A Odontogenic cyst developing from the stellate reticulum which is formed in place of a tooth.

Etiology:

1. Develops through liquefaction and cystic degeneration of stellate reticulum of enamel organ before any calcified enamel or dentine is formed.
2. Usually it may develop from a normal tooth germ, which may be clinically missing from the arch or a supernumerary tooth germ or from dental lamina

Clinical features:

1. Accounts to 5-10 % of the Jaw Cysts
2. It is seen in place of a tooth in an Edentulous area
3. Location: Mandibular third molar region, Ramus region, Pre molar region, incisor region
4. May occur early in life but usually discovered later
5. Usually a tooth is missing
6. Varies in size
7. May expand bone and displace teeth

Radiographic Features:

1. Well demarcated , round or oval radiolucency with sclerotic or reactive border
2. Unilocular or multilocular
3. Seen below or between roots or near to the alveolar ridge
4. More in relation to third molars

Histopathology:

Based on Histology it is of 2 types:

• Keratinized type (more common)
• Non-Keratinized type (less common)

1. Connective tissue capsule shows parallel arrangement of collagen bundles, with varying compactness.
2. Epithelial lining is of stratified squamous – intact or interrupted.
3. Epithelium may also be sometimes non keratinized, with a prominent spinous layer and long and confluent rete ridges and with less conspicuous basal layer.
4. Sometimes the epithelium may be ortho keratinized with a thin to moderate spinous layer and a thin or flattened basal layer.
5. Sometimes the epithelium may also be para keratinized and corrugated in some areas or may also be uniform 6 – 10 cells thick, with a prominent basal layer – with the cells arranged in a PICKET FENCE pattern or TOMB STONE pattern
6. Rete ridge formation is not seen (cf. : odontgenic kerato cyst)
7. Inflammatory infiltrate may be variable.

Treatment:

Radical surgery – Curretage of Bone

Recurrence: Highly recurrent.

Odontogenic cysts

Mentioned here are the various classifications given by scientists for Cysts of Jaw:

1. WHO Classification
2. Shears Classification
3. Shafers Classification

WHO Classification is divided into 2 Types:

1. Developmental
2. Inflamatory

DEVELOPMENTAL:
I. Odontogenic:

1. Primordial ( Kerato ) cyst.
2. Gingival cyst.
3. Eruption cyst.
4. Dentigerous ( Follicular ) cyst.

II. Non Odontogenic:

1. Naso palatine duct ( Incisive canal ) cyst.
2. Globulomaxillary cyst.
3. Naso labial ( naso alveolar ) cyst.

INFLAMMATORY:

1. Radicular cyst.

Shear’s Classification

It is divided into 3 types:

1. Cysts of Jaw
2. Cysts associated with Maxillary Antrum
3. Cysts of the soft tissues of the Face, Neck and Mouth

Cysts Of Jaw:

EPITHELIAL CYSTS OF JAWS:

I. ODONTOGENIC:

a. Developmental:

1. Primordial (Kerato) cyst .
2. Gingival cyst of infants .
3. Gingival cyst of adults .
4. Lateral periodontal cyst .
5. Dentigerous cyst .
6. Eruption cyst .
7. Calcifying odontogenic cyst.

b. Inflammatory:

1. Radicular cyst .
2. Residual cyst .
3. Inflammatory collateral cyst.
4. Para dental cyst.

II. NON-ODONTOGENIC:

1. Nasopalatine duct cyst & Incisive canal cyst
2. Median palatine cyst
3. Median alveolar cyst
4. Median mandibular cyst
5. Globulomaxillary cyst
6. Naso labial (naso alveolar) cyst

a. Simple bone cyst:

1. Traumatic
2. Solitary
3. Hemorrhagic

b. Aneurysmal bone cyst.

