Jaw cyst

Introduction Jaw cyst refers to the appearance of a fluid cystic mass in the jaw, which gradually increases and the jaw expands and destroys. According to the pathogenesis, it can be divided into two types: odontogenic and non-dental, odontogenic. The cyst is evolved from the tooth tissue or the tooth. Non-dental cysts can be formed by the epithelium remaining in the jaw bone during embryonic development, such as facial fissure cysts, blood extravasation cysts caused by injury, and aneurysmal bone cysts. Cysts are more common in adolescents. Initially no symptoms. If the growth continues, the bone gradually expands to the surrounding area, and a facial deformity is formed, and corresponding local symptoms may occur according to different parts.

Cause

The etiology of this disease needs to consider the following factors: odontogenic jaw cysts, non-dental jaw cysts.

Jaw cysts can be classified according to the source of the tissue and the site of the disease. They are derived from the epithelial or epithelial growth of the dentition tissue or the tooth. They are called odontogenic jaw cysts, cysts caused by residual epithelium in the embryonic period. Hemorrhagic fluid cysts caused by injury and aneurysmal bone cysts are called non-dental jaw cysts.

(a) odontogenic jaw cyst

Occurs in the jaw bone and is associated with the formation of teeth and teeth. According to their different sources, they are divided into the following categories:

Apical cyst

It is caused by apical granuloma and chronic inflammation, which causes residual hyperplasia of epithelial cells in the periodontal ligament. Denaturation and liquefaction occur in the center of the hyperplastic epithelial mass, and the surrounding tissue fluid continuously oozes out, gradually forming a cyst, so it can also be called a periapical cyst.

2. Base cyst

Occurs in the early stage of enamel development, before the formation of enamel and dentin, after the inflammation or damage stimulation, the stencil layer of the oil eliminator is denatured, and liquid oozes out to accumulate and form a cyst.

3. Contains dental cysts

Also known as follicular cyst, occurs after the crown or root formation, liquid leakage between the remnant glaze epithelium and the crown surface to form a tooth cyst. Can come from 1 tooth germ (including 1 tooth), also from multiple teeth.

4. Odontogenic keratocyst

It is derived from the original tooth germ or dental plate residue, which is considered to be a primordial cyst. The keratocyst has a typical pathological manifestation. The epithelium and fibrous envelope of the cystic wall are relatively thin, and sometimes contain ascus (or satellite cyst) or epithelial island in the fibrous envelope of the capsule wall. The capsule is white or yellow keratin or oily.

(two) non-dental cysts

It is derived from the epithelium remaining in the embryonic development process, so it is also called non-dentate ectodermal epithelial cyst.

1. Capillary cyst

Occurs between the maxillary incisor and the canine, and the teeth are often displaced and displaced. X-ray films show cyst shadows between the roots of the teeth, not at the apex. The teeth have no discoloration and the pulp has vitality.

2. Bowel cyst

Located in or near the incisor (from the residual epithelium of the incisor). The cystic shadow of the enlarged incisor can be seen on the X-ray film.

3. Median cyst

Behind the incisor, any part of the suture. On the X-ray film, there is a circular cyst shadow between the slits. It can also occur at the midline of the mandible.

4. Nasal and lip cysts

Located in the upper lip and nasal vestibule. May be from the residual epithelium of the nasolacrimal duct. The cyst is on the surface of the bone. There is no damage to the bone on the X-ray film. The presence of cysts can be found on the outside of the oral vestibule.

an examination

Related inspection

CT examination spiral CT examination

1. X-ray film:

The jaw cysts showed a circular or oval density reduction zone on the X-ray film. The boundary was clear and the edges were smooth and sharp. It could be single or multiple rooms. As the cyst fluid accumulates, the cyst has a certain degree of swelling, which can cause displacement of adjacent teeth and a small amount of visible tooth absorption. Peripheral bone absorption, the wall of the capsule is a dense white line (cortical line).

2. Computer tomography:

When the CT is scanned flat, the cyst is round or oval and has a smooth edge. The density of the cyst is related to the contents of the capsule. There are two general conditions: most are low density and a few are equal or high density. The former is related to the contents of the cysts, which are liquid lipids and cholesterol, which are related to the contents of the capsules being keratin, hemorrhage and calcification. On enhanced CT, the wall of the capsule can be slightly enhanced and the cystic fluid is not enhanced. Residual roots or teeth can be seen in the gap, and the continuity of the cortical bone can be interrupted, and the surrounding soft tissue can be seen to expand.

3. Histopathological examination confirmed the diagnosis.

Differential diagnosis

diagnosis:

1. X-ray film:

How should cyst-like shadows be identified as jaw cysts and differentiated from similar lesions. Cysts should be identified with central hemangioma, inflammatory granuloma, malignant lesions, etc.

2. Puncture examination diagnosis:

The purpose of the puncture is to determine the nature of the cyst and the possibility of excluding other lesions.

3. Biopsy diagnosis:

As for biopsy, it is only necessary in a few cases. That is to say, X-ray film, puncture examination, still can not determine its nature, can not rule out inflammatory granuloma, central hemangioma or other lesions, need to use biopsy for final qualitative. A biopsy can determine the nature of the cyst and the presence of other lesions. However, if the puncture is a lot of bright red blood, the biopsy should be very careful to avoid uncontrollable bleeding.

Differential diagnosis:

Jaw bulging: The jaw, which constitutes the upper and lower bones and muscle tissue. The upper part is called the upper jaw, and the lower part is called the jaw bone. It is divided into the maxilla and the mandible. The abnormal protrusion of the jaw is called the jaw bulging.

Jaw joint pain: Jaw joint pain is a manifestation of temporomandibular joint disorders.

Dislocation of the jaw: The dislocation of the jaw is caused by a fracture of the jaw.

The jaw was "fan-shaped" bone destruction: X-ray examination showed that the jaw was "fan-shaped" bone destruction, and the edge was worm-like as one of the main symptoms of gingival cancer.

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