A comparative study of simple bone cysts of the jaw and extracranial bones

Pediatric Gnathic Bony and Mesenchymal Tumors

Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton.

Analysis of the fluid contents of simple bone cyst in the mandible

Description of simple bone cyst (SBC) content has been controversial. This study aimed to assess and give a clearer picture of the SBC cavity contents. Between 2014 and 2016, 19 patients with SBC verified by histopathological examination were included in this study. SBC cavity content was investigated using clinical, radiographic, surgical, and laboratory findings. The difference in components among cavity fluid, blood, and serum was evaluated using a paired sample t-test for statistical analysis. All 19 SBC cases radiographically and surgically revealed a fluid-filled cavity. The patients’ average age was 21.3 ± 13.2 years, with no sex predominance found. SBCs were found mostly in the anterior mandible (n = 12, 63.2%). All lesions were filled with clear straw-colored or blood-colored floods with low concentration. Although the fluid components were similar to those in the blood and serum in the laboratory analysis, the statistical analysis revealed that the fluid components were not significantly different only for eosinophil (p = 0.43) and basophil (p = 0.06) counts as blood components and sodium (p = 0.76), potassium (p = 0.08), and chloride (p = 0.13) concentration as serum components. The results show that SBC is a fluid-filled cavity, with the cavity fluid being more likely similar to serum rather than blood regarding internal components.

Scalloped border as a possible diagnostic aid for differentiating jaw lesions: A pictorial essay

Purpose

The aim of this study was to introduce a category of jaw lesions comprising cysts and tumors associated with scalloped borders.

Materials and Methods

General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, and Scopus, as well as an authoritative textbook, were used to find relevant studies by using keywords such as “jaw lesion,” “jaw disease,” “scalloping,” “scalloped border,” “scalloped margin,” “irregular border,” and “irregular margin.” Out of 289 articles, 252 records were removed because they were duplicates, did not have a relevant title, or did not mention the frequency of findings described using the term “scalloped border.” Finally, 37 closely related articles were chosen.

Results

According to the relevant literature, scalloped borders are found most frequently in ameloblastoma, followed by simple bone cyst, central giant cell granuloma, odontogenic keratocyst, and glandular odontogenic cyst.

Conclusion

The lesions most frequently reported to have scalloped borders are ameloblastoma, central giant cell granuloma, odontogenic keratocyst, simple bone cyst, and glandular odontogenic cyst.

Multimodular Assessment of a Traumatic Bone Cyst Overlapped with Apical Periodontitis

Traumatic bone cyst (TBC), a “pseudocyst” that usually affects long bones, is a rare lesion among cystic lesions in the jaws. The most commonly affected site is the posterior mandible. Most of the time, TBC is asymptomatic and discovered during routine radiographic examination. The treatment recommended for TBC is surgical exploration followed by curettage of the bony walls, which also serves as a diagnostic procedure. A 27-year-old Caucasian male with a noncontributory medical history was referred to our department for the endodontic evaluation of the mandibular right first and second molars, which were connected to an extensive asymptomatic osteolytic lesion. A multimodular diagnostic assessment involving CBCT imaging, ultrasound, and histopathologic examination led to a definite diagnosis of a TBC overlapping with apical periodontitis (AP). Subsequently, a multidisciplinary treatment approach was performed, including surgical excision and biopsy of the lesion, endodontic retreatment of the right mandibular first molar, and postsurgical root canal treatment of the second molar. During the follow-up period of five years, the patient was reassessed periodically once a year and showed, in the absence of signs and symptoms, progressive healing of the affected area. The present article reports a case following the CARE guidelines of a TBC combined with AP where a multimodular diagnostic assessment was performed and discusses the possible pathogenetic mechanisms involved in its generation.

Traumatic bone cyst of mandible: a case series

BACKGROUND

A traumatic bone cyst is an uncommon nonneoplastic lesion of the jaws that is considered as a "pseudocyst" because of the lack of an epithelial lining. This lesion is particularly asymptomatic and therefore is diagnosed by routine dental radiographic examination as a unilocular radiolucency with scalloped borders, mainly in the posterior mandibular region. The exact etiopathogenesis of the lesion remains uncertain, though it is often associated with trauma.

CASE PRESENTATION

We report three Persian cases of traumatic bone cyst with different clinical and radiographic features, and we present a review of the literature to further discuss diagnostic and treatment challenges. Only one of the three patients reported a history of trauma, and despite the usual signs and symptoms of the lesion, extension of the defect to the ramus, swelling of the lingual cortex, and their unusual presence in the anterior mandible were noted in these patients.

CONCLUSIONS

Because features of this cyst can be varied, careful history taking and radiographic evaluation alongside the clinical signs and symptoms have a very significant role in definitive diagnosis, appropriate treatment, and accurate assessment of prognosis.

A rare presentation of a simple bone cyst

Simple bone cyst is an oft-described entity, which goes by many sobriquets and has been presented in the literature as early as 1926. It is a lesion of unclear etiology with many proposed hypothesis for its pathogenesis and nonspecific histopathological presentation. We present a case of a solitary bone cyst, which clinically presented as a solitary lesion, but radiological examination revealed multiple lesions peppering the maxilla and the mandible, thereby highlighting the importance of atypical presentation and “surprise” lesions that may show up on radiological examination.

Solitary bone cysts-A rare occurrence with bilaterally symmetrical presentation

Solitary bone cysts (SBCs) are bone cavities that lack a true epithelial lining. They are more commonly seen during the first 2decades of age.Very few cases have been reported over 40 years of age.SBCs are usually discovered as an accidental coexisting finding during a routine radiologic examination or during another unrelated dental complaint. They present as a unilocular or multilocular radiolucent lesion associated with vital teeth with mild or no cortical expansion. Bilateral presentation is however very rare. We present a case of 52-year-old female patient with bilateral presentation of SBCs.

Management of traumatic bone cyst in a 3-year-old child: a rare case report

The following case report describes a case of traumatic bone cyst (TBC) with classical clinical features occurring as a rare combination in a very young female patient with a traumatic etiology and its management using acrylic splint postsurgery.

How to cite this article: Banda NR, Nayak UA, Vishwanath KH, Sharma DS, Khandelwal V. Management of Traumatic Bone Cyst in a 3-Year-Old Child: A Rare Case Report. Int J Clin Pediatr Dent 2012;5(3):213-216.

Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts

The simple bone cyst (SBC) is a pseudocyst that can occur as a solitary entity in the jaws or may occur in association with cemento-osseous dysplasia (COD).

OBJECTIVE

The purpose of this study was to review the clinical and radiographic features of solitary and COD-associated SBCs.

METHODS

Archived imaging reports from the Special Procedures Clinic in Oral and Maxillofacial Radiology at the Faculty of Dentistry at the University of Toronto between 1 January 1989 and 31 December 2009 revealed 23 COD-associated SBCs and 68 solitary SBCs.

RESULTS

Almost all solitary and COD-associated SBCs were found in the mandible. Furthermore, 87.0% of COD-associated SBCs were found in females in their fifth decade of life (P < 0.001) while solitary SBCs were found in equal numbers in both sexes in their second decade of life (P < 0.005). COD-associated SBCs were also more likely to cause thinning of the endosteal cortex, bone expansion and scalloping of the superior border between teeth (all P < 0.001) than solitary SBCs that are classically described as having these characteristics. Finally, COD-associated SBC demonstrated a loss of lamina dura more often (P < 0.05) than solitary SBCs.

CONCLUSIONS

Knowledge of the sporadic association between COD and SBC and their potential radiographic appearances should prevent inappropriate treatment and management of these patients.