Definition, Overview, and Classification
- Median mandibular cyst is a rare cystic lesion found in the midline of the mandible.
- It is typically asymptomatic and often discovered incidentally during routine dental examinations.
- The cyst arises from remnants of embryonic epithelial tissue and is classified as a developmental cyst.
- It can vary in size and may cause expansion of the mandible.
Causes and Risk Factors
- The exact cause of median mandibular cysts is unknown, but it is believed to be a result of trapped epithelial remnants during embryonic development.
- There may be a genetic predisposition for the development of these cysts.
- Trauma or infection in the mandible region may also contribute to their formation.
- Median mandibular cysts are more commonly seen in males than females.
Symptoms, Diagnosis, and Biopsy
- Median mandibular cysts are often asymptomatic, but symptoms may include swelling or a painless mass in the midline of the mandible.
- The cyst may cause displacement or resorption of adjacent teeth.
- Diagnosis is usually made through radiographic imaging, such as panoramic X-rays or cone beam computed tomography (CBCT).
- A biopsy may be performed to confirm the diagnosis and rule out other conditions.
Treatment Options
- Surgical removal is the typical treatment for median mandibular cysts.
- The cyst is enucleated or excised along with any associated cystic lining or pathological tissue.
- Depending on the size and extent of the cyst, a bone graft may be necessary for mandible restoration.
- Regular follow-up visits are important to monitor for recurrence or complications.
- Orthodontic treatment may be required to correct dental misalignment caused by the cyst.
Prognosis and Complications
- The prognosis for median mandibular cysts is generally good after appropriate treatment.
- Complete removal of the cyst and associated tissue is crucial to prevent recurrence.
- Complications may include infection, damage to adjacent structures, or nerve injury during surgery.
- Delayed diagnosis or inadequate treatment may lead to further expansion of the cyst and associated complications.
- Regular dental check-ups and radiographic monitoring are important for long-term management.
A median mandibular cyst is a type of cyst that occurs in the midline of the mandible, thought to be created by proliferation and cystic degeneration of resting epithelial tissue that is left trapped within the substance of the bone during embryologic fusion of the two halves of the mandible, along the plane of fusion later termed the symphysis menti. A true median mandibular cyst would therefore be classified as a non-odontogenic, fissural cyst. The existence of this lesion as a unique clinical entity is controversial, and some reported cases may have represented misdiagnosed odontogenic cysts, which are by far the most common type of intrabony cyst occurring in the jaws. It has also been suggested that the mandible develops as a bilobed proliferation of mesenchyme connected with a central isthmus. Therefore, it is unlikely that epithelial tissue would become trapped as there is no ectoderm separating the lobes in the first instance.
