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Douglas JE, Wei K, Panara K, Lee DJ, Kohanski MA, Shanti RM, Panchal N, Palmer JN, Adappa ND. Combined Transnasal, Transoral Excision of Odontogenic Cysts Offers Reduced Recurrence Rates and Favorable Sinonasal Outcomes. Laryngoscope 2024; 134:2489-2491. [PMID: 38581361 DOI: 10.1002/lary.31441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/08/2024]
Abstract
Odontogenic cysts impact the adjacent dentition and maxillary sinus. A combined transnasal, transoral approach for removal offers reduced recurrence rates and favorable sinonasal outcomes compared with historic transoral-only approaches.
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Affiliation(s)
- Jennifer E Douglas
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Kimberly Wei
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Kush Panara
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Daniel J Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Rabie M Shanti
- Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, New Jersey, U.S.A
| | - Neeraj Panchal
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - James N Palmer
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, U.S.A
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Fang S, Wang Y, He Y, Yu T, Xie Y, Cai Y, Li W, Wang Y, Huang Z. Machine Learning Model Based on Radiomics for Preoperative Differentiation of Jaw Cystic Lesions. Otolaryngol Head Neck Surg 2024; 170:1561-1569. [PMID: 38557958 DOI: 10.1002/ohn.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/01/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aims to use machine learning techniques together with radiomics methods to build a preoperative predictive diagnostic model from spiral computed tomography (CT) images. The model is intended for the differential diagnosis of common jaw cystic lesions. STUDY DESIGN Retrospective, case-control study. SETTING This retrospective study was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University (Guangzhou, Guangdong, China). All the data used to build the predictive diagnostic model were collected from 160 patients, who were treated at the Department of Oral and Maxillofacial Surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between 2019 and 2023. METHODS We included a total of 160 patients in this study. We extracted 107 radiomic features from each patient's CT scan images. After a feature selection process, we chose 15 of these radiomic features to construct the predictive diagnostic model. RESULTS Among the preoperative predictive diagnostic models built using 3 different machine learning methods (support vector machine, random forest [RF], and multivariate logistic regression), the RF model showed the best predictive performance. It demonstrated a sensitivity of 0.923, a specificity of 0.643, an accuracy of 0.825, and an area under the receiver operating characteristic curve of 0.810. CONCLUSION The preoperative predictive model, based on spiral CT radiomics and machine learning algorithms, shows promising differential diagnostic capabilities. For common jaw cystic lesions, this predictive model has potential clinical application value, providing a scientific reference for treatment decisions.
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Affiliation(s)
- Songling Fang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yuepeng Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yilin He
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Taihui Yu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yutong Xie
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, South Australia, Australia
| | - Yongkang Cai
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Wenhao Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yan Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
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3
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Grover S, Hegde S, Mascarenhas R. Management regulations for odontogenic keratocyst: a case report and review of the literature. J Med Case Rep 2024; 18:152. [PMID: 38576053 PMCID: PMC10996238 DOI: 10.1186/s13256-024-04473-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/24/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Reconstruction of the entire dentition with odontogenic keratocyst is a very challenging quandary. Most cases of odontogenic keratocyst are often reported to be benign, resulting in severe occlusal discrepancies with the maxillary and mandibular dentition. Dental radiographs occasionally reveal an uncommon, locally aggressive developing cyst termed as odontogenic keratocyst, which is typically located in the posterior jaw. When this cyst occurs in the anterior region, it is often misdiagnosed with other periapical lesions due to its lack of response to pulp vitality tests. CASE PRESENTATION This clinical case scenario demarcates the endodontic management of a patient diagnosed with odontogenic keratocyst. A 37-year-old Indian male patient reported to the department with throbbing pain in the lower left posterior tooth requiring endodontic therapy. This patient also presented with odontogenic keratocyst in the anterior region of the jaw, for which he had undergone surgical rehabilitation. This case report highlights the clinical protocol for the endodontic therapy in patient diagnosed with ododntogenic keratocyst. Masticatory impairment was not visible after the follow-up period and the treatment outcome was successful. CONCLUSION This case report details the presentation, characteristic radiographic findings, and endodontic management of a patient with an extremely rare condition of odontogenic keratocyst. The management involves multidisciplinary approach for the rehabilitation.
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Affiliation(s)
- Srishti Grover
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shreya Hegde
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Roma Mascarenhas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Khan O, Bertagna A, Damm D, Weyh A, Callahan N. Multiple radiolucencies in a 12-year-old boy. J Am Dent Assoc 2024:S0002-8177(24)00109-0. [PMID: 38573271 DOI: 10.1016/j.adaj.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
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Seume N, Frerich B, Prall F, Weber MA, Cantré D. [Painless tumour in the lower jaw]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:312-315. [PMID: 38441593 DOI: 10.1007/s00117-024-01282-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/28/2024]
Affiliation(s)
- N Seume
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
| | - B Frerich
- Institut für Mund‑, Kiefer- und plastische Gesichtschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - F Prall
- Institut für Pathologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - M-A Weber
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland
| | - D Cantré
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland
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Omami G, Yeoh M. Cysts and Benign Odontogenic Tumors of the Jaws. Dent Clin North Am 2024; 68:277-295. [PMID: 38417991 DOI: 10.1016/j.cden.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article addresses jaw lesions including cysts and benign odontogenic tumors in terms of their definition and clinical and imaging features and discusses pertinent differential diagnoses..
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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Spille J, Bube N, Wagner J, Spille D, Birkenfeld F, Kübel P, Wiltfang J, Gülses A. Navigational exploration of bony defect mimicking a solid lesion of the mandible compared to conventional surgery by young professionals. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101588. [PMID: 37543209 DOI: 10.1016/j.jormas.2023.101588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION The aim of the current study was to evaluate the accuracy of resection a solid lesion in an acrylic lower jaw by young professionals using a dynamic computer-assisted surgical system comparted to conventional surgery technique. MATERIAL AND METHODS Twenty students performed the removal of the lesion conventionally and twenty students did the operation with a dynamic computer-assisted surgical system. Both groups were compared regarding the defect size, operation time, and surgical complications. RESULTS The defect size in the jaw was significant smaller with the navigated surgery (p < 0.001). Operation time was shorter without navigation system, but no significance was found (p = 0.137). Without navigation system three young professionals perforated the lingual cortex. DISCUSSION Navigated surgery can immediately be used by young professionals and support young surgeons in everyday clinical practice, especially in operations with difficult anatomic situations.
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Affiliation(s)
- Johannes Spille
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany.
| | - Nele Bube
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Juliane Wagner
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Dorothee Spille
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Falk Birkenfeld
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Paul Kübel
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Aydin Gülses
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Christian Albrechts University, UKSH- Campus Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
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Palem SR, Devarakonda V, Navakoti P, Pendyala KS. A rare case of Odontogenic Keratocyst in the Maxillary Sinus: diagnosis and management. Malawi Med J 2023; 35:228-230. [PMID: 38362567 PMCID: PMC10865051 DOI: 10.4314/mmj.v35i4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Odontogenic keratocyst is a benign intraosseous lesion of odontogenic origin which is characterized by its aggressive nature. It is usually present in the mandibular posterior area, although it can also be found in the maxilla, particularly in the canine region. We discuss a unique example of OKC in the maxillary sinus involving the 27&28 region. Due to comparable clinical signs, this lesion is more prone to be mistaken for other lesions of the maxillary sinus, such as sinusitis or polyps. On the other side, this benign disease has the potential to develop into Ameloblastoma or squamous cell carcinoma. A favorable prognosis thus depends on early identification, precise diagnosis, appropriate treatment, and follow-ups.
