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Niu G, Zhang G, Chen JM, Wang T, Wu Y, Lu YG, Lin LS. A 3-year follow-up clinical study on the preservation for vitality of involved tooth in jaw cysts through an innovative method. Sci Rep 2024; 14:128. [PMID: 38168126 PMCID: PMC10761841 DOI: 10.1038/s41598-023-50523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Jaw cysts commonly affect the oral and maxillofacial region, involving adjacent tooth roots. The management of these teeth, particularly regarding root canal therapy and apicoectomy, lacks consensus. This study introduces a novel treatment concept and refined surgical approach to preserve pulp viability in teeth involved in jaw cysts. The objective was to investigate the effectiveness and potential benefits of this approach over a 36-month follow-up period. A conservative management approach prioritized vitality preservation, reserving root canal treatment and apicectomy for cases with post-operative discomfort. A comprehensive follow-up of 108 involved teeth from 36 jaw cyst cases treated with the modified method was conducted. Clinical observation, X-ray imaging, cone-beam computed tomography (CBCT), and pulp vitality testing assessed changes in cyst size, tooth color, pulp vitality, root structure, and surrounding alveolar bone. After 36 months, our modified surgical approach successfully preserved tooth vitality in 84 involved teeth. Adverse symptoms in 19 teeth, such as redness, swelling, fistula, and pain, resolved with postoperative root canal therapy. Follow-up was lost for five teeth in two cases. No cyst recurrences were observed, and in 34 cases, the bone cavity gradually disappeared, restoring normal bone density during long-term follow-up. Our modified surgical method effectively preserves tooth vitality in jaw cysts. This innovative approach has the potential to improve the management of teeth involved in jaw cysts.
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Affiliation(s)
- Gang Niu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - GongHang Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- School of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Jia-Min Chen
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Tao Wang
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ye Wu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - You-Guang Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Preventive Dentistry, Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China.
| | - Li-Song Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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Nyimi BF, Yifang Z, Liu B. The Changing Landscape in Treatment of Cystic Lesions of the Jaws. J Int Soc Prev Community Dent 2019; 9:328-337. [PMID: 31516866 PMCID: PMC6714425 DOI: 10.4103/jispcd.jispcd_180_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 11/11/2022] Open
Abstract
Objective: Cystic lesions of the jaw are common pathologies of chronic swelling of the jaw in oral and maxillofacial regions. Different treatment modalities have been described in the literature. However, the existence and proper treatment of these cysts remains a contentious topic. The aims of this review were to discuss the complexity of various surgical treatment and as factors with potential to influence outcome treatment. Finally, a practical and a rational clinical guideline for the management of such lesions have been suggested. Materials and Methods: A literature search without language limitation was performed in 2018 using MEDLINE, PubMed, Scopus, and Embase. Keywords for the search included the following terms: jaws cyst, cystic lesions, odontogenic cysts, cystic tumors, pseudocysts, treatments, therapy, wound healing, bone regeneration, and teeth involved cysts. Prospective or retrospective clinical studies with a sample size of n ≥ 5 were evaluated and included in this review. The exclusion criteria were studies with unclear reporting of the treatment applied or outcome, nonhuman studies, case reports, letters, preface, comments, and cystic lesions associated to syndrome. After the full reading, 30 articles were included in the quantitative synthesis for the review. No meta-analysis could be performed due to the heterogeneity of the studies included. Clinical radiographic images were presented to illustrate the principles of some surgical treatments. Conclusion: Conservative surgery with primary closure defect (less than 4 cm) remains an initial approach, which reduces the morbidity of aggressive surgeries and obtains the complete bone healing before 24 months of postoperative. Marsupialization is considered as the most common option for the treatment of large cystic lesions when cases are carefully selected. Evocyst is an attractive new technique of obtaining complete bone defect healing within <3 months.
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Affiliation(s)
- Bushabu Fidele Nyimi
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China, People's Republic of China.,Oral and Maxillo-Facial Surgery, Teaching Hospital of Kinshasa University, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Zhao Yifang
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China, People's Republic of China
| | - Bing Liu
- Department of Oral Maxillofacial Head and Neck Oncology Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China, People's Republic of China
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Liu Q, Geng P, Shi L, Wang Q, Wang P. miR-29 promotes osteosarcoma cell proliferation and migration by targeting PTEN. Oncol Lett 2018; 17:883-890. [PMID: 30655843 PMCID: PMC6313002 DOI: 10.3892/ol.2018.9646] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023] Open
Abstract
Osteosarcoma (OS) is an aggressive malignant neoplasm that arises from primitively transformed cells of mesenchymal origin, and that exhibits osteoblastic differentiation and produces malignant osteoid. MicroRNAs (miRNAs) have been widely reported to have important regulatory roles in various human tumors, including OS. However, the potential mechanism of miR-29 in OS remains largely unknown. miR-29 was highly expressed in OS and overexpression of miR-29 promoted OS cell proliferation, as well as proliferating cell nuclear antigen (PCNA) expression and migration, whereas lower expression of miR-29 inhibited OS cell proliferation, PCNA expression and migration. In the present study, a dual-luciferase reporter system supporting phosphatase and tensin homolog (PTEN) was a target of miR-29 and its expression was inhibited by miR-29 mimic, but increased by miR-29 inhibitor. Overexpression of PTEN inhibited OS cell proliferation and migration and it could attenuate miR-29 promotion effect on OS progression. Overall, the results revealed that miR-29, as a tumor promoter, is involved in OS progression and metastasis by targeting PTEN, indicating that the miR-29/PTEN pathway is a potential therapeutic target for the treatment of OS.
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Affiliation(s)
- Qiuliang Liu
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Peishuo Geng
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Longyan Shi
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Qi Wang
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Pengliang Wang
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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Li BB, Zhang JY, Gao Y. Chondroblastic osteosarcoma arising in the maxilla mimicking the radiographic and histological characteristics of cemento-osseous lesions: A case report. Mol Clin Oncol 2017; 6:733-736. [PMID: 28529749 DOI: 10.3892/mco.2017.1219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 02/10/2017] [Indexed: 01/25/2023] Open
Abstract
Osteosarcomas of the jaw are comparatively rare and represent only 2-10% of all osteosarcomas. We herein present a rare case of an osteosarcoma exhibiting the radiographic and histological characteristics of cemento-osseous lesions in the alveolar ridge of the maxilla. A 53-year-old male patient presented with the complaint of gradual swelling of the left maxilla over 4 years. Radiography revealed an ill-defined radioopaque mass, intimately associated with the apices of the involved teeth, without a periosteal reaction. Microscopically, a cementicle-like structure was identified in the alveolar bone. In addition, the lesion exhibited typical characteristics of chondroblastic osteosarcoma in the body of the maxilla. The tumor contained abundant osteoid and cartilage intimately associated with anaplastic tumor cells. The cartilage displayed malignant-appearing cells in lacunae, and there was crowding at the periphery of the lobule where the spindle cells formed sheets. The differential diagnosis included primary osteosarcoma, concurrent cemento-osseous dysplasia and osteosarcoma, or a secondary osteosarcoma based on a pre-existing cemento-osseous lesion. The presence of the cementicle-like structure in the alveolar bone and the involvement of the periodontal ligament and alveolar bone proper were unique in our case. The general invasive growth pattern and the abundance of the irregular tumor bone helped establish the diagnosis of primary osteosarcoma. This case may represent evidence of the pathogenesis of primary osteosarcoma in the jaw.
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Affiliation(s)
- Bin-Bin Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
| | - Jian-Yun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
| | - Yan Gao
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, P.R. China
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