Cysts Associated with the Maxillary Antrum

1.  Benign mucosal cyst .
2. Surgical ciliated cyst of maxilla.

Cysts of the Soft tissues of the Face, Neck and Mouth

1. Dermoid & Epidermoid cysts
2. Branchial cleft cyst (Lympho epithelial cyst)
3. Thyroglossal duct cyst
4. Anterior median lingual cyst
5. Oral cyst with gastro intestinal epithelium
6. Cystic hygroma
7. Cysts of the salivary glands
8. Parasitic cysts: Hydatid cyst, Cysticerous cellulosae

Shafers Classification

1. Primordial cyst .
2. Dentigerous cyst & Eruption cyst .
3. Periodontal cyst :
a. Apical periodontal cyst .
b. Lateral periodontal cyst .
4. Gingival cyst :
a. Gingival cyst of newborn(Dental lamina cyst)
b. Gingival cyst of adult .
5. Odontogenic kerato cyst .
(Jaw cyst , Basal cell nevus & Bifid rib syndrome)
6. Calcifying odontogenic cyst .

Synonyms: Fordyce Spots, Fordyce Disease

Etiology:

Inclusion of ectoderm having potentialities of skin in the oral cavity during development of maxilla & mandible- embryonic life

Differential Diagnosis:

• Sebaceous Hyperplasia
• Epidermoid cyst
• Dermoid cyst

Clinical Features:

Incidence:  80%
Age: Adults
Sex predilection :  M=F
Site or Location:

• Buccal mucosa (opposite molar teeth)
• Fordyce Lips
• Retromolar region

Clinical appearance:

• Bilaterally symmetrical
• Small yellow spots either discreetly separated or forming plaques
• Projecting slightly above the surface of the tissue

Histologic Features:

• Similar to sebaceous glands of skin –but not associated with hair follicles
• Usually superficial just beneath the overlying epithelium which often produce local elevation of the epithelium
• Consist of few or more lobules grouped around one or more ducts which open on the surface of the mucosa

Treatment of Fordyce spots or Granules:

• Treatment is not required.
• Inflamed glands can be treated by Clindamycin
• But in case of any effect to physical appearance due to Fordyce spots or Granules on Lips the mode of treatment is: Laser Treatment of Fordyce spots on Lips is done
• Neoplastic Transformation has been reported but very rare.

Recurrence:

• No Recurrence is seen

Fascial space areas are filled normally with loose connective tissue which readily breakdown when invaded by infection, leading to large swelling.

Fascial space infections are the most common cause of swellings in the head and neck region

These fascia of the head and neck may be divided into:

1. Superficial Fascia
2. Deep Cervical Fascia

Courtesy: Exodontia.info

Classification of Fascial Spaces:

There are 16 fascial spaces in the Head and Neck region, which are further divided into 4 types:

1. Fascial Spaces of the Face
2. Suprahyoid Fascial Spaces
3. Infrahyoid Spaces
4. Fascial Spaces of the Neck

Fascial Spaces of the Face:

1. Canine Space
2. Buccal Space
3. Masticatory Space

• Massetric spaces
• Pterygomandibular space
• Temporal Space (Zygomaticotemporal space)

4. Parotid Space
5. Infratemporal Space

Suprahyoid Fascial Spaces:

1. Sublingual space
2. Submental space
3. Submandibular space
4. lateral Pharyngeal space
5. Peritonsillar space

Infrahyoid Space:

1. Pretracheal space

Fascial Spaces of the Neck:

1. Retropharyngeal space
2. Danger space
3. Space of the carotid sheath

1. Factor I = Fibrinogen
2. Factor II = Prothrombin
3. Factor III = Tissue Thromboplastin
4. Factor IV = Calcium
5. Factor V = Proaccelerin, Labile factor
6. Factor VI – Accelerin (Does not exist as it was named initially but later on discovered not to play a part in blood coagulation)
7. Factor VII = Serum Prothrombin, Stable factor antihemophilic
8. Factor VIII = Antihemophilic factor A, Antihemophilic Globulin, Antihemophilic factor
9. Factor IX = Plasma Thromboplastin component, Antihemophilic factor B or Christmas factor
10. Factor X = Stuart Prower factor
11. Factor XI = Antihemophilic factor C
12. Factor XII = Hageman factor
13. Factor XIII = Fibrin stabilising factor

Knowing about the Blood Coagulation factors in Dentistry is very important to prevent the mishaps from occurring during or after Dental procedures. There are many Hematologic disorders which are related to these factors,which makes it essential to make note of these factors and the concerning disorders.