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Albagieh H, Aldosari M, Alkhathlan A, Alfawaz N, Almutairi M. Radiolucent lesions that may resemble inflammatory periapical lesions: A review article. Saudi Dent J 2023; 35:916-919. [PMID: 38107039 PMCID: PMC10724350 DOI: 10.1016/j.sdentj.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Non-endodontic lesions (NEL) closely resemble lesions of endodontic origin. Its etiology can be odontogenic, non-odontogenic, neoplastic, or anatomic variations that can resemble inflammatory periapical lesions in the periapical area. Inflammatory periapical lesions are caused by pulpal pathoses and require endodontic treatment. Since numerous NEL may resemble inflammatory periapical lesions, they can lead to misdiagnosis and inappropriate management. Thus, a detailed review of the patients' medical and dental histories with clinical examination, including radiographic findings, is essential for the proper assessment of periapical lesions. Numerous cases of misdiagnoses of NEL have been reported in literature. Thus, this review aimed to strengthen the awareness of clinicians on periapical radiolucency, which may resemble inflammatory periapical lesions.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Nawaf Alfawaz
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Jain A, Sharma P, Sivakumar N, Devi P, Gupta S, Chandra S. Role of HIF-1α in Ameloblastoma: A Systematic Review. Indian J Otolaryngol Head Neck Surg 2023; 75:3136-3145. [PMID: 37974737 PMCID: PMC10646133 DOI: 10.1007/s12070-023-03928-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/31/2023] [Indexed: 11/19/2023] Open
Abstract
Hypoxia-inducible factor-1α is a transcriptional protein that has been extensively researched in human cancers whose overexpression is found to be associated with unfavorable prognosis. Contemporary studies have proved its vital role in ameloblastoma by correlating its expression with the aggressiveness of the tumor. Therefore, an attempt was made to explore its significance in the malignant transformation and prognosis of ameloblastoma. The present systematic review aimed to understand the impact of HIF-1α in AMB which might lead to favorable outcomes in the treatment. An electronic search was carried out using PubMed, Scopus, Google scholar, Cochrane library, and EMBASE databases. Original articles from all languages involving HIF-1α in AMB were scrutinized by two independent authors. Data were compiled and tabulated in Microsoft Excel and the Risk of bias was analyzed using the JBI tool. Twelve eligible articles were included for the quantitative analysis comprising 305 cases of AMB in which HIF-1α expression was studied for various characteristics like pattern, intensity, and site of immunoexpression which were found to be increased with an increase in the aggressiveness of AMB. It was concluded that HIF-1α is proven to have a crucial role in the progression and aggressiveness of AMB. Extended research regarding the crucial role of HIF-1α in the initiation of tumors and therapies aiming at HIF-1α in AMB cases might show promising outcomes in the future.
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Affiliation(s)
- Ayushi Jain
- Dept of Oral Pathology & Microbiology and Forensic Odontology, King George’s Medical University, Lucknow, 226003 UP India
| | - Pooja Sharma
- Dept of Oral Pathology & Microbiology and Forensic Odontology, King George’s Medical University, Lucknow, 226003 UP India
| | - N Sivakumar
- Dept of Oral Pathology & Microbiology and Forensic Odontology, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Priya Devi
- Dept of Oral Pathology & Microbiology and Forensic Odontology, King George’s Medical University, Lucknow, 226003 UP India
| | - Shalini Gupta
- Dept of Oral Pathology & Microbiology and Forensic Odontology, King George’s Medical University, Lucknow, 226003 UP India
| | - Shaleen Chandra
- Dept of Oral Pathology & Microbiology and Forensic Odontology, King George’s Medical University, Lucknow, 226003 UP India
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Summersgill KF. Pediatric Oral Pathology: Odontogenic Cysts. Pediatr Dev Pathol 2023; 26:609-620. [PMID: 37212213 DOI: 10.1177/10935266231176245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.
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12
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Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2023; 81:E221-E262. [PMID: 37833025 DOI: 10.1016/j.joms.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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13
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Sundaran ST, Abida R, Aslam SA, Cherian MP, Soman S, Thomas T. An Observational Study on Cystic Alterations in Normal Dental Follicles Associated with Impacted Lower Third Molar for Early Intervention. J Contemp Dent Pract 2023; 24:809-812. [PMID: 38152915 DOI: 10.5005/jp-journals-10024-3552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM To evaluate the cystic changes in the radiographically normal dental follicle associated with impacted mandibular third molar. MATERIALS AND METHODS This study was conducted on 80 patients. Samples were selected using a convenient sampling technique from the patients who had impacted mandibular third molars in Pell and Gregory's positions B and C, with follicular space less than 2.5 mm in diameter. After surgical removal of an impacted tooth, the dental follicle was sent for histopathologic evaluation. RESULTS Pathologic alterations were found in 19% of cases out of 80 samples. Odontogenic keratocystic and dentigerous cystic changes were found in 7% of cases. A statistically significant cystic alteration was found in female patients and distoangular impacted teeth. CONCLUSION This study shows a significant cystic alteration in the radiologically normal dental follicles. Clinical and radiographic features alone may not be a reliable indicator of the absence of pathology. Early intervention of impacted teeth will help to reduce morbidity due to the development of pathology. CLINICAL SIGNIFICANCE This study will help educate patients on the risks of retaining impacted teeth, based on scientific facts, in order to minimize the risks and to assess the correlation of pathologic alterations with the depth of impaction and angular position of the impacted tooth.
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Affiliation(s)
- Sruthi T Sundaran
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India, Phone: +91 8086960285, e-mail:
| | - Roshni Abida
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India
| | - Sachin A Aslam
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India
| | - Mathew P Cherian
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India
| | - Sooraj Soman
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India
| | - Tom Thomas
- Department of Oral and Maxillofacial Surgery, MES Dental College, Kerala, India
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Zhang Z, Hong X, Wang F, Ye X, Yao YD, Yin Y, Yang HY. Solitary intraosseous neurofibroma in the mandible mimicking a cystic lesion: A case report and review of literature. World J Clin Cases 2023; 11:6653-6663. [PMID: 37900249 PMCID: PMC10600983 DOI: 10.12998/wjcc.v11.i27.6653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/15/2023] [Accepted: 08/31/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Neurofibromas are benign tumors of a neurogenic origin. If these tumors occur without any other signs of neurofibromatosis, they are classified as isolated neurofibromas. Neurofibromas in the oral cavity mostly occur within soft tissues, indicating that solitary intraosseous neurofibromas in the mandible are rare. Due to the absence of specific clinical manifestations, early diagnosis and treatment of these tumors are difficult to achieve. CASE SUMMARY A 37-year-old female patient visited our hospital due to numbness and swelling of the gums in the right lower molar area that had persisted for half a month. The patient's overall condition and intraoral examination revealed no significant abnormalities. She was initially diagnosed with a cystic lesion in the right mandible. However, after a more thorough examination, the final pathological diagnosis was confirmed to be neurofibroma. Complete tumor resection and partial removal of the right inferior alveolar nerve were performed. As of writing this report, there have been no signs of tumor recurrence for nine months following the surgery. CONCLUSION This case report discusses the key features that are useful for differentiating solitary intraosseous neurofibromas from other cystic lesions.
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Affiliation(s)
- Zheng Zhang
- School of Stomatology, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Xia Hong
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Feng Wang
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Xin Ye
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - You-Dan Yao
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Ying Yin
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Hong-Yu Yang
- School of Stomatology, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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Pérez-de-Oliveira ME, Louredo BVR, do Amaral-Silva GK, Leite AA, de Almeida OP, Jorge J, Santos-Silva AR, Lopes MA, Vargas PA. Cell block preparation as an adjunctive tool after fine-needle aspiration cytology for screening oral and maxillofacial diseases. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:343-352. [PMID: 37516618 DOI: 10.1016/j.oooo.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 04/25/2023] [Accepted: 05/10/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To describe the use of cell block (CB) preparation from fine-needle aspiration cytology for diagnosing oral and maxillofacial diseases. STUDY DESIGN We performed a retrospective analysis of 568 samples collected by our laboratory for CB preparation from fine-needle aspiration cytology of the oral and maxillofacial region between January 2001 and October 2021. We performed cytologic diagnoses and compared them with the available histopathologic diagnoses to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation for identifying malignant lesions. RESULTS The most frequent diagnosis was pleomorphic adenoma (n = 44, 7.7%), followed by metastatic squamous-cell carcinoma (n = 28, 4.9%) and odontogenic keratocyst (n = 26, 4.6%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation, which revealed detailed morphologic and architectural patterns, were 70.0%, 100.0%, 100.0%, 62.5%, and 80.0%, respectively. CONCLUSIONS Cell block preparation from fine-needle aspiration cytology of the oral and maxillofacial region may be a useful adjunctive diagnostic tool for diagnosing oral and maxillofacial diseases because it reveals morphologic and architectural patterns similar to those shown on histopathologic slides, leading to the better categorization of diseases.
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Affiliation(s)
| | | | - Gleyson Kleber do Amaral-Silva
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Amanda Almeida Leite
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Oslei Paes de Almeida
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Jacks Jorge
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
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DuVal M, Alkhraisat MH. Adjunctive Plasma Rich in Growth Factors in the Treatment of Osteomyelitis and Large Odontogenic Cysts Prior to Successful Implant Rehabilitation: Case Report. Dent J (Basel) 2023; 11:184. [PMID: 37623280 PMCID: PMC10453440 DOI: 10.3390/dj11080184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Osteomyelitis of the jaws presents a clinical challenge to conventional treatment, often requiring multiple surgical interventions resulting in significant deformity and presenting significant problems to satisfactory rehabilitation. While benign odontogenic cysts, such as the radicular cyst, are generally predictably treated, they can cause significant localized bone destruction and thus can present significant problems in satisfactory rehabilitation. In this case report, patients were treated combining conventionally appropriate surgical debridement and oral antibiotics with adjunctive plasma rich in growth factors (PRGF). Patients showed a complete soft tissue and osseous regeneration to their pre-pathologic state, with successful implant rehabilitation. PRGF appears to be highly successful in minimizing or eliminating osseous deformities normally associated with conventional treatment of osteomyelitis of the jaw and treatment of large odontogenic cysts. Future trials must be performed to confirm these results in comparison to controls using conventional treatment alone.
