RADIOGRAPHIC

PICTURE OF
DIFFERENT TYPES
OF CYSTS
 Duringthe diagnosis of oral and maxillofacial diseases, radiological
data play a major role. In this region, only a good clinical diagnosis
along with a radiological examination may lead to a successful
diagnosis.
Intra-oral
radiographs offer a highly detailed view of the teeth and
bone in the area exposed, but it cannot be used for lesions larger than
3 cm, because of the small film size.
Extra-oralradiographs are used to examine larger lesions and to
visualize the skull and facial structures.
Panoramic radiography is a special technique, which includes a broad
area with low radiation dose, and it can be used in patients who are
unable to open their mouths.
IMAGING OF CYSTS

Plain Radiographs
Intra-oral
Extra-oral
OPG

CT scan
Cone Beam CT
 Cysts
A Cyst is a benign pathologic cavity (space) filled with fluid, lined by epithelium,
and surrounded by a connective tissue wall.

Radiographic Features of Cysts:

Because most oral-facial cysts are located within the jaws, they are invisible on
intraoral clinical examination; their presence is discovered on radiographic
examination.
Being composed of soft tissues within bone, jaw cysts appear as radiolucencies.
Jaw cysts usually produce well-circumscribed radiolucencies surrounded by
radiopaque borders, suggesting slow growth. These single well-demarcated
radiolucencies are uni-locular lesions (uni- = one; -locular = locus).
Cysts arising in soft tissues outside of bone are more likely to be discovered on
intraoral examination where they produce a surface swelling
 Types of cysts
Odontogenic Cysts
Radicular cyst
Residual cyst
Dentigerous cyst
Paradental cysts (Buccal bifurcation cysts)
Odontogenic Keratocyst (OKC)
Basal cell nevus-bifid rib-OKC syndrome
Lateral periodontal cyst
Calcifying odontogenic cyst

Non-Odontogenic cysts
Nasopalatine cyst
Nasolabial cyst
Dermoid cyst
Cysts formerly known as developmental cysts

Pseudocysts
Simple bone cyst (Traumatic bone cyst)
Aneurysmal Bone Cyst
Mucous Retention Cyst
Stafne Bone Cyst (aka Stafne Bone Defect)
ODONTOGENIC
CYSTS
Radicular cyst

Themost common type of cysts in the

jaws.
Resultsfrom the stimulation of the
epithelial cell rests in the PDL by the
inflammatory products from the non-vital
tooth.
Radiographically:
radicular cyst appears well defined
radiolucent area. Infection of a cyst causes
resorption of the surrounding tissue.
If the cyst extends slowly, a condensed
radiopaque periphery is present.
Residual cyst

An epithelial lined jaw cyst left in the jaws

after removal of the associated tooth
making determination of its precise origin
difficult; surgical excision will cure this cyst.

RADIOGRAPHIC FEATURES
It may present well defined radiolucency that
can vary in size from a few mm to several cm;
with thin radioopaque margins
Dentigerous cyst

The dentigerous cyst is a cyst that originates

by the separation of the follicle from around
the crown of an unerupted tooth.

RADIOGRAPHIC FEATURES
A unilocular well defined, radio lucency with
sclerotic margins, associated with crown of
impacted / unerupted tooth.
A large DC may show persistence of boney
trabeculae, giving the appearance of
multilocularity.
RADIOLOGICAL FEATURES

CENTRAL TYPE/CORONAL:

LATERAL TYPE :

CIRCUMFERENTIAL TYPE :
Paradental cysts (Buccal bifurcation cysts)

Mostcommon in the 6- to 11-year-old age group, Usually

associated with the mandibular first molar, occasionally the
mandibular second molar.
The associated tooth has an altered eruption pattern with buccal
tilting of the crown.
Theassociated tooth is vital with deep periodontal pockets on the
buccal aspect of the tooth.
 Radiographic Features of the Buccal
bifurcation cyst

Fine radiopaque concave line as lower

limit, producing a U-shaped radiolucent
lesion that appears superimposed over
the roots.
Intact periodontal ligament space and
lamina dura.
Increased prominence of lingual cusps
due to tilting.
Apices tilted toward lingual cortex.
Intact inferior border of mandible.
Odontogenic Keratocyst (OKC)

Jawcysts of dentigerous or primordial origin lined with

keratinizing epithelium appearing as radio-lucencies
around crowns of unerupted teeth or in a tooth-bearing
area unassociated with teeth.
These cysts may be difficult to remove surgically and often
recur.
RADIOGRAPHIC
FEATURES:

OKC demonstrate a well-defined radiolucent

area with smooth and often corticated
margins.

