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Chu T, Qin Q, Liu K, Zhao Y, Fu Y, Liu Q. Enucleation of jaw cyst combined with intentional replantation to retain cyst-involved teeth. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101731. [PMID: 38097014 DOI: 10.1016/j.jormas.2023.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/09/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal. MATERIALS AND METHODS Fifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12-14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption. RESULTS No cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment. CONCLUSIONS IR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst.
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Affiliation(s)
- Tianshu Chu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Qingyan Qin
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Kang Liu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Yitong Zhao
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Yongzhen Fu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China
| | - Qilin Liu
- The Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, PR China.
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Li SR, Li DW, Man QW. Proteomic profile of tissue-derived extracellular vesicles from benign odontogenic lesions. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101921. [PMID: 38795909 DOI: 10.1016/j.jormas.2024.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Benign odontogenic lesions (BOLs) can cause severe jaw bone defects and compromise the quality of life of patients. Extracellular vesicles (EVs) are well-established and versatile players in mediating pathophysiological events. EVs in the interstitial space (tissue-derived EVs or Ti-EVs) possess higher specificity and sensitivity in disease-related biomarker discovery. However, the role of Ti-EV-loaded proteins in mediating the development of BOLs has remained untapped. Herein, we aim to explore the contribution of Ti-EV-loaded proteins to the development of BOLs. METHODS Samples were obtained from 3 with dental follicle, 3 with dentigerous cyst (DC), 7 with odontogenic keratocyst (OKC), and 3 patients with ameloblastoma (AM). Tissue-derived EVs were then extracted, purified, and validated using ultracentrifugation, transmission electron microscopy, and western blotting. Proteins from Ti-EVs were analyzed using LC-ESI tandem mass spectroscopy and differentially expressed proteins were screened, which was then validated by immunohistochemistry and immunofluorescence assays. RESULTS The protein profile of Ti-EVs in each group was mapped by LC-MS analysis. The top 10 abundant proteins in BOL-derived Ti-EVs were COL6A3, COL6A1, ALB, HIST1H4A, HBB, ACTB, HIST1H2BD, ANXA2, COL6A2 and FBN1. Additionally, unique proteins in the Ti-EVs from various lesions were identified. Moreover, focal adhesion kinase (FAK) and myeloid differentiation primary response 88 (MyD88) showed higher expressions in Ti-EVs derived from OKC and AM, which were confirmed by immunohistochemistry and immunofluorescence staining. CONCLUSIONS Ti-EVs containing FAK and MyD88 might be related to the development of OKC and AM, which can be potential therapeutic targets.
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Affiliation(s)
- Su-Ran Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Hongshan District, Wuhan 430079, China
| | - Dong-Wen Li
- Department of Orthodontic, Affiliated Stomatological Hospital of Jiamusi University, Jiamusi 154003, China
| | - Qi-Wen Man
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Hongshan District, Wuhan 430079, China; Department of Oral and Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China..
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Shi D, Dong H, Chen B, Zhu Z, Zhang T. Decompression-first or direct enucleation: The choice of treatment for medium-sized odontogenic jaw cysts. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101892. [PMID: 38670344 DOI: 10.1016/j.jormas.2024.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts. METHODS Odontogenic cysts with lesion sizes ranging 2-4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups. RESULTS Out of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon's preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05). CONCLUSIONS There is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression.
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Affiliation(s)
- Dianyin Shi
- Department of Stomatology, Peking Union Medical College Hospital, CAMS and PUMC, Beijing 100730, PR China
| | - Haitao Dong
- Department of Stomatology, Peking Union Medical College Hospital, CAMS and PUMC, Beijing 100730, PR China
| | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, CAMS and PUMC, Beijing 100730, PR China
| | - Zhihui Zhu
- Department of Stomatology, Peking Union Medical College Hospital, CAMS and PUMC, Beijing 100730, PR China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, CAMS and PUMC, Beijing 100730, PR China.
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Alarcón-Sánchez MA, Luna-Bonilla G, Romero-Servin S, Heboyan A. Podoplanin immunoexpression in odontogenic lesions: a systematic review, meta-analysis, and integrated bioinformatic analysis. Diagn Pathol 2024; 19:115. [PMID: 39182093 PMCID: PMC11344317 DOI: 10.1186/s13000-024-01540-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 08/18/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Podoplanin (PDPN) is a transmembrane glycoprotein implicated in the pathogenesis of odontogenic lesions (OL). It is localized at the membrane and cytoplasmic level, and its interaction with other proteins could trigger cell proliferation, invasion and migration. The main objective of this systematic review is to explore the immunoexpression pattern of podoplanin in OL. In addition, as secondary objectives, we aimed to compare the immunostaining intensity of PDPN in OL, to analyze its interaction networks by bioinformatic analysis and to highlight its importance as a potential diagnostic marker useful in the pathogenesis of OL. METHODS The protocol was developed following PRISMA and Cochrane guidelines. The digital search was performed in the databases: PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science and Google Schoolar from August 15, 2010 to June 15, 2023. We included cross-sectional and cohort studies that will analyze the pattern of PDPN immunoexpression in OL. Two investigators independently searched for eligible articles, selected titles and abstracts, analyzed full text, conducted data collection, and performed assessment of study quality and risk of bias. In addition, part of the results were summarized through a random-effects meta-analysis. STRING database was used for protein-protein interaction analysis. RESULTS Twenty-nine relevant studies were included. The ages of the subjects ranged from 2 to 89 years, with a mean age of 33.41 years. Twenty-two point two percent were female, 21.4% were male, and in 56.4% the gender of the participants was not specified. A total of 1,337 OL samples were analyzed for PDPN immunoexpression pattern. Ninety-four (7.03%) were dental follicles and germs, 715 (53.47%) were odontogenic cysts, and 528 (39.49%) were odontogenic tumors. Meta-analysis indicated that the immunostaining intensity was significantly stronger in odontogenic keratocysts compared to dentigerous cysts (SMD=3.3(CI=1.85-4.82, p=0.000*). Furthermore, bioinformatic analysis revealed that PECAM-1, TNFRF10B, MSN, EZR and RDX interact directly with PDPN and their expression in OL was demonstrated. CONCLUSIONS The results of the present systematic review support the unique immunoexpression of PDPN as a potential useful diagnostic marker in the pathogenesis of OL.
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Affiliation(s)
- Mario Alberto Alarcón-Sánchez
- Biomedical Science, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, 39090, Chilpancingo de los Bravo, Guerrero, Mexico.
| | - Getsemani Luna-Bonilla
- Biomedical Science, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, 39090, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Selenne Romero-Servin
- Oral and Maxillofacial Pathology, National School of Higher Studies, Leon Unit of the National Autonomous University of Mexico, Leon, Guanajuato, 37684, Mexico
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600 077, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Karegar St., Tehran, Iran.
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Aşır F, Özalp Z, Yülek ÖU, Erdemci F, Korak T, Taş F. CITED1 expression in odontogenic cysts. BMC Oral Health 2024; 24:782. [PMID: 38997708 PMCID: PMC11242007 DOI: 10.1186/s12903-024-04413-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/27/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. MATERIAL AND METHOD 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. RESULT Odontogenic keratocysts was imaged with 6-8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. CONCLUSIONS Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts.
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Affiliation(s)
- Fırat Aşır
- Department of Histology and Embryology, Medical Faculty, Dicle University, Diyarbakır, Turkey.
| | - Zeki Özalp
- Department of Oral, Dental and Maxillofacial Surgery, Siirt Oral and Dental Health Center, Siirt, Turkey
| | - Özden Uçtu Yülek
- Department of Pathology, Çanakkale 18 Mart University, Çanakkale, Turkey
| | - Fikri Erdemci
- Department of Histology and Embryology, Medical Faculty, Dicle University, Diyarbakır, Turkey
| | - Tugcan Korak
- Department of Medical Biology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Fatih Taş
- Department of Histology and Embryology, Medical Faculty, Siirt University, Siirt, Turkey
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Giri U, Kuppusami B, Arumugam SD, Nagaraj V. Unwarranted intrusion of odontogenic cyst into the maxillary antrum. BMJ Case Rep 2024; 17:e260671. [PMID: 38960423 DOI: 10.1136/bcr-2024-260671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
During the early growth phase, every individual is involved in a prolonged series of developmental processes in the maxillofacial region. Formation of cysts associated with such three-dimensional growth of the maxillofacial skeleton as well as deciduous and permanent tooth development. The origin of cystic jaw lesions may be odontogenic or non-odontogenic, developmental, or inflammatory and they are epithelial-lined or non-epithelial-lined cysts in nature. These cysts are considered to be aggressive cysts when they tend to grow rapidly and can cause significant damage to the surrounding bone and tissues if left untreated. Aggressive cystic lesion of the jaw needs special attention in order to prevent recurrences or even worsen and widespread disease. The management of the maxillary sinus requires individualisation based on its clinical and histopathological characteristics. Here, we report a case of an aggressive odontogenic cyst in a 30s-aged female patient in the left maxillary sinus with the literature review.
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Affiliation(s)
- Umamaheswari Giri
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, Pondicherry, India
| | - Bhuvanesh Kuppusami
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, Pondicherry, India
| | - Santha Devy Arumugam
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, Pondicherry, India
| | - Vezhavendhan Nagaraj
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, Pondicherry, India
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Bazin H, Felizardo R, Lescaille G, Rochefort J, Boussouni S. Use of Patient-Specific Titanium Plates to Prevent Iatrogenic Mandibular Fracture During the Surgical Removal of Dentigerous Cysts: A Two-Case Series. Cureus 2024; 16:e64520. [PMID: 39139352 PMCID: PMC11321448 DOI: 10.7759/cureus.64520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 08/15/2024] Open
Abstract
Dentigerous cysts, if left untreated, can grow significantly and weaken the mandible, posing risks of pathological or iatrogenic fracture. Treatment options may include decompression, marsupialization, and enucleation, which are available, with the choice being multifactorial and tailored to each case. This article describes the management of two complex dentigerous cysts at risk of fracture, one about an 84-year-old woman and the second about a 41-year-old man. The cysts and associated teeth were surgically removed, and simultaneously custom-made titanium osteosynthesis plates were placed to prevent per- and postoperative fracture risks. This approach appears to be indicated in cases where marsupialization or decompression is impossible and when there is a high risk of iatrogenic fracture.
