The find in the picture
A cyst can be seen on an X-ray or CT scan, although there is no pain.
CONDITION / JAWS, MOUTH AND NECK
Jaw cysts.
A cyst of the jaw is a pathological cavity in the bone, lined from the inside with a membrane. It destroys the bone around it and can dislodge neighboring teeth, and it is often noticed accidentally, in the picture. Treated surgically: the cyst is removed or first reduced, and the tissue is examined under a microscope.
CONCEPTUAL VISUALIZATION- What it is
- A cavity in the jaw bone with a shell from the inside; arises from tissues from which teeth develop.
- Which are
- Inflammatory (radicular) and those arising during tooth development (follicular, keratocyst).
- How to find
- Often by chance, in the picture: there may be no complaints.
- How we treat
- Removed or first reduced by decompression; the type of cyst is confirmed by histology.
01 / WHAT IS ITWhat is
What is
jaw cyst.
A cyst of the jaw is a cavity inside the bone, lined from the inside with a thin membrane. Most cysts of the jaws are odontogenic: they arise from tissues from which teeth develop, so they occur in those areas of the upper and lower jaw where teeth grow.
There are inflammatory cysts and cysts that arise during tooth development. An inflammatory, or radicular, cyst is formed near the apex of the tooth root. Follicular covers the crown of a tooth that has not erupted. A keratocyst also arises from the tissues that form the teeth: it is benign, but can behave aggressively and tends to return after treatment.
The cyst grows inside the bone and destroys it around itself. It can dislodge neighboring teeth or cause resorption of their roots. The sooner the cyst is noticed and referred to a surgeon, the less bone it has time to destroy.
Cysts of the maxillary sinus, salivary glands and neck are separate conditions with their own treatment.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow
How
jaw cyst presents.
Many cysts remain undetected for a long time: they are noticed on a picture taken for another reason.
The teeth shifted
Adjacent teeth have changed position, and the picture shows that their roots have resorbed.
The tooth did not erupt
The permanent tooth did not appear in time - there may be a follicular cyst around its crown.
Swelling and pain
Swollen cheek or jaw, pain, bad taste in the mouth, high temperature - these are signs of purulent inflammation, with which you need to see a doctor on the same day.
Several cysts at once
Several keratocysts in the jaws are a reason to check for Gorlin syndrome.
03 / REASONSWhere do they come from?
Where do they come from?
jaw cysts
The type of cyst tells you where it came from and the treatment depends on it.
Inflammation near the root
A radicular cyst occurs as a result of inflammation near the apex of a tooth root. In a series of 4,226 jaw cysts examined under a microscope, it occurred in 58.6% of cases.
A tooth that has not erupted
A follicular cyst covers the crown of a tooth that has not erupted; in the same series — 17.9% of cysts. In a review of 16 studies, cysts were found in 4.4% of extracted, unerupted wisdom teeth.
Keratocyst
Makes up approximately 2% to 11% of all jaw cysts; among patients there are approximately twice as many men as women. Previously, it was classified as a tumor and was called a keratocystic odontogenic tumor.
Benign tumors of the jawsGorlin's syndrome
With nevoid basal cell syndrome (Ghorlin syndrome), keratocysts are present in almost all patients, usually several. In approximately 40% of children, everything starts with one cyst, so the syndrome is easy to miss.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
The cyst itself usually does not require emergency care: it is treated as planned, but without delay, until it has destroyed more bone. Urgent - if there is purulent inflammation in the jaw or alarming signs have appeared after surgery.
103 immediately if:
- difficulty breathing, speaking or swallowing;
- big swelling inside the mouth;
- swelling makes it difficult to open the mouth;
- the eye is swollen or painful or the vision has suddenly worsened;
- bleeding from the mouth does not stop, although you firmly press the wound with a clean napkin;
- the blood spurts, bright red and hard to stop.
Do not delay if:
Immediately - to the surgeon who operated, and if it does not work - to the waiting room: after the operation, the wound in the mouth bleeds lightly, but does not stop, although you pressed it for at least 10 minutes; pain and swelling of the cheeks are severe or increasing, and painkillers do not help. On the same day - to the surgeon or dentist: the cheek or jaw is swollen and painful, the mouth has an unpleasant taste, the temperature has risen; after surgery - pain with an unpleasant taste, temperature or malaise. Urgently, without waiting for a scheduled appointment, to a dentist or maxillofacial surgeon: a lump appeared in the mouth or on the lip that does not go away. Plan, but don't delay: the cyst was found on the picture; the teeth have shifted or the permanent tooth has not erupted in time.
05 / DIAGNOSTICSAs defined,
As defined,
what kind of cyst is this
- Review and conversation
The doctor examines the jaw and mouth, asks when the changes appeared and whether relatives have had such formations.
