OVERVIEW

What are oral and maxillofacial cysts?

Oral and maxillofacial cysts generally refer to non-suppurative pathological cystic cavities that develop in the oral or maxillofacial regions. They are classified into soft tissue cysts and jaw cysts based on their location.

1. Soft tissue cysts. These include branchial cleft cysts and sublingual gland cysts. Branchial cleft cysts are congenital, appearing at sites corresponding to the branchial arches and clefts. Sublingual gland cysts, commonly known as ranulas, occur in the sublingual or submandibular regions.

2. Jaw cysts. These can be divided into odontogenic cysts and non-odontogenic cysts ^[1,2]. Odontogenic cysts are benign space-occupying lesions in the jawbone, meaning an extra cyst forms in the jaw but remains non-cancerous. Examples include primordial cysts, periapical cysts, and odontogenic keratocysts. Non-odontogenic cysts typically arise from epithelial cells left in the jaw during embryonic development, such as fissural cysts, traumatic bone cysts (blood extravasation cysts), and aneurysmal bone cysts.

Who is at high risk for oral and maxillofacial cysts?

There is no specific high-risk group for oral and maxillofacial cysts. Prolonged exposure to contributing factors—such as developmental abnormalities, inflammation, or infection—can trigger the condition.

Are oral and maxillofacial cysts serious?

Oral and maxillofacial cysts are generally considered severe ^[1].

Soft tissue cysts may progress into malignant tumors, necessitating early detection and surgical removal. Complete excision usually prevents recurrence.

Jaw cysts gradually erode bone. Without timely treatment, they can lead to pathological fractures, tooth displacement, loosening, or even root resorption.

What are the types of oral and maxillofacial cysts?

Maxillofacial cysts include soft tissue cysts and jaw cysts ^[1,3].

1. Soft tissue cysts. Examples are sebaceous cysts, mucous cysts, ranulas, branchial cleft cysts, and thyroglossal duct cysts, all confined to soft tissues.

2. Jaw cysts. These develop within the jawbone and include odontogenic keratocysts, dentigerous cysts, developmental nasolabial cysts, and median mandibular cysts.

SYMPTOMS

What are the common manifestations of oral and maxillofacial cysts?

The symptoms of oral and maxillofacial cysts generally vary depending on the location and stage.

1. Soft tissue cysts. These primarily occur in the affected area and may present with swelling. If secondary infection develops, localized symptoms such as redness, swelling, warmth, and pain may appear, along with noticeable tenderness and fluctuation in the corresponding area.

2. Jaw cysts. These may cause tooth displacement, loosening, or even loss, and can also lead to facial swelling, deformity, restricted mouth opening, or even pathological fractures of the jaw. Similarly, jaw cysts may also become infected, resulting in localized redness, swelling, warmth, and pain.

Cysts typically show no abnormal symptoms in the early stages and are often discovered incidentally during examinations. In advanced stages, as the cysts grow, they may cause facial deformities or functional impairments, making them easily noticeable.

What complications can oral and maxillofacial cysts cause?

Oral and maxillofacial cysts may lead to complications such as sepsis and septicemia ^[1,2,3].

Due to the anatomical structure of the maxillofacial region, which contains many interconnected spaces, infections can enter the bloodstream when the patient's immune system is compromised, potentially causing sepsis or septicemia. The infection may also spread hematogenously to surrounding vital tissues and organs, leading to suppurative infections in other areas.

Additionally, the oral and maxillofacial region is surrounded by critical structures such as the trachea and blood vessels. In cases of infection, swelling can easily compress the trachea, causing breathing difficulties. If blood vessels are compressed, it may result in localized tissue necrosis.

CAUSES

What are the causes of oral and maxillofacial cysts?

The etiology of oral and maxillofacial cysts is relatively complex and often varies depending on the affected area ^[3]. Taking several common types of oral and maxillofacial tumors as examples:

1. Epidermoid cysts (soft tissue tumors). Most are caused by residual epithelial cells during congenital growth and development. As age increases, the patient's cysts will gradually proliferate.

2. Mucous gland cysts (soft tissue tumors). The primary cause is the obstruction of salivary gland excretory ducts, preventing timely saliva drainage, leading to cyst formation in the oral and maxillofacial region.