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Affiliation(s)
- Marc DuVal
- Department of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada
- Montreal Jewish General Hospital, Department of Dentistry and Oral and Oral and Maxillofacial Surgery, Montreal, QC H3T 1E2, Canada
- Santa Cabrini Hospital, Department of Surgery, Division of Plastics, Montreal, QC H1T 1P7, Canada
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17
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Ac V, Parihar A, Saxena A. An Insight Into the Effect of Odontogenic Keratocysts on Surrounding Structures: Cone-Beam Computed Tomography-Based Analysis of Cases. Cureus 2023; 15:e40488. [PMID: 37461795 PMCID: PMC10349913 DOI: 10.7759/cureus.40488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction An odontogenic keratocyst (OKC) is a benign intraosseous lesion with potential to demonstrate aggressive and invasive behavior. The aim of this retrospective study was to analyze the imaging features of the OKC using cone-beam computed tomography (CBCT) and to evaluate the association between the internal structure of the lesion and the effect of the lesion on surrounding structures. Methods Overall, 32 CBCT scans of histopathologically diagnosed cases of OKC were analyzed retrospectively. The following variables were analyzed: anatomic location of the lesions (mandible body (right/left), ramus (right/left), mandible body+ramus (right/left), maxilla (right/left), and both jaws), the internal structure of the lesion (unilocular/multilocular), and the effect of the lesion on the surrounding anatomical structures (involvement of the inferior alveolar nerve canal (IANC), displacement of the IANC, cortical expansion, displacement of the tooth, resorption of the root, associated impacted tooth, associated missing tooth). We also looked for the association between the internal structure and the effect of the lesion on anatomic structures. Results Out of 32 cases, 29 (90.6%) cases involved the mandible alone. Statistically significant association (p-value 0.005) was present between the internal structure and mean age of presentation as well as between the internal structure and impacted tooth (p-value 0.027). The association between the internal structure and other variables was statistically not significant. Conclusions The radiographic features of OKCs can be variable, and these lesions have a considerable effect on the tooth, IANC, and cortical bone. Significant association was found between the internal structure, age, and impacted tooth. Since OKCs have a high recurrence rate, CBCT is advised for evaluating the extent and location of any cortical perforations.
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Affiliation(s)
- Varsha Ac
- Department of Oral Medicine and Radiology, Government College of Dentistry, Indore, IND
| | - Ajay Parihar
- Department of Oral Medicine and Radiology, Government College of Dentistry, Indore, IND
| | - Ashish Saxena
- Department of Pediatric and Preventive Dentistry, Government College of Dentistry, Indore, IND
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18
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Melo G, Batistella EÂ, Bett JVS, Grando LJ, Rivero ERC. Prevalence of oral and maxillofacial lesions in children and adolescents at a regional Brazilian oral pathology service: a retrospective study and the relevant literature review. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00800-7. [PMID: 37099119 DOI: 10.1007/s40368-023-00800-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/10/2023] [Indexed: 04/27/2023]
Abstract
PURPOSE This study assessed the prevalence of maxillofacial lesions in children, i.e., 0-9 years, and adolescents, i.e., 10-19 years, in a Brazilian Oral Pathology Service and compared results with available literature. METHODS Clinical and histopathological records from January 2007 to August 2020 were analysed and a literature review investigating maxillofacial lesions in paediatric populations was also performed. RESULTS Overall, "reactive salivary gland lesions" and "reactive connective tissue lesions" were the most prevalent group of soft tissue lesions, affecting children and adolescents equally. From these, mucocele and pyogenic granuloma were the most prevalent histological diagnoses, respectively, regardless of age. These findings were consistent with the 32 studies included. Considering intraosseous lesions, "odontogenic cysts" and "periapical inflammatory lesions" were the most prevalent groups, with no relevant differences between age groups, except for the odontogenic keratocyst, which was more prevalent in adolescents. Moreover, several odontogenic tumours, such as ameloblastic fibroma and odontogenic myxoma, were significantly more prevalent in children. CONCLUSION Most maxillofacial lesions presented a similar prevalence between children and adolescents. Reactive salivary gland lesions and reactive connective tissue lesions were the prevailing diagnostic categories, regardless of age. Some odontogenic tumours and the odontogenic keratocyst showed significantly different frequencies across these age groups.
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Affiliation(s)
- G Melo
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - E Â Batistella
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - J V S Bett
- Dental School, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - L J Grando
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - E R C Rivero
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Clayton DJ, Bell C, Feigin K, Shope B. Clinical, Radiographic and Histologic Evaluation of 40 Cystic Oral Lesions in 37 Cats. J Vet Dent 2023; 40:57-74. [PMID: 35946117 DOI: 10.1177/08987564221119956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Feline cystic oral lesions are uncommon and include odontogenic cysts and cystic odontogenic tumors. Accurate diagnosis requires close collaboration between the clinician's clinical and radiographic findings and the pathologist's histologic interpretations. The odontogenic cysts identified in this series include a periapical cyst, dentigerous cysts and a type of unclassified collateral cyst that appears to be a previously undefined, distinct entity in cats (UCC). Many of the cysts (52%) were unable to be classified due to insufficient diagnostic information, which often related to the associated tooth being unavailable for evaluation. Cystic odontogenic tumors included ameloblastomas, amyloid producing ameloblastomas (APA), and feline inductive odontogenic tumors (FIOT). The purpose of this case series was to assess correlations between clinical and radiographic findings, histopathologic interpretation and signalment to identify common characteristics and provide recommendations for clinicians and pathologists to optimize diagnostic efficiency and accuracy for cystic oral lesions in cats.
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Affiliation(s)
| | - Cindy Bell
- Specialty Oral Pathology for Animals, LLC, Geneseo, IL, USA
| | | | - Bonnie Shope
- Veterinary Dental Services, LLC, Boxborough, MA, USA
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20
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McLean AC, Vargas PA. Cystic Lesions of the Jaws: The Top 10 Differential Diagnoses to Ponder. Head Neck Pathol 2023; 17:85-98. [PMID: 36928736 PMCID: PMC10063769 DOI: 10.1007/s12105-023-01525-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/06/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that may be reactive or neoplastic in nature. While most cystic jaw lesions are benign, variability in biologic behavior makes distinction between these entities absolutely crucial. METHODS Review. RESULTS Two clinical cases are presented in parallel and are followed by an illustrated discussion of the ten most likely differential diagnoses that should be considered when confronted with a cystic jaw lesion. Strong emphasis is placed on the histologic differences between these entities, empowering readers to diagnose them with confidence. Perhaps even more importantly, the more common diagnostic pitfalls in gnathic pathology are discussed, recognizing that a definitive diagnosis cannot be rendered in every situation. The histologic diagnoses for the two clinical cases are finally revealed. CONCLUSION Cystic lesions of the maxilla and mandible may be odontogenic or non-odontogenic. The most common cystic lesions are the reactive periapical cyst, and the dentigerous cyst (which is developmental in nature). It is important to note that cystic neoplasms also occur in the jaws, and that the presence of inflammation may obscure the diagnostic histologic features of lesions like odontogenic keratocyst and unicystic ameloblastoma. Ancillary testing is of limited diagnostic value in most scenarios. However, both clinical and radiographic information (such as the location, size, duration, associated symptoms, and morphology of the lesion in its natural habitat) are significantly useful.
