上顎正中部に生じた嚢胞の臨床病理組織学的検討

Abstract

Clinical and histological characteristics of 19 cysts that occurred symmetrically in the anterior portion of the midline maxilla were studied. Radicular cysts in the incisal region were excluded because they did not fit to the above category.Twelve were non-dentigerous developmental cysts and palatal swelling was found more often than in the other group of cysts with an unerupted supernumerary tooth, and the bony defect of the palate was noted in 11 cases.Radiographically, nasopalatine duct cyst was suspected in 8 cases, but the other 4 cysts presented the features consistent with those of median palatine cyst and in one the normal structure of the incisal canal was clearly recognized in the cystic radiolucency, although the relationship was confirmed at operation. Pseudostratified ciliated columnar epithelium was the main lining element in 8 cases.Mucous cells and Goblet cells were frequently seen. Neurovascular bundles were found in 8 cases and the subepithelial blood vessels were arranged parallel to the epithelial layer.Diagnosis of nasopalatine duct cyst was suspected in all cases.The other 7 cysts were dentigerous cysts with a swelling on the labial aspect of the anterior maxilla.The lining epithelium was stratified squamous epithelium and mucous cells and neurovascular bundles were noted in 2 cases, but differential diagnosis was easy because of the presence of the crown of an unerupted tooth in the cystic cavity.The results indicate that the cyst occurring symmetrically in the anterior portion of the midline maxilla is either nasopalatine duct cyst or dentigerous cyst and the possibility of median palatine cyst or radicular cyst is comparatively low.