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Rahman A, Alam S, Zia A, Tiwari RK, Andrabi SMUN, Mahmood M. Non-surgical and guided-bone-regeneration surgical management of Type-3b dens invaginatus with an apico-marginal defect: A case report. Clin Adv Periodontics 2024. [PMID: 38491757 DOI: 10.1002/cap.10283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/25/2024] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Dens invaginatus (DI), an unusual developmental anomaly is a challenge for the operating dentist with regard to its diagnosis and treatment. This case report presents the successful management of a Type-3b DI in a permanent maxillary lateral incisor associated with a large radicular cyst and communicating apico-marginal defect (Von Arx type IIb). METHODS AND RESULTS A 19-year-old female patient reported pain and palatal swelling. During the clinical examination, tooth #12 exhibited tenderness to percussion, and presented a deep periodontal pocket depth (PPD) of 12 mm, along with grade I mobility. Radiographic examination revealed a large peri-radicular radiolucency with atypical tooth morphology. Cone beam computed tomography clarified the complicated root canal anatomy to be Type-3b DI associated with an apico-marginal defect. The case was managed successfully by non-surgical endodontic therapy followed by surgical intervention utilizing a guided bone regenerative (GBR) approach. Eighteen-month follow-up showed an asymptomatic and functional tooth with a significant reduction in pocket depth. The periapical radiographs showed continued healing of the osseous defect. CONCLUSIONS The successful healing outcome of a challenging case, characterized by a complex DI morphology, a large peri-radicular lesion, a through-and-through defect, and a combined endodontic-periodontal apico-marginal defect was achieved through accurate diagnosis, treatment planning, and execution using contemporary endodontic and periodontal treatment techniques. The application of GBR techniques during the surgical phase of treatment may have contributed to the improved regenerative healing outcome in this case, which was initially considered prognostically questionable. KEY POINTS Why is this case new information? Type-3b DI exhibits a complex root canal structure, each case displaying unique characteristics, necessitating a case-specific treatment plan. In this case report the Type-3b DI morphology was associated with a large peri-radicular, through and through defect and combined endodontic periodontal apico-marginal defect. The treatment approach involved incorporating guided bone regenerative (GBR) principles during the surgical phase. This case report contributes to the existing evidence on the diagnosis and successful management of Type-3b DI with a concurrent apico-marginal defect. What are the keys to successful management of this case? The successful management of a prognostically challenging case was achieved through a closely integrated multidisciplinary coordination between the endodontist and periodontist. Utilization of contemporary techniques and tools contributed to the successful management The use of three-dimensional radiological examination through cone beam computed tomography enabled a precise preoperative assessment, facilitating the formulation of a treatment plan for managing both the Type-3b DI morphology and the associated peri-radicular lesion. Employing GBR techniques in peri-radicular surgery may have assisted in the healing of through-and-through periapical defects with concurrent apico-marginal defects (Von Arx type IIb). What are the primary limitations to the success of this case? A complex root canal anatomy associated with Type-3b DI morphology A large peri-radicular through and through defect with concurrent apico-marginal defect. Difficulty in weekly and long-term follow-up of the patient.
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Affiliation(s)
- Aaliya Rahman
- Department of Conservative Dentistry & Endodontics, Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Sharique Alam
- Department of Conservative Dentistry & Endodontics, Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Afaf Zia
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - R K Tiwari
- Department of Conservative Dentistry & Endodontics, Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - S Mukhtar Un Nisar Andrabi
- Department of Conservative Dentistry & Endodontics, Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Maahin Mahmood
- Kothiwal Dental College and Research Centre, Moradabad, India
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Nagano R, Nakako Y, Fujii S, Kawano S, Maeda H, Kiyoshima T. The IL-1β-p65 axis stimulates quiescent odontogenic epithelial cell rests via TGF-β signalling to promote cell proliferation of the lining epithelia in radicular cysts: A laboratory investigation. Int Endod J 2024; 57:344-354. [PMID: 38204205 DOI: 10.1111/iej.14016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
AIM Cyst formation of the jaws is frequently accompanied by the proliferation of odontogenic epithelial cells located in the periodontal ligament (PDL), which consists of heterozygous cells and includes the most fibroblasts. The lining epithelium of radicular cyst, an odontogenic cyst of inflammatory origin, is derived from the proliferation of the remnants of the Hertwig epithelial root sheath (odontogenic epithelial cell rests of Malassez; ERMs) in the PDL. ERMs are maintained at a lower proliferative state under physiological conditions, but the regulatory mechanisms underlying the inflammation-dependent enhanced-proliferative capabilities of ERMs are not fully understood. The aim of this study was to evaluate the effects of cytokine pathway association between TGF-β signalling and IL-1β signalling on the regulation of odontogenic epithelial cell proliferation using radicular cyst pathological specimens and odontogenic epithelial cell lines. METHODOLOGY Immunofluorescence analyses were performed to clarify the expression levels of Smad2/3 and Ki-67 in ERMs of 8-week-old mouse molar specimens. In radicular cyst (n = 52) and dentigerous cysts (n = 6) specimens from human patients, the expression of p65 (a main subunit of NF-κB), Smad2/3 and Ki-67 were investigated using immunohistochemical analyses. Odontogenic epithelial cells and PDL fibroblastic cells were co-cultured with or without an inhibitor or siRNAs. Odontogenic epithelial cells were cultured with or without TGF-β1 and IL-1β. The proliferative capabilities and Smad2 phosphorylation levels of odontogenic epithelial cells were examined. RESULTS Immunohistochemically, Smad2/3-positivity was increased, and p65-positivity and Ki-67-positivity were decreased both in ERMs and in the epithelial cells in dentigerous cysts, a non-inflammatory developmental cyst. In contrast, p65-positive cells, along with the expression of Ki-67, were increased and Smad2/3-positive cells were decreased in the lining epithelia of radicular cysts. Co-culture experiments with odontogenic epithelial cells and PDL fibroblastic cells revealed that PDL cells-derived TGF-β1/2 and their downstream signalling suppressed odontogenic epithelial cell proliferation. Moreover, TGF-β1 stimulation induced Smad2 phosphorylation and suppressed odontogenic epithelial cell proliferation, while IL-1β stimulation reversed these phenotypes through p65 transactivation. CONCLUSIONS These results suggest that IL-1β-p65 signalling promotes odontogenic epithelial cell proliferation through suppressing TGF-β-Smad2 signalling, which would be involved in the pathogenesis of radicular cysts.
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Affiliation(s)
- Ryoko Nagano
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yusuke Nakako
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shinsuke Fujii
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
- Dento-Craniofacial Development and Regeneration Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shintaro Kawano
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Hidefumi Maeda
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Murugesan I, Kumar Vadivel J, Ramalingam K. Bone Trabecular Pattern Analysis in Odontogenic Cysts Using Cone Beam Computed Tomography: A Clinical Retrospective Study. Cureus 2024; 16:e54452. [PMID: 38510904 PMCID: PMC10951676 DOI: 10.7759/cureus.54452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction The cysts of the maxillofacial region account for one of the most common pathologies of the head and neck region after the mucosal pathologies. Radiography provides an essential clue in early diagnosis and triaging, but it continues further as it is used to evaluate the post-treatment outcome. However, manual analysis is prone to errors. In this scenario, fractal analysis (FA) in radiographs uses mathematical methods to analyse the changes in grey scales in a given radiographic image. FA in odontogenic cysts is used to characterise their complexity, uncover hidden patterns, monitor treatment response, and potentially provide prognostic information. This paper aimed to assess the fractal characteristics of the radicular cyst (RC), dentigerous cyst (DC), and odontogenic keratocyst (OKC) using cone beam computed tomography (CBCT). The objective was to calculate fractal dimension (FD) values expressed in each of these cysts, which could prove to be a radiological adjunct in diagnosing the above cysts. Materials and methods As this is a retrospective study, the archives of CBCT images from June 2021 to December 2023 were obtained from patients diagnosed and confirmed with a histopathological diagnosis with RC, DC, and OKC. The FA was performed using Image J Software (Ver 1.51, National Institute of Health Bethesda, Fiji). The cortical and cancellous bones were segmented using thresholding techniques and converted to binary images. The mean FD of the three planes was then compared to establish the distinctive fractal characteristic for the specific odontogenic cysts. A one-way ANOVA was performed using the Statistical Product and Service Solutions (SPSS) (version 23.0; IBM SPSS Statistics for Windows, Armonk, NY) to determine the difference between FD values of RC, DC, and OKC with a significance level less than 0.05. Results The FD values of DC, RC, and OKC were 1.33 ± 0.17, 1.08 ± 0.16, and 1.65 ± 0.12, respectively. The results indicated that OKC had higher FD values than DC and RC, which means that OKC had lesser bone destruction compared to DC and RC. Inferential statistics showed that the one-way ANOVA was used to compare the means of the three groups of FD data. When calculated for the three groups, the F-statistic value was at 7.29, which yielded a P value of 0.03, making it statistically significant for a 95% confidence interval (p<0.05). Conclusion Our CBCT study on bone trabecular pattern analysis using FD and FA in odontogenic cysts reveals distinct alterations in bone parameters among different cyst types. The probability of higher FD values in OKC is because of lesser cortical bone destruction in OKC compared to the other cyst types. These findings have potential implications for diagnosing, treating, and prognosticating odontogenic cysts.
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Affiliation(s)
- Induja Murugesan
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jayanth Kumar Vadivel
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Kaur J, Sroa RB, Kaur A, Kaur M, Kumar B, Kaur G. Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report. J Pharm Bioallied Sci 2024; 16:S987-S989. [PMID: 38595372 PMCID: PMC11001145 DOI: 10.4103/jpbs.jpbs_979_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 04/11/2024] Open
Abstract
The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.
