Cysts of the Jaws

Classification of Cysts
Dr Vijay Wadhwan
Oral Pathology & Microbiology Sharad Pawar Dental College ,Sawangi (M) Wardha.

CYSTS

Kramer (1974) has defined a cyst as A pathological cavity having fluid, semifluid or gaseous contents and which is not created by the accumulation of pus.

 Most cysts, but not all, are lined by epithelium (True cysts)
Odontogenic keratocyst Dentigerous cyst Nasopalatine duct cyst etc.

 Non epithelium lined cysts (Pseudocysts)

Mucous extravasation cyst Aneurysmal bone cyst Solitary bone cyst.

Reichart and Philipsen prefer to describe these as cavities rather than cysts.

 Evidence of cystic lesions in the jaws of humans and other animals in the distant past. Lesions have been found in mummified specimens from the predynastic era (c.4500 bc) and from the 5th dynasty (c.2800 bc) in Egypt. Early descriptions were written by Aulus Cornelius Celsus (early part of 1st century), Pierre Fauchard (16901762) and John Hunter (17291793).

 1850, papers on the nature and treatment of jaw cysts became more frequent. Paul Brocas classification of odontomas (1866) which included odontogenic tumours, cysts and malformations.

 During the 20th century

The first (1971) and second (1992) editions of Histologic Typing of Odontogenic Tumors issued by WHO, included classification, definitions and histological descriptions of cysts of the jaws. However, since 1992 no updated classification or monographs on jaw cysts have been published. In the WHO classification of Head and Neck Tumours (1995), cysts were excluded.

 Cysts of developmental origin may be either:

Odontogenic, meaning arising from odontogenic tissues Non-odontogenic, meaning cysts arising from ectoderm involved in the development of the facial tissues

Classification by etiology
Developmental I Gingival cyst of infants ii Odontogenic keratocyst iii Dentigerous cyst iv Eruption cyst v Gingival cyst of adults vi Developmental lateral periodontal cyst vii Botryoid odontogenic cyst viii Glandular odontogenic cyst ix Calcifying odontogenic cyst

 Inflammatory i. Radicular cyst, apical and lateral ii Residual cyst iii Paradental cyst and juvenile paradental cyst iv Inflammatory collateral cyst

By tissue of origin
Rests of malassez
Periapical. radicular

Reduced enamel epithelium

Dentigerous, Eruption

Dental lamina
OKC, Gingival cyst of adults & Newborn, Lateral Periodontal cyst, GOC

Unclassified
Paradental, CEOC

 Cysts of the jaws Cysts associated with the maxillary antrum Cysts of the soft tissues of the mouth, face, neck and salivary glands The cysts of the jaws are divided into those that are:
Epithelial lined Not epithelial lined

The epithelial-lined cysts may be either of:

Developmental origin Inflammatory origin

I Cysts of the jaws Epithelial-lined cysts Developmental origin A) Odontogenic i Gingival cyst of infants ii Odontogenic keratocyst iii Dentigerous cyst iv Eruption cyst v Gingival cyst of adults vi Developmental lateral periodontal cyst vii Botryoid odontogenic cyst viii Glandular odontogenic cyst ix Calcifying odontogenic cyst

B) Non-odontogenic i Midpalatal raph cyst of infants ii Nasopalatine duct cyst iii Nasolabial cyst Inflammatory origin i Radicular cyst, apical and lateral ii Residual cyst iii Paradental cyst and juvenile paradental cyst iv Inflammatory collateral cyst Non-epithelial-lined cysts
Solitary bone cyst Aneurysmal bone cyst

II Cysts associated with the maxillary antrum

Mucocele Retention cyst Pseudocyst Postoperative maxillary cyst

III Cysts of the soft tissues of the mouth, face and neck
Dermoid and epidermoid cysts Lymphoepithelial (branchial) cyst Thyroglossal duct cyst Anterior median lingual cyst (intralingual cyst of foregut origin) Oral cysts with gastric or intestinal epithelium (oral alimentary tract cyst) Cystic hygroma Nasopharyngeal cyst Thymic cyst Cysts of the salivary glands: mucous extravasation cyst; mucous retention cyst; ranula; polycystic (dysgenetic) disease of the parotid Parasitic cysts: hydatid cyst; Cysticercus cellulosae; trichinosis