Mandible & maxilla
Odontogenic cysts
Gingival cyst (adult)


Topic Completed: 1 November 2013

Minor changes: 8 July 2020

Copyright: 2004-2019, PathologyOutlines.com, Inc.

PubMed Search: Gingival cyst [title] adult

Related Topics: Gingival cyst (newborn)

Annie S. Morrison, M.D.
Kelly Magliocca, D.D.S., M.P.H.
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Cite this page: Morrison, A, Magliocca K. Gingival cyst (adult). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/mandiblemaxillagingivalcystadult.html. Accessed August 6th, 2020.
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

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Gingival cyst of adult

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Clinical presentation

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Surgical exposure

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Bone defect after excision

Gross images

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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

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Thin stratified squamous epithelium

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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
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