- Photograph and CT scan
An X-ray shows the cyst, and a CT scan shows its size, jaw walls, and relationship to the teeth.
- Histology
The type of cyst is finally determined under a microscope - in tissue from a biopsy or removed during surgery. This research remains fundamental.
- Check for the syndrome
If there are several keratocysts or a keratocyst is found in a child, the doctor may suggest checking for Gorlin syndrome.
06 / TREATMENTHow we treat
How we treat
jaw cysts
Odontogenic cysts are treated surgically: the cyst is removed completely or first reduced and then removed. There is no one method for all cysts - the type of cyst, its size and location, and the age of the patient are considered.
01
Removal of the cyst
The cyst is removed together with the shell.
- Enucleation
- The cyst is removed from the bone together with the shell, and the tissue is sent for histology. Along with decompression, this is one of the two main methods of treating odontogenic cysts.
- Whether to fill the cavity
- The cavity is sometimes filled with your own bone or a bone substitute. In a review of 13 studies on plain imaging, bone recovery was comparable with and without filling, but there are insufficient data to make firm recommendations. The size and shape of the defect, the preservation of the periosteum, and the type of jaw are important.
- Tooth and cyst
- A tooth around the crown of which a follicular cyst has grown is usually removed along with it. The dentist decides what to do with a tooth with a radicular cyst.
02
Decompression and marsupialization
Large cysts are first reduced, then removed.
- How it works
- The cyst is opened and kept open so that it gradually shrinks. This is mostly the first stage: reduction usually lasts from one to two years, after which the cyst is removed.
- Who suits?
- In a review of 31 studies, larger cysts and cysts were better reduced in younger patients. As a final treatment, the reduction itself was usually not enough, but the second operation after it is less traumatic.
- Children's teeth
- This is how they sometimes save a tooth around which a follicular cyst has grown. In a small review (4 studies), almost 62% of premolars erupted by themselves after decompression — more often at a younger age (on average 10 years) and when the root was formed no more than half. Sometimes the tooth has to be straightened orthodontically.
03
Keratocyst
Benign, but tends to return, so treatment and supervision are more thorough.
- Relapses
- In a Cochrane review, the frequency of keratocyst recurrence after treatment varies from 3% to 60% in different reports. The authors did not find any randomized studies comparing the methods.
- Removal and decompression
- In a review of 1,900 keratocysts, after the removal itself, the cyst returned in 20.8%, after decompression with subsequent removal — in 11.9%, after marsupialization with removal — in 17.8%. Another meta-analysis (5 studies) did not confirm a convincing advantage of marsupialization.
- Additional processing
- To reduce the risk of recurrence, after removal, a thin layer of bone around the cavity is sometimes removed (peripheral osteotomy) or treated with Carnois solution, 5-fluorouracil, or cold. In a network meta-analysis of 40 studies (2989 patients), the combination with 5-fluorouracil, resection and Carnois solution gave the fewest recurrences, but the quality of the evidence was mostly very low.
- Resection
- Almost without relapses, only wide resection — removal of the area of the jaw with clean edges. More aggressive methods have many disadvantages and risks, so they are weighed for each patient.
- Which increases the risk
- In a review of 2,064 keratocysts, recurrences were associated with a size greater than 4 cm, multiple chambers with bone wall breakthrough, communication with teeth, and daughter cysts.
- Supervision
- In the studies, recurrences were counted for an average of 4-5 years of observation, so regular control images are required after keratocyst. The schedule is determined by the surgeon.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Cysts of the jaws at Dr. Valikhnovskyi's Institute of Surgery are considered in the direction of "New face" - together with the restoration of the jaws after injuries and removal of tumors. Here, the cyst is evaluated with a CT scan, treatment is planned, and the bone is restored if a large defect remains after removal.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- CT of the facial skull — the main examination, which evaluates the size of the cyst and the jaw wall.
- Virtual 3D planning — a three-dimensional model of the jaw is built using a CT scan, and surgical templates are printed if necessary.
- Fibula flap — if a section of the jaw had to be removed together with the cyst, it is reproduced with a fragment of the leg bone with its own vessels.
- Titanium and individual plates — fix the jaw bone; individual titanium or PEEK plates are made according to a 3D model.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Pictures onlineSend CT scans or X-rays and reports - the doctor will evaluate the situation beforehand.
- ConsultationExamination, if necessary — a new CT scan of the facial skull.
- PlanRemove the cyst immediately or reduce it first; is a biopsy required before surgery; will you have to restore the bone?
- TreatmentThe scope defines the plan; the removed tissue must be examined under a microscope.
