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The Radiology of Oral and Perioral Cysts

The Radiology of Oral and Perioral Cysts. Juan F. Yepes, DDS, MD, MPH Assistant Professor Division of OD, OM, OMFR Department of Oral Health Practice UKCD ODM 820 Spring 2009. Cyst. Pathologic cavity filled with fluid, lined by epithelium, and surrounded by a connective tissue wall.

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The Radiology of Oral and Perioral Cysts

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  1. The Radiology ofOral and Perioral Cysts Juan F. Yepes, DDS, MD, MPH Assistant Professor Division of OD, OM, OMFR Department of Oral Health Practice UKCD ODM 820 Spring 2009

  2. Cyst Pathologic cavity filled with fluid, lined by epithelium, and surrounded by a connective tissue wall. The cyst fluid either is secreted by the cells lining the cavity or derives from the surrounding tissue Fluid.

  3. Cyst • Cyst occur more often in the jaws because most • cysts originate from the rest of odontogenic • epithelium that remain after tooth formation. • Cyst are radiolucent lesions • Usually asymptomatic **** (infection) • Related with missing teeth

  4. Cyst Radiographic Features: Location Cyst may occur centrally in any location in the maxilla or mandible Cyst are rare in the condyle and the coronoid process A few cyst arise in the soft tissues of the orofacial region Periphery Radiolucent Well defined and corticated However a secondary infection can change this

  5. Cyst Radiographic Features: Shape Cyst are usually round or oval, resembling a fluid filled ballon Some cyst may have a scalloped borders Internal Structure Cyst are often totally radiolucent Long standing cyst may have some calcifications inside Some cyst have septa

  6. Cyst Radiographic Features: Effects on Surrounding Structures Cyst grow slowly Sometimes displacement and resorption of the teeth Cyst can expand the mandible

  7. Cyst • Radicular Cyst • Residual Cyst • Dentigerous Cyst • Buccal bifurcation cyst • Odontogenic Keratocyst • Basal cell nevus syndrome • Lateral Periodontal Cyst • Calcifying odontogenic Cyst Odontogenic Cyst Non-Odontogenic Cyst

  8. The Radiology of Oral and Perioral Cysts Embryonic epithelial precursor Adult epithelial derivative Surface epithelium Rests of Serres Gingival Cyst (Dentigerous Cyst if Crown involved) Reduced Enamel Epithelium Dentigerous Cyst Rest of Malassez Radicular cyst

  9. The Radiology of Oral and Perioral Cysts Odontogenic Cysts Nonodontogenic Cysts

  10. The Radiology of Oral and Perioral Cysts Radicular Cyst Dental Cyst

  11. The Radiology of Oral and Perioral Cysts Radicular Cyst Periapical cyst, Dental cyst Radicular cyst is a cyst most likely originated when rest of epithelial cells (Malassez) in the periodontal ligament are stimulated to proliferate and undergo cyst degeneration by inflammatory products from a non-vital tooth. Most common cyst in the jaws They arise from non-vital teeth Asymptomatic, unless secondary infection occurs

  12. The Radiology of Oral and Perioral Cysts • Radicular Cyst • Periapical cyst, Dental cyst • In most cases the epicenter of the RC is located at the apex • 60% are found in the maxilla, especially around incisors and canines • Well defined cortical border, if secondary infected, the inflammatory • reaction may result in loss of the cortical bone • Internal structure  Radiolucent

  13. The Radiology of Oral and Perioral Cysts • Radicular Cyst • Periapical cyst, Dental cyst • Differential Diagnosis • RO : Granuloma – Cyst – Abscess • Odontogenic Keratocyst • Lateral periodontal Cyst

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  32. The Radiology of Oral and Perioral Cysts Dentigerous Cyst Follicular Cyst

  33. The Radiology of Oral and Perioral Cysts Dentigerous Cyst A dentigerous cyst is a cyst that forms around the crown of an unerupted tooth. It begins from accumulation in the layers of reduced enamel epithelium or between the epithelium And the crown of the unerupted tooth. Second most common cyst in the jaws They develop around the crown of an unerupted or supernumerary tooth

  34. The Radiology of Oral and Perioral Cysts • Dentigerous Cyst • Radiology Features • The epicenter is just above the crown of the involved tooth • The cyst is attaches at the CEJ • Very often are quite big before diagnosis • Well defined cortex • Completely radiolucent

  35. The Radiology of Oral and Perioral Cysts • Dentigerous Cyst • Radiology Features • DG often displace and resorb adjacent teeth • Displaces the associated tooth in a apical direction • Differential Diagnosis - Hyperplastic follicle • - OKC: Less likely resorb teeth • Attach more apical • - Cystic ameloblastoma

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