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Affiliation(s)
- Anne C McLean
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Clements University Hospital UT Southwestern Medical Center, 6201 Harry Hines Blvd, RM UH04.252, Dallas, TX, 75390, USA.
| | - Pablo A Vargas
- Department of Oral Diagnosis, The State University of Campinas, Piracicaba, São Paulo, Brazil
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Chepyshko SI, Maksymiv OO, Gomon ML, Rozhko VI, Tkachyk SV, Tsymbaliuk HY, Fedoniuk LY. RESULTS OF INFLAMMATORY AND IMMUNOLOGICAL PARAMETERS OF THE ORAL CAVITY AFTER CYSTECTOMY WITH DIFFERENT METHODS OF CONNECTING THE EDGES OF THE OPERATED AREA. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:964-971. [PMID: 37326077 DOI: 10.36740/wlek202305112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: To analyze the results of inflammatory and immunological parameters of the oral cavity after cystectomy with different methods of connecting the edges of the operated area. PATIENTS AND METHODS Materials and methods: The research was conducted in 87 patients who sought surgical treatment of odontogenic cysts of the jaws. Patients were divided into groups depending on the method of wound closure after surgery. We analyzed the results of laboratory tests (leukocytes, ESR, IL-1β, IL-6, TNF-α, IL-8, NO synthase, MMP-9). RESULTS Results: The analysis of the effectiveness of using different methods of approximation of the oral mucosa wound on inflammatory and immunological pa¬rameters showed that when using welding of the edges of the operated area using the EKVZ-300 "Patonmed" apparatus, we get positive results of laboratory indicators of inflammatory markers faster (leukocyte counts are normal on day 30, ESR, IL-1β - on the 14th day, TNF-α - on the 7th day, IL-6, IL-8, NO synthase, MMP-9 - on the 30th day), that is, healing in such patients is faster than in patients with wound closure with classic suture material or laser. CONCLUSION Conclusions: When comparing the methods of approximation of postoperative oral mucosa wounds by different methods, based on the results of these inflammatory and immunological parameters, the best results were obtained when using electric welding of tissues. Further research and use of the proposed method will facilitate and shorten the rehabilitation period of patients after surgery.
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Affiliation(s)
| | | | - Mykola L Gomon
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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22
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Sohn C, Ryu J, Nam I, Shin SH, Lee JY. Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases. J Korean Assoc Oral Maxillofac Surg 2022; 48:342-347. [PMID: 36579905 PMCID: PMC9807379 DOI: 10.5125/jkaoms.2022.48.6.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.
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Affiliation(s)
- Changmo Sohn
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jihye Ryu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Inhye Nam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae-Yeol Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea,Jae-Yeol Lee, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea, TEL: +82-55-360-5100, E-mail: , ORCID: https://orcid.org/0000-0003-0678-2499
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23
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Li K, Xu W, Zhou T, Chen J, He Y. The radiological and histological investigation of the dental follicle of asymptomatic impacted mandibular third molars. BMC Oral Health 2022; 22:642. [PMID: 36567318 PMCID: PMC9791750 DOI: 10.1186/s12903-022-02681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The indication for removal of asymptomatic fully impacted third molars is still controversial. In this study, radiological and histological investigation of the dental follicle of asymptomatic impacted mandibular third molars was performed, aiming to provide a reference for clinical prophylactic extraction of these teeth. METHODS Patients with impacted mandibular third molars were included and the maximum width of the dental follicle around the crown was measured in horizontal, sagittal and coronal sections by cone beam computed tomography. The dental follicles were stained with haematoxylin-eosin, analysed by a pathologist and classified as normal, inflammatory or cystic. A Chi-squared test was used to analyse the association of the incidence of inflammation and cysts with the clinical variables of the impacted mandibular third molars. RESULTS Thirty-seven samples were normal dental follicles; 52 samples showed inflammatory infiltration with an incidence of 57.14%; 2 samples with a maximum dental follicle width of 2-3 mm were diagnosed as odontogenic cysts, and the incidence was 2.20%. There was no significant difference in the incidence of inflammatory and cystic dental follicles between males and females, or between different age groups (P > 0.05). With an increase of the maximum width of the dental follicle, there was a rise in the incidence and degree of infiltration of chronic nonspecific inflammation. CONCLUSION Asymptomatic impacted mandibular third molars tend to be extracted, especially for teeth with a 2-3 mm maximum width of the dental follicle on radiological examination.
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Affiliation(s)
- Kuncai Li
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Wei Xu
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Tiejun Zhou
- grid.488387.8Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Junliang Chen
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Yun He
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
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Paré A, Charbonnier B, Veziers J, Vignes C, Dutilleul M, De Pinieux G, Laure B, Bossard A, Saucet-Zerbib A, Touzot-Jourde G, Weiss P, Corre P, Gauthier O, Marchat D. Standardized and axially vascularized calcium phosphate-based implants for segmental mandibular defects: A promising proof of concept. Acta Biomater 2022; 154:626-640. [PMID: 36210043 DOI: 10.1016/j.actbio.2022.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
The reconstruction of massive segmental mandibular bone defects (SMDs) remains challenging even today; the current gold standard in human clinics being vascularized bone transplantation (VBT). As alternative to this onerous approach, bone tissue engineering strategies have been widely investigated. However, they displayed limited clinical success, particularly in failing to address the essential problem of quick vascularization of the implant. Although routinely used in clinics, the insertion of intrinsic vascularization in bioengineered constructs for the rapid formation of a feeding angiosome remains uncommon. In a clinically relevant model (sheep), a custom calcium phosphate-based bioceramic soaked with autologous bone marrow and perfused by an arteriovenous loop was tested to regenerate a massive SMD and was compared to VBT (clinical standard). Animals did not support well the VBT treatment, and the study was aborted 2 weeks after surgery due to ethical and animal welfare considerations. SMD regeneration was successful with the custom vascularized bone construct. Implants were well osseointegrated and vascularized after only 3 months of implantation and totally entrapped in lamellar bone after 12 months; a healthy yellow bone marrow filled the remaining space. STATEMENT OF SIGNIFICANCE: Regenerative medicine struggles with the generation of large functional bone volume. Among them segmental mandibular defects are particularly challenging to restore. The standard of care, based on bone free flaps, still displays ethical and technical drawbacks (e.g., donor site morbidity). Modern engineering technologies (e.g., 3D printing, digital chain) were combined to relevant surgical techniques to provide a pre-clinical proof of concept, investigating for the benefits of such a strategy in bone-related regenerative field. Results proved that a synthetic-biologics-free approach is able to regenerate a critical size segmental mandibular defect of 15 cm3 in a relevant preclinical model, mimicking real life scenarii of segmental mandibular defect, with a full physiological regeneration of the defect after 12 months.
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Affiliation(s)
- Arnaud Paré
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Baptiste Charbonnier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
| | - Joëlle Veziers
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Caroline Vignes
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Maeva Dutilleul
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Gonzague De Pinieux
- Department of Pathology, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Boris Laure
- Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Adeline Bossard
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Annaëlle Saucet-Zerbib
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Gwenola Touzot-Jourde
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Pierre Weiss
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Pierre Corre
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Clinique de Stomatologie et Chirurgie Maxillo-Faciale, Nantes University Hospital, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Olivier Gauthier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - David Marchat
- Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France.
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Lešin A, Galić I, Tadin A, Vilović K, Jerković D. Treatment of Inflammatory Dentigerous Cyst Using a Surgical T Drain in a Child. Eur J Dent 2022. [PMID: 36220112 DOI: 10.1055/s-0042-1756688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Dentigerous cysts are rarely reported in young children. They are usually asymptomatic and only identified when becoming significantly large. Treatment by enucleation may damage structures like the inferior alveolar nerve, maxillary sinus, or permanent teeth, thus reducing the child's quality of life. Therefore, conservative surgical treatment such as decompression is indicated. This case report describes the treatment and subsequent complete regression of an inflammatory dentigerous cyst based on the decompression method using a customized surgical tube in a 10-year-old girl. The innervation was preserved, and permanent teeth erupted.
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Affiliation(s)
- Antonella Lešin
- Department of Maxillofacial Surgery, University Hospital of Split, Split, Croatia
| | - Ivan Galić
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, School of Medicine, University of Split, Split, Croatia
| | - Katarina Vilović
- Department of Anatomy, Department of Pathology, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Daniel Jerković
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
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Use of Leukocyte-PlateletRich Fibrin in Conservative Management of Odontogenic Keratocyst: A Case Report. World J Plast Surg 2022; 11:98-102. [PMID: 36694672 PMCID: PMC9840757 DOI: 10.52547/wjps.11.3.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
A 29-year-old female patient was referred to the Department of Oral and Maxillofacial Surgery in Taleghani Hospital of Shahid Beheshti University of Medical Science, Tehran, Iran, in 2019, complaining of increased volume and pain in the posterior mandibular region. Cone-beam computed tomography and multislice computed tomography were performed, and an incisional biopsy was done. The histopathologic examination confirmed the diagnosis of Odontogenic Keratocyst (OKC). Surgical treatment was performed with marsupialization. After a year of follow-up, the resultant small-sized cyst was curetted, and Leukocyte-PlateletRich Fibrin (LPRF) was placed in the bony depression. The significant healing of the lesion was noted on regular follow-up visits with complete resolution at 15 months. This report showed that the application of LPRF might accelerate the healing of soft tissues and bone regeneration with no inhibitory effect on the natural healing process.
