14, 16, and 17)2 Cysts of the salivary and minor mucous glands (Chapter 15)
3 Developmental cysts of the head and neck (Chapter 18)
Cysts of the Jaws
Odontogenic Cysts
The odontogenic cysts have been divided into cysts of inflammatory origin and cysts of developmental origin. These are convenient categories, since it is clearly understood that the inflammatory odontogenic cysts arise as a result of proliferation of odontogenic epithelium driven by chronic inflammation, resulting from either pulpitis or pericoronitis. The pathogenesis of the developmental cysts is less well understood, however, and in some cases there is evidence for a neoplastic origin. The pathogenic mechanisms involved in cyst development are discussed in Chapter 2, and details for each cyst type are presented in each chapter. Although these categories are widely used, they are not definitive, since some cysts classified as developmental may have an inflammatory origin. In particular, a variant of dentigerous cyst may be inflammatory in nature (see Chapter 5). In each category the cysts are listed in order of their approximate frequency (Tables 1.1–1.3).
Odontogenic Cysts of Inflammatory Origin
1 Radicular cystResidual cyst
2 Inflammatory collateral cystsParadental cystMandibular buccal bifurcation cyst
Odontogenic Cysts of Developmental Origin
1 Dentigerous cystEruption cyst
2 Odontogenic keratocyst
3 Lateral periodontal cystBotryoid odontogenic cyst
4 Gingival cyst of adults
5 Gingival cyst of infants
6 Glandular odontogenic cyst
7 Calcifying odontogenic cyst
8 Orthokeratinised odontogenic cyst
Non‐odontogenic Cysts and Pseudocysts
Non‐odontogenic cysts of the jaws are mostly developmental in origin and arise from vestigial epithelial remnants of ductal structures or from inclusions at the line of fusion of the palatal shelves. The nasolabial and mid‐palatal raphe cyst actually occur in the soft tissues, but are so closely apposed to the maxillary bone that they are included in the classification of jaw cysts. The surgical ciliated cyst is included here because it arises within the alveolar bone of the maxilla. Pseudocysts are not epithelial lined, but are included because they are important in the radiological differential diagnosis of cystic jaw lesions. As discussed above, we are content to use ‘cyst’ as a diagnostic term for the simple bone cyst, since this is clearly understood and widely used by clinicians who recognise that they present clinically and radiologically as a cystic lesion. Stafne bone cavity is neither a cyst nor a pseudocyst, but is an anatomical anomaly causing an indentation of the mandible that appears as a cystic lesion on radiology or imaging. It is often included in classifications and we include it here because of its importance in the radiological differential diagnosis of cystic lesions. Osteoporotic bone marrow defects are controversial lesions, but they present as cystic radiolucencies and must also be considered in the differential diagnosis.
Non‐odontogenic Cysts of the Jaws
1 Nasopalatine duct cyst
2 Nasolabial cyst
3 Mid‐palatal raphe cyst of infants (Epstein pearls)
4 Surgical ciliated cyst
Pseudocysts of the Jaws
1 Simple bone cyst
2 Stafne bone cavity
3 Osteoporotic bone marrow defects
Cysts of the Salivary and Minor Mucous Glands
Cysts affecting the salivary and minor mucous glands of the head and neck are common and may be developmental or reactive in nature. Retention and extravasation cysts (mucoceles) are the most common and may arise at any site associated with minor glands that are found throughout the submucosa of the upper aerodigestive tract and paranasal sinuses. Here we include cystic lesions of the major salivary glands as well as cysts associated with minor glands of the oral cavity and maxillary sinus. Ranula is included as a separate lesion because it has distinctive and specific clinical features and problems of management. Cystic neoplasms are not included. Intraoral lymphoepithelial cysts are included in this category even though their origin is uncertain. Some arise from intraoral tonsillar tissue, while others appear to be associated with dilated ducts of minor salivary gland.
Cysts of the Major and Minor Salivary Glands
1 MucocelesMucous extravasation cystMucous retention cystRanula
2 Salivary duct cyst (of the major glands)
3 Intraoral lymphoepithelial cyst
4 Lymphoepithelial cysts of the parotid gland
5 Polycystic disease of the parotid gland
Cysts of the Maxillary Sinus
1 Mucoceles
2 Retention cyst
3 Pseudocysts
Developmental Cysts of the Head and Neck
These cysts are mostly congenital and are usually present at birth, although some may grow slowly and not become clinically apparent until later in childhood or adolescence. The majority arise from epithelial remnants entrapped during fusion of the facial processes or due to incomplete obliteration of the branchial clefts or pouches.
1 Dermoid and epidermoid cysts
2 Cysts of foregut originHeterotopic gastrointestinal cystBronchogenic cyst
3 Branchial cleft cysts
4 Thyroglossal duct cyst
5 Nasopharyngeal cyst
6 Thymic cyst
Frequency of Cysts of the Oral and Maxillofacial Regions
Frequency