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Affiliation(s)
- Jaspreet Kaur
- Department of Pediatric Dentistry, Government Dental College, Patiala, Punjab, India
| | - Renu Bala Sroa
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Avreet Kaur
- Department of Orthodontics and Dentofacial Orthopaedics, Luxmi Bai Institute of Dental Science and Hospital, Patiala, Punjab, India
| | - Mandeep Kaur
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Baljeet Kumar
- Department of Conservative Dentistry and Endodontics, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Gaganpreet Kaur
- Department of Pediatric Dentistry, Government Dental College, Patiala, Punjab, India
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Huopainen P, Virkkunen S, Snäll J, Tezvergil-Mutluay A, Hagström J, Apajalahti S. Periapical foreign body findings - histological and radiological comparison. Acta Odontol Scand 2023; 81:622-626. [PMID: 37470399 DOI: 10.1080/00016357.2023.2236213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/20/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE This study aimed to clarify the perceptibility of periapical foreign materials in imaging compared with histopathology. We hypothesized that dentoalveolar imaging is sufficient to detect periapical foreign bodies. MATERIAL AND METHODS Radiological and histopathological records of patients diagnosed with periapical granuloma or radicular cyst from 2000 to 2013 were evaluated retrospectively. Patients with histologically verified foreign bodies were included in the study and their pathological samples and radiological images were reviewed. The outcome variable was radiologically detectable foreign material. The predictor variables were histopathological diagnosis, type of inflammation, type and number of foreign bodies, imaging modality, and site of foreign material. RESULTS Compared to the histopathological diagnosis of foreign bodies as the gold standard, the level of radiologic detectability was mild. Histologically verified foreign material could be detected by imaging in 32/59 (53.5%) patients. Histological diagnosis, type of inflammation, type or number of foreign bodies, imaging modality or site of foreign material had no association with radiological detectability (p > 0.05). CONCLUSIONS According to our results, histopathology is a more accurate diagnostic tool than radiology in periapical foreign bodies or foreign body reactions. Clinicians should keep in mind the limitations of imaging when setting the diagnosis and planning treatment.
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Affiliation(s)
- Piia Huopainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sirke Virkkunen
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Arzu Tezvergil-Mutluay
- Department of Restorative Dentistry and Cariology, Adhesive Dentistry Research Group, Institute of Dentistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland
| | - Satu Apajalahti
- HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Agrawal P, Nikhade P, Patel A, Bhopatkar J, Suryawanshi T. Pioneering Periapical Healing: The Novel Synergy of Mineral Trioxide Aggregate and Injectable Platelet-Rich Fibrin. Cureus 2023; 15:e46341. [PMID: 37920636 PMCID: PMC10618628 DOI: 10.7759/cureus.46341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
This case report presents a novel non-surgical approach for managing a substantial periapical lesion associated with tooth 12 using a combination of injectable platelet-rich fibrin (i-PRF) and mineral trioxide aggregate (MTA). A 28-year-old male patient presented with pus discharge and intermittent swelling following a history of dental trauma. Clinical and radiographic assessments confirmed a large periapical cyst associated with tooth 12. The treatment involved root canal therapy with calcium hydroxide medication, leading to symptom relief. Subsequently, i-PRF combined with MTA was used as a regenerative material for periapical healing. Follow-up examinations at three, six, and nine months showed complete resolution of symptoms and radiographic evidence of lesion healing. This innovative technique demonstrates the potential of i-PRF and MTA synergy in the non-surgical management of periapical lesions, avoiding the risks associated with surgical interventions and promoting effective tissue healing.
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Affiliation(s)
- Paridhi Agrawal
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradnya Nikhade
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Suryawanshi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Rathi N, Reche A, Agrawal S. Radicular Cyst: A Cystic Lesion Involving the Hard Palate. Cureus 2023; 15:e47030. [PMID: 37965401 PMCID: PMC10642913 DOI: 10.7759/cureus.47030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/14/2023] [Indexed: 11/16/2023] Open
Abstract
A radicular cyst, also known as a periapical cyst or root end cyst, is a type of odontogenic cyst that is typically associated with permanent teeth. The radicular cyst usually is associated with maxillary central incisors followed by mandibular first molars. It occurs as a result of bacterial infection and pulpal necrosis which leads to inflammatory stimulation of the epithelial cell rests of Malassez along the periodontal ligament area of the tooth. Most cases of the radicular cyst are asymptomatic and they are diagnosed accidentally during routine radiographic examination. This article presents a case report of a 42-year-old male with an apical periodontal cyst associated with the maxillary anterior region. Early diagnosis and treatment planning is necessary. This article signifies the role of the surgeon in the early diagnosis and treatment plan of the cyst.
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Affiliation(s)
- Nishant Rathi
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Amit Reche
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sakshi Agrawal
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Alassaf MS, Abu Aof MM, Othman A, Zaki H, Almutairi AG. Coexistence of a Nasopalatine Duct Cyst and Radicular Cyst: A Unique Clinical Presentation. Cureus 2023; 15:e46774. [PMID: 37954767 PMCID: PMC10632787 DOI: 10.7759/cureus.46774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
This study discusses a case of coexistence of two distinct cysts, a nasopalatine duct cyst (NPDC) and a radicular cyst, within the anterior region of the maxilla. NPDC is a prevalent non-odontogenic developmental cyst, while radicular cysts are commonly found in odontogenic inflammatory cysts. The clinical and radiographic characteristics of these cysts are explored, emphasizing the importance of accurate diagnosis and treatment planning. In this case, a 51-year-old male patient presented with swelling and pain in the maxillary anterior region. Radiographic examinations revealed a heart-shaped radiolucent lesion extending from tooth 13 to 23, associated with the NPDC, and a separate radicular cyst. Surgical enucleation and tooth extraction were performed as the treatment of choice. This unique case underscores the significance of meticulous radiographic assessment to detect multiple cystic lesions within the same area.
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Affiliation(s)
- Muath S Alassaf
- Orthodontics and Dentofacial Orthopedics, Taibah University, Madinah, SAU
| | | | | | - Hattan Zaki
- Oral Basic and Clinical Sciences Department, College of Dentistry, Taibah University, Madinah, SAU
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Agrawal P, Nikhade P, Patel A, Sedani S, Bhopatkar J. Management of Discoloured Anterior Teeth With Radicular Cyst: A Case Report. Cureus 2023; 15:e45536. [PMID: 37868572 PMCID: PMC10586074 DOI: 10.7759/cureus.45536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Dental trauma often has tooth discoloration and periapical lesion as its sequelae. Intracoronal bleaching restores the aesthetics, while a retrograde approach is required for non-healing lesions. A patient with discolored teeth, draining sinus, tenderness and a periapical lesion on the radiograph was treated initially with conventional root canal therapy and walking bleach technique. After four months, the sinus tract reappeared and on cone-beam computed tomography (CBCT) examination, a large periapical lesion with loss of buccal cortical plate was seen. A minimally invasive retrograde cystic enucleation, apicectomy, and filling with biodentine were then performed. The defect area was filled with synthetic nanocrystalline hydroxyapatite granules combined with platelet-rich-fibrin. Follow-ups after one, three, and six months were taken. The six-month CBCT revealed complete bone healing. Non-vital bleaching yields acceptable cosmetic results. Additionally, if the conventional procedures are not successful in treating radicular cyst, apical surgery must be the ultimate choice.
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Affiliation(s)
- Paridhi Agrawal
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Pradnya Nikhade
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Shweta Sedani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
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Ticku S, Shetty L, Desai K, Dharamsi R. Iceberg lesion-A rare case of chronic osteomyelitis of the jaw with underlying radicular cyst: A case report. J Oral Maxillofac Pathol 2023; 27:604. [PMID: 38033960 PMCID: PMC10683915 DOI: 10.4103/jomfp.jomfp_533_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/05/2023] [Accepted: 01/25/2023] [Indexed: 12/02/2023] Open
Abstract
Osteomyelitis is an inflammatory condition of the bones that often starts with an infection of the medullary cavity and swiftly extends to the haversian system and periosteum. If drainage and antimicrobials are ineffective, acute osteomyelitis may progress to chronic osteomyelitis. Here, we offer a unique case that analyzes the radiographic and clinical characteristics of osteomyelitis with underlying disease. Cysts and cyst-like lesions of the jaws must be diagnosed and evaluated using radiographic findings in conjunction with clinical complaints. This case study examines the circumstances that led to the diagnosis of osteomyelitis and demonstrates several noteworthy lessons. As decortication is less invasive and more effective at treating primary chronic osteomyelitis than peripheral or segmental excision of the jaw, and the use of vancomycin as local hard and soft tissue dressing over the surgical site, we emphasize its significance.
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Affiliation(s)
- Smriti Ticku
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Lakshmi Shetty
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Karishma Desai
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
- Department of Oral Pathology, KLE VK Institute of Dental Sciences, Belagavi, KLE Academy of Higher Educationand Research (KLE University), Karnataka, India
| | - Ravina Dharamsi
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Gillner P, Mosch R, von See C. Tunnel Fenestration of the Mandibula after Unsuccessful Post Traumatic Treatment: A Case Report of the One Year Follow-Up. Dent J (Basel) 2023; 11. [PMID: 36826182 DOI: 10.3390/dj11020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Particularly severe cases with tunneled defects are rarely reported and are described only in a few case reports. This case report describes the treatment of a tunnel fenestration in the lower central jaw after unsuccessful endodontic treatment following trauma of incisors 31 and 41 over the course of six years, which led to the development of an internal granuloma and a radicular cyst in the lower jaw. The patient presented with a 2.67 cm3 radicular cyst displacing the surrounding tissue at regio 31 and 41, which resulted in a tunnel-like bony defect. Endodontic treatment and periapical root tip resection on teeth 31 and 41 with cystectomy, and with a 12 month follow-up, were successful in the healing of the bone defect. The preserved teeth received lithium disilicate crowns for definite restoration one year postoperatively. This treatment can be an option for the therapy of large cysts.