- SupervisionControl images while the bone is recovering; after keratocyst — long-term supervision.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it necessary to treat a jaw cyst?
Odontogenic cysts are treated surgically: the cyst is removed or first reduced by decompression. The earlier it is noticed, the less bone it manages to destroy.
Can the cyst come back?
Maybe Keratocists are especially prone to this: in a Cochrane review, the recurrence rate in different reports is from 3% to 60%. Therefore, control images are required after treatment.
What is a keratocyst?
A cyst arising from the tissues that form the teeth. It is benign, but can behave aggressively - destroy the bone and return after treatment, so it is treated more carefully and observed for longer.
What is cyst decompression?
The cyst is opened so that it gradually decreases; it usually lasts a year or two, after which the cyst is removed. So the second operation becomes less traumatic.
Is it necessary to fill the cavity after removal?
Not always. In a review of 13 studies, bone recovery was comparable with and without filling, but there are insufficient data to make firm recommendations. The solution depends on the size and shape of the defect.
Is it possible to save a child's tooth if there is a cyst around it?
Sometimes so: after decompression of the follicular cyst, the tooth can erupt by itself, more often at a younger age. Sometimes it has to be tightened orthodontically.
Can the lip be numb after surgery?
Numbness or tingling of the lip, chin or tongue may occur after operations near the mandibular nerve. This usually goes away, but may last for several weeks or months.
What will the recovery be like?
Pain and swelling are strongest in the first days, and after 1-2 days should begin to decrease; food is bland for a while. How quickly the bone will recover depends on the size and shape of the cavity.
Sources
19 sources · reviews, meta-analyses, Cochrane and NHSshowCollapse
- Odontogenic CystsDental Clinics of North America, 2020doi:10.1016/j.cden.2019.08.002 ↗
- Epidemiological Features of 4777 Cysts and Odontogenic Tumors Based on the 2022 WHO ClassificationOral Diseases, 2025doi:10.1111/odi.15146 ↗
- Odontogenic Cysts and TumorsAnnals of Plastic Surgery, 2019doi:10.1097/SAP.0000000000001738 ↗
- Pediatric Odontogenic Cysts of the JawsOral and Maxillofacial Surgery Clinics of North America, 2016doi:10.1016/j.coms.2015.07.003 ↗
- Prevalence of odontogenic cysts and tumors associated with impacted third molars: A systematic review and meta-analysisJournal of Cranio-Maxillofacial Surgery, 2019doi:10.1016/j.jcms.2019.03.026 ↗
- Effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions: a systematic reviewBritish Journal of Oral and Maxillofacial Surgery, 2021doi:10.1016/j.bjoms.2021.03.004 ↗
- Treatment of enucleated odontogenic jaw cysts: a systematic reviewOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2018doi:10.1016/j.oooo.2017.12.010 ↗
- Factors influencing an eruption of teeth associated with a dentigerous cyst: a systematic review and meta-analysisBMC Oral Health, 2021doi:10.1186/s12903-021-01542-y ↗
- Interventions for the treatment of keratocystic odontogenic tumoursCochrane Database of Systematic Reviews, 2015doi:10.1002/14651858.CD008464.pub3 ↗
- Conservative surgical treatments for nonsyndromic odontogenic keratocysts: a systematic review and meta-analysisClinical Oral Investigations, 2018doi:10.1007/s00784-017-2315-8 ↗
- Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysisOral and Maxillofacial Surgery, 2019doi:10.1007/s10006-018-0737-3 ↗
- Effectiveness of different treatments for odontogenic keratocyst: a network meta-analysisInternational Journal of Oral and Maxillofacial Surgery, 2023doi:10.1016/j.ijom.2022.09.004 ↗
- An evidence-based surgical algorithm for management of odontogenic keratocystOral and Maxillofacial Surgery, 2023doi:10.1007/s10006-022-01064-z ↗
- Novel recurrence risk stratification of odontogenic keratocysts: A systematic reviewOral Diseases, 2022doi:10.1111/odi.13931 ↗
- Pediatric odontogenic keratocyst and early diagnosis of Gorlin syndrome: Clinicopathological aidsThe Saudi Dental Journal, 2024doi:10.1016/j.sdentj.2023.10.012 ↗
- Dental abscessNHS, 2026nhs.uk/conditions/dental-abscess ↗
- Wisdom tooth removalNHS, 2024nhs.uk/tests-and-treatments/wisdom-tooth-removal ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
- Mouth cancer: SymptomsNHS, 2023nhs.uk/conditions/mouth-cancer/symptoms ↗
The figures on the page are from these sources.
The cyst was found
in the picture?
Send pictures and statements. The doctor will tell you what it can be and how to proceed.