Periapical Granuloma:
Etiology: result of necrotic pulp tissue and by-products resulting from an inflammatory process that has damaged the tissue at the apex of the tooth
Method of Transmission: N/A
Characteristics: accumulation of granulation tissue that is focused at the apical of a nonvital tooth. Radiographically seen as a round or ovoid translucent lesion. Size of lesions vary from several mm to larger
Dental Implications: Vitality testing is crucial and if tooth is nonvital endo tx is needed.
Tx & Prognosis: ext , endo tx, apical curettage, apicoectomy, and antibiotic coverage. Prognosis is good if all the granuloma is removed

Radicular Cyst: Etiology: associated with the root of a nonvital tooth, caries, trauma (fracture or injury), or periodontal disease. Method of Transmission: N/A Characteristics: Found in any region of the mandible and maxilla, but mostly the maxillary anterior region at the apex of a nonvital tooth. Radiograph shows root resorption of the tooth. A pulp- testing device is used to as a diagnostic tool, however a biopsy is needed to confirm a radicular cyst. Identification can only be made through microscopic exams.. Dental Implications: Failure to remove the radicular cyst completely results in recurrence. Tx & Prognosis: removal by ext, surgery with curettage, RCT, apicoectomy, and antibiotic coverage. Prognosis is good with complete removal

Aneutysmal Bone Cyst: Etiology: pseudocyst, it appears as a cyst, but does not have the epithelium-lined lumen. Arises from prior trauma or genetic components. Method of Transmission: N/A Characteristics: swelling without pain. Radiographic features include unilocular or multilocular lesion, described as having a "soap bubble" appearance. Thinning and expansion of the cortical bone. Ballooning and distention of the cortical bone. Dental Implications: Aneurysmal bone cysts may cause the teeth to become displaced or loose of bone expansion Tx & Prognosis: Excision, curettage, cryotherapy, sclerotherapy, radionuclide ablation, and en bloc resection. Prognosis is good once lesion is completely removed

Cementoosseous Dysplasia: discovered during a radiographic exam. Pt will not report any sensitivity or discomfort. Term represents three types of lesions that are believed to fall under this heading and are variants of the same category. 1. Periapical cementoosseous dysplasia: occurs in the apical are, usually in the lower anterior region. 2. Focal cementoosseous dysplasia: most commonly occurs in the posterior mandible region. Usually seen in whites. 3. Florid cementoosseous dysplasia: covers a wide area of involvement in both jaws. Generally affects Blacks, Asians, and Whites.

Periapical Cementoosseous Dysplasia:
Etiology: unknown
Method of Transmission: N/A
Characteristics: pt is usually asymptomatic and lesions are discovered on routine radiographs. Occurs at the apex of viral teeth, with propensity for the anterior mandibular teeth
Dental Implications: Vitality of the tooth is important, since the tooth tests vital with periapical COD.
Tx & Prognosis: ext nor surgery is required since the teeth remain vital. Early recognition and determination will alleviate unnecessary tests and surgery

Focal COD: is believed to be closely related to periapical COD. Most cases occur in females around their 40s-60s. Occurs most often in whites rather than blacks. “Focal” means that the lesions occurs in areas other than the apex of the tooth and affects in the posterior of the mandible. Unilateral lesion with well-defined and thin radiolucent perimeter.

Florid COD: mostly affects middle-aged adult black women and Asian women also a familial tendency is reported. Can affect any quadrant of the mouth found in both edentulous and dentulous. Yellow bone like material, and during surgical removal , it is difficult to separate the material from the bone. Radiograph May have “ground-glass” type appearance. Tx is through observation, clinical recalls, and prophylaxis.