Large lesions, particularly in the posterior body

and ascending ramus of the mandible, may
appear multilocular soap-bubble appearance

An unerupted tooth is involved in the lesion in

25% to 40% of cases; in such instances, the
radiographic features suggest the diagnosis of
dentigerous cyst
Basal cell nevus-bifid rib-OKC syndrome

Abnormalities including:
Multiple nevoid basal cell carcinomas of
the skin,
Skeletal abnormalities (bifid ribs, agenesis
and/or synostosis of ribs,
Kyphoscoliosis,
Vertebral fusion,
Temporopatietal bossing, etc.),
CNS abnormalities (calcification of falx
cerebri),
Eye abnormalities,
Multiple OKCs
Lateral periodontal cyst
An uncommon cyst usually found in the
interdental alveolar process between
adjacent teeth.
RADIOGRAPHIC FEATURES
Usually unicystic, it may also appear as a
cluster of small cysts "botryoid odontogenic
cysts
Arise from the epithelial rests in the
periodontium lateral to the root
50-75% develop in the mandible from
lateral incisor to the premolar region In the
maxilla, they appear between lateral incisor
Calcifying odontogenic cyst
Arare, well circumscribed, solid or cystic
lesion derived from odontogenic epithelium
that contains ghost cells and spherical
calcifications

RADIOGRAPHIC FEATURES
The central lesion may appear as a cyst like
radiolucency with variable margins which may
be smooth well defined or irregular in shape with
poorly defined borders
Perforation of cortical plates can be seen
 NON-
ODONTOGENIC
CYSTS
Nasopalatine cyst
In
early embryonic life just after the oral and nasal cavities are
separated, an epithelial tube connects them for a time.
Later on, this nasopalatine duct disappears; however, remnants
of it may persist in the anterior maxilla. A well-known foramen
marks the site: the incisive canal.
Epithelial rests are located within the incisive canal.
Thereare two manifestations of nasopalatine duct cysts: cysts of
the papilla palatini and incisive canal cysts.
 RADIOGRAPHIC FEATURES
Seen as radio-lucency usually in
incisive canal DIFFICULT TO
DISTINGUISH FROM A NATURALLY
LARGE INCISIVE CANAL.

Radiolucency with AP dimension

upto 10 mm considered as enlarged
incisive canal, but if radiolucency <
14 mm, then NP duct cyst.

The radiolucency appears well

defined with sclerotic borders, in
midline of palate between roots of
Nasolabial cyst
The nasolabial cyst occurs outside the bone
in the nasolabial folds below the alae nasi.
It is traditionally regarded as a jaw cyst
although strictly speaking it should be
classified as a soft tissue cyst.
RADIOGRAPHIC FEATURES
Difficult to interpret on radiograph.
May be seen as localized increased radiolucency of
alveolar process above apices of incisors.
Radiolucency results from pressure resorption on
labial surface of maxilla
Globulomaxillary Cyst
Discredited
as a
developmental cyst
Mostare found, upon re-
examination of
histopathological and
radiographic evidence, to be
radicular or lateral
periodontal cysts.
PSEUDOCYSTS
Simple Bone cyst
Traumatic bone cyst

Simple bone cyst associated

withflorid cemento-osseous
dysplasia
Aneurysmal Bone Cyst (ABC)
The aneurysmal bone cyst (ABC) is
an expansible osteolytic
pseudocystic lesion that most often
affects persons during their second
decade of life. Albeit virtually any
bone of the skeleton may be
affected; ABCs are most frequent in
the long tubular bones and spine.
There are several reports of the
occurrence of this pathological
entity in the jaws and other
RADIOGRAPHIC FEATURES
Classically seen as a
unilocular, ovoid / fusiform
lucency which balloons the
cortical plates.
Teeth displacement and root
resorption also observed.
Lesions are usually unilocular
but longer-standing lesions
may show a soap-bubble
appearance and may become
progressively calcified
Mucous retention cyst
Dome shaped opacity in the floor of the
maxillary sinus
Non-epithelial lined
Fluid filled
Usually asymptomatic