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Wamasing N, Yomtako S, Watanabe H, Sakamoto J, Kayamori K, Kurabayashi T. The magnetic resonance imaging characteristics of radicular cysts and granulomas. Dentomaxillofac Radiol 2023; 52:20220336. [PMID: 36688723 PMCID: PMC9944013 DOI: 10.1259/dmfr.20220336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Limited studies have differentiated radicular cysts and granulomas with MRI. Therefore, we investigated the MRI characteristics of the two lesions and clarified features for distinguishing between them. METHODS We collected data of 27 radicular cysts and 9 granulomas definitively diagnosed by histopathology and reviewed the fat-saturated T2 weighted, T1 weighted, and contrast-enhanced fat-saturated T1 weighted images. We measured the maximum diameter and apparent diffusion coefficient values of the lesions. We employed Fisher's exact test, the Mann-Whitney U test, and independent t-tests to compare the two lesions and created a decision tree for discriminating between them. RESULTS There were significant differences between radicular cysts and granulomas with respect to five imaging characteristics-signal intensity of the lesion centre on fat-saturated T2 weighted images; signal intensity, texture, and contrast enhancement of the lesion centre on contrast-enhanced fat-saturated T1 weighted images; and maximum diameter of the lesion. The cut-off diameter for radicular cysts was 15.9 mm. The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.971, 85.2%, and 100%, respectively. CONCLUSIONS From the decision tree analysis, maximum diameter, lesion centre contrast enhancement on contrast-enhanced fat-saturated T1 weighted images, and lesion centre signal intensity on fat-saturated T2 weighted images were important for discriminating between radicular cysts and granulomas.
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Affiliation(s)
- Natnicha Wamasing
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | | | - Hiroshi Watanabe
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Junichiro Sakamoto
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Kou Kayamori
- Oral Pathology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Tohru Kurabayashi
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
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Kagramanyan NV, Grigoryanc LA, Klimenko KE, Simonyan DV. [Treatment tactics for patients with retention cysts, odontogenic cysts, mucocele and other pathologies of the maxillary sinuses as preparation for a sinus lift]. Stomatologiia (Mosk) 2023; 102:61-69. [PMID: 37341084 DOI: 10.17116/stomat202310203161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The aim the studi. Differential diagnosis of retention cysts of the maxillary sinus with odontogenic cysts, acute and chronic sinusitis, aspergillosis, and mucocele in preparation for sinus-lifting surgery. MATERIAL AND METHODS The analysis of the case histories of 265 patients aged 18-65 years of both sexes who were treated at the dental clinic «Rudenta Family» from 2016 to 2021 was carried out. On the basis of clinical symptoms and data of cone-beam computed tomography (CBCT), a description of the pathologies of HPV is given for the purpose of differential diagnosis and correct interdisciplinary interaction with ENT doctors for the purpose of dental implantation in the lateral parts of the upper jaw. RESULTS In 90 (out of 265) patients (34%), a change in the condition of the maxillary sinus mucosa was detected. 18 patients (7%) for preoperative preparation were sent to the ENT department of the FSBI «CCB with polyclinic» of the UDP of the Russian Federation with diagnoses: chronic maxillary sinusitis of various etiologies and mucocele. In this group of patients, sinus lifting followed by dental implantation was performed 6 months after endoscopic maxillofacial surgery under the control of CBCT. Retention cyst Retention cysts of the maxillary sinus were of different sizes in 62 (23.4%) patients and, depending on the size and localization of the sinus-lifting was performed with simultaneous removal of the cyst, or without removal of the cyst. CONCLUSION Retention cysts do not need to be removed as a preoperative preparation for sinus lifting. In the case of large sizes and difficulty in peeling the Schneider membrane, retention cysts are removed by a dental surgeon during antral augmentation as one of the stages of the operation. In such pathologies as odontogenic cyst, acute and chronic sinusitis, aspergillosis, mucocele, interdisciplinary interaction of ENT doctor and dentist is necessary. Differential diagnosis of maxillary snus pathology is carried out on the basis of clinical data and a picture of cone-beam computed tomography.
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Affiliation(s)
| | | | - K E Klimenko
- Central Clinical Hospital of the Management Affair of President Russian Federation, Moscow, Russia
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Muacevic A, Adler JR, S P. Surgical Management of Radicular Cyst With the Application of a Natural Platelet Concentrate: A Case Report. Cureus 2023; 15:e33992. [PMID: 36811049 PMCID: PMC9939000 DOI: 10.7759/cureus.33992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
Traumatic dental injuries usually involve the dentoalveolar region, and they readily affect the teeth and their surrounding soft and hard tissues. The common sequelae of traumatic dental injuries lead to pulpal necrosis and apical periodontitis along with cystic changes. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary incisors and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] used for postoperative healing. A 38-year-old male patient presented to the department with pain and mild swelling in the upper front tooth region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the right maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery and retrograde filling with mineral trioxide aggregate (MTA), and PRF was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled for follow-ups after 12 weeks, 24 weeks, and 36 weeks; he was found to be asymptomatic, and significant periapical healing was observed in the radiograph with almost adequate bone formation.
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15
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Zeng Y, Wang L, Liu L, Wang M, Yan L, Ye L, Song D, Huang D. The Potential Immunomodulatory Roles of Semaphorin 4D in Human Periapical Lesions. J Endod 2023; 49:62-68. [PMID: 36257402 DOI: 10.1016/j.joen.2022.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Semaphorin 4D (SEMA4D) is an important immunoregulator in the development of inflammatory diseases. Currently, the role of SEMA4D in human apical periodontitis remains unclear. This study aims to investigate the expression of SEMA4D and its potential immunomodulatory roles in apical periodontitis. METHODS A total of 31 periapical tissues and 6 healthy gingival tissues were used in this experiment. Hematoxylin-eosin staining, immunohistochemical staining, and multiplex immunofluorescence staining were performed for histologic examination and immunochemical analysis. For data processing, the number of SEMA4D+, CD4+, CD8+, and CD20+ cells was analyzed by QuPath. In addition, the colocalization of SEMA4D with CD4, CD8, and CD20 was detected. RESULTS Radicular cysts (RCs) (n = 18) and periapical granulomas (PGs) (n = 13) were identified by histologic evaluation. The number of SEMA4D+ cells in PGs was significantly greater than that in RCs (P < .05). T-cell and B-cell infiltration did not differ significantly between RCs and PGs. An increased number of CD20+ cells was observed in both types of apical periodontitis compared to CD8+ cells and CD4+ cells. Additionally, the presence of SEMA4D/CD4 and SEMA4D/CD20 double-positive cells was also markedly higher in PGs than in RCs. CONCLUSION The expression of SEMA4D and related immune cells showed different characteristics between RCs and PGs. The disparate expression patterns indicated the possible different pathologic states of the 2 types of periapical lesions. This study provides a new perspective on the description of the comprehensive microenvironment of periapical lesions.
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Affiliation(s)
- Yanglin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mudan Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lixia Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Muacevic A, Adler JR, Thosar NR, Khubchandani M. The Diagnostic Dilemma of an Odontogenic Jaw Lesion in a Pediatric Patient: A Case Report. Cureus 2022; 14:e31225. [PMID: 36514574 PMCID: PMC9733780 DOI: 10.7759/cureus.31225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
This paper presents a case report of a 10-year-old child patient reported with the chief complaint of a painless, hard swelling in the lower right back region of the jaw. The clinical and radiographic examination, including intraoral periapical radiograph (IOPA) and cone-beam CT (CBCT), was performed. Conservative treatment was planned based on the clinical and radiological diagnosis of the cyst. But the histological examination revealed unicystic ameloblastoma (UA). This clinical case of UA, which was misdiagnosed as a combination of a radicular cyst and a dentigerous cyst, is being presented to highlight the importance of histopathologic investigation of all tissue specimens retrieved after surgery, particularly when the clinical and radiological findings are insignificant.
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Brescia G, Alessandrini L, Bacci C, Bissolotti G, Fedrigo M, Contro G, Frasconi S, Boccuto MG, Calcavecchia A, Frigo AC, Barion U, Fusetti S, Angelini A, Marioni G. Odontogenic Chronic Rhinosinusitis: Structured Histopathology Evidence in Different Patho-Physiological Mechanisms. Biomedicines 2022; 10:2768. [PMID: 36359287 PMCID: PMC9687938 DOI: 10.3390/biomedicines10112768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 08/30/2023] Open
Abstract
An increased odontogenic chronic rhinosinusitis (oCRS) occurrence rate has quite recently been reported, likely due to an intensification of conservative dental surgery and implantology. The main aim of the study was to report for the first time the structured histopathological characteristics of the surgical specimens of oCRS. Possible associations between histopathological features and oCRS patho-physiological mechanisms were also evaluated. Structured histopathology features were investigated in the sinonasal mucosa tissue of 42 consecutive oCRS patients.Mean tissue eosinophil counts were significantly different between oCRS with radicular cysts, dental implants, or other dental diseases (p =0.0118): mean tissue eosinophil count was higher in oCRS with dental implants. Sub-epithelial edema score and squamous metaplasia presence were significantly different when comparing the above-mentioned sub-cohorts of oCRS (p =0.0099 and p =0.0258). In particular, squamous metaplasia was more present in oCRS cases with radicular cysts than in those with a dental implant (p =0.0423). Fibrosis presence was significantly different comparing the three sub-cohorts of oCRS (p =0.0408), too. This preliminary evidence supports the hypothesis that: (i) structural histopathology can become a useful tool for clinic-pathological practice in diagnostic, therapeutic, and prognostic terms in CRS; (ii) that oCRS, as CRS in general, is a histo-pathologically heterogeneous disease; (iii) oCRS resulting from dental implants disorders can frequently be characterized as a CRS with a rich tissue eosinophilic component.
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Affiliation(s)
- Giuseppe Brescia
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Lara Alessandrini
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Christian Bacci
- Clinical Dentistry, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Guido Bissolotti
- Maxillo-Facial Surgery Unit, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Marny Fedrigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Giacomo Contro
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Samuele Frasconi
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Maria Grazia Boccuto
- Clinical Dentistry, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Arianna Calcavecchia
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Anna Chiara Frigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Umberto Barion
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Stefano Fusetti
- Maxillo-Facial Surgery Unit, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Annalisa Angelini
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Gino Marioni
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
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Kolari V, Dhabaria H, Sengupta S, Sait AI, Shah A. Use of Marsupialisation for a Conservative Approach to Huge Cystic Lesions of the Jaws - A Report of three Cases. Ann Maxillofac Surg 2022; 12:244-247. [PMID: 36874788 PMCID: PMC9976843 DOI: 10.4103/ams.ams_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/18/2022] [Accepted: 10/27/2022] [Indexed: 01/12/2023] Open
Abstract
Rationale The management of cystic lesions of the jaws presents a challenge to the surgeon. Marsupialisation, one of the conservative management options, has been used as a single or combined surgical treatment modality for the cystic lesions of the jaws. Patient Concerns All patients presented with a complaint of a firm swelling of the face with one of the patients presenting with paraesthesia in the affected area. Diagnosis Clinical and radiographic examination was carried out followed by aspiration cytology. All lesions were provisionally diagnosed with odontogenic cystic lesions. Treatment Marsupialisation under general anaesthesia was carried out for all patients. Postoperatively, a customised obturator was fabricated. Outcomes All the patients showed good radiological ossification postoperatively. Take-Away Lessons The approach to larger cysts remains controversial. The long-term results following the marsupialisation of extensive cysts of this report may help surgeons to opt for a conservative approach to such lesions before aggressive options.