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Affiliation(s)
- Hugo Bazin
- UFR Odontology, Faculté de Santé, Université Paris Cité, Paris, FRA
- Oral Medicine Service, Hôpital Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, FRA
| | - Rufino Felizardo
- UFR Odontology, Faculté de Santé, Université Paris Cité, Paris, FRA
- UMR 8045 BABEL, Centre National de la Recherche Scientifique, Université Paris Cité, Institut Médico-Légal, Paris, FRA
- Oral Medicine Service, Hôpital Rothschild, Assistance Publique Hôpitaux de Paris, Paris, FRA
| | - Geraldine Lescaille
- UFR Odontology, Faculté de Santé, Université Paris Cité, Paris, FRA
- Oral Medicine Service, Hôpital Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, FRA
| | - Juliette Rochefort
- UFR Odontology, Faculté de Santé, Université Paris Cité, Paris, FRA
- Oral Medicine Service, Hôpital Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, FRA
| | - Soufiane Boussouni
- UFR Odontology, Faculté de Santé, Université Paris Cité, Paris, FRA
- Oral Medicine Service, Hôpital Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, FRA
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Batra M, Mohod S, Sawarbandhe PA, Dadgal KV. Multilocular Radiolucent Pathology in the Body and Ramus of the Mandible: A Case Report. Cureus 2024; 16:e63722. [PMID: 39100023 PMCID: PMC11296215 DOI: 10.7759/cureus.63722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Odontogenic keratocyst (OKC), a type of epithelial developmental cyst, is frequently found in the jaw region. It has invasive characteristics such as satellite cysts, rapid progression, and tissue expansion. The OKC often favors the mandibular angle and ascending ramus. OKC symptoms include pain, swelling, displacement or malpositioning of adjacent teeth, and erosion or thinning of the limited or no bucco-lingual cortical expansion. There is radiographic evidence of a distinct, often scalloped, radiolucent lesion with a characteristic "soap bubble" or "honeycomb" appearance. This article reports a female patient, aged 40 years, with the main concern of unilateral pain and swelling of the mandibular left side and the provisional diagnosis of ameloblastoma. After histopathological examination, the final diagnosis of the patient was OKC. This article also includes previously published literature on OKC with differential diagnosis and relevant clinical and radiologic findings of the case.
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Affiliation(s)
- Mahek Batra
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapnil Mohod
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prem A Sawarbandhe
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Komal V Dadgal
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kulkarni S, Alampally H, Guddattu V, Rodrigues G, Carnelio S. Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal. F1000Res 2024; 11:1578. [PMID: 38895097 PMCID: PMC11184278 DOI: 10.12688/f1000research.126091.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 06/21/2024] Open
Abstract
Background Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Methods Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Results Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Conclusions Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.
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Affiliation(s)
- Spoorti Kulkarni
- Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Harishanker Alampally
- Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Vasudev Guddattu
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Gabriel Rodrigues
- Department of General Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sunitha Carnelio
- Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
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Eninanç İ, Mavi E. Three-dimensional evaluation of dentigerous cysts in the Turkish subpopulation. BMC Oral Health 2024; 24:677. [PMID: 38858676 PMCID: PMC11165842 DOI: 10.1186/s12903-024-04448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND To investigate the radiological and demographic features, types, distribution, and treatment methods of dentigerous cysts (DC). METHODS Panoramic radiographs and cone beam computed tomography (CBCT) images of patients diagnosed with DC based on biopsy results between January 2020 and December 2023 were examined. In patients from different age groups, the numbers, types and locations, and radiological features of DCs, associated changes in surrounding tissues, and treatment methods used were reviewed. RESULTS Among 95 patients with DC (66 males, 29 females), sex and age distributions were comparable between those with a single cyst (n = 86) and those with two cysts (n = 9). Of 104 DCs, 44 were central, 38 were lateral, and 22 were circumferential. DC types were not significantly affected by sex, age group, or anatomical location. Circumferential DCs often caused displacement of the mandibular canal inferiorly. While enucleation was preferred for the treatment of central DCs, circumferential DCs were treated with marsupialization. CONCLUSIONS In this study, which is the first to evaluate the DC types on CBCT images, the central type was the most common. Circumferential DCs were mostly treated with marsupialization. CBCT imaging can assist in determining DC types, and may provide guidance for treatment planning.
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Affiliation(s)
- İlknur Eninanç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey.
| | - Esra Mavi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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Fang S, Wang Y, He Y, Yu T, Xie Y, Cai Y, Li W, Wang Y, Huang Z. Machine Learning Model Based on Radiomics for Preoperative Differentiation of Jaw Cystic Lesions. Otolaryngol Head Neck Surg 2024; 170:1561-1569. [PMID: 38557958 DOI: 10.1002/ohn.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/01/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aims to use machine learning techniques together with radiomics methods to build a preoperative predictive diagnostic model from spiral computed tomography (CT) images. The model is intended for the differential diagnosis of common jaw cystic lesions. STUDY DESIGN Retrospective, case-control study. SETTING This retrospective study was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University (Guangzhou, Guangdong, China). All the data used to build the predictive diagnostic model were collected from 160 patients, who were treated at the Department of Oral and Maxillofacial Surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between 2019 and 2023. METHODS We included a total of 160 patients in this study. We extracted 107 radiomic features from each patient's CT scan images. After a feature selection process, we chose 15 of these radiomic features to construct the predictive diagnostic model. RESULTS Among the preoperative predictive diagnostic models built using 3 different machine learning methods (support vector machine, random forest [RF], and multivariate logistic regression), the RF model showed the best predictive performance. It demonstrated a sensitivity of 0.923, a specificity of 0.643, an accuracy of 0.825, and an area under the receiver operating characteristic curve of 0.810. CONCLUSION The preoperative predictive model, based on spiral CT radiomics and machine learning algorithms, shows promising differential diagnostic capabilities. For common jaw cystic lesions, this predictive model has potential clinical application value, providing a scientific reference for treatment decisions.
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Affiliation(s)
- Songling Fang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yuepeng Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yilin He
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Taihui Yu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yutong Xie
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, South Australia, Australia
| | - Yongkang Cai
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Wenhao Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Yan Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Guangdong, Guangzhou, China
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Miloglu O, Torenek-Agirman K, Dalci HL, Miloglu FD, Yildizbas Z. Diagnosis of common intraosseous lesions of the dentomaxillofacial region by chemometry-assisted FT-IR spectroscopy in dental tissue samples. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101706. [PMID: 38000770 DOI: 10.1016/j.jormas.2023.101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/11/2023] [Accepted: 11/21/2023] [Indexed: 11/26/2023]
Abstract
PURPOSES This study aimed to determine the differential diagnosis of three intraosseous lesions (odontogenic keratocyst (OKC), central giant cell granuloma (CGCG), and dentigerous cyst (DC)) of the dentomaxillofacial region with very similar radiological and clinical features by using chemometrics assisted FT-IR (Fourier transform infrared) spectroscopy in tissue samples. METHODS Tissue samples (exposed to formaldehyde for a similar time) of 20-micron thickness belonging to 19 intraosseous lesions diagnosed histopathologically were obtained from the pathology laboratory. The samples were analyzed by FT-IR spectroscopic method using the 400-4000 cm-1 wavenumber range, and the obtained spectra of the samples were evaluated using the orthogonal partial least squares discriminant analysis (OPLS-DA) algorithm. RESULTS The intraosseous lesions with different histopathological diagnoses were accurately and precisely clustered with different FT-IR bands corresponding to the main molecular vibrations, especially the phosphodiester region, of the tissue components using the proposed model with 3 latent variables. CONCLUSIONS The model showed high sensitivity and specificity. The present study is the first to report the elucidation of clear spectral differences between similar lesions in the maxillofacial region. In the future, the FT-IR method may be used in the non-destructive classification of similar lesions in the maxillofacial region as an alternative to histopathological evaluation.
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Affiliation(s)
- Ozkan Miloglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum 25240, Turkey.
| | - Kubra Torenek-Agirman
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum 25240, Turkey
| | - Hatice Lamia Dalci
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum 25240, Turkey
| | - Fatma Demirkaya Miloglu
- Department of Analytical Chemistry, Faculty of Pharmacy, Ataturk University, Erzurum 25240, Turkey
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Tezuka Y, Oneyama T, Kanri Y, Toya S, Okada Y, Ogura I. A case of odontogenic keratocyst in the buccal space: characterization by multimodality imaging including computed tomography, diffusion-weighted magnetic resonance imaging, and ultrasonography. Oral Radiol 2024; 40:304-309. [PMID: 37725221 DOI: 10.1007/s11282-023-00712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Odontogenic keratocyst (OKC) is a relatively common non-inflammatory jaw lesion. OKC is known to occur most often in the mandibular angle and mandibular ramus, but rarely outside the bone. In this report, we describe characteristic multimodality imaging of OKC in the buccal space, especially diffusion-weighted MR imaging (DWI) with apparent diffusion coefficient (ADC) mapping, extra-oral and intra-oral ultrasonography. On clinical examination, an approximately 20 mm in diameter mass with elastic hardness was found the left side of the buccal area. Contrast-enhanced CT showed areas of internal non-contrast lesions in the left buccal space. On T1-weighted image, the mass showed multilocular high signal intensity, and homogeneous internal. T2-weighted images revealed high signal at the marginal part and slightly median signal in the internal part. STIR images revealed a heterogeneous high signal in the interior. Furthermore, DWI and ADC map showed high signal and moderate-to-low signal intensity, respectively. ADC value of the lesion was 1.55 × 10-3 mm2 s-1. On extra-oral ultrasonography, the tumor showed clear boundary, hypoechoic, homogeneous internal architecture and vascular signals, and heterogeneous hard of the lesion. On intra-oral ultrasonography also showed clear boundary, hypoechoic, homogeneous internal architecture, heterogeneous hard of the tumor, and back echo enhance. The histopathologic diagnosis based on a full excisional specimen was odontogenic keratocyst. This case suggests that multimodality imaging, especially MR imaging with ADC and DWI, and extra and intra-oral ultrasonography with color Doppler imaging and elastography, could be effective for evaluating buccal lesions.
