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Preface to the Fifth Edition

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It is an honour to have prepared this fifth edition of Mervyn Shear's classic text on cysts of the maxillofacial regions. This edition is dedicated to his memory and I am grateful to the publishers for agreeing to make the book eponymous and have his name in the title. Mervyn Shear wrote the first edition in 1976 in an attempt to record, in a single volume, all published knowledge on the subject. Subsequent editions were published after 7 years (1983), 9 years (1992), and 15 years (2007), and each continued to attempt to be a comprehensive record of the literature. I was first honoured in this venture when I was asked to assist Professor Shear in the preparation of the fourth edition that was published in 2007. Even as we wrote it, we realised that the task was getting more difficult because of the massive proliferation of new publications. The text was lengthened considerably, but the extra information was additive and we soon realised that it was no longer possible to continue to try to present a definitive account of the entire literature. Feedback from colleagues, and in particular students, reported that the book had become too detailed and that much of the research reviewed had little relevance to the day‐to‐day practicalities of diagnosis and management of cysts.

We agreed that a new approach was needed and in late 2012 I was able to meet with Mervyn at his home near Cape Town. At that time he was no longer able to participate in a new edition, but together we outlined a basic plan for the changes that we felt were necessary. This new fifth edition is a complete rewrite of the book, but still maintains the basic aim of providing an understanding of the pathogenesis of each cyst type as well as recording the clinical, radiological, and histological features. The overall aim is to assist pathologists and clinicians in making a correct diagnosis and informing management, but we also wanted to make the book more accessible to students and trainees at all levels, as well as to non‐specialist clinicians and general pathologists faced with an individual lesion that requires diagnosis and management. This new edition maintains the same basic layout, but is restructured to present the most common lesions first. Each chapter now includes more detailed histopathology with more photomicrographs and sections on radiological or histological differential diagnosis. There are also more detailed discussions of the historical aspects of the classification and naming of cysts that I hope will be of general interest, but also provide some context for the global variation in terminology and explain why there may be so much confusion in the literature about some cyst types. We agreed not to include, and to remove, detailed accounts of research findings that do not advance our understanding of the pathogenesis or assist in diagnosis. The applies especially to the odontogenic keratocyst, where there has been a massive increase in publications in the last two decades, but little of relevance to the practicalities of routine diagnosis and treatment.

At the outset, I had aimed to reduce the number of references and especially to remove references to some of the ‘old’ literature that current students and trainees may not appreciate as relevant. In the final outcome about 250 references have been removed, but about 450 new references have been added. I hope that all these are relevant and helpful. Many younger students may be surprised to find that I have retained many ‘old’ papers, including some landmark studies going as far back as the early 1900s, but also studies carried out in the two to three decades after 1950. Many of these papers are freely available online and report unparalleled observational studies that will never be repeated, but are invaluable because of their original detailed observations relating to the pathogenesis and histological features of many of the cyst types.

As in all previous editions, I have attempted to produce a book that is useful to students and trainees at all levels, but also to practising clinicians, whether specialists or general practitioners. Because the final diagnosis of most lesions lies in the hands of a pathologist, I have enhanced the sections on pathology, histological features, and differential diagnosis, and hope this will assist non‐specialist pathologists as much as oral and maxillofacial pathologists. I have made greater use of subsections, so that information is more accessible, allowing the reader to rapidly ‘dip in’ to the book to find the information they need. In this respect, the book may be a useful bench book for the diagnostician, as well as a gripping read for the keen student.

Shear's Cysts of the Oral and Maxillofacial Regions

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