The botryoid odontogenic cyst is a multi-compartmentalized variant of the lateral periodontal cyst. It is similar to the lateral periodontal cyst in all its features except that its polycystic nature is often evident through its multilocular pattern on radiographs.

Cysts rarely cause any symptoms, unless they become secondarily infected. The signs depend mostly upon the size and location of the cyst. If the cyst has not expanded beyond the normal anatomical boundaries of the bone, then there will be no palpable lump outside or inside the mouth. The vast majority of cysts expand slowly, and the surrounding bone has time to increase its density around the lesion, which is the body's attempt to isolate the lesion. Cysts that have expanded beyond the normal anatomic boundaries of a bone are still often covered with a thin layer of new bone. At this stage, there may be a sign termed "eggshell cracking", where the thinned cortical plate cracks when pressure is applied. A lump may be felt, which may feel hard if there is still bone covering the cyst, or fluctuant if the cyst has eroded through the bone surrounding it. A cyst may become acutely infected, and discharge into the oral cavity via a sinus. Adjacent teeth may be loosened, tilted or even moved bodily. Rarely, roots of teeth are resorbed, depending upon the type of cyst. The inferior alveolar nerve runs through the mandible and supplies sensation to the lower lip and chin. As most cysts expand slowly, there will be no altered sensation (anesthesia or paraesthesia), since the inferior alveolar canal is harmlessly enveloped or displaced over time. More aggressive cysts, or acute infection of any cyst may cause altered sensation.

Botryoid odontogenic cyst is a variant of the lateral periodontal cyst. It is more often found in middle-aged and older adults, and the teeth more likely affected are mandibular (lower) canines and premolars. On radiographs, the cyst appears "grape-like". Often patients with this condition are symptomatic.

Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis (tooth development). Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. It may contain air, fluids, or semi-solid material. Intra-bony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. That odontogenic epithelium is critical in normal tooth development. However, epithelial rests may be the origin for the cyst lining later.

Not all oral cysts are odontogenic cyst. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.

In addition, there are several conditions with so-called (radiographic) 'pseudocystic appearance' in jaws; ranging from anatomic variants such as Stafne static bone cyst, to the aggressive aneurysmal bone cyst.

Most cysts in the body are benign (dysfunctional) tumors, the result of plugged ducts or other natural body outlets for secretions. However, sometimes these masses are considered neoplasm:

- Keratocyst

- Calcifying odotogenic cyst

- According to the current (2005) classification of the World Health Organization, both (parakeratizied) odontogenic keratocyst and calcifying odotogenic cyst have neoplastic characteristics, thus renamed as Keratocystic odontogenic tumor and Calcifying odotogenic tumor, respectively.

- Cystic ameloblastoma

- Long standing dentigerous cyst, odontogenic keratocyst, and residual cyst may have neoplastic potential converting into the locally aggressive ameloblastoma, or the malignant squamous cell carcinoma and mucoepidermoid carcinoma.

Odontogenic cysts have histologic origins in the cells of the dental structures. Some are inflammatory while others are developmental.

- Radicular cyst is the most common (up to two thirds of all cysts of the jaws). This inflammatory cyst originated from a reaction to dental pulp necrosis.

- Dentigerous cyst, the second most prevalent cyst, is associated with the crown of non-erupted tooth.

- Odontogenic keratocyst, which now is considered as tumor, and therefore called "Keratocystic odontogenic tumor". This lesion may be associated with the Nevoid basal cell carcinoma syndrome.

- Buccal bifurcation cyst which appears in the buccal bifurcation region of the mandibular first molars in the second half of the first decade of life.

- Eruption cyst; a small cyst in the gingiva as a tooth erupts, forming from the degenerating dental follicle

- Primordial cyst; previous thought to be a unique entity. Most primordial cysts have proven to be Keratocystic odontogenic tumors

- Orthokeratinized odontogenic cyst; a variant of the Keratocystic odontogenic tumor

- Gingival cyst of the newborn; an inclusion cyst from remanents of the dental lamina on a newborn gingiva

- Gingival cyst of the adult; a soft tissue variant of the lateral periodontal cyst

- Lateral periodontal cyst; a non-inflammatory cyst (vs a radicular cyst) on the side of a tooth derived from remanents of the dental lamina

- Calcifying odontogenic cyst; a rare lesion with cystic and neoplastic features and significant diversity in presentation, histology and prognosis

- Glandular odontogenic cyst; cyst with respiratory like epithelial lining and the potential for recurrence with characteristics similar to a central variant of low-grade mucoepidermoid carcinoma

Gingival cyst of adult is a rare condition. The incidence is less than 0.5%. It is formed from the rests of dental lamina. It is found in the soft tissues on the buccal and labial portions of the jaw. It usually occurs on the facial gingiva as a single small flesh colored swelling, sometimes with a bluish hue due to the cystic fluid. Sometimes, it may occur in cluster, either unilaterally or bilaterally or on the lingual surface of the alveolar process. It is most commonly seen in the canine and premolar regions of the mandible, and are sometimes confused with lateral periodontal cysts. It is not normally problematic, but when it grows larger, it can cause some discomfort. It can be removed by simple surgical excision. They are developed late in life, generally up to the sixth decade of age.