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Affiliation(s)
- Vinayakrishna Kolari
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Husain Dhabaria
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Shreya Sengupta
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Adil Iqbal Sait
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Abhishek Shah
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, Karnataka, India
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Altaie AM, Venkatachalam T, Samaranayake LP, Soliman SSM, Hamoudi R. Comparative Metabolomics Reveals the Microenvironment of Common T-Helper Cells and Differential Immune Cells Linked to Unique Periapical Lesions. Front Immunol 2021; 12:707267. [PMID: 34539639 PMCID: PMC8446658 DOI: 10.3389/fimmu.2021.707267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Periapical abscesses, radicular cysts, and periapical granulomas are the most frequently identified pathological lesions in the alveolar bone. While little is known about the initiation and progression of these conditions, the metabolic environment and the related immunological behaviors were examined for the first time to model the development of each pathological condition. Metabolites were extracted from each lesion and profiled using gas chromatography-mass spectrometry in comparison with healthy pulp tissue. The metabolites were clustered and linked to their related immune cell fractions. Clusters I and J in the periapical abscess upregulated the expression of MMP-9, IL-8, CYP4F3, and VEGF, while clusters L and M were related to lipophagy and apoptosis in radicular cyst, and cluster P in periapical granuloma, which contains L-(+)-lactic acid and ethylene glycol, was related to granuloma formation. Oleic acid, 17-octadecynoic acid, 1-nonadecene, and L-(+)-lactic acid were significantly the highest unique metabolites in healthy pulp tissue, periapical abscess, radicular cyst, and periapical granuloma, respectively. The correlated enriched metabolic pathways were identified, and the related active genes were predicted. Glutamatergic synapse (16–20),-hydroxyeicosatetraenoic acids, lipophagy, and retinoid X receptor coupled with vitamin D receptor were the most significantly enriched pathways in healthy control, abscess, cyst, and granuloma, respectively. Compared with the healthy control, significant upregulation in the gene expression of CYP4F3, VEGF, IL-8, TLR2 (P < 0.0001), and MMP-9 (P < 0.001) was found in the abscesses. While IL-12A was significantly upregulated in cysts (P < 0.01), IL-17A represents the highest significantly upregulated gene in granulomas (P < 0.0001). From the predicted active genes, CIBERSORT suggested the presence of natural killer cells, dendritic cells, pro-inflammatory M1 macrophages, and anti-inflammatory M2 macrophages in different proportions. In addition, the single nucleotide polymorphisms related to IL-10, IL-12A, and IL-17D genes were shown to be associated with periapical lesions and other oral lesions. Collectively, the unique metabolism and related immune response shape up an environment that initiates and maintains the existence and progression of these oral lesions, suggesting an important role in diagnosis and effective targeted therapy.
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Affiliation(s)
- Alaa Muayad Altaie
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Thenmozhi Venkatachalam
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Lakshman P Samaranayake
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Department of Oral Biosciences, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Sameh S M Soliman
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Rifat Hamoudi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Division of Surgery and Interventional Science, University College London, London, United Kingdom
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Schvartzman Cohen R, Goldberger T, Merzlak I, Tsesis I, Chaushu G, Avishai G, Rosen E. The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth. Medicina (Kaunas) 2021; 57:medicina57090991. [PMID: 34577915 PMCID: PMC8464687 DOI: 10.3390/medicina57090991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022]
Abstract
Background and Objectives: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. Materials and Methods: All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012–2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. Results: A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. Conclusions: the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.
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Affiliation(s)
- Ruth Schvartzman Cohen
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
- Correspondence: (R.S.C.); (T.G.)
| | - Tomer Goldberger
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
- Correspondence: (R.S.C.); (T.G.)
| | - Ina Merzlak
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
| | - Igor Tsesis
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
| | - Gavriel Chaushu
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
| | - Gal Avishai
- Oral and Maxillofacial Surgery Department—Rabin Medical Center, Beilinson Campus, 39 Ze’ev Jabotinsky St, Petach Tikvah 4941492, Israel; (G.C.); (G.A.)
| | - Eyal Rosen
- Department of Endodontics, School of Dental Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel; (I.M.); (I.T.); (E.R.)
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Kuźniarz K, Luchowska-Kocot D, Tomaszewski T, Kurzepa J. Role of matrix metalloproteinases and their tissue inhibitors in the pathological mechanisms underlying maxillofacial cystic lesions. Biomed Rep 2021; 15:65. [PMID: 34155449 PMCID: PMC8212445 DOI: 10.3892/br.2021.1441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/27/2021] [Indexed: 12/18/2022] Open
Abstract
Cystic lesions are considered to be one of the most common pathologies of the maxillofacial region, and matrix metalloproteinases (MMPs) may represent potential etiological factors. The aim of the present study was to elucidate the role of MMP-2 and MMP-9, and their endogenous tissue inhibitors, tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2, respectively, in the pathogenesis of maxillofacial cystic lesions. A total of 25 patients diagnosed with radicular cysts (RCs; n=20), dentigerous cysts (n=3) and retention cysts (RtCs; n=7) were enrolled in the present study. Gelatin zymography was performed to assess the gelatinolytic activity of MMP-2 and MMP-9, and commercial ELISA kits were used to determine TIMP-1 and TIMP-2 concentrations. Gelatin zymography revealed the presence of both MMP-2 and MMP-9 in all types of samples analyzed. An increase in MMP-9 activity, TIMP-1 concentration and MMP-9/TIMP-1 ratio was observed in the fluid obtained from RCs compared with that obtained from RtCs. In conclusion, MMP-9 may be involved in the pathogenesis of RCs, whereas the activity of MMP-2 in the wall of RtCs was low, and this gelatinase did not appear to significantly affect the development of this type of lesion.
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Affiliation(s)
- Krystian Kuźniarz
- Department of Maxillofacial Surgery, Medical University of Lublin, Lublin 20-081, Poland
| | | | - Tomasz Tomaszewski
- Department of Maxillofacial Surgery, Medical University of Lublin, Lublin 20-081, Poland
| | - Jacek Kurzepa
- Department of Medical Chemistry, Medical University of Lublin, Lublin 20-081, Poland
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Chalakkal P, De Souza N, de Ataide IDN, Akkara F, Chandran R. The Resistance of Succedaneous Teeth to Periapical Infection: A Series of Seven Cases. Contemp Clin Dent 2021; 12:88-93. [PMID: 33967546 PMCID: PMC8092089 DOI: 10.4103/ccd.ccd_68_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
Pediatric dental procedures are carried out largely to prevent the adverse effects of primary teeth infection on succedaneous teeth (ST). The existing literature on how and when periapical infection (PI) from primary teeth affect ST is conflicted. A series of seven case reports on PI (abscesses and radicular cysts) from primary molars, until the eruption of the premolars, have been illustrated. The resistance of ST to PI based on their developmental stages is also discussed.
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Affiliation(s)
- Paul Chalakkal
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Neil De Souza
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Ida de Noronha de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Roshni Chandran
- Department of Pedodontics and Preventive Dentistry, YMT Dental College and Hospital, Dr. G. D. Pol Foundation, Navi Mumbai, Maharashtra, India
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23
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Savithri V, Suresh R, Janardhanan M, Aravind T, Mohan M. Prevalence of odontogenic cysts and its associated factors in South Indian population. J Oral Maxillofac Pathol 2021; 24:585. [PMID: 33967515 PMCID: PMC8083450 DOI: 10.4103/jomfp.jomfp_171_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 11/03/2020] [Accepted: 12/04/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Odontogenic cysts (OCs) constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations. Aims: The aim was to determine the prevalence and factors associated with the cases of histopathologically diagnosed OCs that report to our institution and to analyze the factors associated with the presence of OCs and to study the biologic behavior of different types of cysts. Materials and Methods: A cross-sectional study was performed on 596 oral and maxillofacial specimens during 2013–2017. Out of these, the cases which were histopathologically proven as OCs were separated and data were collected and analyzed regarding the age, gender, primary symptom, site, radiographic feature, histopathologic diagnosis, treatment given, recurrences and associated conditions if any. Results: Of the 596 cases included in the study, 67 (11.2%) had a histopathological diagnosis of OCs. 41 cases were inflammatory cysts and 26 developmental cysts. 28 cases (41.8%) were reported as periapical cysts, 10 cases (14.9%) were odontogenic keratocysts (OKCs), 9 cases (13.4%) were dentigerous cysts, 8 cases (11.9%) were inflamed cyst wall, 5 cases (7.5%) each of residual cyst and developmental OCs and one case (1.5%) each of orthokeratinized OC and calcifying OC. Conclusion: This study showed that the prevalence of OCs was similar to other reported studies. Periapical cysts were the most common cysts reported, followed by OKCs showing that the latter were more frequent than dentigerous cysts.
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Affiliation(s)
- Vindhya Savithri
- Department of Oral Pathology and Microbiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS Campus, Kochi, Kerala, India
| | - Rakesh Suresh
- Department of Oral Pathology and Microbiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS Campus, Kochi, Kerala, India
| | - Mahija Janardhanan
- Department of Oral Pathology and Microbiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS Campus, Kochi, Kerala, India
| | - Thara Aravind
- Department of Oral Pathology and Microbiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS Campus, Kochi, Kerala, India
| | - Mridula Mohan
- Department of Oral Pathology and Microbiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS Campus, Kochi, Kerala, India
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24
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Naik C, Srinath N, Ranganath MK, Umashankar DN, Gupta H. Evaluation of polycaprolactone scaffold for guided bone regeneration in maxillary and mandibular defects: A clinical study. Natl J Maxillofac Surg 2020; 11:207-212. [PMID: 33897182 PMCID: PMC8051649 DOI: 10.4103/njms.njms_35_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/09/2020] [Accepted: 09/04/2020] [Indexed: 11/04/2022] Open
Abstract
Objective This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects. Materials and Methods This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively. Results PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing. Conclusion Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.
