The lateral periodontal cyst: an update

Odontogenic keratocystic can be misdiagnosed for a lateral periodontal cyst when the clinical and radiographical findings are similar

Lateral periodontal cyst (LPC) and odontogenic keratocystic (OK) are two osteolytic lesions of the jaw with different local invasiveness and percentage of recurrence. The aim of this study was to highlight the attention on the differential diagnosis of these lesions that sometimes can have unexpected location and can lead doubts on diagnosis, therapy, and follow-up. A 34-year-old man presented to our department with a complaint of soft pain in the vestibular aspect of left mandibular second premolar and left mandibular first molar. Vital teeth in the left mandible, no mucosal swelling, and no drainage were observed. The CBCT showed a well circumscribed hypodensity area, extending between 3.5 and the apex of mesial root of 3.6. No displacement and no resorption of the roots were notified. Upon clinical and radiographical examination, a provisional diagnosis of LPC was made and enucleation of the lesion and histological examination were planned. Histologically, a cystic wall partially lined by a keratinizing squamous epithelium was observed. Surrounding and within the lesion, there was a chronic inflammatory infiltrate also of granulomatous type and with cholesterol clefts. Based on these findings, the diagnosis of odontogenic keratocystic was done. Radiolucent lesions in the premolar and canine region are frequently clinically and radiographically misdiagnosed. The identification of keratocyst in a location preoperatively favoring a lateral periodontal cyst should be suspected and biopsy must be considered in all cases to establish the nature of the lesion, the best surgical treatment, and the follow-up appointments.

Usage of Guided Bone Regeneration in the Case of Lateral Periodontal Cyst in the Maxilla with Buccal Cortical Expansion

A lateral periodontal cyst (LPC) is a rare finding. Patients diagnosed with LPC younger than 40 years of age are not that common. Mostly asymptomatic LPCs can be discovered on routine radiographs as an oval radiolucency between two mandibular premolar teeth roots and can vary in shape and size. Most cases are treated with enucleation, bone curettage, or a combination of both, greatly depending on the surgeon’s preference. Because most LPCs are quite small, lesions do not require any regenerative procedures. In the presented case, because of cortical expansion of the lesion and loss of vital bone bridge surrounding two adjacent maxillary teeth, a guided bone regenerative procedure (GBR) with xenograft bone substitute was used. Despite that small lesions can heal on their own, nowadays the approach of full-mouth therapy (FMT), including direct soft or hard tissue reconstruction in the oral cavity, seems to be a wise treatment. The presented paper presents and describes an unusual LPC case with cortical bone expansion in a very rare maxillary canine–premolar region.

Lingual cyst with respiratory epithelium: The importance of differential diagnosis

Lingual cyst with respiratory epithelium (LCRE) is a very rare congenital cyst of the tongue, floor of the mouth, pharynx or hypopharynx with 21 cases reported in the literature (1, 2). Differential diagnosis is very important for patients presenting with lingual cysts, as this may impact treatment and follow-up. LCRE should be included in the different diagnosis of dermoid cyst (3), teratoid cyst (4), epidermoid cyst (5), thyroglossal duct cyst (6), lymphoepithelial cyst (7), mucocele or ranula (8). Each entity has a peculiar histologic presentation, although the clinical aspect may be very similar (1). The dermoid cyst is lined by a keratinized squamous epithelium and contains skin appendages in the cyst. Epidermoid cyst is similar to the dermoid cyst but is characterized by non-keratinized squamous epithelium and has a lumen filled of keratin. Teratoid cyst contains derivatives of the endoderm, ectoderm and/or mesoderm. The thyroglossal duct cyst is usually lined by columnar, stratified squamous epithelium, or an intermediate transition type of epithelium, with the mandatory presence of thyroid tissue in the cyst wall. Lymphoepithelial cyst is identified by the presence of the lymphoid aggregates in the cyst wall. A mucous retention cyst, so called mucocele or ranula, contains mucin and granulation tissue (1). Read the full text [PDF]

Pigmented lateral periodontal cyst: A case report and review of pigmented odontogenic cysts

Pigmented odontogenic cysts are uncommon and to date, only 37 cases have been reported in the English literature. Here, we report a case of a pigmented lateral periodontal cyst (LPC) in the maxilla of a 48-year-old female. The patient presented with clinical swelling in the maxillary anterior region. Microscopic features of the biopsied specimen were consistent with a diagnosis of LPC. The epithelial cyst lining exhibited numerous coarse granules of melanin pigment, which was confirmed by S-100 immunohistochemistry and Fontana-Masson bleach histochemical method. Almost all documented cases of pigmented odontogenic cysts have occurred in Asians and African-Americans, with only three cases in white patients. Racial pigmentation may have a role in the pathogenesis of these lesions. Although the origin and pathologic significance of melanocytes in these pigmented intraosseous lesions cannot be explained, it may be something to consider for investigation in future.