Osteomyelitis: Acute and Chronic Forms:
Etiology: inflammation in the bone. Periapical abscess is the cause of the acute form. Mandible is more susceptible due to poor vascular supply and dense cortical bone. Chronic- caused by long-term inflammatory reaction from some stimulus. Method of Transmission: acute have several infectious organisms involved in the disease process. Characteristics: Acute infection may not produce the destruction that the chronic form produces, because it has not been present long enough to create bone damage. Chronic- more evident patches of necrotic bone and diffuse radiolucent lesions are seen.
Dental Implications: Pt may have pain and lymphadenopathy. Correct antibiotic is needed.
Tx & Prognosis: Drainage and antibiotics for acute. Surgery with antibiotic coverage and drainage for chronic

Lateral Periodontal Cyst: Etiology: develop from the dental lamina remnats from within bone. Often unilocular, radiolucent, and lateral to the root of a vital mandibular cuspid or premolar tooth
Method of Transmission: N/A
Characteristics: unilocular, round or oval, and well delineated. Grape like appearance and are located laterally to the root of viral teeth
Dental Implications: Cysts should be identified, since it is necassary to rule out an inflammatory-type lesion or more serious type of cyst or tumor.
Tx & Prognosis: Surgical excision, pathologic review, and vitality testing. Radiographic follow ups. Prognosis is excellent

Gingival cysst of the adult: is the uncommon soft tissue counterpart to the lateral periodontal cyst. It is located on the facial gingiva or alveolar mucosa. May occur at around 40-60yrs, predominately on premolar and canine mandible region. Firm flesh colored nodule that are painless, nonmobile, and measures 1 to 3mm in diameter. Tx consists surgical excision and histopathologic examination. Alveolar defects may be noted upon removal of growth.

Dentigerous cyst: Etiology: arise from a cystic change in the dental follicle following crown formation when the follicle separates from the crown of the tooth.
Method of Transmission: N/A
Characteristics: only evident on radiographs, well circumscribed, unilocular, and sometimes multiloccular.
Dental Implications: Delayed otth eruption is a common theme. It can be quite large and has the potential to displace teeth and resorb roots. Early diagnosis is important because it can continue to grow.
Tx & Prognosis: Complete removal of the cyst, since recurrence is high when it is not fully accomplished

Eruption Cyst: Etiology: accumulation of of fluid or blood between crown of an erupting toot and the reduced enamel organ, sue to trauma
Method of Transmission: N/A
Characteristics: tissue may have a dark appearance and appear elevated. Smooth bluish swelling on the crest of the alveolar ridge. Enlarged follicular space in a radiograph.
Dental Implications: Failure of the tooth to erupt.
Tx & Prognosis: no tx is needed, but an occasion removal of the overlying tissue could facilitate a quicker eruption.

Odontogenic Keratocyst: Etiology: develops from lamina dura remnants.
Method of Transmission: N/A
Characteristics: Occur most often in posteriro mandibular region and ramus of the mandible. Radiographically, lesions can be multilocular or unilocular, well circumscribed, radiolucent with a scalloped apperance.
Dental Implications: Radiographically resembles other cysts, but the microscopic interpentation is unique once a specimen is submitted.
Tx & Prognosis: Since recurrence is high, careful removal of the entire cyst is crucial.

Nevoid Basal Cell Carcinoma Syndrome: prime concern for pt diagnosed with OKC due to close association between the two disorders. It is an inherited autosomal dominant disorder. BCCs on cutaneous areas. Face is most affected followed by the chest.

Primordial Cyst: It is an older term and was sometimes used in conjunction with the odontogenic keratocyst. Since OKC is diagnosed in most cases, term is no longer used

Calcifying Odontogenic Cyst: Etiology: derived form the reduced enamel epithelium or odontogenic epithelium.
Method of Transmission: N/A
Characteristics: may be found as masses within oral tissues, most always within the gingiva. Occur at any location and present as an expansile intraosseous lesion or tender gingival swelling. Radiographically, lesions are unilocular or multilocular radiolucent and exhibit clearly defined margins. Presence of "ghost cells"
Dental Implications: definitive diagnosis is important to rule out and complete removal is necessary. Tx & Prognosis*: Surgical excision, correct pathological identification is crucial. Prognosis is good, although recurrence is sometimes seen.

Globulomaxillary Cyst: Etiology: arose from the epithelium that was thought to be trapped when the globular portion of the median nasal process fused with the maxillary process
Method of Transmission: N/A
Characteristics: both swelling and expansion may be noted. Some case are asymptomatic and report pain/discomfort, infection, and paresthesia have also been reported. Most distinguishing characteristics are those that differentiate the GOC from other cyst structures.
Dental Implications: Follow ups on important since recurrence is high and radiographic exams are important in an early diagnosis of recurrence
Tx & Prognosis: enucleation, curettage, cystectomy, excision, and partial osteomy. Recurrence of 50% when lesions are treated conservatively.

