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Mandibular Cysts - Types, Symptoms, and Prognosis

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Cysts are epithelium-lined, fluid-filled cavities commonly affecting the mandible. Read the article to know more about the cysts of the jaws.

Medically reviewed by

Dr. Achanta Krishna Swaroop

Published At January 27, 2023
Reviewed AtMarch 10, 2023

Introduction:

A cyst is a pathologic cavity lined by an epithelium containing fluid or a semi-fluid substance that grows gradually due to the internal pressure caused by the fluid. Cysts commonly occur in the bones of the jaws, the maxillary, and the mandibular bones than in other parts of the body as they have abundant epithelial remnants.

What Are the Types of Jaw Cysts?

The World Health Organization has classified jaw cysts as odontogenic and non-odontogenic. Odontogenic cysts are further classified as developmental and inflammatory cysts.

  • The inflammatory cysts of odontogenic origin are periapical cysts, residual cysts, and buccal bifurcation cysts.

  • The developmental cysts of odontogenic origin are dentigerous, eruption cysts, odontogenic keratocysts, gingival cysts of newborns and adults, lateral periodontal cysts, calcifying odontogenic cysts, glandular odontogenic cysts.

  • The non-odontogenic cysts include nasopalatine cysts, nasolabial cysts, median alveolar cysts, median palatal cysts, median mandibular cysts, and globulo-maxillary cysts.

What Are the Cystic Lesions Occurring in the Mandible?

  • Periapical cyst or radicular cyst.

  • Dentigerous or follicular cyst.

  • Odontogenic keratocyst.

  • Primordial cyst of the mandible.

  • Stafne or static bone cyst.

  • Traumatic or hemorrhagic or solitary bone cyst.

  • Residual cyst of the mandible.

  • Lateral periodontal cyst.

What Are the Causes of Mandibular Cysts?

  • Odontogenic cysts develop from tissues involved in the normal development of teeth.

  • Non-odontogenic cysts are lesions that develop from tissues other than teeth, such as soft tissues and bones.

  • Cysts can arise from epithelial remnants left in the jaws. These remnants are left during the process of development of teeth.

  • During the development of jaw bones, embryonic processes fuse with ectodermal tissue trapped in between, which undergoes atrophy and forms a cyst.

  • Some of the cysts are associated with genetic conditions. For example,

What Are the Symptoms of Mandibular Cysts?

  • Cysts cause symptoms only when they are secondarily infected. And the symptoms entirely depend on the site of the cyst.

  • If a cyst undergoes slow expansion, it is not palpable clinically as the bone gets formed around the lesion and attempts to isolate it.

  • If the cyst expands rapidly, it is still covered with a thin layer of bone which cracks on pressure application leading to an eggshell cracking sign.

  • If the bone covers the cyst, it is hard, whereas if the lesion erodes the bone, the cyst fluctuates.

  • If the cyst is infected, it may cause discharge into the oral cavity through the sinus.

  • The cyst may affect the adjacent by causing its displacement and resorption of roots.

What Are the Complications of a Jaw Cyst?

  • Bony destruction.

  • Infection.

  • Oral sinus.

  • Facial sinus.

  • Weakening of the jaw.

  • Displacement of teeth.

  • Resorption of roots of adjacent teeth.

  • Encroachment of the floor of the maxillary sinus.

  • Deflection of inferior alveolar canal.

How Are Mandibular Cysts Diagnosed?

  • Cysts of the jaw can be diagnosed using imaging studies, such as X-rays, Ct(Computed Tomography), and MRI(Magnetic Resonance Imaging).

  • A biopsy of the cystic lining will be performed for lab analysis.

What Are the Radiographic Features of Mandibular Cysts?

Radiographic Features of Mandibular Cysts

How Is a Mandibular Cyst Treated?

Many cysts have a similar clinical presentation, and the following procedures can be performed to treat them based on their severity. First, the cyst lining is removed and sent for histopathological examination. Then the majority of the cysts are surgically removed.

The two techniques to remove the cyst are

  • Enucleation: It is the surgical removal of the entire cyst. A mucoperiosteal flap over the cyst is elevated, and the complete cyst is removed. Then sutures are placed to close the defect.

  • Marsupialization: A mucoperiosteal flap is elevated, a window is created into the cyst's wall, and the lining is attached to the oral mucosa to allow drainage of the cyst. As the window is open, the pressure inside the cyst reduces, and the lesion shrinks. A plug is used to prevent the closure of the window. The window is left open and cleaned regularly until the contents are eliminated. Marsupialization can be performed in the case of a dentigerous cyst, and the tooth is allowed to erupt instead of extraction.

  • Enucleation Following Marsupialization: When cysts are large, and their removal would lead to a fracture of the jaw bone, two steps are performed. Firstly, marsupialization is done to eliminate the contents and shrink the lesion. Secondly, enucleation is done to eliminate the cyst entirely.

  • Enucleation With Curettage: In this method, the cyst removal by enucleation is followed by the removal of surrounding bone to eliminate any remnants of the cystic lining. This method is adopted if the cyst lining is thin or if the cyst is infected. Then the area is irrigated to flush out the debris.

Some options are acquired to reduce the recurrence rate of certain cysts, like odontogenic keratocyst. They include curettage post-enucleation, Carnoy's solution, and mandibular resection. In addition, supportive care is provided for maintaining the quality of life by assisting with nutrition, swallowing, speech, and replacing missing teeth.