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Affiliation(s)
- Yasuhito Tezuka
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan.
| | - Takahiro Oneyama
- Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Yoriaki Kanri
- Department of Pathology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Shuji Toya
- Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Yasuo Okada
- Department of Pathology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Ichiro Ogura
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
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Yildirimyan N, Altay MA, Özbudak İH. Can CAPRIN-1 Be Responsible for the Recurrence Potential of Odontogenic Keratocysts? J Oral Maxillofac Res 2024; 15:e4. [PMID: 39139357 PMCID: PMC11318659 DOI: 10.5037/jomr.2024.15204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 06/29/2024] [Indexed: 08/15/2024]
Abstract
Objectives The purpose of this retrospective study is to compare dentigerous cysts and odontogenic keratocysts for cytoplasmic activation/proliferation - associated protein-1 antibodies via immunohistochemical staining to obtain a new perspective about the specific behavioural characteristics of odontogenic keratocysts at the molecular level. Material and Methods Forty dentigerous cysts (DC) and forty odontogenic keratocysts (OKC) tissue samples were examined using immunohistochemical staining to detect cytoplasmic activation/proliferation - associated protein-1 (CAPRIN-1) antibodies. Nuclear and/or cytoplasmic staining was evaluated as "positive". Cell staining rate (%) and cell staining intensity were determined, and a staining intensity distribution (SID) score was calculated for each sample. Cases were considered "negative" if they showed no staining for CAPRIN-1 antibodies, thus were given a SID score of zero. According to the SID scores, the expression levels were rated as negative, mild, moderate, or high. Results Of 80 samples, 16 that could adversely affect immunohistochemical evaluation were excluded. Ten negative, 21 positive and three negative, 30 positive CAPRIN-1 expressions were observed in DC and OKC groups, respectively. The difference between the negative and positive cases within groups was significant only in the OKC group (P = 0.000). The SID score range and mean were 0 to 160 and 31.1 (SD 35.7) for DC and 0 to 160 and 57.3 (SD 42.3) for OKC groups. CAPRIN-1 expression was significantly higher in the OKC group (P = 0.043). Conclusions The molecular basis for increased mitotic activity, high recurrence rates or presence of satellite cysts in odontogenic keratocysts may be attributed to the expression of cytoplasmic activation/proliferation - associated protein-1.
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Affiliation(s)
- Nelli Yildirimyan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul Medipol University, IstanbulTürkiye.
| | - Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, AntalyaTürkiye.
| | - İrem Hicran Özbudak
- Department of Pathology, School of Medicine, Akdeniz University, AntalyaTürkiye.
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15
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Singh HP, Chahal GK, Sharma G, Gandhi P. A systematic review on odontogenic cysts and tumours. J Oral Maxillofac Pathol 2024; 28:268-274. [PMID: 39157825 PMCID: PMC11329078 DOI: 10.4103/jomfp.jomfp_460_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 08/20/2024] Open
Abstract
Background There are still certain gaps in the research that need to be filled despite the fact that numerous studies have looked into the transformation of odontogenic cysts into neoplastic lesions. To identify pertinent research that had been published and to synthesise the available data and provide an overview of the current body of knowledge, this review also sought to do so. Materials and Methods Adopting the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a search strategy was implemented across several online databases to search for relevant articles as per the defined selection criterion. Results After the search strategy was complete, 31 studies were chosen. Men tended to have more cancer than women. Swelling and discomfort were the primary pathology-related complaints. Although two cases were not detailed, radiologically, well-defined and poorly defined borders were reported in 18 and 11 participants, respectively. Squamous cell carcinoma with good differentiation (n = 12) was the most common cancer kind. More than 74% of patients were still living 6 months to 10 years following follow-up, four (12.90%) experienced recurrences and/or metastases and two (6.45%) experienced a disease-related mortality between 2 months and a year. Conclusion Prompt surgical follow-ups and cautious excision of odontogenic cysts are essential to avoiding neoplastic change and recurrence. Future research is required to look at possible reasons why odontogenic cysts can convert neoplastically.
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Affiliation(s)
- Harkanwal P. Singh
- Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, India
| | - Gagandeep K. Chahal
- Department of Prosthodontics, National Dental College Derra Bassi, Mohali, Punjab, India
| | - Geeta Sharma
- Department of Oral Pathology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Piyush Gandhi
- Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, India
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La Rosa GRM, Priolo CY, Abiad RS, Romeo VR, Ambu E, Pedullà E. Assessment of bone regeneration after maxillary radicular cyst enucleation with or without bone grafting materials: a retrospective cohort study. Clin Oral Investig 2024; 28:213. [PMID: 38480533 PMCID: PMC10937747 DOI: 10.1007/s00784-024-05612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. RESULTS Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). CONCLUSION Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. CLINICAL RELEVANCE Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Carlotta Ylenia Priolo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roula S Abiad
- Endodontic Division, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Virginia Rosy Romeo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Emanuele Ambu
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Wongrattanakarn S, Trachoo V, Kaboosaya B, Charoenlarp P, Chongruangsri NN, Promoppatum P. Factors affecting the reduction rate of odontogenic cysts after decompression based on 3-dimensional volumetric analysis. Imaging Sci Dent 2023; 53:313-323. [PMID: 38174041 PMCID: PMC10761289 DOI: 10.5624/isd.20230083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This study aimed to investigate the potential factors that could affect the reduction rate of odontogenic cysts following decompression using cone-beam computed tomography (CBCT) for 3-dimensional volumetric analysis. Materials and Methods The study sample consisted of CBCT images of 41 individuals who underwent decompression of odontogenic cysts at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, between 2010 and 2022. Preoperative and postoperative CBCT results were collected, and a volumetric analysis was conducted to evaluate the differences in the reduction rate and the percentage of volume reduction of cystic lesions based on different parameters. Correlations between these parameters were analyzed to determine associations. Results In this study, the average time of decompression for odontogenic cysts was 316 days. Males demonstrated a higher reduction rate than females (P<0.05). The reduction rate was directly proportional to initial cyst volume, with higher reduction rates for cysts with large initial volume than those with small initial volume (P<0.05). Spearman's rank correlation coefficient indicated a weak positive correlation between the initial cyst volume and the duration of decompression. Additionally, a strong positive correlation was observed between the initial volume and the reduction rate. Conclusion Knowledge of the reduction rate of odontogenic cysts is vital for surgeons to evaluate the duration of decompression before enucleation and to determine a definitive treatment plan. Sex and initial lesion volume had significant effects on the reduction rate.
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Affiliation(s)
- Sarawut Wongrattanakarn
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Vorapat Trachoo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pornkawee Charoenlarp
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Net-nada Chongruangsri
- Somdech Phra Pinklao Hospital, Naval Medical Department, Royal Thai navy, Bangkok, Thailand
| | - Patcharapit Promoppatum
- Department of Mechanical Engineering, Faculty of Engineering, King Mongkut’s University of Technology Thonburi, Bangkok, Thailand
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Mohamed AA, Babiker AA, Khalfallah MS, Eltohami YI. Odontogenic Keratocysts: Presentation and Surgical Outcome in a Sample of Sudanese Patients. Int J Dent 2023; 2023:8763948. [PMID: 37868107 PMCID: PMC10586893 DOI: 10.1155/2023/8763948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Background Odontogenic keratocyst (OKC) is a benign intraosseous lesion relatively frequent in the oral cavity. It has a locally aggressive behavior and exhibits a high propensity to recur after treatment. The present study aimed to investigate the clinicoradiographic presentations and outcomes of surgical treatment of OKC at Khartoum Teaching Dental Hospital. Material and Methods. Fifty-five cases of OKC files at the Department of Oral and Maxillofacial Surgery in Khartoum Teaching Hospital between 2012 and 2022 were reviewed and studied using a descriptive prospective cross-sectional study. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 27. Results Out of 55 cases studied, the mean age at the time of diagnosis was 30 ± 17.6 years; of them, 28 (50.9%) were males and 27 (49.1%) were females. The most common clinical manifestation was swelling (34.9%), followed by pain (28.0%). Sixty-five percent of the OKCs were located in the posterior mandible, and multilocular radiolucency (73.6%) was the most prevalent radiological finding. Enucleation with Carnoy's solution (CS) (55.2%) was the most common surgical modality that was used in more than half the patients, and only six patients had a recurrence. Marsupialization and segmental resection had no recurrence, while marginal resection and curettage had the highest recurrence rate of 20%. Patients with consanguineous parents had a higher recurrence rate (15%) compared with patients who had nonconsanguineous parents (8.6%). None of the patients died or had a malignant transformation. Conclusion The most common location for the cyst was the mandible, and multilocular radiolucency was the most prevalent radiological finding. Enucleation with CS was the most commonly used surgical modality, used in more than half of the patients, with only six patients experiencing recurrence.
