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34). It is virtuallyidentical with therarelyoccurring replacement type of odontogenic keratocyst (Sec. 6). Asymptomaticcystsalmost invariably reveal a prominent peripheryof dense sclerotic Figure 34 Residualcyst:Awell-definedradiolucency(arrow) is presentInthe alveolus of a recently extracted tooth. This loss of aradiopaque follicular+xevicular epithelium plays a part in its evoluborder is directly proportional to the increasing intensity tion (2, 3, 7). In the series of Ackerman et al. ( 3 , most of acute inflammation (13).
Data pooled from S2cases of GCA ( X ) indicate that the canine-premolar regionis the most favored site in both jaws. , the maxilla. The cyst may occur atany age, but 72% are detected in the fifth and sixth decades o f life. It has a slightly greater propensity to affect men than women (X), and most have occurred i n the white population ( 5 ) . A GCA is usually clinically inapparent and is found as an incidental histopathological finding in surgical specimens of gingiva (l,3). Others, however, present a s a painless, firm or fluctuant, well-circumscribed, domeshaped, white.
Furthermore. IgG plasma cells predominate, although IgA cells seem to represent a significantly higher proportion of the total plasma cell population in periapical and dentigerous cysts ( 1 28). Smith et al. (129) have confirmed thatthe fluids of keratocysts contain smaller amounts of protein and that few high molecular weight proteins are present. This observation reinforced the conclusion that the epitheliallining of the POKC is less permeable thanthatof other odontogenic cysts and that a barrier exists that prevents passage o f higher molecular weight particles.