Gingival Cyst of Adults and Newborn

Gingival Cyst is a small superficial cyst which is found in the alveolar mucosa, and as the name suggests it does not involve the alveolar bone.

Gingival cysts are of 2 types:

1. Gingival (Alveolar) Cyst of Newborn
2. Gingival cyst of the Adult

Gingival (Alveolar) Cyst of the Newborn:

Gingival cyst of the newborn is a small, superficial, keratin-filled cysts that are found on the alveolar mucosa of the infants. Seen in almost 50% of New borns. Gingival Cysts disappear simultaneously by rupture into the oral cavity, due to this feature they are seldom noticed or sampled for biopsy.

Origin of Gingival cyst of newborn:

• These cysts arise from remnants of the dental lamina.

Differential diagnosis:

• Epstein’s Pearls
• Bohn’s Nodules

Clinical Features:

• Gingival Cysts of the newborn appear as small, multiple whitish papules on the mucosa overlying the alveolar processes of the neonates.
• The individual cysts are usually no more than 2 – 3 mm in diameter.
• Maxillary alveolus > Mandibular alveolus

Histopathology Features:

• Examination of an intact gingival cyst of the newborn shows a Thin, Flattened epithelial ligning with a parakeratotic surface.
• It is a true cyst with Thin Epithelial lining
• The Lumen contains Keratinaceous Debris
• Dystrophic calcifications and Rushton’s bodies also may be found.

Treatment of Gingival Cyst of Newborn and Prognosis:

• No treatment is indicated for gingival cysts of the newborn because the lesions spontaneously involute as a result of the rupture of the cysts and resultant contact with the oral mucous surface.
• The lesions are rarely seen after 3 months of age

What are Epstein’s Pearls:

• Develop from the epithelial remnants in the lines of fusion
• Nodules seen along the median palatine raphe.

What are Bohn’s Nodules:

• Derived from the palatal salivary gland structures.
• Seen on the palate at the junction of hard and soft palates – Located lingually to anteriors mostly but occasionally to posteriors.

Gingival cyst of the Adult:

The Gingival cyst of the adult is an uncommon lesion. It is considered to represent the soft tissue counterpart of the Lateral Periodontal cyst because of the origin.

Origin:

The Gingival cyst of the adult arises from the Rests of the dental lamina (Rests of Serres).

 

Clinical Features:

• Occurs mostly in the Mandibular Canine and Premolar area (60% to 75%)
• Age: fifth and sixth decades of life
• The Gingival cyst is seen mostly on the Facial Gingiva or the Alveolar mucosa
• Maxillary gingival cysts are usually found in the Incisor, canine and premolar area.
• Clinically gingival cysts of adults appear as Painless, dome like swellings usually 0.5cm in diameter sometimes larger.
• Color: Bluish or Bluish Gray in color
• “Cupping out” of the alveolar bone: Which is not clear when seen in radiograph but visible when excised.
• If bine loss is visible in radiograph then it can be determined as a lateral periodontal cyst.

Histopathological Features:

• This flattened epithelial lining with or without focal plaques that contain clear cells
• Small nests of these glycogen rich clear cells which represent rests of dental lamina also may be seen in the surrounding connective tissue
• Calcifications or ossifications seen in the traumatic or implantation type
• Unicystic or polycystic
• Sometimes the cystic lining is so thin it is easily mistaken for the endothelial lining of a dilated blood vessel.

Treatment of gingival cyst of adults and Prognosis:

• Gingival cyst of adult responds well to Simple surgical excision.
• Prognosis is excellent.