

Front 30

Epidermoid cyst

Back 30

Abundant in Gardner's syndrome but unlike dermoid cysts, does not show adnexal structures

Front 31

The most common developmental cyst of neck

Back 31

Thyroglossal duct cyst
- Classic cyst at midline

Front 32

Branchial cleft cyst

Back 32

aka Cervical lymphoepithelial cysts
- Presents as a soft swelling located on lateral aspect of the neck

- Multiple lymphoepithelial cysts bilaterally indicates HIV

Front 33

White blood cells

Back 33

Eosinophil - Purple nucleus with red granules
Monocyte - One U shaped nucleus
Neutrophil - Multilobed nucleus
Plasma cells - Eccentric Soccer ball shaped ncleus
Histiocyte - Foamy looking cell
Basophil Purple nucleus with besophilic granules

Front 34

Major components of Acute inflammation and Chronic inflammation

Back 34

Acute:
Vascular and Exudative

Chronic:
Proliferative phase and Granulation tissue

Front 35

Periapical granuloma

Back 35

Area of chronic inflammation at the apex of a nonvital/nonresponsive tooth
- Appears first as widening of PDL space then radiolucency
- Radiographically indistinguishable from other unilocular radiolucent lesions

Front 36

Abscess, Cyst, Granuloma

Back 36

Abscess - With or without epithelial lining. Lumen filled with WBC and necrotic tissue. Predominantly Acute inflammatory cells

Cyst - Epithelial lined. Lumen filled with cellular debris. Contains chronic inflammatory cells

Granuloma - No epithelium. No lumen, just granulation tissue. Filled with Chronic inflammatory cells

Front 37

Chronic hyperplastic pulpitis

Back 37

Excessive growth of chronically inflammed pulp
- Most common in deciduous molars and composed of granulation tissue and surface exposure into the oral cavity

Front 38

Pulp calcifications

Back 38

- Dentin dysplasia type 2
- Pulpal dysplasia
- Ehler-Danlos syndrome type 1
- Tumoral Calcinosis
- Calcinosis Universalis

Front 39

Odontogenic tumors

Back 39

Epithelial
- Ameloblastoma
- Calcifying epithelial odontogenic tumor
- Adenomatoid odontogenic tumor
- Squamous odontogenic tumor
- Clear cell odontogenic tumor

Mesenchymal
- Odontogenic fibroma
- Odontogenic myxoma
- Granular cell odontogenic tumor
- Cementifying fibroma
- Cementoblastoma

Mixed
- Ameloblastic Fibroma/Fibrosarcoma
- Ameloblastic fibro-odontoma
- Odontoma

Front 40

Sexes

Back 40

Cyst: Male > Female except Nasolabial

Everything else: Female >Male except Osteosarcoma and Pagets

Front 41

Associated with Impacted or unerupted teeth

Back 41

Most odontogenic cysts & AACO, AAO, CCC

Ameloblastoma unicystic
AOT
CEOT
Ossifying fibroma

AF
AFO
Odontoma

COC
Cleidocranial
Cherubism

Front 42

Capsulated

Back 42

AF
AFO
Adenoid odontogenic tumor
Dermoid cyst
Ossifying fibroma

Front 43

Inductive

Back 43

COC
AOT
AF
AFO
Odontoma

Front 44

Mixed RL/RO

Back 44

Coc, AAC, AO, OF, PCOD

- COC
- Ameloblastoma desmoplastic
- AOT
- CEOT

- AFO: Due to odontomas
- Odontoma

- Ossifying fibroma
- Periapical COD