What is meant by a rounded jaw

Odontogenic jaw cysts
Categories and types

Cysts, pseudocysts and abscesses

The so-called pseudocysts are to be distinguished from "real" cysts, cavities that are filled in the same way as "real" cysts but are not covered by an epithelium.

Cavities that are filled with pus but have no epithelium are called abscesses.

Another distinguishing feature of jaw cysts concerns their causes (pathogenesis). Here it is important to differentiate between inflammation-related and development-related (dysontogenetic) cysts.

definition: The term cystectomy refers to the surgical removal of the cyst (or the cyst follicle).

During the procedure, in addition to the cyst bellows, bone substance adjacent to the cyst is also removed. Depending on the size of the removed cyst (from approx. 1 cm in diameter), the remaining cavity must be filled. Both bone substitute materials and your own bone tissue, in each case in connection with an autologous blood filling, can be used for this.

After the operation, the wound is sutured.

In special cases it is not possible to surgically remove jaw cysts (cystectomy). This is the case, for example, with cysts that have formed "around" the roots of teeth that are worth preserving or when cysts are located near the nasal or maxillary sinuses.

This is where the cystostomy method is used, i.e. the cyst in question is opened and the secretion flows out. Then the cyst is kept open by inserting a "plug" (obturator) so that the bone can regenerate.

Types of cysts

Developmental odontogenic jaw cysts

This refers to cysts that form during odontogenesis, i.e. the child's development of the dental system. This type of jaw cyst does not usually cause discomfort to the patient as it grows. They are therefore usually diagnosed “by chance”.

Since large jaw cysts can cause misaligned teeth, a misaligned tooth can, however, indicate the presence of a cyst "in reverse". Only in rare cases, when the cyst has increased in volume, are developmental odontogenic jaw cysts visible as swelling of the oral cavity.

Follicular Cyst (Teeth Containing Cyst)

Follicular cysts represent the most common developmental cyst form with approx. 12%. They occur in retained teeth, i.e. teeth that have not yet erupted. There they form between the inner and outer enamel epithelium, i.e. between two layers of the enamel organ - the tissue that is responsible for the formation of tooth enamel.

They occur most frequently in the area of ​​the wisdom teeth, the molars of the lower jaw and the canines in the upper jaw.

therapy: Cystostomy or cystectomy

Eruption cyst (breakthrough cyst)

An eruption cyst is a follicular cyst that forms above the crown of the tooth when the tooth has already broken through the bone but is still under the gum wall. It can be the cause of dentition difficilis.

Eruption cysts can be recognized by a bluish swelling that appears above the crown of affected teeth.

therapy: Cystostomy or cystectomy

The gingival cyst (from Latin Gingiva, dt. Gums) is formed from remnants of the dental ridge, that is, the "thickening" from which the tooth systems later form.

Gingival cysts are most common in the lower jaw. Difficult tooth eruption (Dentitio difficilis) is considered to be one of the causes. They usually pass spontaneously by bursting open.

therapy: Cystostomy

Lateral periodontal cyst

Lateral periodontal cysts (from Lat. Latus, Ger. Flank and Latin. Parodontium, Ger. Tooth holding apparatus) also arise from the remnants of the tooth ridge, between the tooth roots (interradicular). Often these cysts are found in the lower jaw (canines, premolars). A sub-form of the lateral periodontal cyst is the multifocal botryoid odontogenic cyst.

They can be easily diagnosed by radiographic examinations (round oval illumination).

therapy: Cystectomy (enucleation)

Glandular odontogenic cyst

A very rare form of cyst formation is the so-called glandular odontogenic cyst (GOC), also called "sialo-odontogenic" or "mucoepidermoid-odontogenic" cyst.

So far, only 51 cases have been described worldwide. In terms of its appearance and location, it resembles the lateral periodontal cyst, which is why it is sometimes viewed as a subspecies thereof. This type of cyst grows very slowly; a diagnosis can only be made using a microscope.

therapy: Cystectomy and long-term follow-up

Keratocystic odontogenic tumor

After the radicular cysts and the follicular cysts, the keratocystic odontogenic tumor (KOT) is the third most common type of cyst with 4-6%. In the past, this type of cyst was called "odontogenic keratocyst" or "primordial cyst".

Similar to the gingival cyst and the lateral periodontal cyst, the keratocystic odontogenic tumor arises from the dental ridge. In contrast to these, however, the feces spreads aggressively and displaces adjacent teeth in the process.

therapy: Thoroughest cystectomy

Calcifying odontogenic cyst

The calcifying odontogenic cyst is also referred to as "Gorlin cyst" or as "keratinizing and calcifying cyst" and as "odontogenic calcifying ghost cell cyst".

It usually occurs in the anterior region of the lower and upper jaw, and often intraosseously. It must be differentiated from the ghost cell tumor.

therapy: Cystectomy (enucleation)

Odontogenic jaw cysts caused by inflammation

The second type of odontogenic jaw cyst is not developmental but inflammation-related. I. E. these jaw cysts do not arise in the course of odontogenesis, but rather as a result of inflammatory processes.

This most common form of jaw cyst (78%) occurs as a result of inflammation of the tooth roots (chronic apical periodontitis) and after the "death" of the pulp (tooth nerve), with the tip of the root protruding into the cyst .

In extreme cases, the diameter of radicular cysts can be several centimeters. In most cases, radicular cysts are single-chambered. One or more teeth can be involved in the formation of the cyst.

therapy:

Cystostomy or cystectomy

The so-called paradental cyst (= Craig cyst) arises as a result of an inflammation of the gingival pocket (see periodontal abscess) and forms in the area of ​​the tooth neck or on a tooth root. The most common paradental cysts appear on the molars of the lower jaw.

therapy:

Cystectomy

Residual cysts (from Latin residium, dt. That which is left behind) are those jaw cysts that remain after the removal (of a tooth). Originally, residual cysts are therefore e.g. radicular cysts or follicular cysts. If these are not or only partially removed and if this “remainder” is self-contained and growing, then one speaks of residual cysts.

therapy:

Cystectomy or cystostomy