Odontogenic cysts are a group of jaw cysts that are formed from tissues involved in odontogenesis (tooth development). Odontogenic cysts are closed sacs, and have a distinct membrane derived from the rest of odontogenic epithelium. It may contain air, fluids, or semi-solid material. Intra-bony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. That odontogenic epithelium is critical in normal tooth development. However, epithelial rests may be the origin for the cyst lining later.
Not all oral cysts are odontogenic cysts. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.
Most cysts in the body are benign (dysfunctional) tumors, the result of plugged ducts or other natural body outlets for secretions. However, sometimes these masses are considered neoplasm:
According to the current (2005) classification of the World Health Organization, both (parakeratizied) odontogenic keratocyst and calcifying odontogenic cyst have neoplastic characteristics, thus renamed as Keratocystic odontogenic tumor and Calcifying odontogenic tumor, respectively.
Cholesterol clefts in a periapical (radicular) cyst.
On histopathology, cholesterol clefts indicate mainly a periapical (radicular) cyst[4] or an inflamed dentigerous cyst.[5]
Treatment
Treatment ranges from simple enucleation of the cyst to curettage to resection. For example, small radicular cyst may resolved after successful endodontic ("root-canal") treatment. Because of high recurrence potential and aggressive behaviour, curettage is recommended for keratocyst. However, the conservative enucleation is the treatment of choice for most odontogenic cysts. The removed cyst must be evaluated by pathologist to confirm the diagnosis, and to rule out other neoplastic lesions with similar clinical or radiographic features (e.g., cystic or solid ameloblastoma, central mucoepidermoid carcinoma).[6] There are cysts, e.g. buccal bifurcation cyst with self-resolation nature, in which close observation can be employed unless the cyst is infected and symptomatic.[7]
^Zadik, Yehuda; Aktaş, Alper; Drucker, Scott; Nitzan W., Dorrit (2012). "Aneurysmal bone cyst of mandibular condyle: A case report and review of the literature". Journal of Craniomaxillofacial Surgery. 40 (8): 243–248. doi:10.1016/j.jcms.2011.10.026. PMID22118925.
^Shear, Mervyn; Speight, Paul (2007). Cysts of the oral and maxillofacial regions (4th ed.). Oxford: Blackwell Munksgaard. ISBN978-14051-4937-2.
