Benign tumors and tumor-like lesions of the oral cavity and jaws: An analysis of 709 cases

Inflammatory fibrous hyperplasia between surgery and tissue conditioning: A case report

INTRODUCTION AND IMPORTANCE

Inflammatory fibrous hyperplasia also called epulis fissuratum, often caused by an ill-fitting prosthesis and typically treated surgically, can be managed entirely conservatively with proper prosthetic adjustments.

CASE PRESENTATION

A female edentulous patient with an epulis fissuratum brought on by a too lengthy and ill-fitting removable full denture is described in this case study. Soft-conditioner material was used to treat the oral lesion, with the modified existing prosthesis serving as support.

CLINICAL DISCUSSION

Early conditioning tissue care of the epulis fissuratum, in conjunction with proper prosthesis rehabilitation and appropriate oral hygiene, produces positive clinical outcomes and prevents the need for surgery.

CONCLUSION

The effectiveness of this conservative therapy highlights how different surgical and prosthetic specialties can complement each other, advocating for a systematic tissue conditioning step before proceeding with a surgical approach.

Clinical and radiological characteristics of odontomas: A retrospective study of 90 cases

PURPOSE

Odontomas represent a common clinical entity among odontogenic tumors, but are not well-addressed in the Vietnamese population. The present study aimed to determine the clinical and preclinical characteristics of odontomas and associated factors in the Vietnamese population.

MATERIALS AND METHODS

This retrospective study retrieved data from histopathological diagnoses from 2 central hospitals of Odonto-Stomatology in Ho Chi Minh City, Vietnam during 2004-2017. The odontomas were classified as complex (CxOD) or compound (CpOD) subtypes. The epidemiological, clinical, and radiological characteristics of the odontomas, stratified by subtype and sex, were obtained and analyzed.

RESULTS

Ninety cases, consisting of 46 CxODs and 44 CpODs, were included. The average age of patients was 32.4 (±20.2) years. The patients with CxOD were older than those with CpOD (P<0.05). Clinically, 67% of patients showed an intraoral bone expansion. Approximately 60% of patients with CxOD exhibited a painful symptom, about 3-fold more than those with CpOD (P<0.05), whereas almost all patients with CpOD exhibited perturbations of dentition, unlike those with CxOD (P<0.05). Radiologically, CxOD was characterized by a larger dimension than CpOD in both sexes (P<0.05), and CpOD induced complications in adjacent teeth more often than CxOD (P<0.05). The development of odontoma with advancing age differed significantly in odontoma subtypes related to their pathological origins, and between the sexes, resulting from different physiological states.

CONCLUSION

The findings of this study highlight the value of clinical and radiological features of odontomas and their associated factors for the early diagnosis and adequate treatment of younger patients.

Jaw Cysts: A Retrospective Study in a Turkish Subpopulation

Objectives: Cysts seen in the jaws may be odontogenic or non-odontogenic, depending on the tissue of origin. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient. Materials and Methods: Pathology results of 436 patients who applied to Zonguldak Bülent Ecevit University Faculty of Dentistry, Oral and Maxillofacial Radiology Clinic between 2016-2021 for any reason and underwent biopsy were retrospectively scanned using digital archives. While classifying the cyst, the criteria published by the World Health Organization (WHO) in 2017 were taken into account. Obtained results were recorded for statistical analysis. SPSS 22.0 Software Package Program (SPSS 22.0 Software Package Program, Inc. Chicago, IL, USA) was used as statistical software in the study. Results: Of the 436 patients included in the study, 250 (57.3%) were male and 186 (42.7%) were female. The ages of the patients ranged between 7 and 82 years, and the mean age of the patients was 35.5±15.8. As a result of the findings, it was determined that the most common cysts were radicular cysts (53.7%). Radicular cysts were most commonly located in the posterior mandible and anterior maxilla anatomically. Conclusions: In addition to clinical and radiological examination, histopathological examination of biopsy samples taken from tissues is of great importance in the correct diagnosis and treatment planning of jaw cysts.

Oral Mucosal Lesions in Childhood

Childhood diseases are a continuous source of interest in all areas of general and dental medicine. Congenital, developmental, and hereditary diseases may either be present upon birth or appear in early childhood. Developmental anomalies, although often asymptomatic, may become grounds for different infections. Furthermore, they can indicate certain systemic disorders. Childhood age frequently brings about benign tumors and different types of traumatic lesions to the oral mucosa. Traumatic lesions can be caused by chemical, mechanical, or thermal injury. Mucocele and ranula are, by definition, traumatic injuries of the salivary glands or their ducts. Recurrent aphthous lesions are the most common type of ulcerations in childhood, and their etiology is considered multifactorial. Oral mucosal lesions in children require different treatment approaches depending on etiological factors and clinical presentation. Clinicians should have adequate knowledge of oral anatomy in order to diagnose and treat pathological conditions.