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Affiliation(s)
- Alaa Ayman Mohamed
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Abdualhameed Abbas Babiker
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Mazin Salah Khalfallah
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Yousif Idris Eltohami
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Sun R, Zheng LW, Sun YQ, Li TT, Ren JG, Zhao JH. Is it safe and effective to extract impacted maxillary tooth adjacent to maxillary sinus via submaxillary sinus membrane space approach?-a randomized controlled trial. Clin Oral Investig 2023; 27:6081-6087. [PMID: 37624523 DOI: 10.1007/s00784-023-05223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To evaluate the clinical outcomes following extraction of impacted maxillary tooth adjacent to maxillary via submaxillary sinus membrane space approach. MATERIALS AND METHODS Seventy-two patients were enrolled in our study. The positions of the maxillary impacted tooth were confirmed by cone-beam computed tomography (CBCT). Cases were randomly divided into two groups: the "submaxillary sinus membrane space approach" was applied in the new method (NM) group, and the conventional "avoid maxillary sinus membrane exposure" strategy was executed in the traditional method (TM) group. The clinical and follow-up data were recorded. RESULTS The duration of the procedure in the TM group was significantly longer than those in the NM group (P < 0.05). Four teeth were accidentally displaced into the maxillary sinus with MSM perforation. The MSM perforation rate was slightly higher in the TM group than in the NM group, however, without significant difference between the two groups (8/36 vs. 3/36, P = 0.19). The maxillary sinus membrane perforation was associated with the displacement of tooth into the maxillary sinus (OR = 16.2, P = 0.026). The root tip exposure of the adjacent tooth was significantly higher in the TM group than in the NM group (10/36 vs. 1/36, P = 0.006). The incidence of reduced pulp vitality of the adjacent tooth was significantly higher in the TM group (10/36 vs. 1/36, P = 0.006), and it was associated with the exposure of the root tip intraoperatively (OR = 456.5, P < 0.001). The incidence of external root resorption was significantly lower in the NM group, and there was no significant association with the root exposure intraoperatively (OR = 3.7, P = 0.47). CONCLUSIONS Submaxillary sinus membrane space approach is a safe and efficient approach in extraction of impacted maxillary tooth. It is an alternative way for cases which are in close proximity to the maxillary sinus. CLINICAL RELEVANCE A novel method to extract impacted maxillary tooth adjacent to maxillary sinus.
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Affiliation(s)
- Rui Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China
| | - Lin-Wei Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China
| | - Yu-Qi Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China
| | - Ting-Ting Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China
| | - Jian-Gang Ren
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China.
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China.
| | - Ji-Hong Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China.
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, No. 237 Luoyu Road, Wuhan, 430079, China.
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20
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Taxis J, Platz Batista da Silva N, Grau E, Spanier G, Nieberle F, Maurer M, Spoerl S, Meier JK, Ettl T, Reichert TE, Ludwig N. Novel Three-Dimensional and Non-Invasive Diagnostic Approach for Distinction between Odontogenic Keratocysts and Ameloblastomas. Dent J (Basel) 2023; 11:193. [PMID: 37623289 PMCID: PMC10453484 DOI: 10.3390/dj11080193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Aim of this study was to demonstrate the diagnostic ability to differentiate odontogenic keratocysts (OKCs) from ameloblastomas (AMs) based on computed tomography (CT) or cone beam computed tomography (CBCT) scans. Preoperative CT and CBCT scans from 2004 to 2019 of OKCs and AMs were analyzed in 51 participants. Lesions were three-dimensionally (3D) assessed and Hounsfield units (HU) as well as gray scale values (GSV) were quantified. Calculated HU spectra were compared within the same imaging modalities using unpaired t-tests and correlated with participants characteristics by calculating Pearsons correlation coefficients. Within the CT scans, AMs had highly significantly higher HU values compared to OKCs (43.52 HU and 19.79 HU, respectively; p < 0.0001). Analogous, within the CBCT scans, AMs had significantly higher GSV compared to OKCs (-413.76 HU and -564.76 HU, respectively; p = 0.0376). These findings were independent from participants' gender and age, anatomical site, and lesion size, indicating that the HU- and GSV-based difference reflects an individual configuration of the lesion. HU and GSV spectra calculated from CT and CBCT scans can be used to discriminate between OKCs and AMs. This diagnostic approach represents a faster and non-invasive option for preoperative diagnosis of such entities and has potential to facilitate therapeutic decision making.
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Affiliation(s)
- Juergen Taxis
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | | | - Elisabeth Grau
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, Liebigstraße 12, 04103 Leipzig, Germany;
| | - Gerrit Spanier
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Felix Nieberle
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Michael Maurer
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Steffen Spoerl
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Johannes K. Meier
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Tobias Ettl
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Torsten E. Reichert
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Nils Ludwig
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
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Marelli S, Ghizzoni M, Pellegrini M, Scribante A, D'Ambrosio G, Sfondrini D. Lung Cancer Cells Infiltration into a Mandibular Follicular Cyst. Case Rep Dent 2023; 2023:7297821. [PMID: 37492277 PMCID: PMC10365922 DOI: 10.1155/2023/7297821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/25/2023] [Accepted: 07/04/2023] [Indexed: 07/27/2023] Open
Abstract
Introduction The oral cavity is a rare site for other organs' tumor metastases. The incidence rate ranges from 1% to 3% of all oral malignancies. Metastases more frequently localize in the mandible, especially in the molar area. Metastases within odontogenic cysts are extremely rare, thus in the literature, only a few cases have been reported. The follicular cyst is one of the most frequent cysts of the jaws. Radiologically it shows as a unilocular lesion with a sclerotic border, characterized by a homogenous radiolucency that incorporates the crown of the unerupted tooth. Methods A 76-year-old female patient, affected by stage IV of lung adenocarcinoma, reported pain on the left mandible border, alongside lip dysesthesia. The ortho-panoramic radiograph showed a follicular cyst in the posterior left side of the mandible, with involvement of the ascending branch region. The cyst was surgically removed together with the impacted tooth. A histopathological examination of the specimen confirmed the diagnostic suspect of a follicular cyst, but in the cystic wall, focal infiltration of epithelial neoplastic cells was also found. The immunohistochemical analysis showed the presence of three different markers: CK 7+, TTF1+/-, and P40-. These markers identify the cells as metastatic lung carcinoma. Results Secondary tumor spreading in the jaws' area is rare (3% of all malignant lesions). Despite odontogenic cysts can undergo a dysplastic transformation (affecting the epithelial covering in ≤1% of the cases), infrequently these neoplastic cells can be related to secondary tumor spreading in a cystic wall. This report describes a metastatic localization within a mandibular follicular cyst. Conclusions Malignant cancers' metastasis in the oral district remains a rare and unexplored condition, especially when metastases are located in odontogenic cysts. In this circumstance, surgical removal and histopathological examination are strongly recommended.
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Affiliation(s)
- Stefano Marelli
- Maxillo-Facial Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, Milan 20122, Italy
| | - Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Gioacchino D'Ambrosio
- Department of Molecular Medicine, Anatomic Pathology Unit, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia 27100, Italy
| | - Domenico Sfondrini
- Maxillo-Facial Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
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22
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Visicchio Cusati S, Manresa Bruguera C, Gallego Mengod V, Villarroel-Dorrego M. [Stafne's bone cavity in a venezuelan population. Prevalence study]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e162. [PMID: 38287993 PMCID: PMC10809964 DOI: 10.21142/2523-2754-1103-2023-162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/31/2023] [Indexed: 01/31/2024] Open
Abstract
Objective To determine the prevalence of the Stafne´s bone cavity in a Venezuelan population and to characterize it radiographically. Method Descriptive and cross-sectional study. Of 500 panoramic radiographs, those that had radiolucent images in the mandible, circumscribed and not associated with any dental organ, as well as those that could correspond to the mandibular fossa, were selected. Results were collated and discrepancies resolved by consensus. The selected ones were characterized radiographically. The variables were compared using the student's t test for equality of means, applying the Levene test, values of p <0.05 were considered statistically significant. Results Of the 500 radiographs evaluated, 22 presented images corresponding to deep mandibular fossa or Stafne bone cavities, which represented 4.4%. Of which 5 presented bilaterally (22.7%) and 17 (77, 3%) unilocularly. Among the radiographic characteristics studied, images located in the posterior area (81.81%), without sclerosis (54.54%), continuous to the basal mandibular area, round shape (59.09%) and partial radiolucency (72%) were presented with a higher prevalence). They were more common in male patients with 63.63%. Conclusions Our results show a higher prevalence of Stafne's bone cavity in a Venezuelan population than that reported in other studies in other populations.
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Affiliation(s)
- Sabrina Visicchio Cusati
- Facultad de Odontología, Universidad Santa María. Caracas, Venezuela. Universidad Santa María Facultad de Odontología Universidad Santa María Caracas Venezuela
| | - Carlos Manresa Bruguera
- Odontólogo, Esp. Cirugía Maxilofacial, MSc. Hospital General del Oeste Dr. José Gregorio Hernández. Caracas, Venezuela. Hospital General del Oeste Dr. José Gregorio Hernández Caracas Venezuela
| | - Valeria Gallego Mengod
- Odontólogo. Esp. Radiología Oral y Maxilofacial, Universidad Santa María. Caracas, Venezuela. Universidad Santa María Universidad Santa María Caracas Venezuela
| | - Mariana Villarroel-Dorrego
- PhD Patología Bucal y Maxilofacial, Universidad Central de Venezuela. Caracas, Venezuela. Universidad Central de Venezuela Universidad Central de Venezuela Caracas Venezuela
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Khalifa C, Garma M, Mabrouk R, Slim A, Bouguezzi A, Selmi J. Conservative management of dentigerous cyst in children: Report of two clinical cases. Clin Case Rep 2023; 11:e7051. [PMID: 37064731 PMCID: PMC10090943 DOI: 10.1002/ccr3.7051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 04/18/2023] Open
Abstract
The dentigerous cyst is the second most common odontogenic. The prevalence rates ranging from 0.8% to 3.6% in the general population. It affects people especially at the second and third decade of life with a male predilection. It presents a preference for the mandibular region particularly for the second lower premolar. Surgical marsupialization or decompression are the most conservative treatment modalities as it prevents the risks of cyst removal as nerve injuries and preserves the unerupted tooth. Two clinical cases of two young patients presenting a dentigerous cyst involving impacted teeth, which were successfully treated by decompression will be reported in order to highlight the benefits and limits of cyst decompression as well as detailing its operating protocol and its instructions.