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Heinrich A, Burmeister U, Lenz JH, Weber MA. [Clinical radiological evaluation of teeth-part 2 : Caries, inflammatory dental changes and important differential diagnoses]. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:701-714. [PMID: 35819469 DOI: 10.1007/s00117-022-01035-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
Inflammatory diseases of the teeth and periodontium are widespread and are frequent secondary diagnoses in head and neck examinations. Periapical inflammation can be the cause of sinusitis or abscess formation in the oral and maxillofacial region. Early detection is important for the patient's course of treatment. For further diagnostics, a dental presentation should be carried out. Dental radiological examinations, such as panoramic radiographs and dental films are used for specific diagnostics. This article is intended to provide an overview of the different stages of caries, the most important inflammatory dental changes and their most frequent differential diagnoses.
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Affiliation(s)
- A Heinrich
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
| | - U Burmeister
- Poliklinik für Zahnerhaltung und Parodontologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Jan-Hendrik Lenz
- Klinik und Poliklinik für Mund‑, Kiefer- und Plastische Gesichtschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - M-A Weber
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland
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Alnour A, Sahlol E, Wehbi E, Achour H, Abdo A. Heterotopic gastrointestinal cyst in the mandible of a young adult: A rare case-report from Syria. Ann Med Surg (Lond) 2022; 80:104296. [PMID: 36045817 PMCID: PMC9422310 DOI: 10.1016/j.amsu.2022.104296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Heterotopic gastrointestinal cyst (HGC) is a rare entity in the head and neck region. The dorsal surface of tongue and the floor of the mouth is the most commonly affected sites and rarely affects bone. Histologic examination reveals a lesion resembling any part in the gastric tract; colonic, intestinal or gastric mucosa. We report a HGC presenting in a twenty-one-year-old Syrian female patient. To Document this kind of cases which is still not well recognized well in literature. Give full information about the case which may lead to identify any difference or tendency to occur in certain location that may vary among communities. That may lead to make this entity well known and encourage researches to study it on a long term to give specific follow up.
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Lowry N, Peralta S. Diagnostic Imaging in Veterinary Dental Practice. J Am Vet Med Assoc 2022; 261:201-203. [PMID: 35905153 DOI: 10.2460/javma.22.06.0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Natalie Lowry
- 1Dentistry and Oral Surgery Service, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Santiago Peralta
- 2Shelter Medicine Service, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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Usage of Guided Bone Regeneration in the Case of Lateral Periodontal Cyst in the Maxilla with Buccal Cortical Expansion. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A lateral periodontal cyst (LPC) is a rare finding. Patients diagnosed with LPC younger than 40 years of age are not that common. Mostly asymptomatic LPCs can be discovered on routine radiographs as an oval radiolucency between two mandibular premolar teeth roots and can vary in shape and size. Most cases are treated with enucleation, bone curettage, or a combination of both, greatly depending on the surgeon’s preference. Because most LPCs are quite small, lesions do not require any regenerative procedures. In the presented case, because of cortical expansion of the lesion and loss of vital bone bridge surrounding two adjacent maxillary teeth, a guided bone regenerative procedure (GBR) with xenograft bone substitute was used. Despite that small lesions can heal on their own, nowadays the approach of full-mouth therapy (FMT), including direct soft or hard tissue reconstruction in the oral cavity, seems to be a wise treatment. The presented paper presents and describes an unusual LPC case with cortical bone expansion in a very rare maxillary canine–premolar region.
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Ortiz-García JZ, Munguía-Robledo S, Estrada-Orozco JJ, Licéaga-Escalera C, Rodríguez MA. Expression level and proteolytic activity of MMP-2 and MMP-9 in dental follicles, dentigerous cysts, odontogenic keratocysts and unicystic ameloblastomas. J Oral Biol Craniofac Res 2022; 12:339-342. [DOI: 10.1016/j.jobcr.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/23/2021] [Accepted: 03/29/2022] [Indexed: 11/27/2022] Open
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Wang J, Yao QY, Zhu HY. Efficacy of bone grafts in jaw cystic lesions: A systematic review. World J Clin Cases 2022; 10:2799-2808. [DOI: 10.12998/wjcc.v10.i9.2799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone grafts have been applied for many years in orthopedic surgery to assist with bone repair for defects or bone discontinuity caused by trauma and tumors as well as periodontal defects. Jaw cysts are another common benign disease of the maxillofacial region which may lead to pathological bone fracture, loss of teeth, and infection. However, whether bone grafts are beneficial for bone regeneration in jaw cystic lesions and when bone grafts should be used remains unclear.
AIM To study the efficacy of bone grafts compared to spontaneous healing in the treatment of jaw cystic lesions.
METHODS A literature search was performed in Medline, Cochrane Library and Embase to identify related articles published in English in the last ten years. The following key words and MeSH terms were used: “jaw cyst”, “cystic lesion”, “odontogenic cyst”, “periapical cyst”, “dentigerous cyst”, “follicular cyst”, “keratocyst”, “treatment”, “surgery”, “bone graft”, “enucleation”, “cystectomy”, and “bone regeneration”. Case reports, clinical trials, clinical studies, observational studies and randomized controlled trials were included. Study quality was evaluated.
RESULTS Ten studies (n = 10) met the inclusion criteria. Five studies reported spontaneous bone healing after enucleation, three studies investigated the efficacy of various bone grafts, and two randomized comparative studies focused on the comparison between spontaneous healing and bone grafting. Over 90% of bone regeneration occurred within 6 mo after bone grafting. The bone regeneration rate after cystectomy showed great variation, ranging from 50% to 100% after 6 mo, but reaching over 90% after 12 mo.
CONCLUSION While the long-term superiority of bone grafting compared with spontaneous healing after cystectomy is unclear, bone grafts accelerate the process of healing and significantly increase bone quality.
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Affiliation(s)
- Jin Wang
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Qiu-Yun Yao
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hui-Yong Zhu
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Wang J, Yao QY, Zhu HY. Efficacy of bone grafts in jaw cystic lesions: A systematic review. World J Clin Cases 2022; 10:2801-2810. [PMID: 35434117 PMCID: PMC8968803 DOI: 10.12998/wjcc.v10.i9.2801] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/23/2021] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone grafts have been applied for many years in orthopedic surgery to assist with bone repair for defects or bone discontinuity caused by trauma and tumors as well as periodontal defects. Jaw cysts are another common benign disease of the maxillofacial region which may lead to pathological bone fracture, loss of teeth, and infection. However, whether bone grafts are beneficial for bone regeneration in jaw cystic lesions and when bone grafts should be used remains unclear.
AIM To study the efficacy of bone grafts compared to spontaneous healing in the treatment of jaw cystic lesions.
METHODS A literature search was performed in Medline, Cochrane Library and Embase to identify related articles published in English in the last ten years. The following key words and MeSH terms were used: “jaw cyst”, “cystic lesion”, “odontogenic cyst”, “periapical cyst”, “dentigerous cyst”, “follicular cyst”, “keratocyst”, “treatment”, “surgery”, “bone graft”, “enucleation”, “cystectomy”, and “bone regeneration”. Case reports, clinical trials, clinical studies, observational studies and randomized controlled trials were included. Study quality was evaluated.
RESULTS Ten studies (n = 10) met the inclusion criteria. Five studies reported spontaneous bone healing after enucleation, three studies investigated the efficacy of various bone grafts, and two randomized comparative studies focused on the comparison between spontaneous healing and bone grafting. Over 90% of bone regeneration occurred within 6 mo after bone grafting. The bone regeneration rate after cystectomy showed great variation, ranging from 50% to 100% after 6 mo, but reaching over 90% after 12 mo.
CONCLUSION While the long-term superiority of bone grafting compared with spontaneous healing after cystectomy is unclear, bone grafts accelerate the process of healing and significantly increase bone quality.
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Affiliation(s)
- Jin Wang
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Qiu-Yun Yao
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hui-Yong Zhu
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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A Rare Case of Front Mandible Orthokeratinized Odontogenic Cyst - Surgical Management with Preventive Rigid Osteosynthesis. J Craniofac Surg 2022; 33:2228-2230. [PMID: 35184113 DOI: 10.1097/scs.0000000000008569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/30/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Cysts and other intrabony lesions can grow asymptomatic until being diagnosed by occasionally done radiologic examination. Missing tooth and malposition of adjacent teeth should induce clinicians to perform X-Ray diagnostic. METHODS A 37-year-old, male patient was admitted with a hopeless tooth 36, to be extracted and replaced with an implant. Clinical examination revealed also missing one of lower incisors and malposition of remaining lower incisors. Cone-beam computed tomography revealed horizontally impacted lower incisor surrounded by bone defect - 15 × 20 × 8 mm with the bone thickness remaining only 3.5 mm in the narrowest area. The basis on strong masticatory muscles and low thickness of bone after surgical removal of tooth and lesion, prophylactic osteosynthesis was planned. To explain the surgery to the patient model of the mandible was 3D printed. RESULTS Two treatment plans were presented to the patient: 1. custom plate production according to the bone defect and the shape of remaining bone and 2. choosing a standard plate and adjusting it on the 3D printed model. Costs of the material were 10 times higher in a custom solution. Plan 2 was then accepted. 1.2 mm straight plate was prebend on the model and sterilized. Lesion and impacted tooth were removed in local anesthesia. Prepared plates were fixed. CONCLUSIONS In the presented case custom 3D printed osteosynthesis plate was about 10 times more expensive compared to the standard osteosynthesis plate used. 3D printing of bone model may be helpful for prebending chosen standard plate and planning the surgery.