Periapical cysts begin as asymptomatic and progress slowly. Subsequent infection of the cyst causes swelling and pain. Initially, the cyst swells to a round hard protrusion, but later on the body resorbs some of the cyst wall, leaving a softer accumulation of fluid underneath the mucous membrane.

Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur. Patient will present negative results to electric and ice test of the affected tooth but will be sensitive to percussion. Surrounding gingival tissue may experience lymphadenopathy. The alveolar plate may exhibit crepitus when palpated.

Periapical cysts exist in two structurally distinct classes:

Periapical true cysts - cysts containing cavities entirely surrounded in epithelial lining. Resolution of this type of cyst requires surgical treatment such as a cystectomy.

Periapical pocket cysts - epithelium lined cavities that have an opening to the root canal of the affected tooth. Resolution may occur after traditional root canal therapy.

Gingival cyst (or dental lamina cyst) is a type of cysts of the jaws that originates from the dental lamina and is found in the mouth parts. It is a superficial cyst in the alveolar mucosa. It can be seen inside the mouth as small and whistish bulge. Depending on the ages in which they develop, the cysts are classsfied into gingival cyst of newborn (or infant) and gingival cyst of adult. Structurally, the cyst is lined by thin epithelium and shows a lumen usually filled with desquamated keratin, occasionally containing inflammatory cells. The nodes are formes as a result of cystic degeneration of epithelial rests of the dental lamina (called the rests of Serres).

Gingival cyst was first described by a Czech physician Alois Epstein in 1880. In 1886, a German physician Heinrich Bohn described another type of cyst. Alfred Fromm introduced the classification of gingival cysts in 1967. According to him, gingival cysts of newborns can be further classsified based on their specific origin of the tissues as Epstein’s pearls, Bohn’s nodules and dental lamina cysts.

Two thirds of cases are located in the anterior maxilla, and one third are present in the anterior mandible.

Two thirds of the cases are associated with an impacted tooth (usually being the canine).

On radiographs, the adenomatoid odontogenic tumor presents as a radiolucency (dark area) around an unerupted tooth extending past the cementoenamel junction.

It should be differentially diagnosed from a dentigerous cyst and the main difference is that the radiolucency in case of AOT extends apically beyond the cementoenamel junction.

Radiographs will exhibit faint flecks of radiopacities surrounded by a radiolucent zone.

It is sometimes misdiagnosed as a cyst.

There are two main types: compound and complex.

- A "compound" odontoma still has the three separate dental tissues (enamel, dentin and cementum), but may present a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets" (or denticles). It usually appears in the anterior maxilla.

- The "complex" type is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities. It usually appears in the posterior maxilla or in the mandible.

In addition to the above forms, the dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary teeth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma.

Periapical cysts comprise approximately 75% of the types of cysts found in the oral region. The ratio of individuals diagnosed with periapical cysts is 3:2 male to female, as well as individuals between 20 and 60 years old. Periapical cysts occur worldwide.

Types of Periapical cysts:

Apical: 70%

Lateral: 20%

Residual: 10%

The lateral periodontal cyst is a non-inflammatory developmental cyst that arises from the epithelial post-functional dental lamina, which is a remnant from odontogenesis. It is more common in middle-aged males. Usually asymptomatic, it presents as a regular well-corticated radiolucency on the side of a mandibular canine or premolar root. Histologically, the cyst appears similar to the gingival cyst of the adult, having a non-keratinized squamous epithelial lining. The involved tooth is usually vital and has no indication for root canal treatment unless the signs of non-vital or necrotic pulpal tissue were confirmed. The cysts arise from epithelial rest cells in the periodontal ligament, although it is unknown whether from the cell rests of Malassez, reduced enamel epithelium or dental lamina remnants, and are generally treated by surgical enucleation.

A dentigerous cyst or follicular cyst is an odontogenic cyst - thought to be of developmental origin - associated with the crown of an unerupted (or partially erupted) tooth. The cyst cavity is lined by epithelial cells derived from the reduced enamel epithelium of the tooth forming organ. Regarding its pathogenesis, it has been suggested that the pressure exerted by an erupting tooth on the follicle may obstruct venous flow inducing accumulation of exudate between the reduced enamel epithelium and the tooth crown.

In addition to the developmental origin, some authors have suggested that periapical inflammation of non-vital deciduous teeth in proximity to the follicles of unerupted permanent successors may be a factor for triggering this type of cyst formation.

Histologically a normal dental follicle is lined by enamel epithelium, whereas a dentigerous cyst is lined by non-keratinized stratified squamous epithelium. Since the dentigerous cyst develops from follicular epithelium it has more potential for growth, differentiation and degeneration than a radicular cyst. Occasionally the wall of a dentigerous cyst may give rise to a more ominous mucoepidermoid carcinoma. Due to the tendency for dentigerous cysts to expand rapidly, they may cause pathological fractures of jaw bones.