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Affiliation(s)
- Chaima Khalifa
- Department of Oral medicine and Oral SurgeryDental Clinic of MonastirMonastirTunisia
- Faculty of Dental Medicine, Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11)University of MonastirMonastirTunisia
| | - Maroua Garma
- Department of Oral medicine and Oral SurgeryDental Clinic of MonastirMonastirTunisia
- Faculty of Dental Medicine, Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11)University of MonastirMonastirTunisia
| | - Rihab Mabrouk
- Department of Pediatric and Preventive DentistryDental Clinic of MonastirMonastirTunisia
| | - Afef Slim
- Department of Oral medicine and Oral SurgeryDental Clinic of MonastirMonastirTunisia
- Faculty of Dental Medicine, Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11)University of MonastirMonastirTunisia
| | - Adel Bouguezzi
- Department of Oral medicine and Oral SurgeryDental Clinic of MonastirMonastirTunisia
- Faculty of Dental Medicine, Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11)University of MonastirMonastirTunisia
| | - Jamil Selmi
- Department of Oral medicine and Oral SurgeryDental Clinic of MonastirMonastirTunisia
- Faculty of Dental Medicine, Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11)University of MonastirMonastirTunisia
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Viggness A, Priyaa S, Pethagounder Thangavelu R, Fenn SM, Rajaram Mohan K. The Three-Dimensional Evaluation of Radicular Cyst by Cone-Beam Computed Tomography. Cureus 2023; 15:e36162. [PMID: 37065301 PMCID: PMC10102671 DOI: 10.7759/cureus.36162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 03/17/2023] Open
Abstract
A radicular cyst is the most typical odontogenic cyst affecting the human jaws. A radicular cyst is frequently asymptomatic and is discovered accidentally during a radiological procedure. Radicular cyst most commonly occurs during the third and fourth decades of life. The patient affected by a radicular cyst usually gives a history of trauma, and they may even not be aware of the occurrence of the traumatic episode. Such a case of a Radicular cyst that occurred in a 22-year-old-young female who did not follow up further for root canal treatment was radiographically evaluated in three-dimensional view with the help of cone-beam computed tomography.
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Wang Y, Tang F, Li Z, Chen Q. Pseudocysts of the jaw: a retrospective study of 41 cases from a single institution. BMC Oral Health 2023; 23:87. [PMID: 36774464 PMCID: PMC9922462 DOI: 10.1186/s12903-023-02741-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/12/2023] [Indexed: 02/13/2023] Open
Abstract
OBJECTIVE The purpose of this retrospective study was to investigate and compare the clinical, radiographic, pathological, pathogenesis, and therapeutic features of simple bone cysts (SBCs) and aneurysmal bone cysts (ABCs) of the jaw. METHODS 35 patients with SBCs and 6 patients with ABCs who received treatment at the Department of Oral and Maxillofacial Surgery, Zhejiang University School of Medicine from 2017 to 2022 were followed up and reviewed retrospectively. RESULTS The study included 41 patients, accounting for 2.14% of all jaw pathologies, with 35 patients having SBCs and 6 patients having ABCs; their average ages were 26.63 ± 13.62 years and 17.83 ± 7.88 years, respectively. The prevalence of SBC and ABC did not differ significantly by sex. The mandible was the most vulnerable area to be involved. Only 5.71% (2/35) of patients with SBCs and 16.7% (1/6) of patients with ABCs reported histories of previous trauma in the same region of the pseudocysts. A total of 42.86% (15/35) of SBC cases and 66.67% (4/6) of ABC cases had malocclusions. The radiographic features of pseudocysts varied in shape, were associated with the root, and unilocular or multilocular. All patients had curettage with or without bone graft or substitute implantation, and recurrences did not occur in 94.29% (33/35) of SBC patients and 100% (6/6) of ABC patients after a mean follow-up time of 26.23 ± 15.47 months and 21.67 ± 19.75 months, respectively. CONCLUSIONS Pseudocysts, including SBCs and ABCs, are benign osteolytic lesions without an epithelial lining that occur occasionally in the jaw, mostly in adolescents and young adults, and their incidence did not significantly differ by sex. The most vulnerable site of involvement is the mandible, and they are generally not overtly aggressive. Trauma has a less significant role in pseudocysts, but minor trauma, such as malocclusion, has the potential to influence pseudocyst development. The clinical presentation of pseudocysts lacks specificity, and most patients are asymptomatic and found incidentally during radiographs. Dental panoramic radiographs and CBCT cannot accurately distinguish between SBC and ABC, and the final diagnosis depends on pathological diagnosis. Curettage combined with bone grafting is currently the best treatment for both, with a 5.71% (2/35) recurrence rate for SBC and no recurrence found for ABC.
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Affiliation(s)
- Yahui Wang
- grid.13402.340000 0004 1759 700XStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Fan Tang
- grid.13402.340000 0004 1759 700XStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Zhiyong Li
- grid.13402.340000 0004 1759 700XStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
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Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020335. [PMID: 36832466 PMCID: PMC9954982 DOI: 10.3390/children10020335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.
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Sulistyani LD, Iskandar L, Zairinal VN, Arlen AK, Purba F, Ariawan D. Transformation of Odontogenic Cysts to Neoplasms - A Systematic Review. Ann Maxillofac Surg 2023; 13:76-80. [PMID: 37711539 PMCID: PMC10499293 DOI: 10.4103/ams.ams_226_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/08/2023] [Accepted: 04/27/2023] [Indexed: 09/16/2023] Open
Abstract
Background Odontogenic cysts have the potential to transform into neoplasms. However, the characteristics of those which transformed to neoplastic tissues have not been well described and the exact causes of that phenomenon are not yet clear. Objectives This study aims to describe characteristics of odontogenic cysts that transformed into neoplasms and to look for their potential etiologies. Data Sources English-written studies indexed in PubMed, Science Direct, and Proquest were assessed using keywords verified by Medical Subject Headings: 'Odontogenic Cyst' and 'Neoplastic Cell Transformation'. Study Eligibility Criteria Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were used as guidance. Participants Following steps in PRISMA guidelines, 19 articles were fully reviewed (three case series and 16 case reports) with 27 subjects of 16 males (59%) and 11 females (41%) from 15 to 86 years old. Results Cystic origins were eight dentigerous cysts, four odontogenic keratocysts, two residual cysts, one radicular cyst, one calcifying odontogenic cyst, one follicular cyst, one glandular odontogenic cyst, and nine unspecified odontogenic cysts that transformed to ameloblastoma (3 cases) and carcinoma (24 cases). Limitations Neoplastic transformations of odontogenic cysts arose from epithelial remnants of inadequate odontogenic cyst removal and chronic inflammation due to infection. However, the exact causes of their transformations remain unclear. Conclusions Therefore, careful removal of odontogenic cysts and regular postoperative follow-ups are key to prevent recurrence and neoplastic transformation. Future studies are needed to investigate potential causes of neoplastic transformation of odontogenic cysts.
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Affiliation(s)
- Lilies Dwi Sulistyani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
| | - Lilis Iskandar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
| | - Vaza Nadia Zairinal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
| | - Antonius Kevin Arlen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
| | - Fatmasari Purba
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
| | - Dwi Ariawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Indonesia, West Java, Indonesia
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Sohn C, Ryu J, Nam I, Shin SH, Lee JY. Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases. J Korean Assoc Oral Maxillofac Surg 2022; 48:342-347. [PMID: 36579905 PMCID: PMC9807379 DOI: 10.5125/jkaoms.2022.48.6.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.
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Affiliation(s)
- Changmo Sohn
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jihye Ryu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Inhye Nam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae-Yeol Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea,Jae-Yeol Lee, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea, TEL: +82-55-360-5100, E-mail: , ORCID: https://orcid.org/0000-0003-0678-2499
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Li K, Xu W, Zhou T, Chen J, He Y. The radiological and histological investigation of the dental follicle of asymptomatic impacted mandibular third molars. BMC Oral Health 2022; 22:642. [PMID: 36567318 PMCID: PMC9791750 DOI: 10.1186/s12903-022-02681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The indication for removal of asymptomatic fully impacted third molars is still controversial. In this study, radiological and histological investigation of the dental follicle of asymptomatic impacted mandibular third molars was performed, aiming to provide a reference for clinical prophylactic extraction of these teeth. METHODS Patients with impacted mandibular third molars were included and the maximum width of the dental follicle around the crown was measured in horizontal, sagittal and coronal sections by cone beam computed tomography. The dental follicles were stained with haematoxylin-eosin, analysed by a pathologist and classified as normal, inflammatory or cystic. A Chi-squared test was used to analyse the association of the incidence of inflammation and cysts with the clinical variables of the impacted mandibular third molars. RESULTS Thirty-seven samples were normal dental follicles; 52 samples showed inflammatory infiltration with an incidence of 57.14%; 2 samples with a maximum dental follicle width of 2-3 mm were diagnosed as odontogenic cysts, and the incidence was 2.20%. There was no significant difference in the incidence of inflammatory and cystic dental follicles between males and females, or between different age groups (P > 0.05). With an increase of the maximum width of the dental follicle, there was a rise in the incidence and degree of infiltration of chronic nonspecific inflammation. CONCLUSION Asymptomatic impacted mandibular third molars tend to be extracted, especially for teeth with a 2-3 mm maximum width of the dental follicle on radiological examination.
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Affiliation(s)
- Kuncai Li
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Wei Xu
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Tiejun Zhou
- grid.488387.8Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Junliang Chen
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
| | - Yun He
- grid.410578.f0000 0001 1114 4286Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China ,Oral and Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, China
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Use of Leukocyte-PlateletRich Fibrin in Conservative Management of Odontogenic Keratocyst: A Case Report. World J Plast Surg 2022; 11:98-102. [PMID: 36694672 PMCID: PMC9840757 DOI: 10.52547/wjps.11.3.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
A 29-year-old female patient was referred to the Department of Oral and Maxillofacial Surgery in Taleghani Hospital of Shahid Beheshti University of Medical Science, Tehran, Iran, in 2019, complaining of increased volume and pain in the posterior mandibular region. Cone-beam computed tomography and multislice computed tomography were performed, and an incisional biopsy was done. The histopathologic examination confirmed the diagnosis of Odontogenic Keratocyst (OKC). Surgical treatment was performed with marsupialization. After a year of follow-up, the resultant small-sized cyst was curetted, and Leukocyte-PlateletRich Fibrin (LPRF) was placed in the bony depression. The significant healing of the lesion was noted on regular follow-up visits with complete resolution at 15 months. This report showed that the application of LPRF might accelerate the healing of soft tissues and bone regeneration with no inhibitory effect on the natural healing process.