Lateral Periodontal Cyst - A diagnostic dilemma: Report of a rare case with CBCT and histological findings

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Lateral periodontal cyst [LPC] is a rare developmental odontogenic cyst.

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It is difficult to differentiate a LPC from a cyst of endodontic origin by clinical and radiographic methods. Histopathological evaluation is the only method to confirm diagnosis.

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Usually seen in association of a vital tooth, but in this case it was seen in a non-vital tooth.

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LPC is usually seen within bone, but in this case besides Intrabony component there was a gingival presentation as a swelling.

Introduction

Lateral Periodontal Cyst (LPC) is considered as a rare developmental odontogenic cyst. It is often diagnosed as an incidental radiographic finding, presenting as a circumscribed round radiolucent area between the roots of vital teeth. LPC usually does not present any clinical features. Differentiating the origin of the lesion from an endodontic or periodontal perspective presents as clinical challenge.

Presentation of case

A female patient presented with an asymptomatic gingival swelling in the lingual aspect of mandibular anterior region. The associated tooth (#34) was endodontically treated 3 years back. A periapical radiograph showed a well-defined round radiolucency on the tooth. Cone beam computed tomography (CBCT) revealed extensive bone destruction. The lesion was surgically excised and histological examination confirmed the diagnosis of LPC. The site healed satisfactorily post-operatively. The case was followed up for a year without any recurrence seen.

Discussion

LPC is a very rare clinical entity, the diagnosis of which requires a detailed case history taking, clinical and radiographic examination are essential to get proper assessment of the pathology. It is said to originate from either the remnants of dental lamina, reduced enamel epithelium or rests of Malassez. LPC presents with a typical histological picture which ensures the confirmatory diagnosis. Surgical enucleation with thorough curettage is the treatment of choice.

Conclusion

By reporting this rare case, we would like to stress to clinicians that there are a wide range of cysts and anatomic structures are present in the canine-premolar region of mandible of which LPC is a rare possibility.

Lateral Periodontal Cyst Treated with Enucleation and Guided Bone Regeneration: A Report of a Case and a Review of Pertinent Literature

Lateral periodontal cyst (LPC) is an uncommon developmental odontogenic cyst arising on the lateral surface of tooth roots. Commonly reported in mandibular canine-premolar or maxillary anterior regions, it presents as a well-circumscribed or tear drop-shaped radiolucency with a sclerotic border. Associated teeth are asymptomatic and vital, and roots may be displaced without resorption. Histopathologically, cystic lining resembles reduced enamel epithelium along with glycogen-rich clear cells and epithelial plaques. Unilateral variant of LPC has low recurrence and is managed by enucleation. A 43-year-old male patient reported with asymptomatic swelling in the left mandibular canine and first premolar region. Both teeth were vital, and radiographs revealed well-circumscribed radiolucency between the roots. Following consent, surgical enucleation and guided bone regeneration (GBR) with xenograft and resorbable collagen membrane were done under local anesthesia. The immediate postoperative period was uneventful, and complete bone fill of cystic cavity and healing of periodontal tissues was observed after a one-year follow-up. Histopathologic examination confirmed the diagnosis. LPC should be a differential diagnosis in cystic lesions lateral to the surface of a tooth and without any associated inflammation. Based on this case report, unicystic LPC can be successfully managed through surgical enucleation with GBR for better periodontal healing.

Suspected Lateral Periodontal Cyst Presenting Concurrently with Canine Acanthomatous Ameloblastoma in a 2-Year-Old Standard Poodle

Lateral periodontal cysts (LPCs) are odontogenic epithelial cysts composed of nonkeratinized epithelial cells that are in the category of developmental cysts, rather than inflammatory cysts. Lateral periodontal cysts are rare both in people and domestic animals; they are associated with vital teeth and located lateral to a tooth root. Lateral periodontal cysts are typically asymptomatic lesions that are characterized radiographically as a unilocular lucency with well-defined corticated borders. Canine acanthomatous ameloblastoma (CAA) is the most common odontogenic neoplasm in dogs and rarely presents as a cystic lesion. This case report describes the diagnosis and treatment of a cyst that occurred as a swelling apical to a gingival mass that was diagnosed histologically as CAA. Surgical management by conservative gingivectomy, cyst enucleation, and bone grafting was an effective treatment in this patient.