Comparative analysis between developmental and inflammatory odontogenic cysts: retrospective study and literature review

PURPOSE

To assess epidemiological, clinical, and radiographic characteristics of odontogenic cysts (OCs) in a South Brazilian sample and to compare the results with international literature.

METHODS

For the main study purposes, biopsy and histopathological records were retrospectively analyzed from December 2006 to December 2018, OC cases were selected, and data about clinical characteristics were evaluated. Further, a literature review was performed for similar studies.

RESULTS

In the main study, the prevalence of OCs was 11.26% (n = 406), the majority of patients was male (56.73%), and the mean age was 39 ± 17.33 years. Radicular cyst was the most common OC (46.06%), followed by the odontogenic keratocyst (15.02%), dentigerous cyst (14.04%), and paradental cyst (13.55%). Inflammatory OCs were more prevalent in the maxilla (54.84%) and developmental cysts in the mandible (69.92%) (p < 0.05). Individuals with inflammatory OCs were usually older (41.0 ± 15.34 years) than the ones with developmental OC (28.0 ± 19.68 years) (p < 0.05). Regarding the literature review, 22 articles were included. Analysis of pooled data showed that global prevalence of OCs was 11.62% (95%CI = 9.97-13.37), from which radicular cyst was the most common (54.26%; 95%CI = 49.30-59.18), followed by dentigerous cyst (22.94%; 95%CI = 19.22-26.89) and odontogenic keratocyst (11.99%; 95%CI = 8.88-15.49). Furthermore, studies from Asia (72.40%; 95%CI = 70.30-74.40) and South America (68.48%; 95%CI = 64.07-72.72) presented the highest frequencies of inflammatory OCs.

CONCLUSION

The main study showed that the prevalence of OCs was 11.26%, which corroborates with international literature. Considering geographic variability of OC distribution, public health authorities and researchers could use these data for the development of focused prevention interventions, especially with regard to inflammatory OCs.

Three-dimensional radiographic features of ameloblastoma and cystic lesions in the maxilla

OBJECTIVES

To characterize the radiographic features of maxillary ameloblastoma (AM), odontogenic keratocyst (OKC) and dentigerous cyst (DC) comparatively by using spiral CT and cone beam CT (CBCT).

METHODS

Clinical records, histopathological reports, and nonenhanced spiral CT or CBCT images of 191 consecutive patients with primary maxillary AMs, OKCs, or DCs were retrospectively acquired, and radiographic features were analyzed.

RESULTS

The study included 118 males and 73 females (age: 5-84 years). 72.0% of AMs and 84.3% of OKCs originated from the posterior maxilla, while 69.6% of DCs occurred in the anterior maxilla. Among 25 AMs, 44.0% were of desmoplastic type, with honey-combed appearance. 84.0% of AMs were circular or oval in shape, 84.0% expanded buccally, and 36.0% invade the nasal floor. Among 89 OKCs of 88 patients, 61.8% were circular or oval, 58.4% expanded buccally, 49.4% were dentigerous, 41.6% nearly filled the maxillary sinus, and 13.5% invaded the nasal floor. 93.7% (74/79) of DCs enveloped a single tooth, and the tooth-cyst relationship was centripetal in 35, eccentric in 30, and circumferential in 9. Moreover, 98.2% (55/56) of the cysts enveloping a supernumerary tooth were DCs, while 80.9% (38/47) of the cysts enveloping the third molar were OKCs.

CONCLUSIONS

Maxillary AMs tend to grow with buccal expansion and invade the nasal floor, and DAs with honey-combed lobularity are common. Maxillary OKCs have variant shapes and tend to invaginate the maxillary sinus. The tooth-cyst relationship of dentigerous OKCs and DCs can be centripetal, eccentric, or circumferential.

The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis

PURPOSE

This study was conducted in order to gain insight in the actual ratio of odontogenic keratocysts occurring in the tooth-bearing area as compared to the posterior region of the jaws in order to come up with reliable data to base upon a rational treatment policy.

METHODS

We searched MEDLINE, Web of Science, Scopus, and Cochrane databases for studies reporting on the location of mandibular and maxillary odontogenic keratocysts. All records were independently assessed and a meta-analysis was performed. Risk difference with a confidence interval of 95% of having the lesion in the posterior region versus the tooth-bearing area was the effect measure. P value for the summary effect of < 0.05 was considered statistically significant.

RESULTS

The 2615 records retrieved were reduced to 34 studies to be qualitatively/quantitatively assessed. The pooled values showed that the difference in the clinical risk of having keratocysts in the posterior region of the mandible and in the tooth-bearing area of the maxilla is 21 and 43%, respectively (P < 0.02 and P < 0.00001).

CONCLUSIONS

A substantial amount of keratocysts occur in the tooth-bearing area of the jaws, requiring attention.