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Vizuete-Bolaños MX, Salgado-Chavarria F, Ramírez-Martínez CM, Ramos-Nieto JDJ, Vazquez-Dávalos NM. Compound odontoma associated with a calcifying odontogenic cyst. Case report and systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e97-e105. [PMID: 34687949 DOI: 10.1016/j.jormas.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
The objectives of the present study were to comprehensively evaluate all the published cases on compound odontoma associated with calcifying odontogenic cyst (COaCOC) in the English literature and to describe the clinical, imaging and therapeutic variables for this condition. In August 2020, an electronic search of the PubMed / MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases was carried out. The eligibility criteria included publications with enough information to confirm the diagnosis. Furthermore, we present a clinical case of a 16-year-old male patient with OCCaC, who was treated with enucleation, obtaining favorable and functional results. A total of 32 cases reported in the literature that met the inclusion and exclusion criteria, including ours, were analyzed and discussed. The mayority of the patients were women (n = 17) with an average age of 14.4 years, the maxilla was the most affected bone (n = 22) and the maxillary anterior region was the area with the highest number of cases (n = 18), the main clinical presentations were the volume increase (n = 14) and asymptomatic (n = 14). The choice treatment was enucleation (n = 26) and, in most cases, no recurrence was reported (n = 20). This study allows to update the characteristics of the OCCaC, giving an effective vision of how to treat this rare pathological association made up of two conditions that are completely different from each other.
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Affiliation(s)
- Marco Xavier Vizuete-Bolaños
- Resident of Oral and Maxillofacial Surgeon, National Autonomous University of Mexico - UNAM, City of Mexico - Mexico.
| | - Fabiola Salgado-Chavarria
- Oral and Maxillofacial Surgeon, National Autonomous University of Mexico - UNAM, City of Mexico - Mexico
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Wang J, Yao QY, Zhu HY. Efficacy of bone grafts in jaw cystic lesions: A systematic review. World J Clin Cases 2022; 10:2799-2808. [DOI: 10.12998/wjcc.v10.i9.2799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone grafts have been applied for many years in orthopedic surgery to assist with bone repair for defects or bone discontinuity caused by trauma and tumors as well as periodontal defects. Jaw cysts are another common benign disease of the maxillofacial region which may lead to pathological bone fracture, loss of teeth, and infection. However, whether bone grafts are beneficial for bone regeneration in jaw cystic lesions and when bone grafts should be used remains unclear.
AIM To study the efficacy of bone grafts compared to spontaneous healing in the treatment of jaw cystic lesions.
METHODS A literature search was performed in Medline, Cochrane Library and Embase to identify related articles published in English in the last ten years. The following key words and MeSH terms were used: “jaw cyst”, “cystic lesion”, “odontogenic cyst”, “periapical cyst”, “dentigerous cyst”, “follicular cyst”, “keratocyst”, “treatment”, “surgery”, “bone graft”, “enucleation”, “cystectomy”, and “bone regeneration”. Case reports, clinical trials, clinical studies, observational studies and randomized controlled trials were included. Study quality was evaluated.
RESULTS Ten studies (n = 10) met the inclusion criteria. Five studies reported spontaneous bone healing after enucleation, three studies investigated the efficacy of various bone grafts, and two randomized comparative studies focused on the comparison between spontaneous healing and bone grafting. Over 90% of bone regeneration occurred within 6 mo after bone grafting. The bone regeneration rate after cystectomy showed great variation, ranging from 50% to 100% after 6 mo, but reaching over 90% after 12 mo.
CONCLUSION While the long-term superiority of bone grafting compared with spontaneous healing after cystectomy is unclear, bone grafts accelerate the process of healing and significantly increase bone quality.
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Affiliation(s)
- Jin Wang
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Qiu-Yun Yao
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hui-Yong Zhu
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Cao YT, Gu QH, Wang YW, Jiang Q. Enucleation combined with guided bone regeneration in small and medium-sized odontogenic jaw cysts. World J Clin Cases 2022; 10:2764-2772. [PMID: 35434093 PMCID: PMC8968821 DOI: 10.12998/wjcc.v10.i9.2764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/26/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The odontogenic jaw cyst is a cavity containing liquid, semifluid or gaseous components, with the development of the disease. In recent years, with the rapid development of oral materials and the transformation of treatment of jaw cysts, more options are available for treatment of postoperative bone defect of jaw cysts. Guided bone regeneration (GBR) places biomaterials in the bone defect, and then uses biofilm to separate the proliferative soft tissue and the slow-growing bone tissue to maintain the space for bone regeneration, which is widely used in the field of implantology.
AIM To observe the clinical effect of GBR in repairing bone defect after enucleation of small and medium-sized odontogenic jaw cysts.
METHODS From June 2018 to September 2020, 13 patients (7 male, 6 female) with odontogenic jaw cysts were treated in the Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Adults without hypertension, heart disease, diabetes or other systemic diseases were selected. The diagnosis was based on the final pathological results: 11 cases were diagnosed as apical cysts, one as primordial cyst, and one as dentigerous cyst. The lesions were located in the maxilla in seven cases, and in the mandible in six cases. All cases were treated with the same method of enucleation combined with GBR.
RESULTS Three to four months after the operation, the boundary between the implant site and the surrounding normal stroma was not obvious in patients with small-sized odontogenic jaw cysts. The patients with tooth defects were treated with implant after 6 mo. For the patients with medium-sized odontogenic jaw cysts, the density of the center of the implant area was close to the normal mass at 6 mo after surgery, and there was a clear boundary between the periphery of the implant area and the normal mass. The boundary between the periphery of the implant area and the normal mass was blurred at 8-9 mo after surgery. Patients with tooth defects were treated with implants at > 6 mo after the operation.
CONCLUSION Enucleation combined with guided bone regeneration in small and medium-sized odontogenic jaw cysts can shorten the time of osteogenesis, increase the amount of new bone formation, reduce complications, and improve quality of life.
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Affiliation(s)
- Yi-Ting Cao
- Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Qin-Hua Gu
- Department of Stomatology, Shanghai Ninth People’s Hospital Huangpu Branch, Shanghai Jiao Tong University, School of Medicine, Shanghai 200125, China
| | - Yi-Wei Wang
- Department of Oral Medicine, Huai’an Stomatological Hospital, Huai’an 223300, Jiangsu Province, China
| | - Qian Jiang
- Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
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Wang J, Yao QY, Zhu HY. Efficacy of bone grafts in jaw cystic lesions: A systematic review. World J Clin Cases 2022; 10:2801-2810. [PMID: 35434117 PMCID: PMC8968803 DOI: 10.12998/wjcc.v10.i9.2801] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/23/2021] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone grafts have been applied for many years in orthopedic surgery to assist with bone repair for defects or bone discontinuity caused by trauma and tumors as well as periodontal defects. Jaw cysts are another common benign disease of the maxillofacial region which may lead to pathological bone fracture, loss of teeth, and infection. However, whether bone grafts are beneficial for bone regeneration in jaw cystic lesions and when bone grafts should be used remains unclear.
AIM To study the efficacy of bone grafts compared to spontaneous healing in the treatment of jaw cystic lesions.
METHODS A literature search was performed in Medline, Cochrane Library and Embase to identify related articles published in English in the last ten years. The following key words and MeSH terms were used: “jaw cyst”, “cystic lesion”, “odontogenic cyst”, “periapical cyst”, “dentigerous cyst”, “follicular cyst”, “keratocyst”, “treatment”, “surgery”, “bone graft”, “enucleation”, “cystectomy”, and “bone regeneration”. Case reports, clinical trials, clinical studies, observational studies and randomized controlled trials were included. Study quality was evaluated.
RESULTS Ten studies (n = 10) met the inclusion criteria. Five studies reported spontaneous bone healing after enucleation, three studies investigated the efficacy of various bone grafts, and two randomized comparative studies focused on the comparison between spontaneous healing and bone grafting. Over 90% of bone regeneration occurred within 6 mo after bone grafting. The bone regeneration rate after cystectomy showed great variation, ranging from 50% to 100% after 6 mo, but reaching over 90% after 12 mo.
CONCLUSION While the long-term superiority of bone grafting compared with spontaneous healing after cystectomy is unclear, bone grafts accelerate the process of healing and significantly increase bone quality.
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Affiliation(s)
- Jin Wang
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Qiu-Yun Yao
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hui-Yong Zhu
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Ozturk G, Dogan S, Gumus H, Soylu E, Bahadir A, Yilmaz S. Consequences of Decompression Treatment with a Special-Made Appliance of Non-Syndromic Odontogenic Cysts in Children. J Oral Maxillofac Surg 2022; 80:1223-1237. [DOI: 10.1016/j.joms.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
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Kumar Singh A, Khanal N, Chaulagain R, Bhujel N, Singh RP. How effective is 5-Fluorouracil as an adjuvant in the management of odontogenic keratocyst? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 2022; 60:746-754. [DOI: 10.1016/j.bjoms.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
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Vizuete–Bolaños MX, Salgado–Chavarría F, Cruz–Tapia RO. Quiste dentígero. Revisión de la literatura y reporte de caso. ACTA ODONTOLÓGICA COLOMBIANA 2022. [DOI: 10.15446/aoc.v12n1.98021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: el quiste dentígero, también conocido como quiste folicular, es la segunda forma más habitual de los quistes de la región maxilar después del quiste radicular. Tiene una incidencia del 20% con respecto a todos los quistes odontogénicos y se encuentra más en el género masculino entre los 20-40 años. El manejo conservador en lesiones quísticas de gran tamaño es indispensable para evitar defectos óseos o daño a estructuras vecinas. Sin embargo, en lesiones de menor tamaño, la enucleación continúa siendo el tratamiento de elección. Objetivo: presentar un caso clínico de un quiste dentígero y hacer una revisión de la literatura actualizada. Caso clínico: paciente masculino de 23 años que presentó aumento de volumen en zona geniana derecha y, además, en su ortopantomografía se observó una lesión en el sector de los incisivos superiores. Se realizó enucleación de la lesión, cuyo diagnóstico histológico previo fue quiste dentígero y posteriormente se obtiene una correcta regeneración ósea tras un año de seguimiento Conclusión: el manejo del quiste dentígero es variado: puede ir desde la enucleación quirúrgica hasta la descompresión y marsupialización del mismo. No obstante, todos los tratamientos actuales se basan en contrarrestar los factores de expansión quística que permiten a esta lesión alcanzar grandes tamaños intraóseos y poder causar desde rizolisis de dientes adyacentes hasta una asimetría facial como sucedió en este caso clínico.