Odontogenic Cysts and Neoplasms

This article reviews a myriad of common and uncommon odontogenic cysts and tumors. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts (periapical cyst, mandibular infected buccal cyst/paradental cyst), developmental cysts (dentigerous, lateral periodontal, glandular odontogenic, orthokeratinized odontogenic cyst), benign tumors (keratocystic odontogenic tumor, ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibroma and fibroodontoma, odontoma, squamous odontogenic tumor, calcifying cystic odontogenic tumor, primordial odontogenic tumor, central odontogenic fibroma, and odontogenic myxomas), and malignant tumors (clear cell odontogenic carcinoma, ameloblastic carcinoma, ameloblastic fibrosarcoma).

Odontogenic Cysts - An Overview

This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.

Pediatric Odontogenic Cysts of the Jaws

Odontogenic cysts represent a common form of pathology of the jaws, and the natural history, clinicopathologic findings, and appropriate management strategies are important to the oral and maxillofacial surgeon. Odontogenic cysts in the pediatric populations are important pathologic entities given their potential impact on the growth and development of the maxillofacial complex. Inappropriate management strategies can severely affect the form and function of the growing child. Categorizing pediatric odontogenic cysts into inflammatory or developmental causes provides a convenient way of conceptualizing these various entities and helps facilitate the appropriate diagnosis and the subsequent management.

Botryoid odontogenic cyst: a diagnostic chaos

Botryoid Odontogenic cyst (BOC) originally described by Weathers and Waldron (1973) is a variant of a lateral periodontal cyst characterized by macroscopic and microscopic multilocular growth pattern. We report a case of BOC in a 21-year-old male patient. Orthopantamogram revealed a multilocular radiolucency extending from 43 to 47. The histological examination of incisional biopsy revealed a thin 2-4 layered non keratinised epithelium without rete ridges resembling a reduced enamel epithelium with few localised plaque like thickenings and occasional mural bulges. These features were suggestive of BOC. The excisional biopsy revealed histological features similar to those of incisional biopsy except for the presence of 5-6 epithelial follicles with outer columnar cells and inner stellate reticulum like cells. CD56 and calretinin immunohistochemical staining (IHC) was done. This paper highlights the unusual appearance of follicles in BOC with differential diagnosis and IHC staining characteristics.

Treatment of lateral periodontal cyst with guided tissue regeneration

Lateral periodontal cyst (LPC), originated from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically. In this case report, clinical, histological and radiographical findings and periodontal treatment of 32-year-old female patient, who was referred to Department of Periodontology Clinic of Faculty of Dentistry, Marmara University with a painless hyperplastic lesion on the distobuccal site of the tooth number 12, were presented. The tooth number 12 was vital and a well-defined round radiolucent area with corticated borders was determined radiographically. Preliminary diagnosis was LPC based on clinical and radiographical findings. Mechanical periodontal treatment consisted of oral hygiene instructions, scaling and root planing was applied and flap operation was performed to gain access to the lesion. Following enucleation of the lesion, alveolar bone destruction shaped as a tunnel from labial to palatinal site was observed. The bone cavity was grafted with bovine-derived xenograft, followed by placement of a resorbable collagen membrane. Tissues removed from of the lesion were examined histologically. Hematoxylen-eosin stained sections showed vasculature granulomatous structure underlying squamous epithelium, and destructed bone spaces, all of which were consisted with LPC. Acceptable clinical healing was achieved at 6 months follow-up period. Satisfactory clinical and radiographical outcome can be achieved in the treatment of LPC using regenerative periodontal approach.

Botryoid odontogenic cyst developing from lateral periodontal cyst: A rare case and review on pathogenesis

Botryoid odontogenic cyst (BOC) is considered to be a polycystic variant of the lateral periodontal cyst (LPC) as the specimen resembled a cluster of grapes. It is a non-inflammatory odontogenic cyst. The BOCs can be unicystic or multicystic. These cysts have potential to extend in the bone and become multilocular and they have a high recurrence rate. Till now, only 73 cases of BOC have been reported. The pathogenesis of BOC is still debatable. We review different pathogenesis proposed for BOC and discuss a rare case of BOC developing from lining of an abnormally large LPC which showed aggressive behaviour in terms of growth and size.