Consult a Doctor:

If an individual experiences the symptoms of a jaw cyst, it is good to visit a dentist or a physician immediately. Most commonly, jaw cysts are not symptomatic and are accidentally found during routine radiographic examinations. And if the jaw cysts are diagnosed and are found to be aggressive, a team of specialists will formulate the treatment plan.

How Is the Prognosis of Mandibular Cysts?

The prognosis of a cyst depends on the type, size, and location of the cyst. Benign cysts do not require treatment, whereas locally aggressive cysts may lead to the destruction of the surrounding bone if left untreated. In such cases, the cyst and the healthy bone lining are removed to prevent residue build-up and recurrence. In some cases, a cyst can expand and lead to pathological fractures.

Conclusion:

Treatment options vary for each type of jaw cyst based on the cysts' symptoms, type, and growth stage. An oral and maxillofacial surgeon will formulate the treatment plan for the particular cyst and treats the lesion through surgery, medical therapy, or a combination of both.

Frequently Asked Questions

1.

Which Mandibular Cyst Is Most Frequently Found?

A dentigerous cyst is the most common mandibular cyst. It occurs around the wisdom tooth, which is partially erupted. The cyst surrounds the crown of the tooth structure with fluid accumulation. Common in the ages of twenties or thirties. It is harmless and can be removed with a minor surgical procedure. The affected tooth, along with the cyst tissue, is removed.

2.

What Signs and Symptoms Indicate a Mandibular Cyst?

Most mandibular cysts do not show symptoms and are diagnosed on routine dental radiographs. In some cases, the symptoms are:


- Tooth sensitivity.


- Swelling.


- Mobility of the tooth.


- Pain and tenderness.

3.

What Is the Prognosis for Dentigerous Cysts?

The prognosis of dentigerous cysts is excellent, and recurrence is rare. Dangerous cysts, left untreated, can lead to serious infections and other periapical pathologies. The treatment depends on the size of the cyst. In marsupialization, the cyst is opened, and fluid is drained, allowing the reputed tooth to come out without obstruction.

4.

How Can Cyst Be Cured Naturally?

Natural remedies can reduce the symptoms associated with cyst formation, and a complete cure is doubtful. Some of the natural remedies are


- Hot compress.


- Tea tree oil.


- Aloe vera.


- Massage and Relaxation techniques.


- Castor oil.


- Dietary changes.


- Turmeric.

5.

Can Dental Cyst Be Treated Without Surgery?

The treatment depends on the size and complexity of the cyst. A small dental cysts can be treated successfully with antibiotics and anti-inflammatory medications. This will help to reduce the infection, and the body will absorb the cyst naturally.

6.

How Serious Is a Jaw Cyst?

The jaw cysts are classified as odontogenic and nonodontogenic based on their origin. The jaw cyst also varies in size and complexity. Some lesions can be noncancerous and harmless and can be treated with antibiotics and surgery. Some large lesions that are expanding aggressively and destroying the surrounding tissues are serious. The severity can be assessed by a proper diagnosis.

7.

What Is the Most Common Oral Cyst to Recur?

Odontogenic keratocystic tumor, also called OKC, has the highest recurrence rate. After surgical management, the affected tooth is preserved. Due to the cortical perforation, there is a high chance of cyst recurrence. Proper therapeutic management combined with electrocauterization and cryotherapy helps reduce the chance of recurrence.

8.

Which Foods Prevent Cysts?

- Food with anti-inflammatory properties like berries, fatty fish, tomatoes, avocados, broccoli, green tea, and pepper.


- High protein content foods like fish and seafood, milk and dairy products, and chicken


- Food rich in omega-3 fatty acids helps regulate hormone levels.

9.

Can Cyst Be Cured Without Medicine?

Most common cysts are harmless without showing any symptoms and go away naturally. Certain cysts growing large and showing symptoms like pain and swelling need proper diagnosis and treatment.

10.

What Is a Jaw Cyst That Is Not Cancerous?

A noncancerous cyst of the jaw refers to its benign nature. It lacks the properties of malignant tumors. It does not aggressively grow in size and does not spread to surrounding areas. And has an excellent or good prognosis following treatment.

11.

Which Vitamins Help Treat Cysts?

Vitamin C has antioxidant and anti-inflammatory properties that significantly reduce cyst formation. It also prevents the invasion and metastasis of tumors. Vitamin C also boosts immune activity. It prevents the abnormal growth of cysts.

12.

What Percentage of Jaw Cysts Are Cancerous?

The odontogenic cysts are benign lesions, and the chances of becoming cancerous are very less. Only 0.13% - 3% changes for a jaw cyst will become cancerous.

13.

What Is the Recovery Time for Jaw Cyst Removal?

The recovery time also depends on the size, severity, location, and surgical technique used. In general, the patients can recover and return to normal life within 7- 10 days after surgery. If the dentist suggests a longer resting period, follow it accordingly.

14.

Why Am I Getting Cysts on My Jaw?

The jaw cyst can originate from tooth-forming tissues and other tissues unrelated to teeth. The exact cause of jaw cysts is unknown; some are associated with genetic disorders. Like in Gorlin Goltz syndrome, the patient will have multiple odontogenic keratocysts.

15.

How Common Are Jaw Cysts?

Jaw cysts are not very common but can be seen in the population. The cyst can be odontogenic or nonodontogenic, depending on the size and type of cyst. Most are harmless, resolved, and noncancerous.

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Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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