Lateral periodontal odontogenic cysts are developmental cysts arising adjacent or lateral to the roots of vital teeth and botryoid odontogenic cysts are multilocular variants of lateral periodontal odontogenic cysts.
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Epidemiology
Lateral periodontal and botryoid odontogenic cysts are rare, with a peak incidence between the 5th and 7th decades 1-3.
Diagnosis
The diagnosis is established histologically.
Clinical presentation
Most lateral periodontal and botryoid odontogenic cysts are found incidentally and can present as an expansion of the mandible or maxilla 1,2.
Pathology
Location
The cysts are most frequently found in an anterior location of the jawbones. Botryoid cysts were found more often in the mandible than in the maxilla 1-3.
Microscopic appearance
Histologically lateral periodontal and botryoid odontogenic cysts are characterized by the following features 1,2:
- non-keratinized squamous epithelium consisting of a few cell layers
- often plaque-like epithelial thickening
- zones of clear cells
- periodic acid-Schiff material
Lateral periodontal odontogenic cysts are unicystic whereas botryoid odontogenic cysts are multicystic.
Radiographic features
Plain radiograph
The radiographic appearance of periodontal and botryoid odontogenic cysts has been described as well-delineated unilocular or multilocular radiolucency 1,3. Despite being a multicystic lesion histologically botryoid odontogenic cyst might appear unilocular or multilocular on radiography 3.
CT
CT might show a well-demarcated expansile unilocular or multilocular cyst ref.
Radiology report
The radiological report should include a description of the following imaging features:
- type location and size of the cyst
- unilocular or multilocular appearance
- relation to the adjacent structures and teeth
Treatment and prognosis
Treatment consists of enucleation. Lateral periodontal odontogenic cysts recur rarely, whereas recurrence in botryoid odontogenic cysts is more common 1,2.
History and etymology
A series of lateral periodontal odontogenic cysts were described by Bernard Moscow and colleagues in 1970 3. Botryoid odontogenic cysts were first reported by Weathers and Waldron in 1973 1, who compared their appearance with a bunch of grapes.
Differential diagnosis
The differential diagnosis of ameloblastic carcinomas include the following conditions 1,2:
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