Nasopalatine Duct Cyst: Etiology: arises form epithelial remnants of the embryologic structure fo the nasopalatine ducts and the structure connects the oral and nasal cavities in the area of the incisive canal bc of infection or some stimulation
Method of Transmission: N/A
Characteristics: pt may complain of pain, tenderness, swelling, and drainage may be noted in the mx incisor region. When drainage occurs pt may complain foul, salty taste. Pt may also experience pain, discomft, and burning.
Dental Implications: cyst is not radiographically diagnostic and must be removed and biopsied for definitive microscopic evaluation
Tx & Prognosis: Complete surgical removal is needed and prognosis is good, and recurrence rate is low with compete removal

Median Palatine Cyst: located in the same vicinity as the nasopalatine cyst but is more apically centered toward the midline of the hard palate. Lined by stratified squamous epithelium and is surrounded by dense connective tissue. Rare and is beleived to be developed from entrapped epithelium along the embryonic line of fusion in the two lateral maxillary process. Pt may complain of pain and expansion of the palate when the cyst impinges the nasopalatine nerve.

Static Bone Cyst: Etiology: not a true cyst, but its a defect in the mandible that surrounds salivary gland tissue. Entrapment of salivary gland tissue and is not lined by epithelium
Method of Transmission: N/A
Characteristics: asymptomatic and is usually discovered in a pano film is taken. Bone cyst is seen as a radiolucency in the posterior mandible below the mandibular canal. Sharply circumscribed, oval, radiolucent lesion with a sclerotic border. Found at the angle of the mandible
Dental Implications: Diagnosed clinically by using radiographs, however when location is superior to the mandibular canal, a biopsy may be needed to rule out pathology.
Tx & Prognosis: they are noted and followed long term and if any changes occur.

Adenomatoid Odontogenic Tumor: Etiology: an encapsulated benign epithelial odontogenic tumor. Method of Transmission: N/A Characteristics: as the tumor expands and increases in size, there may be root displacement and a bony hard expansion with an eggshell cracking appearance over the protrusion. Small opaque foci within the tumor. The granular or duct like features form a rosette pattern differentiates it from other lesions. Dental Implications: Facial asymmetry is the first sign to be noticed by the patient as the tumor increases. Tx & Prognosis: Complete removal of the tumor is necessary and the prognosis is excellent without any recurrence

Odontogenic Myxoma: Etiology: derived from odontogenic ectomesenchyme
Method of Transmission: N/A
Characteristics: Radiographically, the tumors can be unilocular or multilocular and radiolucencies may have a scalloped appearance. "Step ladder" or "honey combed" apperance.
Dental Implications: Enlarged dental follicles or the dental papilla of a developmental tooth may be mistaken for the myxomas upon microscopic examination. Tumors can be quite large, causing tooth displacement
Tx & Prognosis: Removed surgically with a wide margin of normal bone. Recurrence is a high 25% because the tumor is encapsulated.

Ameloblastic Fibroma: Etiology: originate from odontogenic ectomesenchyme and odontogenic epithelium
Method of Transmission: N/A
Characteristics: pt usually experience no pain with any swelling that may occur. Extensive growth causes jaw expansion. Radiographically, lesions are unilocular or multilocular and well defined. Associated with an erupted tooth.
Dental Implications: it is asymptomatic
Tx & Prognosis: Conservative excision and recurrence is seen in approx. 20% of cases. Some recur as ameloblastic fibrosarcoma

Langerhans Cell Disease: Langerhans Cell Histiocytosis: Etiology: unknown
Method of Transmission: N/A
Characteristics: may involve one or more multiple bones in the body, including the bones around the teeth, contributing to lessening (floating teeth).
Tenderness, pain, and swelling are common complaints. Premature loosening and exfoliation of teeth in children.
Dental Implications: Occur periapically and can be confused with periapical cyst or granulomas. Tooth vitality would still be present.
Tx & Prognosis: tx depends on the involvement of the disease and the age of the pt. Conservative surgical tx is the only tx. More extensive disease involve chemotherapy. The prognosis is more favorable when the disease staes develop in older yound adults