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Affiliation(s)
- Charudatta Naik
- Department of Oral and Maxillofacial Surgery, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - N Srinath
- Department of Oral and Maxillofacial Surgery, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Mahesh Kumar Ranganath
- Department of Oral and Maxillofacial Surgery, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - D N Umashankar
- Department of Oral and Maxillofacial Surgery, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Himani Gupta
- Department of Periodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
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25
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Uehara K, Hisatomi M, Munhoz L, Kawazu T, Yanagi Y, Okada S, Takeshita Y, Saito EA, Asaumi J. Assessment of Hounsfield unit in the differential diagnosis of odontogenic cysts. Dentomaxillofac Radiol 2020; 50:20200188. [PMID: 32783633 DOI: 10.1259/dmfr.20200188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the usefulness of Hounsfield unit (HU) assessment with multislice-CT in the differentiation of radicular cysts (RCs), dentigerous cysts (DCs) and odontogenic keratocysts (OKCs). METHODS In total, 307 odontogenic cysts (RCs, DCs and OKCs) were included in this study. Cysts with lesion diameter <10 mm, cysts with artefacts affecting measurement of HU values, cysts involving infection and recurrent cysts were regarded as exclusion criteria. Images were acquired in three different types of CT scanners: Aquilion ONE, Discovery CT750 HD and SOMATOM Definition Flash. Differences in HU values among scanners and among types of odontogenic cysts were assessed using one-way analysis of variance; multiple comparisons were performed post hoc, using the Tukey-Kramer honestly significant difference test. RESULTS In total, 164 cysts were analysed in this study (64 RCs, 57 DCs and 43 OKCs). Regardless of the type of lesion, the Aquilion ONE scanner demonstrated a significant difference in HU value, compared with the Discovery CT750 HD scanner. Regardless of CT scanner model, HU values significantly differed between DCs and OKCs (p < 0.0001), as well as between OKCs and RCs (p < 0.0001). CONCLUSIONS HU values were found to vary among CT scanners and should always be associated with other lesion imaging features while interpreting and elaboration diagnostic hypothesis. Notably, the results suggested that OKCs might be able to be differentiated from DCs and RCs by using HU values.
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Affiliation(s)
- Kyonori Uehara
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Miki Hisatomi
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, Okayama, Japan
| | - Luciana Munhoz
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Toshiyuki Kawazu
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshinobu Yanagi
- Department of Dental Informatics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shunsuke Okada
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, Okayama, Japan
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Emiko Arita Saito
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Junichi Asaumi
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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26
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Nik Abdul Ghani NR, Abdul Hamid NF, Karobari MI. Tunnel' radicular cyst and its management with root canal treatment and periapical surgery: A case report. Clin Case Rep 2020; 8:1387-1391. [PMID: 32884760 PMCID: PMC7455399 DOI: 10.1002/ccr3.2942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/29/2020] [Accepted: 03/06/2020] [Indexed: 11/10/2022] Open
Abstract
An untreated root canal infection usually stimulates the development of a radicular cyst. Nonsurgical root canal procedures and periapical surgery followed by placement of bone substitute will promote the healing process of the bony defect.
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Affiliation(s)
| | - Nor Faharina Abdul Hamid
- Centre of Restorative Dentistry StudiesFaculty of DentistryUniversiti Teknologi MaraSungai BulohMalaysia
| | - Mohmed Isaqali Karobari
- Conservative UnitSchool of Dental SciencesHealth CampusUniversiti Sains MalaysiaKubang KerianMalaysia
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27
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Madishetti S, Tiwari PK, Sinha R, Uppada UK, Banavath S, Tiwari RVC. Multiple radiolucencies in the mandible: A diagnostic dilemma. J Family Med Prim Care 2020; 9:2111-2113. [PMID: 32670975 PMCID: PMC7346900 DOI: 10.4103/jfmpc.jfmpc_1204_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 12/28/2019] [Accepted: 02/20/2020] [Indexed: 11/06/2022] Open
Abstract
Diagnosis and treatment planning of maxillofacial pathologies is an art. It requires careful evaluation and correlation of clinical presentation and radiologic investigations. When the pathology concerned is an intraosseous lesion, the radiographic findings assume a significantly more important role. While carrying out the radiographic assessment, we rely on typical findings regarding the number, location, and appearance of radiolucent areas which point towards certain types of pathologies. Whenever these findings are atypical or at variance with the clinical presentation, it creates a diagnostic dilemma for the clinician. We report a case of a 34-year-old man who presented with a simple clinical history but multiple radiolucencies on the radiograph.
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Affiliation(s)
- Susmitha Madishetti
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Prabhat K Tiwari
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Ramen Sinha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Uday K Uppada
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Sameer Banavath
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Rahul V C Tiwari
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
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28
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Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care 2020; 9:1253-1256. [PMID: 32318508 PMCID: PMC7113959 DOI: 10.4103/jfmpc.jfmpc_1059_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/10/2020] [Accepted: 01/29/2020] [Indexed: 11/16/2022] Open
Abstract
Radicular or periapical cysts are one of the most commonly occurring odontogenic cysts of the jaws. The present article reported a case of a 12-year-old female with the chief complaint of swelling and pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border with respect to the right mandibular 1st, 2nd and 3rd molar. The case was managed by complete enucleation under general extraction with the extraction of right mandibular 1st, 2nd and 3rd molar. The success of the surgery was apparent by the uneventful healing during the follow-up period and evidence of complete healing after 1-month follow-up. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.
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Affiliation(s)
- Priyesh Kesharwani
- Department of Oral and Maxillofacial Surgery, Consultant and Private Practitioner DENT-O-FACIAL Multispeciality Clinic, Mira Road, Thane-Mumbai, Maharashtra, India
| | - Shaikh A Hussain
- Department of Anatomy, SSR Medical College, Belle Rive, Mauritius
| | - Nitesh Sharma
- Department of Prosthodontics and Crown and Bridge, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Shilpi Karpathak
- Department of Prosthodontics, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Rishabh Bhanot
- Consultant, Department of Oral and Maxillofacial Surgery, SRCJC Hospital, Ludhiana, Punjab, India
| | - Sonal Kothari
- Department of Pedodontics, Reader, Pacific Dental College and Hospital, Bhelo Ka Bedala, Udaipur, Rajasthan, India
| | - Rahul V C Tiwari
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
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29
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Talukdar M, Kumar A, Goenka S, Mahajani M, Ambhore MP, Tattu VD. Management of radicular cyst in deciduous molar: A case report. J Family Med Prim Care 2020; 9:1222-1225. [PMID: 32318500 PMCID: PMC7114007 DOI: 10.4103/jfmpc.jfmpc_1147_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/13/2020] [Accepted: 02/03/2020] [Indexed: 12/05/2022] Open
Abstract
Radicular cysts associated with deciduous teeth are very rare. They constitute 0.5–3.3% of the total number of cysts in primary dentition. Radicular cysts involving deciduous teeth occur mostly in 3–19 years of age and has a male predominance. Enucleation with extensive removal of bone and vital teeth is preferred treatment for large radicular cysts and marsupialization can be preferred as a conservative approach to reduce morbidity. This paper presents a case report of a radicular cyst associated with a mandibular left deciduous first molar of a 7-year-old male child. The first premolar was displaced and the path of eruption was disturbed, horizontally placed below the first primary molar. The management comprised enucleation of the cystic sac and extraction of the involved permanent and primary teeth under general anesthesia.
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Affiliation(s)
- Manjaree Talukdar
- Department of Pediatric Dentistry, Suncity Layout, JP Nagar, 7th Phase, Bengaluru, Karnataka, India
| | - Abhinav Kumar
- Department of Oral and Maxillofacial Surgery, Dr. H.S.R.S.M Dental College and Hospital, Hingoli, Maharashtra, India
| | - Shachi Goenka
- Department of Conservative Dentistry and Endodontics, Dr. H.S.R.S.M Dental College and Hospital, Hingoli, Maharashtra, India
| | - Monica Mahajani
- Department of Periodontics, Dr. H.S.R.S.M Dental College and Hospital, Hingoli, Maharashtra, India
| | - Milind Prabhakar Ambhore
- Department of Conservative Dentistry and Endodontics, Dr. H.S.R.S.M Dental College and Hospital, Hingoli, Maharashtra, India
| | - Vivek Dilip Tattu
- Department of Conservative Dentistry and Endodontics, Dr. H.S.R.S.M Dental College and Hospital, Hingoli, Maharashtra, India
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Yang J, Xu S, Wang HC. Heterogeneity of fibroblasts from radicular cyst influenced osteoclastogenesis and bone destruction. Oral Dis 2020; 26:983-997. [PMID: 32112663 DOI: 10.1111/odi.13317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 01/17/2023]
Abstract
AIM To analyze the heterogeneity of fibroblasts isolated from the fibrous capsules of radicular cysts and explore the effects of fibroblast subsets on bone destruction. METHODOLOGY Radicular cysts were divided into groups according to varying perilesional sclerosis identified by radiograph. Colony-forming units (CFUs) were isolated from the fibrous capsules of cysts, by which Trap + MNCs were induced, and the expression of osteoclastogenesis-related genes was compared among groups by real-time PCR. The variances in gene profiles of CFUs were identified by principal component analysis, and then, CFUs were divided into subsets using cluster analysis. The induction of Trap + MNCs and related gene expression was compared among subsets, and osteoclastogenic induction was blocked by IST-9 or bevacizumab. The fibroblast subsets in cysts were investigated by retrospective immunostaining with IST-9, VEGF-A, and CD34. A fibroblast subset that underwent gene editing by CRISPR/Cas was injected into the site of bone defects in animal models, and the in vivo effects on osteoclastogenesis were investigated. RESULTS The fibroblast CFUs isolated from radicular cysts with perilesional unsclerotized cysts induced more Trap + MNCs than those with perilesional sclerotic cysts (p < .05). Most fibroblast CFUs from unsclerotized cysts belonged to Cluster 2, which induced more Trap + MNCs (p < .05) and highly expressed genes facilitating osteoclastogenesis; these results were different from those of Cluster 1 (p < .05), in which most CFUs were isolated from perilesional sclerotic cysts or controls (p < .05). The high expression of EDA + FN and VEGF-A was investigated in both the fibroblasts of Cluster 2 and the fibrous capsules of unsclerotized cysts (p < .05), and the number of Trap + MNCs induced by Cluster 2 was decreased by treatment with IST-9 and bevacizumab (p < .05). Consistently, EDA exon exclusion significantly decreased the osteoclastogenic induction of fibroblasts from Cluster 2 in vivo (p < .05). CONCLUSION The fibrous capsules of radicular cysts contain heterogeneous fibroblasts that can form subsets exhibiting different effects on osteoclastogenesis. The subset, which depending on the autocrine effects of EDA + FN on VEGF-A, mainly contributes to the osteoclastogenesis and bone destruction of radicular cysts. The regulation of the proportion of subsets is a possible strategy for artificially interfering with osteoclastogenesis.
