The cyst is a hollow cavity of the pathological epithelium that fills with fluid or soft material and usually grows from the internal pressure produced by the fluid being drawn into the cavity of the osmosis (hydrostatic pressure). The bone of the jaw, the lower jaw and the upper jaw, is the bone with the highest prevalence of cysts in the human body. This is because of the large amount of residual epithelium remaining in the jawbone. Tooth enamel is formed from the ectoderm (the precursor layer of germs on the skin and mucosa), so that epithelial remains can be left in the bone during odontogenesis (dental development). The jaw bones develop from embryological processes that merge together, and the ectodermal tissue can be trapped along this fusion line. These "rest" epithelium (also termed cells) are usually inactive or atrophic, but when stimulated, may form cysts. The reason why epithelial rest can proliferate and undergo cystic transformation is generally unknown, but inflammation is considered to be a major factor. The high prevalence of tooth impaction and dental infection that occurs in the jawbone is also significant to explain why cysts are more common in these sites.
Cysts that emerge from the tissue (s) that normally develop into teeth are referred to as odontogenic cysts. Other cysts in the jaw are called non-odontogenic cysts. Non-odontogenic cysts are formed from tissues other than those involved in dental development, and consequently may contain structures such as the epithelium of the nose. When the cyst grows from hydraulic pressure, causing the surrounding bone to be resorb, and can cause movement of teeth or other vital structures such as nerves and blood vessels, or absorb tooth roots. Most cysts do not cause any symptoms, and are found on routine dental radiography. Some cysts may not require any treatment, but if treatment is necessary, it usually involves several small operations to remove the cyst partially or completely in one or two stages of the procedure.
Video Cysts of the jaws
Classification
odontogenic cyst
Odontogenic cysts have a histologic origin in the tooth structure cells. Some are inflammatory while others are progressive.
- Radicular cyst is the most common (up to two thirds of all cysts in the jaw). This inflammatory cyst is derived from the pulp necrosis reaction of the tooth.
- Dentigerous cyst , the second most common cyst, associated with an unerupted tooth crown.
- odontogenic keratocyst , which is now considered a tumor, and is therefore called keratosistik odontogenic tumor . These lesions may be associated with Nevoid basal cell carcinoma syndrome.
- bucurcation cysts that appear in the bucurcation area of ​​the mandibular first molar bifurcation in the second half of the first decade of life.
- Eruption cyst; a small cyst in the gingiva when the tooth erupts, formed from a worsening tooth follicle
- Primordial cyst; previous thoughts as unique entities. Most primordial cysts have been shown to be keratocystic odontogenic tumors
- orthokeratinized odontogenic cysts; variant of the Keratocystic odontogenic tumor
- Gingival cysts in newborns; inclusion cysts from dental lamina remanents in the newborn gingiva
- Gingival cysts in adults; soft tissue variant of the lateral periodontal cyst
- Lateral periodontal cysts; non-inflammatory cyst (vs radicular cyst) on the tooth side derived from dental lamina remanent
- Reduces odontogenic cysts; rare lesions with cystic and neoplastic features and significant diversity in presentation, histology and prognosis
- Glandular odontogenic cysts; respiratory cysts such as epithelial lining and the potential for recurrence with characteristics similar to the central variant of low grade mucoepidermoid carcinoma
Developmental/non-odontogenic cyst
There are several developmental cysts on the head and neck that are mostly formed in soft tissue rather than bone. There are also several cysts, previously thought to originate from epithelial remanents trapped in embryonic fusion lines, most of which are now believed to originate from odontogenic or have unknown causes. Their names are included for the sake of completeness.
Developmental cyst of the jaw
- Nasopalatine duct cyst , the most common jaw development cyst, appears only in the maxillary midline.
The soft tissue development cyst around the jaw
- The newborn's cyst palate (Epstein pearl)
- Nasolabial cyst (nasoalveolar cyst)
- Skin epidermoid cyst
- Dermoid cyst
- Thyroglossal duct sacs
- Branchial branch cyst (Cervical lymphoepithelial cyst)
- Oral lymphoepithelial cyst
Causes of the development of the underlying cause
- Globulomaxyl cyst
- Median median cyst
- Median mandibular cyst
Maps Cysts of the jaws
Signs and symptoms
Cysts rarely cause any symptoms, unless they become secondary infected. The signs depend on the size and location of the cyst. If the cyst has not developed beyond the normal anatomical bone limit, there will be no lumps palpated outside or inside the mouth. Most cysts dilate slowly, and the bone around it has time to increase its density around the lesion, which is the body's attempt to isolate the lesion. Cysts that have evolved beyond the normal anatomical borders are still often covered with a new thin layer of bone. At this stage, there may be a sign called "cracked eggshell", in which thin cortical plates are cracked when pressure is applied. The lump can be felt, which may feel hard if there is still a bone covering the cyst, or fluctuate if the cyst has eroded through the bone around it. The cyst can become acutely infected, and out into the oral cavity through the sinuses. The adjacent teeth can be loosened, tilted or even physically moved. Rarely, the root of the tooth is resorbed, depending on the type of cyst. The inferior alveolar nerve runs through the mandible and supplies the sensation to the lower lip and chin. Since most cysts grow slowly, there will be no altered sensations (anesthesia or paresthesias), because the inferior alveolar canal is harmlessly enveloping or migrating over time. More aggressive cysts, or acute infections in any cyst can cause an altered sensation.
Diagnosis
Most cysts are found to be accidental findings on routine dental radiography. On x-rays, the cyst appears as a radiolucent (dark) area with a radiopaque (white) boundary. Cysts are usually unilocular, but may also be multilocular. Sometimes aspiration is used to aid in the diagnosis of cystic lesions, such as fluid aspiration from radicular cysts may appear colored like straw and glossy appearance due to cholesterol content. Almost always, the cyst lining is sent to a pathologist for histopathological examination after surgery is removed. This means that a definite diagnosis of this type of cyst is often made in retrospect.
Treatment
When treatment is required, this is usually by surgical removal of the cyst. There are four ways in which a cyst is administered:
- Enucleation - removal of all cysts
- Marsupialization - making windows into cyst walls, allowing the contents to be dried. The window is left open, and the lack of pressure inside the cyst causes the lesion to shrink, as the surrounding bone begins to refill.
- Enucleation after marsupialization - Sometimes marsupialization is performed as a single procedure, but usually followed by a second procedure to remove the cyst. This is especially true when the cysts are very large and their removal will leave significant surgical defects.
- Enucleation with curettage - this is the removal of the cyst and some of the surrounding bone, which may contain several layers of cysts.
Prognosis
The prognosis depends on the type, size and location of a cyst. Most cysts are completely benign, and some may not require treatment. Rarely, some cystic lesions are an aggressive localized tumor that can cause damage to the surrounding bone if left untreated. This type of cyst is usually removed with healthy bone margins to prevent recurrence of new cysts. If the cyst expands to a very large size, the mandible may weaken so that pathologic fracture occurs.
Epidemiology
Radicular cysts are by far the most common cysts in the jaw.
References
Source of the article : Wikipedia
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