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Vizuete–Bolaños MX, Salgado–Chavarría F, Cruz–Tapia RO. Quiste dentígero. Revisión de la literatura y reporte de caso. ACTA ODONTOLÓGICA COLOMBIANA 2022. [DOI: 10.15446/aoc.v12n1.98021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: el quiste dentígero, también conocido como quiste folicular, es la segunda forma más habitual de los quistes de la región maxilar después del quiste radicular. Tiene una incidencia del 20% con respecto a todos los quistes odontogénicos y se encuentra más en el género masculino entre los 20-40 años. El manejo conservador en lesiones quísticas de gran tamaño es indispensable para evitar defectos óseos o daño a estructuras vecinas. Sin embargo, en lesiones de menor tamaño, la enucleación continúa siendo el tratamiento de elección. Objetivo: presentar un caso clínico de un quiste dentígero y hacer una revisión de la literatura actualizada. Caso clínico: paciente masculino de 23 años que presentó aumento de volumen en zona geniana derecha y, además, en su ortopantomografía se observó una lesión en el sector de los incisivos superiores. Se realizó enucleación de la lesión, cuyo diagnóstico histológico previo fue quiste dentígero y posteriormente se obtiene una correcta regeneración ósea tras un año de seguimiento Conclusión: el manejo del quiste dentígero es variado: puede ir desde la enucleación quirúrgica hasta la descompresión y marsupialización del mismo. No obstante, todos los tratamientos actuales se basan en contrarrestar los factores de expansión quística que permiten a esta lesión alcanzar grandes tamaños intraóseos y poder causar desde rizolisis de dientes adyacentes hasta una asimetría facial como sucedió en este caso clínico.
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Golob Deeb J, Deeb GR, Schafer DR. Odontogenic Keratocyst is frequently misdiagnosed for a Lateral Periodontal Cyst in premolar and anterior tooth-bearing areas. J Endod 2021; 48:337-344. [PMID: 34922990 DOI: 10.1016/j.joen.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/07/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Radiolucent lesions with gingival swelling found in the premolar and intercanine region can elicit a different clinical diagnosis than one confirmed by histologic findings. The purpose of the study is to identify and present the frequency of the unexpected microscopic diagnosis of Odontogenic Keratocyst (OKC) in a location preoperatively favoring a Lateral Periodontal Cyst (LPC) with similar clinical and radiographic appearance. METHODS A retrospective analysis of biopsies received from 2011 and 2019 was performed and the number of LPC and OKC cases were assessed. The alignment of clinical and radiographic diagnosis to histologic findings and anatomic location was analyzed and the number of OKC cases preoperatively misdiagnosed as LPCs was identified. RESULTS A total of 79257 biopsies were received. Of those, 184 were diagnosed as LPCs and 742 as OKCs. For all preoperatively diagnosed LPCs, the clinical and histological diagnosis aligned; however, 182 of 742 OKCs were submitted with a clinical misdiagnosis of LPCs. The location of these lesions with the unanticipated diagnosis overlapped with those for LPCs, specifically the maxillary and mandibular anterior and premolar regions. CONCLUSION Radiolucent lesions with gingival swelling in the premolar and intercanine region are frequently clinically and radiographically misdiagnosed. A biopsy should be considered in all cases to establish the correct pathologic diagnosis and treatment course.
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Affiliation(s)
- Janina Golob Deeb
- Associate Professor, Virginia Commonwealth University, School of Dentistry, Department of Periodontics, Richmond, Virginia, USA.
| | - George R Deeb
- Professor, Virginia Commonwealth University, School of Dentistry, Department of Oral and Maxillofacial Surgery, Richmond, Virginia, USA
| | - Duane R Schafer
- Professor, Virginia Commonwealth University, School of Dentistry, Director, Department of Oral Diagnostic Sciences, Richmond, Virginia, USA
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The Importance of Using Physical Tridimensional Models for the Management and Planning of Extended Osseous Odontogenic Lesions. Dent J (Basel) 2021; 9:dj9110134. [PMID: 34821598 PMCID: PMC8624155 DOI: 10.3390/dj9110134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/11/2021] [Accepted: 11/03/2021] [Indexed: 01/18/2023] Open
Abstract
(1) Surgical intervention becomes crucial in situations in which lack of action would cause a decrease in quality of life for the patient. As healthcare professionals, our next objective is to reduce patient fear perception. This work’s aim is to illustrate how physical tridimensional models can serve not only as confidence boosters for the patient, but also as a valid tool to aid both the clinician and the fostering of a patient–doctor relationship. (2) An example case managed using a stereolithographic model in the pre-surgical planning stage is presented in which surgical planning was carried out by analysis of radiographic investigations combined with a tridimensional resin model derived from the patient’s x-ray exam. (3) Successful enucleation, surgical debridement, and stable follow-up shows the effectiveness of the applied surgical protocol, confirming that planification using a physical representation of the tridimensional exam aids in the correct surgical management of said lesions. (4) The effectiveness o101f the surgical act itself as well as the follow-up showing ossification of the bony lesion and absence of relapse of a highly recurrent lesion confirms the effectiveness of the tools used for this surgical intervention.
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Noujeim Z, Nasr L. The prevalence, distribution, and radiological evaluation of dentigerous cysts in a Lebanese sample. Imaging Sci Dent 2021; 51:291-297. [PMID: 34621656 PMCID: PMC8479438 DOI: 10.5624/isd.20210075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample. Materials and Methods It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed. Results Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients (52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%). Conclusion The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors.
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Affiliation(s)
- Ziad Noujeim
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.,Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
| | - Lara Nasr
- Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
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Salehani A, Mooney J, Lepard J, Hackney JR, Harmon D. Rare Ameloblastic Carcinoma Metastasis to the Cervical Spine: A Case Report. Neurosurgery 2021; 88:E537-E542. [PMID: 33611519 DOI: 10.1093/neuros/nyab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/26/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Ameloblastic carcinoma (AC) is a malignant neoplasm of epithelial origin that typically arises from the mandible or maxilla. It represents approximately 2% of all odontogenic tumors. Gross total resection is the surgical goal given AC's aggressiveness and propensity for recurrence. We present the first reported AC metastasis to the cervical spine. CLINICAL PRESENTATION A 61-yr-old African American female with a history of AC of bilateral mandibles and lung metastases presented with neck pain and right arm weakness progressive over several months. Cervical spine imaging demonstrated a cervical 3 pathological fracture with severe anterior vertebral body compression and resultant cervical 2-3 kyphotic deformity and bony retropulsion causing severe cord compression. The patient underwent a cervical 3 corpectomy and cervical 2-4 anterior fixation followed by a cervical 3 laminectomy and cervical 2-5 dorsal internal fixation and fusion. Postoperatively, the patient's neurological exam remained stable and imaging showed improved spinal alignment and appropriate anterior and posterior instrumentation. Unfortunately, the patient thereafter suffered a decline in performance status and progression of lung metastatic disease. Her oncology team is considering chemotherapy and stereotactic radiosurgery, but her prognosis remains grim. CONCLUSION AC is a rare and aggressive pathology with a poor prognosis despite multimodal therapy. We present the first case of AC metastatic spread to the spine. We aim to bring this pathology to the attention of our worldwide neurosurgical colleagues and share our surgical approach and multidisciplinary management to assist those who may encounter this pathology in the future.
