cysts of the jaws

Definition : The jaws are host to a variety of cysts due in large part to the tissues involved in tooth formation.

Cysts derived from odontogenic epithelium are called odontogenic cysts; those that originate from other epithelial structures are known as non-odontogenic cysts.

Within the odontogenic cysts, one discerns between developmental and inflammatory. The inflammatory cysts are thought to arise from inflammation-induced epithelial proliferation with subsequent central liquefaction. The developmental cysts lack a clear-cut aetiology.

Unless stated specifically, all cysts are cured by simple enucleation and do not show any tendency to recur.

From a practical view, the radicular cyst, the dentigerous cyst and the odontogenic keratocyst are the most important, as they have the highest incidence. All other cyst types are very rare.

Types

 odontogenic cysts
 non-odontogenic cysts

 odontogenic cysts

• inflammatory
  • radicular cyst
  • residual cyst
  • paradental cyst

• developmental
  • dentigerous cyst
  • lateral periodontal cyst
  • botryoid odontogenic cyst
  • glandular odontogenic cyst
  • odontogenic keratocyst (keratocystic odontogenic tumour )
  • gingival cyst

 non-odontogenic cysts

• nasopalatine duct cyst
• nasolabial cyst
• surgical ciliated cyst

Localization

 mandibular cysts
 maxillary cysts

Diagnostic of cysts of the jaws

 associated with unerupted tooth and no basal layer palisading, no corrugated surface, no parakeratosis, mucus-producing columnar cells

• dentigerous cyst

 mucus-producing columnar cells

• dentigerous cyst

 palisaded basal layer, corrugated surface, parakeratosis

• keratocystic odontogenic tumor

 ameloblastomatous change

• ameloblastoma
  • unicystic vs cystic with wall invasion

 no history or radiographic information

• "squamous lined cyst" with no features of keratocystic odontogenic tumor or ameloblastoma

 cyt of the jaws with calcifications

Types

 periapical cyst / radicular cyst

• A periapical cyst, also known as a radicular cyst, is inflammatory, develops from a periapical granuloma, and is associated with the root of a tooth. It is most common in the anterior maxilla. It shows a stratified squamous epithelium and fibrous capsule with mixed (mostly acute) inflammation. It is the most common odontogenic cyst, and most common cyst of the jaw.

 keratocystic odontogenic tumor / keratocyst

• Keratocystic odontogenic tumor (odontogenic keratocyst), is a neoplastic cyst usually in the posterior jaw, lined by parakeratotic epithelium with a hyperchromatic, palisaded basal layer and wavy surface. It is associated with nevoid basal cell carcinoma syndrome / Gorlin’s syndrome.

 dentigerous cyst - follicular cyst

• A dentigerous cyst is usually associated with impacted teeth (third molars, maxillary canines).
• It has stratified squamous epithelium and may or may not be inflamed.
• It is the second most common odontogenic and jaw cysts , behind periapical cysts.

Paywall References

 Lesions of the jaws. Slootweg PJ. Histopathology. 2009 Mar;54(4):401-18. Epub 2008 Jul 11. PMID: 18637149

 Pattern of Odontogenic and Nonodontogenic Cysts. 2011.
doi : 10.1097/SCS.0b013e3182323fbe