A jaw cyst refers to a cystic mass containing fluid that appears within the jawbone, gradually enlarging and causing expansion and destruction of the jawbone. Based on its etiology, it can be classified into two major categories: odontogenic and non-odontogenic. Odontogenic cysts originate from tooth-forming tissues or teeth, while non-odontogenic cysts may develop from epithelial remnants left in the jawbone during embryonic development, such as fissural cysts. They can also include extravasation cysts caused by injury or tumor-like bone cysts such as aneurysmal bone cysts.

bubble_chart Clinical Manifestations

1. Progressive painless enlargement of the jaw, with slow progression and usually no subjective symptoms.

2. Larger lesions may exhibit a ping-pong ball-like resilience on palpation.

3. Often associated with dental pathology (e.g., radicular cyst) or missing teeth.

4. Aspiration yields straw-yellow fluid, with cholesterol crystals visible under microscopy. The cystic fluid of keratocysts (a type of jaw cyst) appears as milky-white keratinized material or sebum-like substance.

5. Radiographic findings show a cystic radiolucent area within the jawbone. This radiolucency has smooth, gently contoured borders and a dense white sclerotic rim.

[Ancillary Examinations]

1. For cases with typical clinical presentation and relatively clear preoperative diagnosis, the examination should focus on items under "A" in the examination framework.

2. For cases with atypical clinical presentation or challenging differential diagnosis, examinations may include items under "B" and "A" in the examination framework. {|107|}

bubble_chart Diagnosis

2. Aspiration yields straw-yellow fluid, while odontogenic keratocysts produce white keratinized or greasy material.

3. Odontogenic cases involve a causative tooth or missing tooth.

4. Radiographic findings show a cystic radiolucent area within the jawbone, with smooth, gently curved borders and a dense white sclerotic rim.

5. Definitive diagnosis is confirmed by histopathological examination.

bubble_chart Treatment Measures

For general surgical procedures, prophylactic anti-infection measures typically involve sulfonamides (such as compound formula co-trimoxazole) or drugs primarily effective against Gram-positive bacteria (e.g., erythromycin, penicillin, etc.). Patients with poor constitution or concurrent infections often require combination therapy, commonly including: drugs targeting Gram-positive bacteria (e.g., penicillin series) + drugs targeting Gram-negative bacteria (e.g., gentamicin) + drugs targeting anaerobic bacteria (e.g., metronidazole). For severe infections or complications before or after surgery, effective antibiotics may be selected based on clinical evaluation and drug sensitivity testing.

Jaw cysts are benign sexually transmitted disease lesions, and non-surgical treatments are ineffective. They should be surgically removed as early as possible after discovery, as the mass gradually enlarges over time, potentially causing significant bone tissue defects, pathological fractures, or affecting multiple teeth, thereby impairing chewing function. Clinically, jaw cysts are often confused with ameloblastomas of the jaw, but the surgical approaches for these two conditions are entirely different. The former requires only simple curettage, while the latter necessitates resection 0.5 cm beyond the lesion to avoid postoperative recurrence. Therefore, in addition to relying on X-rays and other auxiliary diagnostic methods for accurate preoperative diagnosis, a biopsy or intraoperative frozen section may be necessary for confirmation when needed.

1. Cure: The cyst was completely removed, and the wound has basically healed.

2. Improvement: After treatment, there is still residual cyst.

3. No improvement: No surgical treatment was performed, with no changes in appearance or function. {|102|}