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Affiliation(s)
- Arsalaan Salehani
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - James Mooney
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - Jacob Lepard
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - James R Hackney
- Division of Neuropathology, Department of Pathology, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
| | - Daniel Harmon
- Department of Neurosurgery, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
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Suppamaeteekulwat B, Apaijai N, Aschaitrakool Y, Chamusri N, Jaiwongkam T, Kerdphoo S, Chattipakorn N, Chattipakorn SC. The differences in mitochondrial function, mitochondrial dynamics, and cell death between odontogenic cysts/tumors and normal dental follicles. Mitochondrion 2021; 59:175-183. [PMID: 34091078 DOI: 10.1016/j.mito.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 05/16/2021] [Accepted: 06/01/2021] [Indexed: 12/06/2022]
Abstract
We aimed to compare mitochondrial function, mitochondrial dynamics, apoptosis, and necroptosis between odontogenic cysts/tumors, including radicular cysts, dentigerous cysts, ameloblastoma, vs. dental follicles as control. We demonstrated that mitochondrial dysregulation and imbalanced mitochondrial dynamics were observed in ameloblastoma. Apoptosis was increased in dentigerous cysts, and ameloblastoma, while necroptosis was suppressed in ameloblastoma. Necroptosis in radicular cysts was higher than that of control, suggesting that the inflammation-associated cell death occurred in radicular cysts. Our findings suggest ameloblastoma exhibited mitochondrial dysfunction, decreased mitochondrial fusion, and potential apoptosis. Therefore, alleviating mitochondrial dysregulation and apoptosis may be novel-targeted therapy for odontogenic cysts and tumors.
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Affiliation(s)
- Bussara Suppamaeteekulwat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nattayaporn Apaijai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Yuthakran Aschaitrakool
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nutchapon Chamusri
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Thidarat Jaiwongkam
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sasiwan Kerdphoo
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand.
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Holmes KR, Holmes RD, Martin M, Murray N. Practical Approach to Radiopaque Jaw Lesions. Radiographics 2021; 41:1164-1185. [PMID: 34086497 DOI: 10.1148/rg.2021200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ©RSNA, 2021.
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Affiliation(s)
- Kenneth R Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - R Davis Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Montgomery Martin
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Nicolas Murray
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
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Nahajowski M, Hnitecka S, Antoszewska-Smith J, Rumin K, Dubowik M, Sarul M. Factors influencing an eruption of teeth associated with a dentigerous cyst: a systematic review and meta-analysis. BMC Oral Health 2021; 21:180. [PMID: 33827533 PMCID: PMC8028237 DOI: 10.1186/s12903-021-01542-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background A dentigerous cyst (DC) is a pathology embracing the crown of an unerupted tooth at risk of malignant transformation. The causal tooth is usually removed together with the cyst. However, if there are orthodontic contraindications for extraction, two questions arise. (1) Which factors favor spontaneous eruption? (2) Which factors imply the necessity of applying orthodontic traction? This systematic review aimed to identify factors conducive/inconducive to the spontaneous eruption of teeth after dentigerous cyst marsupialization. Methods In accordance with the PRISMA guidelines, the main research question was defined in the PICO format (P: patients with dentigerous cysts; I: spontaneous tooth eruption after surgical DC treatment; C: lack of a spontaneous tooth eruption after surgical DC treatment; O: determining factors potentially influencing spontaneous tooth eruption). The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched for keywords combining dentigerous/odontogenic/follicular cysts with teeth and/or orthodontics, as well as human teeth and eruption patterns/intervals/periods/durations. The following data were extracted from the qualified articles (4 out of 3005 found initially): the rate of tooth eruption after surgical treatment of the cyst, the age and sex of the patients, the perpendicular projection distance between the top of the tooth cusp and the edge of the alveolar process, tooth angulation, the root formation stage, the cyst area, and the eruption space. The articles were subjected to risk of bias and quality analyses with the ROBINS-I protocol and the modified Newcastle–Ottawa QAS, respectively. Meta-analyses were performed with both fixed and random effects models. The GRADE approach was used to evaluate the quality of the evidence. The systematic review was registered in PROSPERO under ID CRD42020189044. Results Nearly 62% of DC-associated premolars erupted spontaneously after cyst marsupialization/decompression. Young age (mean = 10 years) and root formation not exceeding 1/2 of its fully developed length were the factors likely to favor spontaneous eruption. Conclusion The small number of published studies, as well as their heterogeneity and the critical risk of bias, did not allow the creation of evidence-based protocols for managing teeth with DC after marsupialization. More high-quality research is needed to draw more reliable conclusions. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01542-y.
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Affiliation(s)
- Marek Nahajowski
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland.
| | - Sylwia Hnitecka
- Department of Maxillofacial Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Joanna Antoszewska-Smith
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
| | - Kornelia Rumin
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
| | - Magdalena Dubowik
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
| | - Michał Sarul
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
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de Rezende G, Bandiera L, Motta V, Bonoldi E. Odontogenic fibroma amyloid-variant: a typical case and brief considerations about mimickers. Pathologica 2021; 113:136-140. [PMID: 34042096 PMCID: PMC8167397 DOI: 10.32074/1591-951x-152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 11/30/2022] Open
Abstract
The World Health Organization's (WHO) updated classification of head and neck tumors (2017) defined odontogenic fibroma as a rare neoplasm. In this report, we describe an unusual, typical and rare variant of a central odontogenic fibroma with diffuse amyloid-like protein stromal deposition, and discuss the differential diagnosis with other entities. Radiographically, this lesion presented as a well-defined radiolucency of the mandible, partially cystic. Histologically, the lesion showed a unique confluence of odontogenic epithelial rests in a moderately cellular connective tissue. Immunohistochemical staining highlighted a mixture of benign epithelial and Langerhans cells within connective tissue with diffuse amyloid-like stromal deposition. The importance of recognizing this variant of odontogenic fibroma is due to its benign prognosis and clinical course.
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Affiliation(s)
- Gisele de Rezende
- Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Laura Bandiera
- Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Valentina Motta
- Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Emanuela Bonoldi
- Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Clinical and Cone-Beam Computed Tomography Features of Orthokeratinized Odontogenic Cysts and Odontogenic Keratocysts in the Mandible. J Oral Maxillofac Surg 2020; 79:1255-1261. [PMID: 33352113 DOI: 10.1016/j.joms.2020.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of the study was to compare the clinical and cone-beam computed tomography features of orthokeratinized odontogenic cysts (OOCs) and odontogenic keratocysts (OKCs) and to fully understand features of these 2 odontogenic cysts. MATERIALS AND METHODS This retrospective cross-sectional study included patients with mandibular OOCs and OKCs. The predictor variables included age at the time of diagnosis, sex, anatomical location of the cysts, lesion size, cortical bone expansion rate, and presence of cortical bone destruction, impacted tooth, tooth displacement, and root resorption. The outcome variable was the type of cystic lesion. A 1-way analysis of variance test was used to analyze the differences among the cases of OOCs and OKCs. The specificity and sensitivity of the radiological features were calculated to differentiate OOCs from OKCs. RESULT The sample was composed of 12 patients with OOCs and 36 patients with OKCs. The mean ages of the patients with OOCs (30.50 ± 6.14 years) and OKCs (38.39 ± 19.44 years) were concentrated in the third decade. The cystic lesions occurring in areas II and III accounted for 66.67 and 52.78% of the OOC and OKC cases, respectively. The cortical bone expansion rate of the OOC was larger than that of the unilocular OKC (OOC, 2.20 ± 1.05; OKC, 1.48 ± 0.50; P < .05). The specificity and sensitivity of unilocular or multiocular cysts to differentiate OOC from OKC were 100%, 42%, 95% confidence interval of 0.1479 to 0.3892 (P < .05) and tooth displacement were 100%, 3%, 95% confidence interval of 0.1479 to 0.3892 (P < .05). CONCLUSIONS The results of this study suggest clinical and radiological features of OOCs and OKCs mostly overlap, but OOC has distinctive characteristics. Most cystic lesions of OOC are unilocular cysts, rarely accompanied by tooth displacement. The cortical bone expansion rate is larger than that of unilocular cysts of OKC.
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Soukup JW, Bell CM. The canine furcation cyst, a newly defined odontogenic cyst in dogs: 20 cases (2013-2017). J Am Vet Med Assoc 2020; 256:1359-1367. [PMID: 32459593 DOI: 10.2460/javma.256.12.1359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize clinical, radiographic, and histologic features of canine furcation cysts (CFCs) in dogs and to propose possible mechanisms of CFC development. ANIMALS 20 client-owned dogs with CFCs biopsied between January 1, 2013, and December 31, 2017. PROCEDURES Medical records of the Center for Comparative Oral and Maxillofacial Pathology at the University of Wisconsin-Madison were retrospectively searched to identify records of dogs that had surgical biopsy specimens of mandibular or maxillary cavitary lesions diagnosed as odontogenic cysts and that met additional inclusion criteria. Biopsy sample submission records, medical records, clinical and radiographic images, and histologic samples were reviewed. Clinical, radiographic, and histologic features were evaluated. RESULTS Mean body weight and age of affected dogs were 23.5 kg (51.7 lb) and 8.2 years, respectively. All 20 dogs had a unilateral cyst, with the right (n = 13) or left (7) maxillary fourth premolar tooth affected and viable in all dogs. A predominant clinical sign was a fluctuant swelling of the buccal gingiva and mucosa overlying the CFC, and enucleation of the cyst lining, with or without extraction of the affected tooth, resolved the lesion in most dogs. CONCLUSIONS AND CLINICAL RELEVANCE Our findings indicated that CFC is an odontogenic cyst of uncertain etiopathogenesis and that complete evaluation of the clinical, radiographic, and histologic features of the lesion in affected patients is necessary to distinguish a CFC from other odontogenic cysts and tumors in dogs. Defining CFCs in terms of characteristic features permits accurate diagnosis and appropriate treatment of these previously unclassifiable odontogenic cysts in dogs.
