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Non odontogenic cyst

  1. 1. Fissural cysts of oral origin  Nasopalatine duct cyst  Median palatal cyst  Globulomaxillary cyst  Median mandibular cyst  Nasolabial cyst  Palatal and alveolar cyst of new born (Epstein’s pearls and Bohn’s nodules)  Thyroglossal cyst  Epidermal inclusion cyst  Dermoid cyst  Heterotopic oral gastrointestinal cyst Lymphoepithelial cyst
  2. 2.  Most common non odontogenic cyst  Midline anterior maxilla  Persistence of epithelial remnants  Stimulus – trauma, infections Clinical features  Males, wide age range  Small cyst- asymptomatic  Large cyst- fluctuant swelling, discharge & pain  Salty taste in mouth, devitalization of pulp  Tooth displacement  Extra bony cyst- soft tissue of incisive papilla- bluish colour dome shaped swelling
  3. 3. Treatment : enucleation
  4. 4.  Line of fusion of palatal processes of maxilla  Mid line of hard palate between lateral palatal processes  Swelling – asymptomatic  Radiographic- well circumscribed radiolucent area bordered by sclerotic bone  H/P- stratified squamous epithelium, dense fibrous connective tissue, chronic inflammatory cell infiltration.  Pseudostratified ciliated columnar epithelium – occasionally  Treatment – surgical removal + curettage
  5. 5.  Between maxillary lateral incisor and canine  Epithelial entrapment between medial nasal process and maxillary process  Bone suture between premaxilla and maxilla  Often asymptomatic, pain – if infected  Incidental finding in radiograph  Inverted pear shape radiolucency between lateral incisor and cuspid causing divergence of roots
  6. 6. Treatment Surgical removal with preservation of teeth
  7. 7.  Rare swelling in the mucolabial fold and in the floor of the nose  not visible on radiograph  h/p – pseudostratified columnar epithelium, sometimes with stratified squamous epithelium  Treatment – careful surgical excision to prevent perforation of the floor of the nose
  8. 8.  Extremely rare  Midline of mandible  Epithelial remnants entrapped in the median mandibular fissure  Asymptomatic expansion of cortical plates  Incidental radiographic finding  Unilocular / multilocular, well circumscribed radiolucency  h/p – thin, stratified squamous epithelium with many folds  Treatment – surgical excision with preservation of teeth
  9. 9. Epstein’s pearls Bohn’s nodules Entrapment of epithelial remnants From Palatal glandular structures
  10. 10. h/p – thin stratified squamous epithelium, connective tissue stroma, Lumen- filled with keratin (onion rings) Treatment – no treatment required
  11. 11.  Rare, benign, midline neck mass  Dilation of a remnant at the site where the primitive thyroid descended from its origin at the base of the tongue to the neck  Palpable, asymptomatic, moves with swallowing  h/p – stratified squamous epithelium, ciliated columnar epithelium, connective tissue wall containing patches of lymphoid tissue, thyroid tissue and mucous glands  Treatment – Antibiotics, if infected Surgical excision of cyst, path’s tract and branches
  12. 12.  Implantation of epidermal elements  Source is often the infundibulum of hair follicle  Asymptomatic, slow growth  3rd to 4th decade of life  Foul smelling , cheesy discharge  Firm, round, mobile, subcutaneous nodules  In oral location, it causes difficulty in feeding, swallowing and phonation  h/p– Stratified squamous epithelium with glandular differentiation, filled with keratin Calcifications in connective tissue, malignant transformation of epithelium is common  Treatment – surgical removal  Prognosis – malignant transformation: poor prognosis
  13. 13.  Hamartomatous tumor, multiple sebaceous glands, skin adnexa (nails, dental, cartilage, bone)  Occurs on skin of face, neck, scalp  Intra cranial, intra abdominal, ovary  3 sub classes : epidermoid cyst, dermoid cyst & teratoid cyst  h/p – lined by epidermis possessing epidermal appendages, hair projecting in lumen, sebaceous glands  Treatment – surgical excision
  14. 14.  Esophagus, small intestine, thoracic cyst, pancreas, gall bladder  Oral cysts lined by gastric or intestinal mucosa  Tongue, floor of the mouth  Any age, males  Asymptomatic small nodule  h/p – lined by stratified squamous epithelium as well as gastric mucosa  Treatment – surgical excision
  15. 15.  Benign lymphoid aggregate  Cervical – branchial cleft cyst  Entrapped duct epithelium in the lymph nodes  Movable painless sub mucosal nodule, ~0.6cm in diameter  Intra orally floor of the mouth, tongue, soft palate, tonsils  Ruptured to release foul tasting cheesy keratinaceous material  h/p – atrophic stratified squamous epithelium, no rete ridges, minimal granular layer, goblet cells  Treatment – surgical excision, no malignant potential.

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