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Affiliation(s)
- Jingwen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Shuyu Xu
- Department of Oral Implant, School & Hospital Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Hai-Cheng Wang
- Department of Pathology, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
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31
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Konschake W, Westphal T, Jünger M, Arnold A, Lutze S. A rare case of a patient with PPP syndrome presenting pancreatic pseudocysts, panniculitis, and symptoms of polyarthritis. A radicular cyst of the upper jaw could be another manifestation of the syndrome. Clin Case Rep 2020; 8:625-629. [PMID: 32274023 PMCID: PMC7141739 DOI: 10.1002/ccr3.2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 11/26/2022] Open
Abstract
In rare cases, pancreatic enzymes can enter the bloodstream and cause fat necrosis in the bone and tissue leading to a disorder called pancreatitis, panniculitis, and polyarthritis syndrome. Clinicians should have this syndrome in mind when treating patients with pancreatitis.
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Affiliation(s)
| | - Thea Westphal
- Department of Dermatology University of Greifswald Greifswald Germany
| | - Michael Jünger
- Department of Dermatology University of Greifswald Greifswald Germany
| | - Andreas Arnold
- Department of Dermatology University of Greifswald Greifswald Germany
| | - Stine Lutze
- Department of Dermatology University of Greifswald Greifswald Germany
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32
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Vieira CC, Pappen FG, Kirschnick LB, Cademartori MG, Nóbrega KHS, do Couto AM, Schuch LF, Melo LA, Dos Santos JN, de Aguiar MCF, Vasconcelos ACU. A Retrospective Brazilian Multicenter Study of Biopsies at the Periapical Area: Identification of Cases of Nonendodontic Periapical Lesions. J Endod 2020; 46:490-495. [PMID: 32061420 DOI: 10.1016/j.joen.2020.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The purpose of this study was to analyze the features of lesions obtained from biopsies at the periapical area of teeth with a radiographic or clinical initial diagnosis of apical periodontitis. METHODS A retrospective study was conducted on biopsies obtained from 1953-2018 at 3 Brazilian oral and maxillofacial pathology centers. Cases of endodontic and nonendodontic periapical lesions (NPLs) with a clinical diagnosis of endodontic pathoses were retrieved. Data regarding patient age, sex, and anatomic location were obtained from patients' records. The frequency and percentage of cases with clinical diagnoses of a periapical cyst, periapical granuloma, or dentoalveolar abscess were recorded, and the final histopathologic diagnosis was documented. RESULTS Among 66,179 oral biopsies, 7246 (10.94%) were clinically diagnosed as periapical disease, 306 (4.22%) of which were histopathologically diagnosed as NPLs. The most frequent NPLs were odontogenic keratocysts (n = 107, 34.96%) followed by dentigerous cysts (n = 48, 15.68%). The mean age at diagnosis was 39.68 years with a range of 6-80 years. A total of 159 (51.96%) cases occurred in females and 147 (48.03%) in males (female to male ratio = 1.08:1). Most lesions (137, 44.77%) were located in the posterior mandible. CONCLUSIONS A wide variety of histopathologic diagnoses, including benign odontogenic and nonodontogenic cystic and tumorous lesions, infectious diseases, and malignant neoplasms, was reported in the present survey. The features presented in this study were consistent with previous findings reported in the literature.
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Affiliation(s)
- Carolina Clasen Vieira
- Department of Semiology and Clinics, Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Geraldo Pappen
- Department of Semiology and Clinics, Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Laura Borges Kirschnick
- Department of Semiology and Clinics, Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Gonzalez Cademartori
- Department of Semiology and Clinics, Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kaio Heide Sampaio Nóbrega
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aline Maria do Couto
- Department of Pathology, Postgraduate Program in Oral Pathology, School of Dentistry, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Lauren Frenzel Schuch
- Department of Pathology, Postgraduate Program in Oral Pathology, School of Dentistry, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Leonardo Araújo Melo
- Department of Semiology and Clinics, Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Jean Nunes Dos Santos
- Department of Semiology and Clinics, Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Maria Cássia Ferreira de Aguiar
- Department of Pathology, Postgraduate Program in Oral Pathology, School of Dentistry, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Ana Carolina Uchoa Vasconcelos
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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33
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Roy SF, Berdugo J. Periapical Cyst and Odontogenic Remnants on Osseous Mandibulectomy Margins: Two Diagnostic Pitfalls. Int J Surg Pathol 2020; 28:507-509. [PMID: 32031051 DOI: 10.1177/1066896920905085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, we describe 2 high-stake diagnostic pitfalls that occurred in a single patient having undergone partial glossectomy and marginal mandibulectomy for invasive squamous cell carcinoma. Margins were grossly uninvolved. Histopathology showed a moderately differentiated squamous cell carcinoma. Microscopic evaluation of margins was challenging, as the inferior osseous margin submitted en face showed spongiotic epithelium with mixed chronic and acute inflammation, representing a periapical cyst after correlation with the gross examination. Another section of the osseous margin showed a small non-atypical epithelial nest, consistent with an odontogenic epithelial rest. We wish to raise awareness of these diagnostic pitfalls as a bone margin with such epithelial foci could be misinterpreted as positive, with serious therapeutic consequences.
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Affiliation(s)
- Simon F Roy
- University of Montreal, Montreal, Quebec, Canada
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Myciński P, Dobroś K, Kaczmarzyk T, Zarzecka J. Assessment of conformity between clinical (radiological) and histopathological diagnoses of chronic inflammatory periapical lesions treated with apicoectomy. Clinical and histopathological diagnoses of periapical lesions. Research article. Folia Med Cracov 2020; 60:103-111. [PMID: 33821855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Periapical inflammation is one of the most common pathologies within the jaws, leading to the destruction of periodontal ligaments, bone resorption and the formation of periapical granulomas or radicular cysts. The final diagnosis can be made only on the basis of histopathological examination. The aim of the study was to assess the conformity between clinical and histopathological diagnosis of inflammatory periapical lesions treated with apicoectomy. MATERIALS AND METHODS The case histories of 52 patients subjected to surgical treatment at the Clinic of Conservative Dentistry with Endodontics between 2008 and 2018 were analyzed. Demographic data (age, gender), clinical (radiological) diagnosis, and data on the presence of sinus tracts and causal tooth were obtained from patients' records. RESULTS In the light of clinical and radiological examination, 32 (61.5%) periapical granulomas, 18 (34.6%) radicular cysts and 2 (3.9%) periapical scars were diagnosed, whereas the result of histopathological examination revealed granuloma in 34 (65.4%) cases and in 18 (34.6%) - radicular cyst. For clinical diagnosis of granuloma, the result coincided with the result of the histopathological examination in 28 cases, and in the case of cysts in 14. The analysis showed a significant relationship between the clinical and histopathological diagnoses (p <0.05). CONCLUSIONS The study emphasizes the importance of histopathological assessment for the proper diagnosis of periapical lesions. CLINICAL RELEVANCE The article emphasizes the high importance of histopathological examination for the correct diagnosis of chronic inflammatory periapical lesions.
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Affiliation(s)
- Paweł Myciński
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
| | - Katarzyna Dobroś
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Kaczmarzyk
- Department of Oral Surgery, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jolanta Zarzecka
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Kolari V, Rao HTA, Thomas T. Maxillary and mandibular unusually large radicular cyst: A rare case report. Natl J Maxillofac Surg 2019; 10:270-273. [PMID: 31798272 PMCID: PMC6883872 DOI: 10.4103/njms.njms_6_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/19/2018] [Accepted: 05/28/2019] [Indexed: 11/22/2022] Open
Abstract
Radicular cysts are the most common odontogenic cyst. It is an inflammatory cyst associated with the root apex of a nonvital tooth. Most radicular cysts are small but can reach a large size causing displacement of surrounding structures. Here, we present a rare case of huge radicular cyst in both maxilla and mandible in a 36-year-old patient.
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Affiliation(s)
- Vinayakrishna Kolari
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - H T Arvind Rao
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
| | - Taniya Thomas
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India
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Yang JW, Jiang JH, Wang HC, Li CY. The extra domain A of fibronectin facilitates osteoclastogenesis in radicular cysts through vascular endothelial growth factor. Int Endod J 2019; 53:478-491. [PMID: 31654436 DOI: 10.1111/iej.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/24/2019] [Indexed: 11/28/2022]
Abstract
AIM To analyse the effects of the alternatively spliced fibronectin (FN) gene and its isoforms on osteoclastogenesis in radicular cysts. METHODOLOGY Specimens of radicular cysts were collected surgically from 22 patients whose radiolucent periapical areas were measured on digital panoramic radiographs before surgery. The associations between the radiolucent areas and FN isoforms, vascular endothelial growth factor (VEGF) expression or micro-vessel density, as well as the relationships amongst them, were analysed by immunohistochemical staining using the antibodies IST-9, BC-1, P1F11, VEGF and CD34. Fibroblasts isolated from those specimens were used to induce Trap + MNCs, and the effects of induction were assessed by blocking FN containing extra domain A (EDA + FN), COX-2 or VEGF in vitro. The effects of EDA exon knockout using CRISPR/Cas system were also assessed. Quantitative PCR was used to analyse relative expression of FN isoforms and osteoclastogenic genes. Data were analysed using linear regression, Spearman's rank correlation analysis, chi-square test and Student's t-test; P < 0.05 was considered significant. RESULTS Micro-vessel density and EDA + FN staining were positively associated with the size of radiolucent periapical areas (mm2 ; P < 0.05), consistent with a positive association between Trap + MNCs and VEGF expression in fibroblasts (P < 0.05). Blocking the interaction between EDA + FN and fibroblasts inhibited Trap + MNC formation. In addition, EDA exon knockout decreased VEGF expression and inhibited Trap + MNC formation to the extent of blocking VEGF by bevacizumab, but osteoclastogenic induction was restored by recombinant VEGF. Using retrospective clinicopathological data, VEGF staining was shown to be positively associated with EDA + FN staining, micro-vessel density and the size of radiolucent areas (P < 0.05). CONCLUSION In fibrous capsules of radicular cysts, the alternatively spliced isoform EDA + FN generated by fibroblasts stimulated VEGF expression via an autocrine effect and then facilitated osteoclastogenesis. Both blockage of VEGF and EDA exon knockout could be used to inhibit bone destruction.
