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:
- Gingival (Alveolar) Cyst of Newborn
- 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.
- Epstein’s Pearls
- Bohn’s Nodules
- 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
- 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.
The Gingival cyst of the adult arises from the Rests of the dental lamina (Rests of Serres).
- 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.
- 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.