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Mrad MA, Shah Mardan QNM, Mahabbat NA. Radicular cysts and Chin implants; An unexpected complication prompting explantation - Case report. Int J Surg Case Rep 2020; 77:766-768. [PMID: 33395891 PMCID: PMC7718126 DOI: 10.1016/j.ijscr.2020.11.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022] Open
Abstract
Radicular cysts are benign, odontogenic, and inflammatory in nature that commonly arise in the maxilla. No link has been previously found between silicone chin implants and radicular cysts or fistulating radicular cysts. We suggest dental panoramic X-ray screening for patients with poor oral hygiene or dental trauma to detect radicular cysts before the operation. The decision to proceed with chin implant in a patient known for treated radicular cyst may be unsafe, as the recurrence rate is unknown.
Introduction Implant-based genioplasty is a simple and safe but not complication-free cosmetic procedure. Patients are commonly briefed about anticipated complications and their management pre-operatively, but few unexpected complications may arise; and this case report is an example. This paper is the first to report a radicular cyst fistulating through chin implant pocket to the skin. Moreover, we present our prevention strategy and recommendations. Presentation of case A 39-year-old-lady underwent a silicone implant-based genioplasty that was uneventful. Later, she developed a reddish nodule on the chin necessitating fistulectomy followed by a recurrence leading to explantation. It was not until the second recurrence that a fistulating radicular cyst was discovered and was treated with the help of a dentist. Discussion Radicular cysts are benign, inflammatory cysts that arise in a background of dental trauma or caries. No link has been discovered yet between silicone implants and radicular cysts or fistulating cysts. Moreover, we propose that poor oral hygiene could be implicated in the development of these cysts. Dental panoramic X-ray has been used to diagnose radicular cysts, but its efficacy as a screening tool needs to be studied. Finally, the recurrence rate of radicular cysts is unknown. Conclusion In a patient with chin implant, radicular cysts could lead to a disastrous outcome. Through history and physical examination, a plastic surgeon should identify patients with poor oral hygiene and dental trauma prior to implant-based genioplasty to arrange for a dental panoramic X-ray. Patients known to have radicular cysts should not undergo an implant-based genioplasty.
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Affiliation(s)
- Mohamed A Mrad
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia.
| | - Qutaiba N M Shah Mardan
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia
| | - Nehal A Mahabbat
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia
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Loureiro RM, Sumi DV, Tames HLVC, Ribeiro SPP, Soares CR, Gomes RLE, Daniel MM. Cross-Sectional Imaging of Third Molar-Related Abnormalities. AJNR Am J Neuroradiol 2020; 41:1966-1974. [PMID: 32912872 DOI: 10.3174/ajnr.a6747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/19/2020] [Indexed: 01/21/2023]
Abstract
Third molars may be associated with a wide range of pathologic conditions, including mechanical, inflammatory, infectious, cystic, neoplastic, and iatrogenic. Diagnosis of third molar-related conditions can be challenging for radiologists who lack experience in dental imaging. Appropriate imaging evaluation can help practicing radiologists arrive at correct diagnoses, thus improving patient care. This review discusses the imaging findings of various conditions related to third molars, highlighting relevant anatomy and cross-sectional imaging techniques. In addition, key imaging findings of complications of third molar extraction are presented.
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Affiliation(s)
- R M Loureiro
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - D V Sumi
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - H L V C Tames
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - S P P Ribeiro
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - C R Soares
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - R L E Gomes
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - M M Daniel
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Marchal A, Gérard É, Curien R, Bourgeois G. Primary intraosseous carcinoma arising in dentigerous cyst: Case report. Int J Surg Case Rep 2020; 76:530-533. [PMID: 33207425 PMCID: PMC7599364 DOI: 10.1016/j.ijscr.2020.10.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/29/2022] Open
Abstract
Primary intraosseous carcinoma arising in a dentigerous cyst is a rare observation. There are no clinical or radiological pathognomonic characteristics and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. A systematic and careful microscopic analysis of any cyst, even if look like benign, should be undertaken.
Introduction Carcinomas arising in odontogenic cysts are uncommon. Malignant transformation of a dentigerous cyst is a rare observation. A primary intraosseous carcinoma from a dentigerous cyst in a 69 years old female is presented in this case report. Presentation of case The patient initially consulted for pain in the mandibular left molar region. Primary investigations firstly showed a probably benign lesion but immunochemistry analysis finally revealed a squamous cell carcinoma arising in a dentigerous cyst. An extension assessment was performed and no evidence of lymph node extension or distant metastasis were found. A non-interrupting mandibular bone resection without neck dissection was realized. The patient made a good recovery after surgery without postoperative complication. No clinical symptoms or sign of local recurrence or metastasis was detected after 17 months follow-up. Discussion PIOC arising in a dentigerous cyst is a rare observation. PIOC from odontogenic cysts have an incident rate of 0,3 to 2% and only 16%–51% of them are PIOC from dentigerous cyst. There are no clinical or radiological pathognomonic characteristics. They often look like benign lesion and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. Clinical and radiological follow-up of the patient is recommended. Conclusion This case underlines the importance of a systematic and careful microscopic analysis of any lesion, even benign at first sight. Surgeons and pathologists should be aware of the malignant potential of odontogenic cysts. This can modify the surgical management and the follow-up of the patient.
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Affiliation(s)
- Alix Marchal
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France.
| | - Éric Gérard
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
| | - Rémi Curien
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
| | - Geoffrey Bourgeois
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
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Bouneff AE, Stojanov IJ. A Painful Right Maxillary Swelling. JAMA Otolaryngol Head Neck Surg 2020; 147:2770967. [PMID: 32970103 DOI: 10.1001/jamaoto.2020.2967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alexander E Bouneff
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Ivan J Stojanov
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
- Department of Pathology and Laboratory Medicine, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, Ohio
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Ramesh R, Sadasivan A. Lateral Periodontal Cyst - A diagnostic dilemma: Report of a rare case with CBCT and histological findings. Int J Surg Case Rep 2020; 75:454-457. [PMID: 33076193 PMCID: PMC7527614 DOI: 10.1016/j.ijscr.2020.09.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/02/2022] Open
Abstract
Lateral periodontal cyst [LPC] is a rare developmental odontogenic cyst. It is difficult to differentiate a LPC from a cyst of endodontic origin by clinical and radiographic methods. Histopathological evaluation is the only method to confirm diagnosis. Usually seen in association of a vital tooth, but in this case it was seen in a non-vital tooth. LPC is usually seen within bone, but in this case besides Intrabony component there was a gingival presentation as a swelling.
Introduction Lateral Periodontal Cyst (LPC) is considered as a rare developmental odontogenic cyst. It is often diagnosed as an incidental radiographic finding, presenting as a circumscribed round radiolucent area between the roots of vital teeth. LPC usually does not present any clinical features. Differentiating the origin of the lesion from an endodontic or periodontal perspective presents as clinical challenge. Presentation of case A female patient presented with an asymptomatic gingival swelling in the lingual aspect of mandibular anterior region. The associated tooth (#34) was endodontically treated 3 years back. A periapical radiograph showed a well-defined round radiolucency on the tooth. Cone beam computed tomography (CBCT) revealed extensive bone destruction. The lesion was surgically excised and histological examination confirmed the diagnosis of LPC. The site healed satisfactorily post-operatively. The case was followed up for a year without any recurrence seen. Discussion LPC is a very rare clinical entity, the diagnosis of which requires a detailed case history taking, clinical and radiographic examination are essential to get proper assessment of the pathology. It is said to originate from either the remnants of dental lamina, reduced enamel epithelium or rests of Malassez. LPC presents with a typical histological picture which ensures the confirmatory diagnosis. Surgical enucleation with thorough curettage is the treatment of choice. Conclusion By reporting this rare case, we would like to stress to clinicians that there are a wide range of cysts and anatomic structures are present in the canine-premolar region of mandible of which LPC is a rare possibility.
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Affiliation(s)
- Roshni Ramesh
- Department of Periodontics, Government Dental College, Thrissur, Kerala, India.
| | - Arun Sadasivan
- Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulashekaram, Tamil Nadu, India.
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