1. Nasopalatine cyst is the most common non-odontogenic cyst
2. Globulomaxillary cyst entity is controversial - many consider it a variant of lateral periodontal cyst
3. Median mandibular cyst is extremely rare - always consider other diagnoses first
4. Nasolabial cyst is the only one with no radiographic features
5. All these cysts are developmental in origin

Quick Facts for MCQs:

• Oval + Maxillary midline = Nasopalatine cyst
• Pear-shaped + Between teeth = Globulomaxillary cyst
• Soft tissue swelling + No X-ray changes = Nasolabial cyst
• Mandibular midline + Rare = Median mandibular cyst

MEMORY AIDS

"NASAL" for Nasopalatine Cyst:

• Non-odontogenic (most common)
• Anterior maxilla
• Spacing of centrals
• Above/between central incisors
• Location: incisive canal

"PEAR" for Globulomaxillary:

• Pear-shaped (inverted)
• Enlarges slowly
• Adjacent to lateral incisor & canine
• Root divergence

"SOFT" for Nasolabial:

• Soft tissue cyst
• Obstruction of nose
• Fold involvement (nasolabial)
• Tissue only (no bone involvement)

• Epithelial Plaques (localized thickenings): Found in:

  • Lateral Periodontal Cyst

  • Botryoid Odontogenic Cyst

  • Gingival Cyst of Adults

  • Glandular Odontogenic Cyst

• Actinomycosis (Sulfur Granules):

  • Yellow sulfur granules: Are actually bacterial colonies.

  • Histopathology: Colonies appear "cotton wool" shaped. (Note: "Cotton wool appearance" is seen radiographically in Paget's disease).

• Tuberculosis (TB):

  • Diagnosis (Gold Standard): Presence of acid-fast bacilli in sputum.

  • Staining Method: Ziehl-Neelsen staining method is used to identify acid-fast bacilli.

  • Scrofula: TB of cervical lymph nodes.

  • Lupus Vulgaris: TB of skin.

• Tongue & Gingival Appearance in Systemic Conditions:

  • Strawberry tongue and Raspberry tongue: Seen in stomatitis of Scarlet Fever.

  • Strawberry Gingivitis: Seen in Wegener's Granulomatosis.

Infantile Osteomyelitis

• Osteomyelitis Maxillaries Neonatarum, Maxillitis of infancy
• Osteomyelitis in the jaws of new born infants occurs almost exclusively in maxilla.

Etiology

• Trauma – through break in mucosa cause during delivery.
• Infection of maxillary sinus
• Paunz & Ramon et al  believe that disease caused through infection from the nose.
• Hematogenous spread through streptococci & pneumococci

Clinical features

• Fever, anorexia & intestinal disturbances.
• swelling or redness below the inner canthus of the eye in lacrimal region.
• Followed by marked edema of the eyelids on the affected side.
• Next, alveolus & palate in region of first deciduous molar become swollen.
• Pus discharge from affected sites

D/D for Infantile Osteomyelitis

• Dacrocystitis neonatarum
• Orbital cellulitis
• Ophthalmia neonatarum
• Infantile cortical hyperostosis

TREATMENT

• Intravenous antibiotics, preferably penicillin.
• Culture & sensitivity testing
• Incision & drainage of fluctuant areas
• Sequestrectomy
• Supportive therapy

 Benign Migratory Glossitis

• Also called Erythema migrans, wandering rash, or geographic tongue.

• Associated with fissured tongue.

Fissured Tongue

• Seen in:

  • Melkersson-Rosenthal syndrome

  • Down syndrome

  • Benign migratory glossitis

Melkersson-Rosenthal Syndrome

• Triad:

  • Bell’s palsy

  • Cheilitis granulomatosa (lip/facial swelling)

  • Fissured tongue

Ankyloglossia

• Tongue-tie may cause speech defects.

• Affects articulation of: l, r, t, d, n, th, sh, z

• Pioneer bacteria invade dentinal tubules before clinical signs
• Tubules contain pure forms:
  • One tubule → cocci
  • Adjacent tubule → bacilli or threads
• No mixed forms within a single tubule