Experimental extra-follicular histogenesis of follicular cysts.

An animal model has been developed in which implantation cysts have been produced very close to developing teeth within the jaws of Vervet monkeys. Various deciduous teeth were extracted from both the maxilla and the mandible of 6 young Vervet monkeys. After 4 weeks, full thickness mucoperiosteal flaps were raised in these areas, up to 6 recipient sites were prepared in each monkey by drilling holes in the alveolar bone and small pieces of autogenous palatal mucosa were placed in these graft recipient sites. One monkey was killed after 5, 8, 22 and 25 weeks respectively and 2 after 52 weeks. Of the 33 implants placed, cyst formation occurred from 11 (33%). The distribution of the cysts was irregular in that 4 cysts were produced in each of 2 animals while no cysts were found in another 2 animals. The cysts produced were filled with keratin and lined partly by a thick keratinising epithelium and partly by a thin non-keratinising epithelium only a few cell layers thick. In one of the animals killed after 52 weeks, the follicle of an erupting premolar tooth had collided with one of the cysts resulting in the cyst lining becoming incorporated into the follicle, partly replacing the follicular reduced enamel epithelium and forming now an integral part of the follicle. This observation supports the hypothesis that the follicular odontogenic keratocyst has an extra-follicular origin arising after the eruption of a tooth into a pre-existing cyst cavity.