Benign cysts and tumors of the paranasal sinuses

To thoroughly understand the biology of any lesion and render the appropriate management, clear and accurate definitions are paramount. For benign cysts and tumors of the oral maxillofacial region, an accurate depiction of these lesions needs to be elucidated to provide both the treating surgeon and the patient with a clear understanding of the course of treatment and the outcome.

Multifocal lateral periodontal cysts: a report of 4 cases and review of the literature

Lateral periodontal cyst (LPC) is a developmental jaw cyst of odontogenic origin. It has characteristic histopathologic features that are identical to those seen in the peripherally occurring gingival cyst of adults (GCA). The polycystic variant of LPC is termed the botryoid odontogenic cyst (BOC). The histogenetic origin of LPC is probably the rests of dental lamina in the alveolar bone. In the case of BOC, it might be that several adjacent epithelial rests simultaneously undergo cystic change and eventually form a polycystic lesion. Few previous examples of multifocal occurrence of LPC can be found in the literature. We report an additional 4 patients with this rare presentation of multiple, separate LPCs, and review the literature on this topic.

Lateral periodontal cyst: a case report and literature review

Background

The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts.

Methods

A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp.

Results

A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was "lateral periodontal cyst of developmental origin". There was no recurrence or complications for 24 months follow-up.

Conclusions

The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.

Lateral periodontal cyst: report of case and review of the literature

BACKGROUND

As the lateral periodontal cyst (LPC) is an unusual odontogenic cyst, most papers are single case reports or series with a limited number of cases, with few large series. The aim of this study is to report an additional case of LPC, emphasizing the clinical, radiographic, and histopathological features, differential diagnosis, and review of 264 cases reported in the English-language literature.

CASE REPORT

A 51-year-old male patient presented with a well-delimited, radiolucent, mandibular lesion, located between the roots of the right lower lateral incisor and canine and evidenced during routine radiographic examination. A surgical excision was performed. Microscopically, there was a cystic cavity lined by simple squamous epithelium, compatible with LPC.

DISCUSSION

LPC is an unusual odontogenic cyst and presents a marked predilection for occurring in the mandible between the roots of canines and premolars. Accurate clinical and imaging exams should be performed for a correct approach and diagnosis.

Botryoid odontogenic cyst: a clinicopathologic study of 10 cases

Botryoid odontogenic cyst is a rare multilocular variant of lateral periodontal cysts. In this study, a series of 10 cases of botryoid odontogenic cysts retrieved from the archives of the Postgraduation Program in Oral Pathology, Federal University of Rio Grande do Norte (Brazil), were reviewed for epidemiologic data, clinical presentation, radiographic and histopathologic characteristics, treatment, and recurrence.

Glandular odontogenic cyst involving the posterior part of maxillary sinus, a rare entity

The Glandular Odontogenic Cyst (GOC) was first coined by Gardner et al. [2], in 1988 as an odontogenic origin, is a rare developmental lesion considered a distinct entity because of its uncommon clinical and histopathological characteristics. This lesion can involve either jaws, but the anterior region of the mandible is the most affected area. It strikes distinct age groups, with an average patient age of 50 years. Radiographically, GOC does not display specific or pathognomonic features. It may present as a multilocular or unilocular radiolucencies. The cyst has an aggressive nature and high tendency of recurrence, so long-term follow-up should be carried out. The treatment is controversial, varying from conservative methods to block excision. It is believed that the low prevalence of GOC in the literature is because of not only its rarity, but principally to the fact that its main characteristics are also found in other pathological entities, thereby generating controversial diagnoses. The aim of this paper is to present a rare case of Glandular Odontogenic Cyst (GOC), which is uncommon in the posterior maxilla, that mimicks the lateral odontogenic cyst/botroid odontogenic cyst/Central Muco-epidermoid carcinoma. Owing to its tendency to recur, the lesion needs careful and meticulous planning for its surgical removal.