On Fine needle aspiration, thin straw colored fluid is seen.

The usual radiographic appearance is that of a well-demarcated radiolucent lesion attached at an acute angle to the cervical area of an unerupted tooth. The border of the lesion may be radiopaque. The radiographic differentiation between a dentigerous cyst and a normal dental follicle is based merely on size. Radiographically, a dentigerous cyst should always be differentiated from a normal dental follicle. Dentigerous cysts are the most common cysts with this radiographic appearance. Radiographically the cyst appears unilocular with well defined margins and often sclerotic borders but sometimes it may be multilocular in appearance and may also have a continuous cystic membrane. Infected cysts show ill-defined margins. Follicular space more than 3mm is to be considered a dentigerous cyst.

Radiographically there are three types of dentigerous cyst, namely the Central type, Lateral type and the Circumferential type.

The most common location of dentigerous cysts are the Mandibular 3rd Molars and the Maxillary Canines, and they rarely involve deciduous teeth and are occasionally associated with odontomas.

A dentigerous cyst is often treated by excision of the cyst along with the extraction of the associated tooth.

In case of a large cyst marsupialization is done.

Swelling is the most common presenting complaint; however, OKCs may be asymptomatic and found incidentally on dental X-rays.

frequency:- rare type of cyst

It can occur at any age, mostly between 2nd and 3rd decade of life.

Diameter is 2 to 4 cm

swelling pain maybe present.

intra bony expansions may produce hard bony expansion.

may perforate cortical bones

also it extends to soft tissue

maybe asymptomatic

Cementoblastoma usually occurs in people under the age of 25, particularly males. It usually involves the permanent mandibular molars or premolars. The involved tooth usually has a vital pulp. It is attached to the tooth root and may cause its resorption, may involve the pulp canal, grows slowly, tends to expand the overlying cortical plates, and, except for the enlargement produced, is usually asymptomatic. This involves the buccal and lingual aspects of the alveolar ridges. But may be associated with diffuse pain and tooth mobility, but the tooth is still vital.

Since a cementoblastoma is a benign neoplasm, it grossly forms a mass of cementum-like tissue as an irregular or round mass attached to the roots of a tooth, usually the permanent mandibular first molar.

The adenomatoid odontogenic tumor is an odontogenic tumor arising from the enamel organ or dental lamina.

The calcifying odotogenic cyst or the Gorlin cyst, now known in the WHO Classification of Tumours as the calcifying cystic odontogenic tumor, is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. It is most common in people in their second to third decades but can be seen at almost any age. On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency (dark area). In one-third of cases, an impacted tooth is involved. Microscopically, there are many cells that are described as "ghost cells", enlarged eosinophilic epithelial cells without nuclei.

A cementoblastoma in a radiograph appears as a well-defined, markedly radiopaque mass, with a radiolucent peripheral line, which overlies and obliterates the tooth root. it is described as having a rounded or sunburst appearance. There is usually apparent external resorption of the root where the tumor and the root join. Severe hypercementosis and chronic focal sclerosing osteomyelitis are lesions to consider in the differential diagnosis of this lesion.

The epidermoid cyst may have no symptoms, or it may hurt when touched. It can release pus. It is very common for women on the major or minor labia. In contrast to pilar cysts, epidermoid cysts are usually present on parts of the body with relatively little hair.

Occasionally, an epidermoid cyst will present with Trigeminal neuralgia.

Although they are not malignant, there are rare cases of malignant tumors arising from an epidermoid cyst.

An odontoma (also termed odontome) is a benign tumour of odontogenic origin (i.e. linked to tooth development). Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way.

The average age of people found with an odontoma is 14. The condition is frequently associated with one or more unerupted teeth. Though most cases are found impacted within the jaw there are instances where odontomas have erupted into the oral cavity.

Radiographically, odontogenic myxomas appear most commonly as multilocular radiolucencies with ill-defined borders, though unilocular cyst-like tumors can occur, especially when associated with impacted teeth or when discovered in childhood. Ideally, the septa that cause the multilocular feature are thin and straight, producing a tennis racket or stepladder pattern. In reality, the majority of the septa visible in the tumor are curved and coarse, causing a "soap bubble" or "honeycomb" appearance, though locating one or two straight septa can aide in the diagnosis of this tumor.

Odontogenic myxomas have been found in patients ranging in age between 10 and 50 years, however, they are most commonly diagnosed in young adults (specifically between 25 and 35 years of age). The mandible is more likely to be affected than the maxilla. The region between the molar and premolar is the site of most common occurrence for multilocular lesions while the anterior portion of the mouth favors a smaller, unilocular variety.

Patients afflicted with an odontogenic myxoma generally notice a painless, slowly enlarging expansion of the jaw with possible tooth loosening or displacement. As the tumor expands, it frequently infiltrates adjacent structures. Maxillary lesions frequently enter the sinuses while mandibular tumors often extend into the ramus.

The nasopalatine cyst is the most common non-odontogenic cyst of the oral cavity, at an estimated occurrence rate of 73%.