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Gingival Cyst of Adult

Gingival Cyst of Adult

Odontogenic Cysts

Gingival cyst of adult is a small, uncommon developmental odontogenic cyst of the gingival soft tissue (free or attached gingiva) that contains a lining epithelium of cuboidal cells and distinctive focal thickenings.

Origin


The possible sources of gingival cyst includes:

  • Cystic transformation of the remnants of dental lamina or the glands or rests of Serres.
  • Traumatic implantation of surface epithelium (not truly odontogenic cyst).

Clinical Findings


  • Small, well-circumscribed, painless swelling of the gingiva.
  • More common in mandibular premolar and canine region, with predilection for males.
  • The lesion resembles adjacent mucosa or bluish in colour.
  • Size : Less than 1 cm in diameter.
  • The lesions are soft and fluctuant and the adjacent teeth are usually vital.

Histologic Features


  • Lined by thin stratified squamous epithelium, ranging from one flattened cell to several cells in thickness.
  • Glycogen-rich clear cells may be present, especially in the focal thickenings or plaques of the lining.
  • Dental lamina rests may also be found in the connective tissue wall and are commonly composed of the same type of glycogen-rich clear cells.
  • May be unicystic or polycystic.

Treatment


Local surgical excision is usually recommended and the lesions do not tend to recur.

Points to Note


  • Wysocki and colleagues concluded that gingival cyst arise from postfunctional rests of dental lamina and represents the extraosseous counterpart of lateral periodontal cyst.
  • GIngival cyst is a true cyst as it consists of a pathologic epithelium lined cavity that usually contains fluid.

Dental Lamina / Gingival Cyst of Newborn


  • Dental lamina cyst of the newborn comprise of multiple, occasionally solitary, superficial raised nodules on edentulous alveolar ridges of infants.
  • They are derived from rests of the dental lamina and consist of keratin-producing epithelial lining.
  • Whitish in colour, as they are filled with keratin.
  • Histologically, they present with a thin epithelial lining which lacks rete processes and a lumen usually filled with desquamated keratin, occasionally containing inflammatory cells.
  • No treatment is required as they usually disappear by opening onto the mucosal surface or through disruption by erupting teeth.

Epstein's Pearls


  • Cystic, keratin-filled nodules found along the mid-palatine raphe, probably derived from entrapped epithelial remnants along the line of fusion.

Bohn's Nodules


  • Keratin-filled cysts scattered over the palate, most numerous along the junction of the hard and soft palate and apparently derived from the palatal salivary gland structures.

References


  • Shafer, Hine, Levy Shafer's Textbook of Oral Pathology (7th edition), Editors - R Rajendran, B Sivapathasundharam, Elsevier.

  • Textbook of Oral Medicine (3rd edition), Anil Govindrao Ghom, Savita Anil Ghom (Lodam), Jaypee Brothers Medical Publishers (P) Ltd.

  • The image used is licensed under the Creative Commons Attribution-Share Alike 4.0 International license.

    • Source : Gingival Cyst of the Adult: Report of an Inconspicuous Lesion Associated with Multiple Agenesis. Case Reports in Dentistry Volume 2017 (2017), Article ID 4346130, 4 pages. https://doi.org/10.1155/2017/4346130.
    • Author : Juliana Mançano Melhado Brod, Fabrício Passador-Santos, Andresa Borges Soares, and Marcelo Sperandio.

*This article is an excerpt from the above mentioned books and Medical Sutras does not make any ownership or affiliation claims.