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Affiliation(s)
- J W Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - J H Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - H C Wang
- Department of Pathology, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - C Y Li
- The Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
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Godhi BS, Shanbhog R, Chanchala HP. Interceptive management of ectopically erupting central incisor - A case report. J Indian Soc Pedod Prev Dent 2019; 37:409-413. [PMID: 31710018 DOI: 10.4103/jisppd.jisppd_193_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Radicular cysts are considered to be rare in the primary dentition comprising 0.5%-3.3% of the total number of radicular cysts in both primary and permanent dentition. Ectopic eruption is an eruption disturbance with the prevalence of 5.6% with majority being permanent central incisors. Etiology for eruption disturbance commonly includes odontoma, cysts, supernumerary teeth, and crown-root malformation. Ectopic eruption of permanent incisor due to radicular cyst associated with traumatized primary incisor is a very rare clinical entity that requires timely interception. The present case illustrates the clinical feature and multi-disciplinary management of ectopic eruption of permanent central incisor in a 9-year-old girl child.
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Affiliation(s)
- Brinda Suhas Godhi
- Department of Pedodontics and Preventive Dentistry, JSS Academy of Higher Education and Research, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Raghavendra Shanbhog
- Department of Pedodontics and Preventive Dentistry, JSS Academy of Higher Education and Research, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - H P Chanchala
- Department of Pedodontics and Preventive Dentistry, JSS Academy of Higher Education and Research, JSS Dental College and Hospital, Mysore, Karnataka, India
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Ali A, Asif M, Ahmad B, Jamal S, Ali I, Khadim MT. Stromal Expression of CD10 by Immunohistochemistry in Odontogenic Keratocyst (OKC), Dentigerous and Radicular Cysts and Its Correlation with Local Recurrence and Aggressive Behaviour. Asian Pac J Cancer Prev 2019; 20:249-253. [PMID: 30678440 PMCID: PMC6485571 DOI: 10.31557/apjcp.2019.20.1.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective: To assess and compare the stromal expression of CD10 in OKC, dentigerous and radicular cysts. Materials and Methods: This comparative, cross sectional study was conducted at Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Jan 2017 to Dec 2017. Total sixty cases comprising 20 of each OKC, Dentigerous and Radicular cysts were included in this study. Hematoxylin and eosin (H and E) sections were performed followed by immunohistochemical staining for CD10 antibody. Expression of CD10 was evaluated and compared. Results were analyzed by using SPSS version 20.0. Chi Square test was performed with P value < 0.05 was considered as significant. Results: A total of 60 cases, 20 of each OKC, dentigerous and radicular cysts were taken. In our study, 38 (63.3%) male and 22 (36.7%) female patients with the mean age of 32 ± 15 (mean ± SD) were included. Percentage of CD10 positive cells were highest in sub-epithelial stroma of OKC (95% cases) as compared to radicular and dentigerous cysts (60 and 70%) with highest number of cases showing intense staining in OKC 13(65%) as compared to other odontogenic cysts i-e 4(20%) and 2 (10%) respectively. There was a statistically significant association between odontogenic cysts and proportional score, intensity score and combined score of stromal CD10 expression (P=0.009, p=0.001 and p=0.000). Conclusion: In this study, we found that highest stromal CD10 expression in OKC as compared to dentigerous and radicular cyst, which might be due to aggressive behaviour and increased risk of recurrence in OKC. Expression of CD10 marker will further aid the clinician to plan appropriate surgical intervention and keep regular follow-ups to identify recurrences.
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Affiliation(s)
- Anam Ali
- Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan.
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Kontogiannis TG, Tosios KI, Kerezoudis NP. Effect of calcium hydroxide as intracanal medicament on the expression of caspase-9 located within the radicular cyst epithelium. AUST ENDOD J 2019; 45:352-356. [PMID: 30632228 DOI: 10.1111/aej.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Abstract
Apoptosis (a programmed cell death mechanism) within the radicular cyst epithelium has still not been correlated with any clinical factor. This study aimed to investigate the effect of calcium hydroxide on apoptosis, via the detection of caspase-9. Thirty radicular cysts collected during apicoectomies and stored in paraffin were retrospectively retrieved. Conservative endodontic treatments had been carried out either without (group (a) n = 14), or with calcium hydroxide application (group (b), n = 16) before obturation. All cysts were immunohistochemically stained for caspase-9 to record apoptosis of the epithelium. Statistical analysis followed. The frequency of caspase-9 immunoreactivity in the cystic epithelium in the two groups was 42.86% and 93.75% of cysts respectively. This difference was statistically significant (P = 0.04 < 0.05). In cysts larger than (or equal to) 10 mm, caspase-9 was more frequently expressed. It was found calcium hydroxide appears to enhance the expression of caspase-9, especially in large lesions.
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Affiliation(s)
- Taxiarchis G Kontogiannis
- Department of Endodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos I Tosios
- Department of Oral Pathology, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos P Kerezoudis
- Department of Endodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
Radicular cysts associated with primary teeth are rare. This case report describes radicular cyst associated with carious primary mandibular second molar in a 5-year-old patient and discusses its surgical intervention, space management, and follow-up for 3½ years.
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Affiliation(s)
- Shrirang Sevekar
- Department of Pediatric Dentistry, Gokuldham Medical Center, Mumbai, India
| | - H N Subhadra
- Department of Pediatric and Preventive Dentistry, YMT, Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Vaishali Das
- Department of Oral Maxillofacial Surgery, Gokuldham Medical Center, Mumbai, India
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Abstract
RATIONALE Pathological fracture of the mandible caused by radicular cyst is rare. This report describes a unique case of a mandibular pathological fracture caused by radicular cyst, arising from an endodontically treated molar. PATIENT CONCERN A 49-year-old female was referred to our department with persistent pain in left mandibular angle, accompanying with restricted mouth opening and malocclusion. DIAGNOSE An orthopantomograph (OPG) showed a unilocular lesion with a relatively well-defined border, and the lesion was associated with a fracture in the inferior border of the mandible. INTERVENTION This patient was treated through curettage of the cyst combined with open reduction and internal fixation of the fracture. OUTCOMES At the 1-year follow-up visit, the patient did not have any complaints, and the radiographs indicated the consolidation of the fracture without recurrence of cyst. LESSONS This case report highlights the routine follow-up of endodontically treated teeth in order to check for apical healing and detect the cystic change at early stages.
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Affiliation(s)
- Xian Xiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Endodontic
| | - Jia-Wei Dai
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhi Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education
- Department of Endodontic
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Jaafari-Ashkavandi Z, Tuyeh AA, Assar S. Immunohistochemical Expression of CDC7 in Dentigerous Cyst, Odontogenic Keratocyst and Radicular Cyst. Acta Medica (Hradec Kralove) 2018; 61:17-21. [PMID: 30012245 DOI: 10.14712/18059694.2018.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
CDC7 is a serine/threonine kinase which has an essential role in initiation of DNA proliferation and S phase. It increases the invasion and proliferation in many pathologic lesions. This study aimed to evaluate the expression of CDC7 in the most common odontogenic cysts. We evaluated 17 dentigerous cysts, 18 odontogenic keratocysts (OKC) and 13 radicular cysts immunohistochemically. The mean expression of CDC7 was analyzed using ANOVA and Post-HOC methods. All specimens revealed CDC7 expression. Higher expression of CDC7 in OKC and radicular cyst was shown in comparison to dentigerous cyst (P < 0.001), while radicular cyst and OKC groups showed no difference in CDC7 expression (P = 0.738). The high expression of CDC7 in OKC suggests that this protein could be related to the higher proliferation rate and invasiveness of OKC. On the other hand, the higher CDC7 expression in radicular cyst may simply be related to inflammation as this cyst is neither aggressive nor invasive.
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Affiliation(s)
- Zohreh Jaafari-Ashkavandi
- Department of Oral & Maxillofacial Pathology, Shiraz Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sepideh Assar
- Department of Oral & Maxillofacial Pathology, Hormozgan Dental School, Hormozgan University of Medical Sciences, Hormozgan, Bandar-Abbas, Iran.
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Modi TG, Chalishazar M, Kumar M. Expression of Ki-67 in odontogenic cysts: A comparative study between odontogenic keratocysts, radicular cysts and dentigerous cysts. J Oral Maxillofac Pathol 2018; 22:146. [PMID: 29731577 PMCID: PMC5917528 DOI: 10.4103/jomfp.jomfp_94_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 12/03/2017] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Odontogenic cysts are the most common cysts of the jaws and are formed from the remnants of the odontogenic apparatus. Among these odontogenic cysts, radicular cysts (RCs) (about 60% of all diagnosed jaw cysts), dentigerous cysts (DCs) (16.6% of all jaw cysts) and odontogenic keratocysts (OKCs) (11.2% of all developmental odontogenic cysts) are the most common. The behavior of any lesion is generally reflected by its growth potential. Growth potential is determined by measuring the cell proliferative activity. The cell proliferative activity is measured by various methods among which immunohistochemistry (IHC) is the commonly used technique. Most of the IHC studies on cell proliferation have been based on antibodies such as Ki-67 and proliferating cell nuclear antigen. MATERIALS AND METHOD In the present study, the total sample size comprised of 45 cases of odontogenic cysts, with 15 cases each of OKC, RC and DC. Here, an attempt is made to study immunohistochemical (streptavidin-biotin detection system HRP-DAB) method to assess the expression of Ki-67 in different layers of the epithelial lining of OKCs, RCs and DCs. OBSERVATIONS AND RESULTS Ki-67 positive cells were highest in epithelium of OKC as compared to DC and RC. CONCLUSION The increased Ki-67 labeling index and its expression in suprabasal cell layers of epithelial lining in OKC and its correlation with suprabasal cell layers of epithelial lining in DC and RC could contribute toward its clinically aggressive behavior. OKC is of more significance to the oral pathologist and oral surgeon because of its specific histopathological features, high recurrence rate and aggressive behavior.
