Skip to Main Content

++

Cysts of the maxilla and mandible are common occurrences. Bone cysts occur more frequently in the jawbones than in any other bone because of the presence of epithelium from odontogenic elements (eg, teeth) and nonodontogenic epithelial remnants of embryonic structures.

++

A cyst is defined as an epithelial-lined pathologic cavity that may contain fluid or a semisolid material. A group of cystic lesions devoid of an epithelial lining is classified as pseudocysts. A jaw cyst is usually located deep within the jawbone, but it may occur on a bony surface, producing a saucerization.

++

Essentials of Diagnosis

++

  • Well-defined, totally or predominantly radiolucent, and sometimes expansile lesions.
  • Usually slow growing and benign.
  • Initially asymptomatic unless long-standing with significant enlargement or secondary infection.
  • Usually initially discovered on routine dental X-rays.
  • Requires histopathologic examination for diagnosis.

++

General Considerations

++

Jaw cysts encompass a group of lesions that are variable in their incidence, etiology, location, clinical behavior, and treatment. The most common jaw cyst is the radicular cyst, which is odontogenic and inflammatory in nature. The odontogenic developmental cyst is the second most common jaw cyst. Nonodontogenic cysts, pseudocysts, and ganglionic cysts of the temporomandibular joint (TMJ) are much less common. Cysts occur in both the mandible and the maxilla: inflammatory radicular cysts occur around the roots of nonvital teeth; odontogenic developmental dentigerous cysts and keratocysts occur in the common regions of impacted and unerupted teeth; nonodontogenic developmental cysts are found in regions of epithelial embryonic remnants; pseudocysts usually present in site-specific regions; and ganglionic cysts develop in the TMJ. Each type of jaw cyst usually has a specific behavior pattern, ranging from small 5- to 6-mm osteolytic defects to massive involvement of the jaw and contiguous structures.

++

Classification of Jaw Cysts

++

The classification of jaw cysts includes (1) odontogenic cysts, (2) nonodontogenic cysts, and (3) pseudocysts. The ganglion cyst, which presents in the TMJ, has been added to this conventional classification for completeness; it is significant to clinicians managing the pathology of the head and neck region.

++

Pathogenesis

++

The pathogenesis of jaws cysts varies according to the specific cyst type. Inflammatory cysts derive their epithelial lining from the proliferation of odontogenic epithelium within the periodontal ligament; dentigerous developmental cysts result from the proliferation of reduced enamel epithelium. Figure 25–1 illustrates the development of dentigerous and radicular cysts. Cystic lesions may also result from cortical bone defects or trauma, they may represent reactive lesions, or they may have an unknown pathogenesis. It has been shown that there is an osmotic pressure gradient that produces fluid accumulation within the cyst lumen and generates pressure, creating cyst expansion.

++
Figure 25–1.
Graphic Jump Location

(A) Development of the dentigerous cyst around the crown of an unerupted tooth. (B) Development of a radicular cyst ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.