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Franklin JRB, Vieira EL, Brito LNS, Castro JFLD, Godoy GP. Epidemiological evaluation of jaw cysts according to the new WHO classification: a 30-year retrospective analysis. Braz Oral Res 2021; 35:e129. [PMID: 34878084 DOI: 10.1590/1807-3107bor-2021.vol35.0129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/02/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to analyze the epidemiology of maxillofacial odontogenic and non-odontogenic cysts diagnosed for 30 years in a Brazilian population. A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1989 and 2019. Data regarding age, gender, anatomical location, and histopathological diagnosis were collected and categorized. Further, a literature search for similar studies was performed. A total of 6.994 biopsy records were evaluated, but only 367 (5.24%) cases were classified as odontogenic cysts (OC) or non-odontogenic cysts (NOC). Among all cystic lesions, 341 cases (92.9%) were OC and 26 cases (7.1%) were NOC. These lesions were more common in females (n = 208 / 56.67%) and located mostly in the mandible (n = 195 / 53.1%). In patients with OC, the radicular cyst was the most frequent (n = 134 / 36.5%), followed by the dentigerous cyst (n = 101 / 27.5%) and the odontogenic keratocyst (n = 52 / 14.2%). Patients with NOC had a higher frequency of epidermoid cyst (n = 12 / 3.3%), oral lymphoepithelial cyst (n = 7 / 1.9%), and nasopalatine duct cyst (n = 4 / 1.1%). The OCs were more prevalent than NOCs, and inflammatory cysts were the most common among all the OCs.
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Affiliation(s)
| | - Eduardo Luis Vieira
- Universidade Federal de Pernambuco - UFPE, School of Dentristry, Recife, PE, Brazil
| | - Lívia Natália Sales Brito
- Universidade Federal de Pernambuco - UFPE, School of Dentristry, Department of Prosthesis and Oral-Facial Surgery, Recife, PE, Brazil
| | - Jurema Freire Lisboa de Castro
- Universidade Federal de Pernambuco - UFPE, School of Dentristry, Department of Clinical and Preventive Dentistry, Recife, PE, Brazil
| | - Gustavo Pina Godoy
- Universidade Federal de Pernambuco - UFPE, School of Dentristry, Department of Pathology, Recife, PE, Brazil
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Odontogenic Maxillary Sinusitis: The Interface and Collaboration between Rhinologists and Dentists. JOURNAL OF OTORHINOLARYNGOLOGY, HEARING AND BALANCE MEDICINE 2021. [DOI: 10.3390/ohbm2040008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Odontogenic maxillary sinusitis (OMS) is an inflammatory condition affecting the paranasal sinuses and is commonly encountered by both Otorhinolaryngologists and Dentists. However, there is an ongoing debate regarding the best sequence of management. Clinicians are faced with the dilemma of first addressing either the affected tooth or the affected sinus. This paper provides a review of the current literature on the aetiology, presentation, and management of OMS, as well as our experience in managing this condition. Overall, the causative pathology of the patient’s OMS, their symptoms, and the risk of surgery should drive decision making with regards to sequence of management.
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Irimia A, Moraru L, Ciubotaru DA, Caruntu C, Farcasiu AT, Caruntu A. Minimally Invasive Two-Staged Surgery in the Treatment of Large Cystic Lesions of the Jaw. Healthcare (Basel) 2021; 9:healthcare9111531. [PMID: 34828577 PMCID: PMC8621310 DOI: 10.3390/healthcare9111531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Cystic lesions of the jaw are commonly found in clinical practice. Large, expansive cysts raise challenges for the clinician from both diagnostic and surgical perspectives. The aim of our work is to present a combined, two-staged surgical approach in histologically confirmed non-aggressive cystic lesions of the jaw. Methods and Results: We report the case of an extensive mandibular cyst, associating a high risk of bone fracture, that is treated in the initial stage by cystic decompression through marsupialization with concomitant histological diagnostic confirmation, followed in the second stage by radical excision and mandibular reconstruction with titanium mesh, with the purpose of prevention for oro-cystic chronic fistula formation. Conclusions: Large odontogenic mandibular cysts imply a meticulously conducted assessment and treatment. Marsupialization should be taken into consideration for the treatment of large cystic lesions, followed by secondary enucleation, with minimal risks for the patient. The soft tissue healing process can be optimized with the use of titanium meshes, as an alternative for other reconstructive techniques, in the management of large cystic lesions.
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Affiliation(s)
- Andreea Irimia
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.I.); (L.M.); (D.A.C.); (A.C.)
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.I.); (L.M.); (D.A.C.); (A.C.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Diana Alina Ciubotaru
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.I.); (L.M.); (D.A.C.); (A.C.)
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Correspondence: (C.C.); (A.-T.F.)
| | - Alexandru-Titus Farcasiu
- Department of Removable Prosthodontics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence: (C.C.); (A.-T.F.)
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (A.I.); (L.M.); (D.A.C.); (A.C.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
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Noujeim Z, Nasr L. The prevalence, distribution, and radiological evaluation of dentigerous cysts in a Lebanese sample. Imaging Sci Dent 2021; 51:291-297. [PMID: 34621656 PMCID: PMC8479438 DOI: 10.5624/isd.20210075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample. Materials and Methods It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed. Results Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients (52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%). Conclusion The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors.
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Affiliation(s)
- Ziad Noujeim
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.,Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
| | - Lara Nasr
- Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
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Bispo MS, Pierre Júnior MLGDQ, Apolinário Jr AL, dos Santos JN, Junior BC, Neves FS, Crusoé-Rebello I. Computer tomographic differential diagnosis of ameloblastoma and odontogenic keratocyst: classification using a convolutional neural network. Dentomaxillofac Radiol 2021; 50:20210002. [PMID: 33882255 PMCID: PMC8474127 DOI: 10.1259/dmfr.20210002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To analyse the automatic classification performance of a convolutional neural network (CNN), Google Inception v3, using tomographic images of odontogenic keratocysts (OKCs) and ameloblastomas (AMs). METHODS For construction of the database, we selected axial multidetector CT images from patients with confirmed AM (n = 22) and OKC (n = 18) based on a conclusive histopathological report. The images (n = 350) were segmented manually and data augmentation algorithms were applied, totalling 2500 images. The k-fold × five cross-validation method (k = 2) was used to estimate the accuracy of the CNN model. RESULTS The accuracy and standard deviation (%) of cross-validation for the five iterations performed were 90.16 ± 0.95, 91.37 ± 0.57, 91.62 ± 0.19, 92.48 ± 0.16 and 91.21 ± 0.87, respectively. A higher error rate was observed for the classification of AM images. CONCLUSION This study demonstrated a high classification accuracy of Google Inception v3 for tomographic images of OKCs and AMs. However, AMs images presented the higher error rate.
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Affiliation(s)
- Mayara Simões Bispo
- Postgraduate Program in Dentistry and Health, Federal University of Bahia, Salvador, Brazil
| | | | | | | | - Braulio Carneiro Junior
- Division of Oral and Maxillofacial Surgery, Southwest Bahia State University, Vitória da Conquista, Brazil
| | | | - Iêda Crusoé-Rebello
- Division of Oral and Maxillofacial Radiology, Federal University of Bahia, Salvador, Brazil
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Quiroz-Quiroga MJ, González Valdivia H, Palazón Cabanes A, Rubio Palau J, Prat Bartomeu J. Amblyopia due a dentigerous cyst. Case report and literature review. J Fr Ophtalmol 2021; 44:1249-1255. [PMID: 34353662 DOI: 10.1016/j.jfo.2021.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 01/17/2021] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The goal of this article is to present an infrequent clinical case and to review the available literatura, with an emphasis on ophthalmological symptoms. METHODS We present the case of a 4-year-old girl with a large dentigerous cyst on the maxillary bone, who had long-standing unilateral epiphora associated with progressive ocular dystopia, facial asymmetry and ipsilateral amblyopia. A multidisciplinary approach was taken by the maxillofacial surgery, ophthalmology and optometry teams. This included systemic antibiotic administration, surgical cyst drainage and amblyopia treatment. The literature review was carried out in the MEDLINE database through the free electronic access to PubMed in March 2020. RESULTS At the 6-month follow-up, the patient was asymptomatic. The most common symptoms of dentigerous cysts are epiphora 36.8%, ocular dystopia 31.2%, diplopia 21.1%, proptosis, nasolacrimal duct obstruction and blurred vision at 10.5%. Amblyopia has not been reported. CONCLUSIONS Dentigerous cysts are benign odontogenic cysts, which can be found in the jaw and less frequently on the maxillary bone. They are usually asymptomatic, and the occurrence of ophthalmic complications is very infrequent. Multidisciplinary management is essential to avoiding long-term morbidity of maxillary dentigerous cysts and should include an ophthalmologist.