Diagnosis and osseous healing of a lateral periodontal cyst mimicking a deep unusual interdental pocket in a young patient

A 17-year-old male patient presented for the evaluation of his nonhealing interdental deep pocket in relation to the mandibular second premolar and mandibular first molar. He denied any history of pain. Excessive food lodgment, salty taste, and smell related to the specific region were his chief complaints. The periapical radiograph exhibited well-defined interradicular unilocular radiolucency with sclerotic margins between the vital mandibular second premolar and mandibular first molar. The lesion was completely enucleated with deep curettage and root planning. Histopathologic reports showed a heavy inflammatory infiltrate. Successive radiographs showed excellent bone healing. Teeth were endodontically treated for severe sensitivity to cold. Step-by-step radiographic follow-up showed osseous repair with no evidence of disease till 25 months.

Gingival cyst of the adult: regenerative therapy of associated root exposure. A case report and literature review

BACKGROUND

The gingival cyst of the adult (GCA) is an uncommon developmental cyst of odontogenic origin most frequently seen near mandibular canines and premolars and is routinely treated with excisional biopsy. This article presents a case of a GCA treated with a combined regenerative approach and reviews the GCA literature with an emphasis on the clinical aspects of this lesion.

METHODS

A 54 year-old man presented for treatment of generalized severe chronic periodontitis. Clinical examination revealed a cystic lesion in the gingiva of the mandibular canine-premolar area. Radiographs revealed a well-defined radiolucency in the coronal one-third of the tooth roots. Surgical enucleation of the lesion revealed root exposure of the second premolar. Because of the anatomy of the lesion-associated defect, regenerative treatment, using a combination of freeze-dried bone allograft and a collagen membrane, was considered the therapeutic approach of choice.

RESULTS

The biopsy revealed histologic features consistent with a GCA. Clinical and radiographic examinations 1 year post-surgery indicated uneventful soft tissue healing and bone fill of the initial defect. The review of the literature revealed only one other case of root exposure associated with GCA and no previous report of regenerative therapy.

CONCLUSIONS

In rare instances, a GCA lesion may result in tooth-root exposure. In such cases, a combined regenerative treatment approach may be used to achieve resolution.

Odontogenic cysts: analysis of 680 cases in Brazil

The purpose of this study was to evaluate the prevalence of 680 odontogenic cysts diagnosed in Porto Alegre, RS, Brazil, and to compare results with findings in the literature. Data of odontogenic cysts diagnosed from 1985 to 2005 were collected from the files of the Oral Pathology Laboratory of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil, and entered in a standardized form for later comparisons. The most prevalent odontogenic cysts were radicular (72.50%), dentigerous (22.20%) and residual (4.26%) cysts. The mandible of white patients was the anatomic site and ethnic group most frequently affected by this disease. Four of the six types of cysts were more frequent in the second and fourth decades of life, and no significant differences were found between sexes in the diagnosis of odontogenic cysts. In conclusion, the prevalence of odontogenic cysts was similar to that reported in the literature, which shows that inflammatory cysts are the most frequent.

Use of guided tissue regeneration in the treatment of a lateral periodontal cyst with a 7-month reentry

BACKGROUND

The lateral periodontal cyst (LPC) is an unusual cyst of odontogenic origin, most frequently encountered in the mandible between the roots of canines and premolars. The most common treatment for LPC is surgical enucleation. This article reports a case of an LPC treated with guided tissue regeneration (GTR) and bone allograft.

METHODS

A 74-year-old woman presented for periodontal examination. Radiographs revealed a cystic lesion with LPC characteristics. After surgical incisions and flap reflection, the cyst was removed and sent for biopsy. Because of the anatomy of the resulting intrabony defect, GTR was considered the ideal treatment.

RESULTS

The biopsy revealed the histologic features of an LPC. Radiographs at 7 months post-treatment indicated bone fill of the initial defect. Although some attachment loss occurred, the reentry demonstrated a high percentage of bone fill of the defect after 7 months.

CONCLUSION

Depending on the anatomy of the defect left after the removal of an LPC, GTR, along with bone grafting, can be a very useful tool for its treatment by reducing the attachment loss observed after simple enucleation of the cyst.

Demographic profile of odontogenic and selected nonodontogenic cysts in a Brazilian population

OBJECTIVE

To determine the demographic profile of all histologically diagnosed odontogenic cysts (OC) and nonodontogenic cysts (nOC) over a 51-year period in the Brazilian population.

STUDY DESIGN

Case records of patients with OC and nOC from the files of the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil, during the period of 1953-2003 were evaluated.

