Intrabony cysts are most common in the jaws, because the mandible and maxilla are the only bones with. Though these are restrictedly expressed in odontogenic cysts, one case of plexiform ameloblastoma was reported, by takeda et al. This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. Hyaline bodies of rushton are peculiar microscopic structures found.
A small percentage of radicular cysts have crescentshaped hyaline rushton bodies within the epithelial lining. Rushton bodies rbs are one of the characteristic features seen in the epithelial lining of odontogenic cysts mainly radicular, dentigerous and odontogenic keratocyst. Dentigerous cysts account for about 20% of all odontogenic cysts, developing duringa peakage of 10to 30years,witha male predilection3. Odontogenic cysts, tumors, and related jaw lesions ento key. Although cysts are common in the jaws, most are radicular cysts of in. A rushtons hyaline body hb is a concretion occasionally found in odontogenic cysts. We have examined a series of rushton bodies seen in.
Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis. Developmental odontogenic cysts 1 dentigerous cyst a cyst that forms around the crown of an unerupted tooth. Data from published studies suggest an overall incidence of about 8%. Factors related to cholesterol formation in cysts and granulomas. Rushton bodies are hyalinized structures that may be observed within the epithelial lining of odontogenic cysts. Oral cavity cysts oral cavity cysts exist in jaw bones and soft tissue, gingiva odontogenic.
Exclusive occurrence of hyaline bodies in odontogenic cysts and the restricted presence within the epithelial lining suggest. Apoptosis and rushton body formation, histopathology 10. Dentigerous cyst is a developmental odontogenic cyst that is formed by expansion of dental follicle and therefore always attached to the neck of an impacted or unerupted tooth. Calcifying odontogenic cysts have a wide age distribution that peaks at 10 to. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of 10% followed by. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. The cystic lumen will frequently contain necrotic cellular debris. These cysts show variable features and some lie on a cysttumour interface, making classification and diagnosis difficult. Electron microscopic investigation of hyaline bodies in. Clinicopathological analysis of 232 radicular cysts of the jawbone in. Initially this lesion is asymptomatic, other than a clinically missing tooth. Apoptosis and rushton body formation apoptosis and rushton body formation pesce, c. In this case report, we present a rare case of radicular cyst with rushton bodies in a 42 years male patient.
If the cyst not lined by epithelium it is pseudo cyst. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of 10% followed by dentigerous cysts 410% and odontogenic keratocysts okc 7% 1,2. Giant radicular cyst of the maxilla bmj case reports. Pathogenesis develops between enamel epithelium and tooth after odontogenesis is completed. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of. Rushton bodies, spongiosis, ciliated cells, necrosis, microabscesses and russel bodies, cholesterol crystals, hemosiderin and inflammatory.
Review of literature residual cysts informatics journals. Rushton bodies may be seen as irregular structures on the surface epithelium of odontogenic cysts. Though these are restrictedly expressed in odontogenic cysts, one case of plexiform ameloblastoma was. Rushton bodies hyaline are observed occasionally, and these are described as cuticular or keratinlike products of odontogenic epithelium. Bilateral or multiple dentigerous cysts are usually associated with the maroteauxlamy mucopolysaccharidosis, type vi syndrome 16 and cleidocranial dysplasia. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst. Rushton bodies definition of rushton bodies by medical.
Rushton bodies or hyaline bodies in radicular cysts. It has two different histomorphological appearances. Although widely investigated, the exact pathogenesis and histogenesis of rbs is still an enigma. Introduction a cyst is an epithelium lined sac containing fluid or semifluid material the epithelial cells first proliferate and later undergo degeneration and liquefaction grow by expansion, causing displacement of adjacent teeth 3. Rushton bodies or hyaline bodies in radicular cyst a morphologic curiosity. Cysts that derive their epithelium from tissues involved in tooth formation are classed odontogenic and can be inflammatory or developmental in origin.
Discussion although dentigerous cysts are common developmental cysts, reported bilateral dentigerous cysts are extremely rare. Radicular cyst is the most common inflammatory odontogenic cyst. Odontogenic cyst and non odontogenic cyst epithelium. Malignant transformation of an odontogenic cyst in a. Bilateral dentigerous cysts report of an unusual case. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. It is a consequence to pulp necrosis of carious teeth. Odontogenic cysts are largely classified based on their location, viability of the associated tooth and clinical setting the principal exception to this is the odontogenic keratocyst, which can occur in any site or setting unlike most of the other cysts, it has aggressive potential. Implications of cholesterol crystals in odontogenic cysts. Oralsurgery 548 dentalupdate julyaugust 2015 odontogenic cysts an overview abstract.
Rushtons hyaline bodies are found in odontogenic cysts, in particular in radicular cysts, as amorphous or lamellar concretions. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development. Inflammatory odontogenic cysts are benign osteolytic asymptomatic lesions, but that. It forms as a result of pulp necrosis due to the presence of carious teeth. Rushton bodies rb or hyaline bodies in odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structures within the epithelial lining of odontogenic cysts. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. Syndrome composed of multiple odontogenic keratocysts, bifid ribs, frontal bossing and multiple nevoid basal cell carcinomas in the patient. Unspecified substances produced by the lining epithelium or derived from blood components have been suggested as possible causes of hb formation, but the origin of hbs is still elusive. Comparison of components of odontogenic cyst fluids. Ectopic production of hair keratin constitutes rushtons. Occasionally dentigerous cysts contain rushtons hyaline bodies. Extremely rare examples have even been reported in a glandular odontogenic cyst and in an ameloblastoma. Rushton bodies are characterized by a glassy pink hyalinized appearance in. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.
The origin and nature of rb have been hotly debated. Odontogenic cysts free download as powerpoint presentation. Distribution of morphological alterations observed in radicular cysts from. Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Calcifying odontogenic cyst also called gorlin cyst as a cystic neoplasm. Epidemiology most common odontogenic cyst is periapical. Histopathological study of radicular cysts diagnosed in a. These form as a result of entrapment of blood vessels within the epithelium, resulting in vascular thrombosis. Rushton bodies rb or hyaline bodies in odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structures within. The relationship between cholesterol crystals, foamy macrophages. Although unique to odontogenic cysts, the biologic significance of rushton bodies is unknown.
Comparison of components of cystic fluid in odontogenic keratocyst, dentigerous cyst, and radicular cyst. Calcifying odontogenic cyst calcifying odontogenic cyst. Histologic or microscopic features of dentigerous cyst. Most of these lesions involve the apex of offending tooth and appear as welldefined radiolucencies. Odontogenic cysts and tumors are uncommon lesions and should be included in the differential diagnosis of gnathic bone pathoses.
Other types of epithelial lining were also observed, including simple table 1. Fibrous to fibromyxoid connective tissue no rete ridges, flat interface. Rushton bodies rbs are one of the characteristic features seen in the epithelial lining of odontogenic cysts mainly radicular, dentigerous and odontogenic. Odontogenic cysts and tumors ppt linkedin slideshare. Odontogenic cysts are jaw lesions that may be misdiagnosed due to lack of complete data. Theory of rushton bodies formation one theory is that hyaline bodies are particular products of odontogenie epithelium wertheimer et al. Rushton bodies scattered mucous, or ciliated or sebaceous cells uncommon but possible occasional dystrophic calcifications odontogenic epithelial rests, small, inactive appearing. Odontogenic epithelial rest was noted in one case 0. Results 115 cases with 20% quiescent epithelium fig. A number of published studies have been carried out on large series table 1 relative frequency of 470 odontogenic cysts included in a study in the college of dentistry, king saud university, riyadh. Cysts of the jaw and soft tissues cairo university.