Cysts Of The Jaws

Cysts Of The Jaws

Describe the cysts of jaw and their management.

Answer. Cyst is defied as “A pathological cavity having flid,semiflid or gaseous contents and which is not created by accumulation of pus.” Kramer (1974)

Classification of Cyst of Jaw by Mervin Shear

Cysts of the Jaws:

Epithelial:

Developmental:

Odontogenic

“Comprehensive Overview Of Jaw Cyst Symptoms”

Read and learn More Cysts: Types, Causes, Symptoms, and Treatment

• Gingival cyst of infants
• Odontogenic keratocyst (neoplasm)
• Dentigerous cyst
• Eruption cyst
• Lateral periodontal cyst
• Gingival cyst of adults
• Botryoid odontogenic cyst
• Glandular odontogenic cyst
• Calcifying odontogenic cyst (neoplasm).

“Can Impacted Teeth Cause Jaw Cysts”

Non-odontogenic

• Naso palatine duct cyst
• Nasolabial cyst
• midpalatal raphe cyst of infants
• Median palatine, median alveolar
• Median mandibular cyst
• Globulo maxillary cyst.

Inflammatory:

• Radicular cyst, apical and lateral
• Residual cyst
• Paradental cyst and mandibular infected buccal cyst
• Inflmmatory collateral cyst.

Non epithelial: (Pseudocysts)

• Solitary bone cyst
• Aneurysmal bone cyst.

“Effective Ways To Manage Jaw Cyst Recovery”

Cyst associated with maxillary antrum:

• Benign mucosal cyst of the maxillary antrum
• Post operative maxillary cyst.

Cyst of the soft tissues of mouth, face and neck:

• Dermoid and epidermoid cyst
• Lymphoepithelial cyst (Brachial cyst)
• Thyroglossal duct cyst.
• Anterior medial lingual cyst (Intra lingual cyst of foregut origin)
• Oral cyst with gastric or intestinal epithelium
• Cystic hygroma
• Nasopharyngeal cyst
• Thymic cyst
• Cyst of salivary glands: mucous extravasation cyst,mucous retention cyst, ranula, polycystic disease of the parotid.
• Parasitic cyst: hydatid cyst, cysticercus cellulosae,trichinosis.

“Best Practices For Jaw Cyst Surgical Management“

Management of Cysts of the jaw

Cysts of the Jaws is also known as parts operation.

Cysts of the Jaws Principle

• Marsupialization or decompression, refers to creating a surgical window in the wall of the cyst and evaluation of the cystic contents.
• This process decreases intracystic pressure and promotes shrinkage of the cyst and bone fil.

Cysts of the Jaws Method

• The area is anesthetized with local anesthesia.
• The incision should be long enough to provide good exposure (circular/oval).
• In edentulous patient, incision is given along the crest of ridge and in dentulous patient, the incision is given around the neck of teeth.
• Incision is given bucally or lingually depending on location of cyst.
  Mucoperiosteal flp is raised.
• The character of underlying bone is determined. If this layer of bone is present on cyst, it is carefully peeled of with periosteal elevator.
  If the bone over the cyst is intact, a window is made with a bur/chisel in the postage stamp method.
• Window is enlarged with rongeurs.
• An incision shaped like St Andrew and cross is made on the cyst lining.
• Fluid content of cyst is evaluated with suction.
• Four triangular flps created are turned outwards and sutured with mucoperiosteum.
• The cavity is packed with the gauge in iodoform or white head varnish.
• If the cyst lining is friable as in infected cyst, be sutured with mucoperiosteum the gauge is used to hold the cyst lining and mucoperiosteum together.
• One week later, the gauge is removed. Sutures also, by new union occur between the lining and new periosteum.
• Now a plug is made to maintain the opening of cavity patent and prevent food from entering the cavity.
• The plug is worn continuously but removed after meals.
• The cavity is irrigated with syringe.
• The plug is never made of full cavity depth because it interferes with bone regeneration of the cavity.
• The size of the plug (depth) is decreased gradually as the cavity is filled with bone.
• Finally the mucoperiosteum is closed with sutures.

Cysts of the Jaws Enucleation

Cysts of the Jaws Method

• The area is anesthetized by local anesthesia.
• Incision should be long enough to provide good exposure and at the end of operation flp edge must rest on healthy bone.
• In edentulous patient incision is given along the crest of ridge and in edentulous patient, it is given around the neck of the teeth.
• The incision is given facially or lingually depending on the location of the cyst.
• The mucoperiosteal flap is raised.
• The character ofunderlying bone is determined. Ifthinlayer of bone is present on cyst, it is carefully peeled of with periosteal elevator.
  If the bone over a cystis intact, a window is made with bur or chisel in the postage stamp method.
• The window is enlarged with rongeurs forceps to allow complete enucleation.
• Care is taken not to puncture the cyst wall because the intact cyst is removed easily.
• The cyst lining is gently separated from the cavity wall using the periosteal elevator or curette/Mitchell trimmer/spoon excavator.
  The convex surface of the blade is kept facing the lining of the cyst.
• If the cyst lining is difficult to separate from the cavity wall or nasal or antral lining use H2O2 gauge packing and then perform blunt dissection.
• A plane of cleavage is used to remove the cystic sac in one piece.
• If any tooth or root is involved in a cyst it is either extracted or
• The cavity is cleaned, debrided, irrigated, and inspected.
• Bony margins are smoothened.
• Bleeding is checked and flp is re-positioned.
• Wound is closed with interrupted suture.
• Sutures are removed after 6 to 7 days.
• Routine analgesics and antibiotics are prescribed to prevent postoperatory pain and infection.

“The Role Of Imaging Tests In Diagnosing Jaw Cysts”

Cysts of the Jaws Decompression Followed by enucleation

• Decompression of a cyst relieves the pressure within the cyst and causes it to grow.
• It is performed by making a small opening in the cyst and keeping it open with drain.
• Cyst is kept open initially by medicated gauze pack and an acrylic plug.
• Bone regeneration occur and cavity reduces in size
• This technique is not a defiitive treatment but allows a second stage of enucleation to be undertaken on much smaller lesion which would have been impossible.