Jaw cysts are round growths of benign nature that develop within the bones of the upper or lower jaw. They are filled with semi-liquid or liquid content, and their size can vary from a few millimeters to several centimeters in diameter.
There are about twenty types and subtypes of jaw cysts. In practice, the most commonly encountered are:
RADICULAR CYST
Radicular cysts are the most common type of jaw cysts. They arise as a result of stimulation of the Malassez epithelial cells near the root of a tooth with a dead pulp.
FOLLICULAR CYST
Follicular cysts belong to the developmental cysts of the jaw. They are associated with the crown of an unerupted/impacted tooth, most commonly the lower wisdom teeth and upper canines.
KERATOCYST
Keratocysts are developmental jaw cysts characterized by a thin epithelial lining composed of several layers of cells, the presence of keratin within the cyst cavity, as well as daughter cysts in the epithelial layer (satellites).
HOW DO JAW CYSTS FORM?
It is not possible to assert with certainty what causes cyst formation. Some jaw cysts develop from odontogenic tissue, or cellular remnants of the tissue from which teeth develop. Others may arise from bone or soft tissue that is not related to teeth. Genetic factors and mutations may also be responsible for their development.
SYMPTOMS
Due to their tendency to grow, cysts can exert pressure on surrounding tissue, causing tooth migration, facial deformities, and resorption of the jawbone.
Cysts often do not exhibit any symptoms and are usually discovered through radiographs of the jaw or teeth.
JAW CYSTS – SURGICAL THERAPY
Depending on the size of the cyst and its location, diagnostic procedures in addition to clinical examination may include:
Smaller radicular and follicular cysts are operated on using the enucleation technique. In the case of radicular cysts, an apicoectomy of the tooth root or tooth extraction is performed along with enucleation.
The enucleation of follicular cysts most often involves the extraction of an impacted tooth. Sometimes, it is a therapeutic procedure that creates conditions for the eruption of an impacted incisor, canine, or premolar that was associated with the cyst.
Keratocysts of smaller dimensions are removed using the enucleation technique, with the mandatory application of Carnoy’s solution.
Cysts that are several centimeters in size or larger, which threaten vital teeth or whose surgery would cause spontaneous jaw fractures, are operated on using the marsupialization technique.
This technique involves cutting part of the cyst wall, aspirating the contents, and suturing the cystic epithelium to the mucosa of the mouth. In this way, the cyst no longer exerts hydrostatic pressure on the surrounding tissue, allowing it to regenerate and reduce the size of the cyst, potentially leading to complete healing.
In rare cases, a cyst of reduced size is removed using the enucleation technique.