What is a cyst?

A cyst is a pathological cavity in tissue that is filed with fluid or soft material and usually grows from internal pressure generated by fluid being drawn into the cyst cavity from osmosis (hydrostatic pressure). The upper and lower jaw are the bones with the highest risk of developing cysts in the human body. This is consequence of the abundant amount of epithelial tissue remnants that can be left in the bones of the jaws. The tooth enamel is formed from ectoderm (the precursor germ layer to skin and mucosa), and so remnants of epithelium can be left in the jaws during tooth development. Cysts that can develop from tissues that would normally develop into teeth are called as odontogenic cysts. Some are inflammatory while others are developmental. Odontogenic cysts are radicular cyst, dentigenous cyst, keratocystic, buccal bifurcation cyst, eruption cyst, primordial cyst, gingival cist of the newborn, gingival cyst of adult, lateral periodontal cyst, calcifying odontogenic cyst and glandular odontogenic cyst.

Cysts of the jaws that are called non-odontogenic cysts are developed from the other tissues, not from those involved in tooth development, and consequently may contain structures such as epithelium from the nose.

On this radiograph you can see a radicular cyst.

How do cysts grow?

All the cyst grows by osmosis. Osmosis process causes the bone around the cyst to resorb, and this may cause movement of teeth or other vital structures such as nerves and blood vessels, or even resorb the roots of teeth. In some extreme cases undiagnosed dental cyst can grow so big that can put a jaw bone at risk of fracture. Cysts usually dont have symptoms. Most comonly they are discovered on routine dental radiograph. On an x-ray, cysts appear as dark, round areas with light white borders. Cysts can be unilocular and multilocular. Some cyst can become infected and this can be the first simptom in their diagnostics. Sings and symptoms of the cyst depend on their localization and size. If the cyst has not grown beyond the normal anatomy of the bone, then there will be no visible or palpable. Most cysts grow slowly and the surrounding bone has time to increase its thickness around the cyst, which is the organisms attempt to isolate the lesion. Some cyst can grow out of anatomical proportions of the bone. When this happens cyst is possible to inspect by palpation.

Every cyst need a thorough examination by a dentist or maxillofacial surgeon. Treatment and therapy for the cyst will depend on the type of the cyst and her localization. Some smaller radicular cyst will require endodontic therapy. In some cases, for example if the cyst has been present for some time, and if patients immune system is compromised for any reason root canal therapy wont be adequate choice. In this cases dentist can suggest apicoectomy or even tooth extraction. Bigger cysts must be removed by surgical procedure called cystectomy. This procedure is done in local anesthesia and it include surgical removal of the cyst.

The best prevention for dental cyst are regular check ups, usually twice a year. Since the dental cysts are mostly asymptomatic it is very important to diagnose them in early stage. Early diagnostic will prevent any long term consequences on oral health.