Mandible / maxilla
Odontogenic cysts
Gingival cyst (adult)

Author: Annie Morrison, M.D. (see Authors page)
Editor: Kelly R. Magliocca, D.D.S., M.P.H.

Revised: 21 June 2018, last major update November 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Gingival cyst [title] adult

Related Topics: Gingival cyst (newborn)

Page views in 2018: 409
Page views in 2019 to date: 1,679
Cite this page: Morrison, A. Odontogenic cysts: gingival cyst (adult). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mandiblemaxillagingivalcystadult.html. Accessed December 10th, 2019.
Definition / general
  • Gingival cysts of adults occur along gingiva of older adults, arise from dental lamina epithelial rests
Epidemiology
  • Rare, approximately 0.5% of all odontogenic cysts
  • Arise in middle aged or elderly adults, peak incidence in fifth to sixth decade of life
  • More common in females
Sites
  • Most common location is facial gingiva of mandibular canines and premolars
  • Maxillary gingival cysts usually found in facial gingival incisor, canine, premolar region
Pathophysiology
  • Arise from epithelial rests of dental lamina epithelium (rests of Serres) within soft tissue
  • Cause of cystic degeneration of this epithelium is unknown
  • Is considered the soft tissue counterpart of lateral periodontal cyst
Clinical features
  • Solitary, well circumscribed, usually less than 0.5 cm
  • Rarely bilateral
  • Bluish, smooth surfaced, dome shaped swelling on attached gingiva or unattached alveolar mucosa
  • May cause superficial pressure resorption of underlying alveolar bone (See "Bone defect" in Clinical images)
Radiology description
  • Cyst may cause a superficial "cupping out" of alveolar bone, usually not detected on a radiograph but apparent when cyst is excised
  • If more bone is missing or the pre-operative lesion is visible on a radiograph, one could argue that the lesion may be a lateral periodontal cyst that has eroded the cortical bone rather than a gingival cyst that originated in the mucosa
Case reports
Treatment
  • Local surgical excision, typically do not recur
Clinical images

Images hosted on other servers:
Missing Image Missing Image

Gingival cyst of adult

Missing Image

Clinical presentation

Missing Image

Surgical exposure

Missing Image

Bone defect after excision

Gross images

Images hosted on other servers:
Missing Image

Excised lesion

Microscopic (histologic) description
  • Unicystic structure lined with attenuated, non-keratinized low cuboidal or stratified squamous epithelium
  • Cyst lining may be with or without contiguous epithelial plaques (focal thickened areas of epithelium) which may have clear cells
  • Surrounding fibrovascular stroma is relatively uninflamed, except biopsy includes a portion of junctional epithelium
  • Variable inflammation
Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Thin stratified squamous epithelium

Missing Image Missing Image

Gingival cyst histology

Differential diagnosis
  • Cyst of incisive papilla: only occurs in soft tissues of midline anterior hard palate between central incisor teeth
  • Epidermoid cyst: usually floor of mouth, large size
  • Epithelial inclusion cyst: after gingival graft
  • Lateral periodontal cyst: originates within bone
  • Odontogenic keratocyst: occasionally reported in soft tissues
  • Salivary duct cyst: occurs in non-gingival, salivary gland bearing tissues
Back to top