RESULTS

Among 19,064 oral biopsies, 2,905 (15.2%) presented criteria of OC and nOC. Of these, 2,812 specimens (14.7%) were diagnosed as OC and 93 (0.5%) represented nOC. The 3 most frequent OC diagnosed were radicular cyst (61.0%), dentigerous cyst (25.3%), and odontogenic keratocyst (7.2%). The most frequent nOC was the nasopalatine duct cyst (2.2%).

CONCLUSION

Our results demonstrate that there is a wide range of OC and nOC, with some cysts having a predilection for age, gender, and localization. We also showed demographic aspects and clinical characteristics of these cysts. These could be used as baseline data to obtain more epidemiologic information about the OC and the nOC especially in the Brazilian population.

Potential pitfalls in diagnostic oral pathology: a review for the general surgical pathologist

Oral developmental, reactive, benign neoplastic and malignant neoplastic conditions, many odontogenic in origin, may not be seen routinely by the general surgical pathologist and therefore may present a diagnostic dilemma. This article describes odontogenic and nonodontogenic conditions with little or no destructive potential along with the more aggressive conditions that resemble them clinically and histologically. The importance of clinical and radiographic correlation as an adjunct to tissue diagnosis is highlighted. Additionally, a brief summary of odontogenesis is presented with attention given to odontogenic embryologic remnants and the developmental and pathologic processes that may arise from them.

Botryoid odontogenic cyst: report of a case with extensive epithelial proliferation

Botyroid odontogenic cyst (BOC) is considered a rare multilocular variant of the lateral periodontal cyst. In this report; clinical and histopathological features of a case of BOC found in mandibular mental region of a 32-year-old woman is presented. There was a multilocular radiolucency extending from the roots of the right premolar to the left premolar, involving almost the whole height of the mandible. Histologically, there was extensive intraluminal epithelial proliferation in the lining and MIB-1 positive cells were noted in the basal layer.

Common benign oral soft tissue masses

This article reviews some of the more common benign oral soft tissue masses with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include traumatic fibroma, mucocele, warts/papilloma, pyogenic granuloma, peripheral giant cell granuloma, generalized gingival hyperplasia, gingival fibromatosis, lateral periodontal cyst, lipoma, and denture-induced hyperplasia.

Radiological features of glandular odontogenic cyst

OBJECTIVES

To present five new cases of glandular odontogenic cyst (GOC) and to review the radiological features at presentation as reported in the English literature.

METHODS

From 1993 to 2002, five patients in our department were diagnosed with GOC based on histopathological findings and supported by radiography and CT. The radiographic features of the new GOC cases were analysed in addition to 51 literature cases.

RESULTS

There were 31 male and 25 female patients, aged 14-90 years (mean 50 years). The mandible was involved in 80% and the maxilla in 20%; most of the lesions were located in the anterior jaw. Radiographically, 52% of the lesions were unilocular and 48% were multilocular; 94.5% showed well defined borders, which were sclerotic in 7.7% and scalloped in 13%. Information on cortical plate integrity was available in only 24 cases: 50% showed perforation, 8.3% erosion of the cortical plates and 8.3% thinning of the cortical plates. Root resorption was reported in 22% of patients and tooth displacement in 24.4%.

CONCLUSIONS

Data collected indicate that GOC has potentially aggressive behaviour, with expansion and perforation in a significant number of cases. We recommend the use of multiple plane radiographs, with CT reserved for large lesions, especially those that are multilocular or involve extragnathic structures.

Glandular odontogenic cyst (sialo-odontogenic cyst): report of two cases and literature review of 45 previously reported cases

The clinical, radiological, histopathological and immunohistochemical (cytokeratin) features of two cases of glandular odontogenic cyst (GOC) are presented and discussed in a review of 45 cases of GOC hitherto reported. Of cases with available information, 34 occurred in the mandible and 6 in the maxilla; the male:female ratio was 19:28, and the mean age was 46.7 years in males and 50.0 years in females. Six cysts recurred once after 2-8 years (mean 2 years 8 months) and 2 (5.3%) recurred twice after 2 and 5 years and after 3 and 5 years, respectively, giving a rate of recurrence of 21%. The identification of osteodentin in one of the present cases and the co-expression of cytokeratins (CK) 13, 19 and 8 strongly support the concept of odontogenic differentiation in the GOC. Careful surgical removal of the lesion succeeded by a 5-year follow-up period is recommended.