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Affiliation(s)
- Tapan G Modi
- Department of Oral Pathology and Microbiology, College of Dental Science and Research Centre, Gujarat University, Ahmedabad, Gujarat, India
| | - Monali Chalishazar
- Department of Oral Pathology and Microbiology, Ahmedabad Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Malay Kumar
- Department of Oral Pathology and Microbiology, Carrier Postgraduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
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Turovsky AB, Kolbanova IG, Kuznetsov GV, Kudryavtseva YS. [The radicular cyst in the maxillary sinus encountered in the clinical otorhinolaryngological practice]. Vestn Otorinolaringol 2017; 82:60-63. [PMID: 28980600 DOI: 10.17116/otorino201782460-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article was designed to report the clinical case of the radicular cyst localized in the maxillary sinus of the 23 year-old man that had been detected before the surgical intervention was undertaken for its treatment. In the preceding visits of the patient to other medical settings, this condition was misinterpreted as a genuine (rhinogenic) cyst. It accounted for the choice of the inadequate surgical strategy for the management of this pathology. As a result, the patient experienced two relapse episodes of the disease. The thorough analysis of the patient's medical history and CT images of the sinus obtained during the 4 year follow up period allowed to establish the definitive diagnosis of odontogenic cyst of the upper jaw. The authors present a brief overview of the relevant scientific literature concerning etiology and pathogenesis as well as the methods of diagnostics and treatment of radicular cyst of the upper jaw.
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Affiliation(s)
- A B Turovsky
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - I G Kolbanova
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - G V Kuznetsov
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - Yu S Kudryavtseva
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Dhote VS, Thosar NR, Baliga SM, Dharnadhikari P, Bhatiya P, Fulzele P. Surgical Management of Large Radicular Cyst Associated with Mandibular Deciduous Molar Using Platelet-rich Fibrin Augmentation: A Rare Case Report. Contemp Clin Dent 2017; 8:647-649. [PMID: 29326521 PMCID: PMC5754991 DOI: 10.4103/ccd.ccd_370_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Radicular cysts arising from deciduous teeth are rare and usually cause a large bony defect. Autologous platelet-rich fibrin (PRF) is an easily available healing biomaterial in oral surgical defect with the new perspective of accelerated healing of a large bony defect. The present case is of unusually large radicular associated with neglected carious mandibular deciduous second molar in 10-year-old girl and its surgical management with PRF augmentation as a healing biomaterial in the bony defect. One-year follow-up showed uneventful healing and eruption of succedaneous tooth. Healing was relatively faster and facilitated by PRF placement. Furthermore, the importance of anticipatory guidance about the treatment of diseased primary teeth and their preservation gets highlighted.
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Affiliation(s)
- Vijaya S Dhote
- Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Mumbai, India
| | - Nilima R Thosar
- Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
| | - Sudhindra M Baliga
- Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
| | | | | | - Punit Fulzele
- Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
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Akshatha BK, Karuppiah K, Manjunath GS, Kumarswamy J, Papaiah L, Rao J. Immunohistochemical evaluation of inducible nitric oxide synthase in the epithelial lining of odontogenic cysts: A qualitative and quantitative analysis. J Oral Maxillofac Pathol 2017; 21:375-381. [PMID: 29391711 PMCID: PMC5763859 DOI: 10.4103/jomfp.jomfp_96_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction The three common odontogenic cysts include radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs). Among these 3 cysts, OKC is recently been classified as benign keratocystic odontogenic tumor attributing to its aggressive behavior, recurrence rate, and malignant potential. The present study involved qualitative and quantitative analysis of inducible nitric oxide synthase (iNOS) expression in epithelial lining of RCs, DCs, and OKCs, compare iNOS expression in epithelial linings of all the 3 cysts and determined overexpression of iNOS in OKCs which might contribute to its aggressive behavior and malignant potential. Aims The present study is to investigate the role of iNOS in the pathogenesis of OKCs, DCs, and RCs by evaluating the iNOS expression in the epithelial lining of these cysts. Subjects and Methods Analysis of iNOS expression in epithelial lining cells of 20 RCs, 20 DCs, and 20 OKCs using immunohistochemistry done. Statistical Analysis Used The percentage of positive cells and intensity of stain was assessed and compared among all the 3 cysts using contingency coefficient. Kappa statistics for the two observers were computed for finding interobserver agreement. Results The percentage of iNOS-positive cells was found to be remarkably high in OKCs (12/20) -57.1% as compared to RCs (6/20) - 28.6% and DCs (3/20) - 14.3%. The interobserver agreement for iNOS-positive percentage cells was arrived with kappa values with OKCs → Statistically significant (P > 0.000), RCs → statistically significant (P > 0.001) with no significant values for DCs. No statistical difference exists among 3 study samples in regard to the intensity of staining with iNOS. Conclusions Increased iNOS expression in OKCs may contribute to bone resorption and accumulation of wild-type p53, hence, making OKCs more aggressive.
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Affiliation(s)
- B K Akshatha
- Department of Oral Pathology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Karpagaselvi Karuppiah
- Department of Oral Pathology, Vydehi Institute of Dental Sciences and Research Center, Bengaluru, Karnataka, India
| | - G S Manjunath
- Department of Oral and Maxillofacial Surgery, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Jayalakshmi Kumarswamy
- Department of Oral Pathology, Vydehi Institute of Dental Sciences and Research Center, Bengaluru, Karnataka, India
| | - Lokesh Papaiah
- Department of Oral Pathology, Vydehi Institute of Dental Sciences and Research Center, Bengaluru, Karnataka, India
| | - Jyothi Rao
- Department of Oral Pathology, Vydehi Institute of Dental Sciences and Research Center, Bengaluru, Karnataka, India
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Salaria SK, Kamra S, Ghuman SK, Sharma G. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report. Contemp Clin Dent 2016; 7:562-565. [PMID: 27994430 PMCID: PMC5141677 DOI: 10.4103/0976-237x.194098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Radicular cyst (RC) is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.
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Affiliation(s)
- Sanjeev Kumar Salaria
- Department of Periodontology and Oral Implantology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Shilpa Kamra
- Department of Periodontology and Oral Implantology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Simrat Kaur Ghuman
- Department of Periodontology and Oral Implantology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Garima Sharma
- Department of Periodontology and Oral Implantology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
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48
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Abstract
Pulpectomy is preferably more conservative treatment option than the extraction of deciduous teeth despite few undesirable consequences of obturating materials of which odontogenic cysts are one. This article aims to report a case of an 11-year-old female child having bilateral odontogenic cysts, i.e., radicular and infected dentigerous cyst followed by pulpectomy of deciduous molars using zinc oxide eugenol which was surgically enucleated and followed up to 6 months until satisfactory healing of bone was observed. The article also emphasizes on the importance of regular follow-up of the pulpectomized tooth which can be harmful otherwise.
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Affiliation(s)
- B Sandhyarani
- Department of Pedodontics and Preventive Dentistry, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Sangli, Maharashtra, India
| | - Hina Noorani
- Department of Pedodontics and Preventive Dentistry, P.M.N.M. Dental College and Hospital, Bagalkot, Karnataka, India
| | - P K Shivaprakash
- Department of Pedodontics and Preventive Dentistry, P.M.N.M. Dental College and Hospital, Bagalkot, Karnataka, India
| | - A Huddar Dayanand
- Department of Prosthodontics, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Sangli, Maharashtra, India
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49
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Borkar SA, Dhupar V, Gadkar AM, Nivedita CKVS. Management of large radicular cyst associated with amalgam particles in cystic lining. J Conserv Dent 2016; 19:280-4. [PMID: 27217645 PMCID: PMC4872586 DOI: 10.4103/0972-0707.181948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The failure of amalgam retrofilling and presence of an associated cystic lesion makes surgical endodontic intervention inevitable. Amalgam retrofilling can also give rise to mucoperiosteal tattoo formation and allow incorporation of amalgam particles in the cystic lining. Such a finding has not yet been reported in the endodontic literature. This case report describes the successful endodontic management of a large radicular cyst associated with failed amalgam retrofilling, mucoperiosteal tattoo and amalgam particles dispersed in the epithelial cystic lining. All four mandibular incisors associated with the lesion presented with Weine Type II canal anatomy. The follow-up revealed clinical and radiographic signs of healing.
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Affiliation(s)
- Swati A Borkar
- Department of Conservative Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Abhilasha M Gadkar
- Department of Conservative Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - C K V S Nivedita
- Department of Oral and Maxillofacial Radiology, Goa Dental College and Hospital, Bambolim, Goa, India
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50
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Abstract
Periapical infection in the primary tooth may lead to periapical abscess, granuloma, radicular cyst and even osteomyelitis. The infection in primary teeth can also affect the developing successor teeth leading to hypomineralization, hypoplasia, arrest of tooth development, regional odontodysplasia, delayed eruption etc. The purpose of this article is to report a case of malformed permanent tooth in relation to overlying infected deciduous teeth. The probable role of inflammation in pathogenesis of the present condition is also being discussed.
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Affiliation(s)
- Sandeep S Gupta
- Department of Oral and Maxillofacial Pathology and Microbiology, RKDF Dental College, Bhopal, Madhya Pradesh, India
| | - Devi C Shetty
- Department of Oral and Maxillofacial Pathology and Microbiology, ITS College of Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Aadithya B Urs
- Department of Oral and Maxillofacial Pathology and Microbiology, Maulana Azad Dental College, New Delhi, India
| | - P Nainani
- Department of Oral and Maxillofacial Pathology and Microbiology, RKDF Dental College, Bhopal, Madhya Pradesh, India
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