CYSTS & TUMORS
There are relatively rare growth or lesions that develop in the jaw bone or soft tissues in the mouth & face. They are usually noncancerous (benign) but can be aggressive & invade surrounding bone & tissue & may displace teeth. Jaw tumors and cysts, sometimes called odontogenic tumors and cysts, can vary greatly in size and severity.
A CYST May be defined as a pathological encapsulated collection of fluid. Several types of cyst occur in jaws, most of which have an epithelial lining. Someone these are of dental origin whilst others are not.
A TUMOUR is caused by the overproduction of tissues; both can be found in the head and neck region.
SYMPTOMS: Not infrequently a cyst may be completely symptomless and the patient is quite unaware of the lesion until his attention drawn to its existence by either his dental or medical advisor.
- Intraoral Discharge
- Acute Infection of a cyst may cause the patient to present with a large acute abscess.
- Enlarged mandibular cysts – these may be accompanied by impairment of sensation in the lower lip on the affected side.
- In very rare instance pain impairment of labial sensation may be caused by a non-infected cyst of the mandible and in this circumstance, the symptoms are attributed to pressure.
- Incompletely or partially edentulous patients a cyst may be a cause of either discomfort under or difficulty in wearing dentures.
- Adjacent natural teeth may be either moved or tilted as the lesion expands.
Proper diagnosis and treatment have to be done which includes examining the area, getting proper X-rays. A biopsy may be needed at times.
Examples of certain jaw tumors and cysts include:
- Ameloblastoma. This is a relatively common, slow-growing, usually noncancerous (benign) tumor. It develops most often in the jaw near the molars and can invade local structures such as bone and soft tissue. This tumor can recur after treatment; however, aggressive surgical treatments will typically reduce the chance of recurrence.
- Central giant cell granuloma. Central giant cell granulomas are benign lesions that most often occur in the front portion of the lower jaw. Some of these tumors can grow rapidly, can cause pain and destroy bone, and have a tendency to recur after surgical treatment. The other types are less aggressive and may not have symptoms. Rarely, a tumor may shrink or resolve on its own, but typically these tumors require surgical treatment.
- Dentigerous cyst. This cyst originates from tissue that surrounds a tooth before it erupts into the mouth. This is the most common form of cyst that affects the jaws. Most often these cysts will occur around wisdom teeth that are not fully erupted, but they can also involve other teeth.
- Odontogenic keratocyst. Also referred to as keratocystic odontogenic tumor because of its tumorlike tendency to recur after surgical treatment, this slow-growing, a benign cyst can be destructive to local structures. Most often the cyst develops in the lower jaw near the third molars. These cysts may also be found in people with an inherited condition called nevoid basal cell carcinoma syndrome.
- Odontogenic myxoma. This is a rare, slow-growing, benign tumor that occurs most often in the lower jaw. The tumor can be large and aggressively invade the jaw and surrounding tissue and displace teeth. Odontogenic myxomas are known to recur after surgical treatment; however, the chances of tumor recurrence are typically lessened by aggressive surgical treatment.
- Odontoma. This benign tumor is the most common odontogenic tumor. Odontomas often have no symptoms, but may interfere with tooth development or eruption. Odontomas are made up of dental tissue that grows around a tooth in the jaw. They can resemble an oddly shaped tooth or can be a small or large calcified tumor. These tumors may be part of some genetic syndromes.
- Other types of cysts and tumors. These include adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibromas, glandular odontogenic cysts, squamous odontogenic tumors, calcifying odontogenic cysts, cementoblastomas, aneurysmal bone cysts, ossifying fibromas, osteoblastomas, and central odontogenic fibromas to name a few.
Odontogenic jaw tumors and cysts originate from cells and tissues that are involved in normal tooth development. Others tumors that affect the jaws can be nonodontogenic, meaning that they can develop from other tissues within the jaws that are not related to the teeth. Generally, the cause of jaw tumors and cysts is not known; however, some are associated with genetic syndromes.
People with nevoid basal cell carcinoma syndrome, also called Gorlin-Goltz syndrome, lack a gene that suppresses tumors. The genetic mutation that causes the syndrome is inherited. This syndrome results in the development of multiple odontogenic keratocysts within the jaws, multiple basal cell skin cancers and other characteristics.
To gather more information about the jaw tumor or cyst, certain tests recommended prior to treatment. These test may include:
- Imaging studies, such as X-ray, CT or MRI
- A biopsy to remove a sample of tumor or cyst cells for laboratory analysis
This information is put together for a treatment plan that’s best and the most effective option for treating tumor or cyst.
Treatment options for jaw tumors and cysts vary, depending on the type of lesion, the lesion’s stage of growth and symptoms. The treatment goals and personal preferences might be considered when making a treatment recommendation.
Treatment of jaw tumors and cysts generally involves surgical care. In some cases, treatment may be medical therapy or a combination of surgery and medical therapy.
During surgery, the removal of the jaw tumor or cyst may include removing nearby teeth, tissue and jawbone, and it has to be sent for pathological examination. A pathologist examines the removed tissue and reports a diagnosis.
Other treatments may include:
- Reconstruction of the jawbone or other structures
- Medical therapy for certain types of jaw tumors and cysts
- Supportive care to help maintain your quality of life, including assisting with nutrition, speech, and swallowing, and replacements for missing teeth
Lifelong follow-up exams after treatment can address any recurrence of jaw tumors and cysts early.
Dr. Aseema is trained to treat cysts & tumors of mouth & face with various modalities so as to improve the quality of life after the surgical treatment. In COMHTS, Dr. Aseema along with her experienced team will work with you to review all of your treatment options and choose the approach that best suits your needs and goals.