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Affiliation(s)
- M J Quiroz-Quiroga
- Ophthalmology Department, Hospital de l'Esperanza-Consorci Parc de Salut MAR, Sant Josep de la Muntanya 12, 08024 Barcelona, Spain.
| | - H González Valdivia
- Pediatric Oculoplastic and Orbital Surgery Department, Hospital Sant Joan de Déu, Barcelona, Spain.
| | - A Palazón Cabanes
- Ophthalmology Department, Hospital Universitario Los Arcos del Mar Menor, Murcia, Spain.
| | - J Rubio Palau
- Head of Maxillofacial Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Barcelona, Spain.
| | - J Prat Bartomeu
- Head of Pediatric Ophthalmology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
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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] [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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Vinereanu A, Bratu A, Didilescu A, Munteanu A. Management of large inflammatory dentigerous cysts adapted to the general condition of the patient: Two case reports. Exp Ther Med 2021; 22:750. [PMID: 34035847 PMCID: PMC8135138 DOI: 10.3892/etm.2021.10182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 11/06/2022] Open
Abstract
Dentigerous cysts may be of developmental or inflammatory origin. The latter occur in unerupted permanent teeth as a result of inflammation from a preceding non-vital primary tooth or from another source spreading to involve the tooth follicle. This report presents two clinical cases of children with dentigerous cysts of inflammatory origin. Case 1 is a healthy boy (7 years 11 months) referred for a large cystic cavity in the right mandibular premolar region. Extraction of 84 and 85 and marsupialization of the cyst were performed under nitrous sedation. A removable appliance with an acrylic piece fitted into the socket was applied on the same occasion. The in-socket piece was progressively reduced as the cystic cavity was shrinking. After a 20-month follow-up, 44 and 45 are sound and correctly erupted and 46 remains unaffected. Case 2 is an autistic girl (10 years 9 months) with bilateral large odontogenic cysts enclosing the crowns of 35 and 45. Extractions of 75, 85 were performed under general anesthesia, leaving large bone defects. Given the limited compliance of the patient under common dental office circumstances, no appliance was used. Thirteen months after extraction, 35 and 45 are sound, fully erupted and no visible mesial drifting of 36 and 46 occurred. In conclusion, conservative treatment of large inflammatory dentigerous cysts in children gives good results with minimal intervention, ensures physiologic development of teeth and proper bone healing. The general condition of the patient can influence treatment choice. Patients must be followed up until eruption of the displaced permanent teeth and bony consolidation of the cyst.
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Affiliation(s)
- Arina Vinereanu
- Department of Pedodontics, 'Carol Davila' University of Medicine and Pharmacy, Faculty of Dental Medicine, 010221 Bucharest, Romania
| | | | - Andreea Didilescu
- Department of Embryology, 'Carol Davila' University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Aneta Munteanu
- Department of Pedodontics, 'Carol Davila' University of Medicine and Pharmacy, Faculty of Dental Medicine, 010221 Bucharest, Romania
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Kishimoto T, Sukegawa S, Ono S, Nakamura S, Ando M, Yoshino T, Furuki Y. Endoscope-assisted enucleation of mandibular dentigerous cysts. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2021. [DOI: 10.1016/j.ajoms.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Demirsoy MS, Erdil A, Çolak S, Maden A, Tümer MK. Evaluation of postoperative changes in the course of mandibular canals impacted by cystic lesions. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:31-36. [PMID: 33429065 DOI: 10.1016/j.jormas.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study aims to determine the positional alterations in the course of mandibular canal, which were caused by the common cystic lesions in the posterior mandible. Also, the effects of treatment methods on bone formation were evaluated. METHODS We designed a retrospective cohort study with patients which were treated due to cystic lesions in the maxillofacial region between the years 2012-2018. Forty eight subjects were included and grouped regarding histopathologic diagnoses (radicular dentigerous and odontogenic keratocyst) and treatment methods (enucleation and marsupialization). The mean (range) of patients' age was 31.25 (18-66) years, and there were 32 male and 16 female individuals. The displacement of mandibular canals was verified on preoperative cone-beam computed tomographic images. The measurements of displacement and bone formation were performed on panoramic radiographs. In the statistical analysis of the data, descriptive statistics, parametric independent sample t-test, non-parametric Kruskal Wallis test, and one-way analysis of variance test were utilized. RESULTS All the evaluated mandibular canals were replaced by a mean(SD) of 5.46(2.59) mm after the lesions eliminated, which was significant in the marsupialization group (p = 0.002). The bone formation was significantly higher in the enucleation group (p = 0.003). The multiple regression analyses revealed that the treatment methods significantly influenced the replacement of mandibular canal (p < 0.001) and the bone formation (p = 0.026). CONCLUSION In cases where there is an adequate distance between the lesion and the mandibular canal, the enucleation technique was found to be superior in terms of bone formation and the amount of bone height obtained.
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Affiliation(s)
- Mustafa Sami Demirsoy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - Aras Erdil
- Sivas Dental Health Hospital, TR Ministry of Health, Sivas, Turkey.
| | | | - Abdulsamed Maden
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Mehmet Kemal Tümer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
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Mrad MA, Shah Mardan QNM, Mahabbat NA. Radicular cysts and Chin implants; An unexpected complication prompting explantation - Case report. Int J Surg Case Rep 2020; 77:766-768. [PMID: 33395891 PMCID: PMC7718126 DOI: 10.1016/j.ijscr.2020.11.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022] Open
Abstract
Radicular cysts are benign, odontogenic, and inflammatory in nature that commonly arise in the maxilla. No link has been previously found between silicone chin implants and radicular cysts or fistulating radicular cysts. We suggest dental panoramic X-ray screening for patients with poor oral hygiene or dental trauma to detect radicular cysts before the operation. The decision to proceed with chin implant in a patient known for treated radicular cyst may be unsafe, as the recurrence rate is unknown.
Introduction Implant-based genioplasty is a simple and safe but not complication-free cosmetic procedure. Patients are commonly briefed about anticipated complications and their management pre-operatively, but few unexpected complications may arise; and this case report is an example. This paper is the first to report a radicular cyst fistulating through chin implant pocket to the skin. Moreover, we present our prevention strategy and recommendations. Presentation of case A 39-year-old-lady underwent a silicone implant-based genioplasty that was uneventful. Later, she developed a reddish nodule on the chin necessitating fistulectomy followed by a recurrence leading to explantation. It was not until the second recurrence that a fistulating radicular cyst was discovered and was treated with the help of a dentist. Discussion Radicular cysts are benign, inflammatory cysts that arise in a background of dental trauma or caries. No link has been discovered yet between silicone implants and radicular cysts or fistulating cysts. Moreover, we propose that poor oral hygiene could be implicated in the development of these cysts. Dental panoramic X-ray has been used to diagnose radicular cysts, but its efficacy as a screening tool needs to be studied. Finally, the recurrence rate of radicular cysts is unknown. Conclusion In a patient with chin implant, radicular cysts could lead to a disastrous outcome. Through history and physical examination, a plastic surgeon should identify patients with poor oral hygiene and dental trauma prior to implant-based genioplasty to arrange for a dental panoramic X-ray. Patients known to have radicular cysts should not undergo an implant-based genioplasty.
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Affiliation(s)
- Mohamed A Mrad
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia.
| | - Qutaiba N M Shah Mardan
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia
| | - Nehal A Mahabbat
- King Faisal Specialist Hospital and Research Centre, Department of Surgery, Plastic and Reconstructive Surgery Section, Riyadh, Saudi Arabia
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de França GM, da Silva LBA, Mafra RP, da Silva WR, de Lima KC, Galvão HC. Recurrence-free survival and prognostic factors of odontogenic keratocyst: a single-center retrospective cohort. Eur Arch Otorhinolaryngol 2020; 278:1223-1231. [PMID: 32696249 DOI: 10.1007/s00405-020-06229-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the 5-year recurrence-free survival and prognostic factors of odontogenic keratocyst (OKC) from a single-center retrospective cohort in the northeastern region of Brazil. METHODS Forty cases of OKC comprised the study population. In the cohort analyzed, 18 (45%) cases were recurrent OKCs and 22 (55%) were non-recurrent OKCs. Recurrence-free survival was defined as the period from the release of the histopathological report to the occurrence of relapse or last visit to the service. RESULTS Comparison of the clinicopathological variables between primary and recurrent OKC lesions revealed no differences in the frequency of epithelial thickness, presence of satellite cysts and cystic spaces, presence of an inflammatory infiltrate, locularity, and lesion borders. The frequency of symptoms was practically the same even after recurrence. Satellite cysts were more frequent in the group of recurrent lesions (n = 9, p = 0.002) and the presence of an inflammatory infiltrate was also significantly associated with recurrent lesions (n = 15, p = 0.006). Previous decompression or marsupialization was associated with recurrence of the lesion (p = 0.010). CONCLUSIONS In conclusion, the most significant prognostic factors were previous decompression or marsupialization, as well as, morphological parameters associated with the recurrence cases were the presence of an inflammatory infiltrate and satellites cysts. The risk of recurrence is low but continues due to the particularities of epithelial proliferation in OKC.
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Affiliation(s)
- Glória Maria de França
- Department of Dentistry, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Avenue Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
| | | | - Rodrigo Porpino Mafra
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Weslay Rodrigues da Silva
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kênio Costa de Lima
- Department of Dentistry, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Hébel Cavalcanti Galvão
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Pang Y, Zhang K, Liu L, Feng D, Liu C, Wang J, Du Y, Guo Z. [Biomechanical study of cystic lesions of the mandible based on a three-dimensional finite element model]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:911-915. [PMID: 32895206 DOI: 10.12122/j.issn.1673-4254.2020.06.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To analyze the biomechanics of cystic lesions in the mandibular body in a three-dimensional (3D) finite element model. METHODS A 3D finite element model of cystic lesion of the mandibular body was constructed based on the CT images of the mandible of a healthy adult female volunteer with normal occlusion. The size of the cyst and the residual bone wall were analyzed when the lesion area approached the stress peak under certain constraints and loading conditions. RESULTS When the size of the cyst reached 37.63 mm×11.32 mm×21.45 mm, the maximal von Mises stress in the lesion area reached 77.295 MPa, close to the yield strength of the mandible with a risk of pathological fracture. At this point, the remaining bone thickness of the buccal and lingual sides and the lower margin of the mandible in the lesion area was 1.52 mm, 0.76 mm and 1.04 mm, respectively. CONCLUSIONS Residual bone mass is an important factor to affect the risk of pathological fracture after curettage of cystic lesions. A thickness as low as 1 mm of the residual bone cortex in the cystic lesion area of the mandibular body can be used as the threshold for a clinical decision on one-stage windowing decompression combined with two- stage curettage.
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Affiliation(s)
- Yaqian Pang
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Kai Zhang
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Liang Liu
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Dajun Feng
- Department of Oral and Maxillofacial Surgery, Fourth Affiliated Hospital of Anhui Medical University, Hefei 230001, China
| | - Chang Liu
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Jing Wang
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Yue Du
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
| | - Zhenfei Guo
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
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