nasopalatine duct cyst incisive canal cyst. the most common nonodontogenic cyst of the oral cavity...
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Nasopalatine Duct CystINCISIVE CANAL CYST
the most common nonodontogenic cyst of the oral cavity(in about 1% of the population).
arise from remnants of the nasopalatine duct, an embryologic structure connecting the oral and nasal cavities in the area of the incisive canal.
incisive canals begin on the floor of the nasal cavity on either side of the nasal septum,.........downward and forward to exit the palatal bone via a common foramen in the area of the incisive papilla
these canals contain .....1.nasopalatine ducts2.Nasopalatine nerve3.branches of the descending palatine and sphenopalatine arteries.
Although the pathogenesis of this lesion is still uncertain..... but.................. spontaneous cystic degeneration of remnants of the nasopalatine duct.
any age / most common in the fourth to sixth decades of life
The most common presenting symptoms .........swelling of the anterior palate, drainage, and pain
many lesions are asymptomatic
Fluctuant swelling of the anterior hard palate.
1.incisive canal type (intraosseous)
2.originating in the papilla palatina. (within soft tissue with no radiographic changes)
Almost all nasopalatine duct cysts occur within the incisive canal.
at any level between the nasal and the oral cavity
teardrop shape and shows a well demarcated, slightly sclerotic border.
Some cysts may have an inverted pear shape
The central incisors gave vital responses to pulp tests.
superimposition of the nasal spine.......classic heart shape
Radiographic features
cysts of the incisive papilla.....In rare instances in the soft tissues of the incisive papilla area without any bony involvement.
• a larger incisive canal cyst with a more ill defined border.
Nasopalatine Duct Cyst
superimposition over the apex ofa central incisor.
differential diagnosis periapical lesions
the vitality of the teeth
The highly variable epithelial lining ...............
♦ Stratified squamous epithelium..........most common
♦ Pseudostratified columnarepithelium....approximately 1/3 cases
♦ Simple columnar epithelium
♦ Simple cuboidal epithelium
Histopathology
• Respiratory pseudostratified columnar epithelium(arrow1).
• The fibrous connective tissue capsule contains focal areas of chronic inflammation
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2
Cilia and goblet cells maybe found in association with columnar linings
Epithelial lining
cuboidal cells with an uninflamed capsule
.•Those originating higher in the canal are usually lined by respiratory epithelium
•those located toward tile oral cavity feature a squamous lining.
The type of epithelium is mainly dependent upon the location of the lesion
the presence of numerous large nerves(arrow1) and blood vessels(arrow2).
(These, of course, represent the normal structures that pass through the incisive canal.)
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2
The contents of the cyst wall can be a helpful diagnostic aid.
moderate-sized nerves andsmall muscular arteries and veins
• Peripheral Nerve Bundles (40X10)
• Large Vein
In biopsy specimens from this area
( a normal component of the papilla palatina.)
Occasionally…irregular cartilage
• Bleeding Secondary to Surgical Procedure
• Mucous Glands
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