3. Odontogenic cysts (jawbone tumors). Contributing factors include persistent infection and inflammation from dental caries. Additionally, after onset, patients may experience facial deformities, jawbone defects, and other issues that impair normal physiological functions.

DIAGNOSIS

Which department should be consulted for oral and maxillofacial cysts?

Oral and maxillofacial cysts are usually treated in the oral and maxillofacial surgery department. If the hospital does not have this department, patients can visit the dental department instead.

What symptoms of oral and maxillofacial cysts require medical attention?

Generally, oral and maxillofacial cysts often show no obvious symptoms. However, if the cyst occurs in the soft tissues of the tongue or throat, it may directly cause symptoms such as difficulty swallowing, speech impairment, and breathing difficulties. If the cyst is located in the jawbone, it may lead to pathological fractures, double vision, or loose teeth. In such cases, prompt medical treatment is necessary.

Various oral and maxillofacial tumors may exhibit symptoms like swelling and compression, requiring timely medical diagnosis.

Additionally, patients should avoid self-assessing the severity of the condition and seek medical examination immediately if symptoms arise to prevent missing the optimal treatment window.

What tests are needed to diagnose oral and maxillofacial cysts?

Diagnosing oral and maxillofacial cysts typically involves puncture, ultrasound, and X-ray examinations.

1. Puncture: If the lesion is located in the front middle neck and moves with swallowing, it may be a thyroglossal duct cyst. For submandibular or parotid gland cysts, puncture may reveal egg-white-like fluid, aiding in differential diagnosis.

2. Ultrasound: The clarity of the cyst's boundaries and the uniformity of internal echoes help determine whether the cyst is benign or malignant.

3. X-ray examination: For cysts originating from hard tissues, X-ray imaging (e.g., panoramic radiography or CT) is crucial. A white-line boundary visible on imaging is typically indicative of a cyst.

TREATMENT

Do Oral and Maxillofacial Cysts Require Treatment?

Oral and maxillofacial cysts generally require treatment.

If a cyst develops over a long period, soft tissue cysts, sebaceous cysts, and even branchial cleft cysts may potentially become malignant. For jaw cysts, if left untreated, the cyst can gradually destroy the bone, leading to tooth displacement and loosening. Therefore, early detection and treatment are necessary for oral and maxillofacial cysts.

What Are the Treatment Options for Oral and Maxillofacial Cysts?

Most oral and maxillofacial cysts require surgical treatment ^[4]. The surgical approach varies depending on whether the cyst is a soft tissue cyst or a jaw cyst.

1. Soft tissue cysts. The cyst is completely excised through surgery, and postoperative recovery is generally good.

2. Jaw cysts, including radicular cysts and dentigerous cysts, can be completely removed through surgery, with a favorable prognosis.

Additionally, liquid nitrogen cryotherapy or iodine cauterization may sometimes be used. For complex cysts, partial resection of the maxilla or mandible may be performed. Since keratocysts often contain multiple daughter cysts, recurrence is possible if proper measures are not taken during surgery. After surgical removal of any cyst, appropriate antibiotics and hemostatic drugs should be administered to effectively prevent postoperative infection and bleeding.

DIET & LIFESTYLE

What are the lifestyle precautions for patients with oral and maxillofacial cysts?

Patients with oral and maxillofacial cysts generally need to pay attention to daily care, dietary habits, and maintaining cleanliness of the surgical site.

1. Daily care. In daily life, patients should protect the cyst and avoid irritation or damage to the affected area to prevent secondary infections.

2. Dietary habits. Patients should avoid hard and irritating foods to prevent pulling or irritating the wound. Postoperative patients should consume light liquid foods, such as rice porridge or egg soup. Adequate nutrition should also be supplemented to promote wound healing.

3. Surgical site hygiene. After surgery, patients should avoid prolonged exposure to dusty environments to prevent wound infections. Additionally, the wound should not come into contact with water for at least one week, and strenuous exercise should be avoided to prevent bacterial invasion from water or sweat, which could lead to infection.

PREVENTION

Can oral and maxillofacial cysts be prevented? How to prevent them?

Oral and maxillofacial cysts generally cannot be effectively prevented.

Oral and maxillofacial cysts are mainly caused by abnormal development during embryonic growth, making effective prevention impossible. However, maintaining oral hygiene and cleanliness in daily life to avoid damaging the oral mucosa can help prevent infections or traumatic stimulation that may lead to cyst formation.