Osseous repair of a lateral periodontal cyst

THE LATERAL PERIODONTAL CYSTS is a slow-growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through-and-through perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze-dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months.

Glandular odontogenic cyst: report of a case with cytokeratin expression

The glandular odontogenic cyst is a rare lesion that was recognized as a distinct entity in the latest WHO typing of odontogenic tumors. We report a glandular odontogenic cyst that recurred after surgical removal from the anterior mandible of a 54-year-old white man. Immunohistochemical study showed that the cystic epithelium reacted positively to antibodies directed against cytokeratins (CKs) 7, 13, 14, and 19 and negatively to CKs 8 and 18.

Pigmented lateral periodontal cyst and other pigmented odontogenic lesions

OBJECTIVE

To report a case of lateral periodontal cyst (LPC) with marked melanin pigmentation in a 38-year-old Black male and to discuss the phenomenon of melanin pigmentation in odontogenic cysts and tumors.

RESULTS

Histologically, the epithelial lining of the LPC contained an abundant amount of melanin granules throughout the entire epithelium. Ultrastructurally, epithelial cells contained mature melanosomes (stage IV melanosomes). Melanophages containing aggregates of melanosomes were identified in the connective tissue cyst wall. Perusal of the literature revealed that melanin pigmentation in odontogenic lesions is uncommon. Melanin has been reported in calcifying odontogenic cyst (18 cases), odontogenic keratocyst (8 cases), adenomatoid odontogenic tumor (3 cases), ameloblastic fibroma (3 cases), odontoma (2 cases), and ameloblastic fibro-odontoma, odonto-ameloblastoma, and odontogenic fibroma (1 case each).

CONCLUSIONS

Almost all pigmented odontogenic lesions; occurred in Blacks and Asians; they are almost non-existent in Whites. Thus, racial pigmentation probably plays an important role in such lesions.

Glandular odontogenic cyst with hyaline bodies: an unusual dentigerous presentation

We present an unusual case of glandular odontogenic cyst (GOC) enclosing the crown of an impacted canine that developed in the anterior mandible in a 54-year-old woman. Microscopically, it contained numerous glandular structures and hyaline bodies in the epithelial lining. The present rare case is sufficiently distinctive to be considered a dentigerous variant of GOC.

Report of a lateral periodontal cyst and gingival cyst occurring in the same patient

The lateral periodontal cyst and gingival cyst of the adult are both developmental odontogenic cysts located predominantly in the mandibular premolar-canine region. In this paper, a case report is described of a lateral periodontal cyst and gingival cyst occurring in the same patient along with a discussion of clinical, radiographic, and histological features of these lesions.

Lateral periodontal cyst. Multifactorial analysis of a previously unreported series

The objective of the present study was to review a series of 23 lateral periodontal cysts and 2 botryoid odontogenic cysts retrieved from the files of the State University of New York at Buffalo (SUNY) Oral Pathology Biopsy Service for epidemiologic characteristics as well as radiographic findings, clinical presentation, histopathologic features, and management. This study corroborated some previously established characteristics of the lesion but also revealed some surprising aberrations. A significant difference in the age range and mean age by gender was detected with the Student's t test within this population at the 0.05 level. The classic presentation of a lateral periodontal cyst seems to be that of an asymptomatic, small, ovoid, well-corticated radiolucency that occurs in an interradicular locus in the mandibular premolar segment of a middle-aged man. However, lateral periodontal cysts may manifest with pain and cause cortical perforation, may present as large expansile radiolucencies, may arise in the maxillary molar segment, and may develop in young females. Because of the tendency for aggressiveness of other lesions that may present with a similar picture, it is important to establish the final diagnosis of lateral periodontal cyst on a histologic basis in conjunction with the clinical and radiographic findings.

Botryoid odontogenic cyst: analysis of 33 cases

The botryoid odontogenic cyst is considered to be a multiloculated variant of the lateral periodontal cyst. Fewer than 40 of these lesions have been described, many of which have recurred. This paper describes the demographic, clinical, microscopic, and radiographic features of 33 unreported cases from the files of the Oral Pathology Biopsy Service at the University of North Carolina School of Dentistry. Our findings are in agreement with previously published cases for an average age of 57 years and the most common site for occurrence in the lower premolar area. Follow-up information on 12 patients determined that 2 had recurrences.

Glandular odontogenic cyst: analysis of cytokeratin expression and clinicopathological features

The glandular odontogenic cyst (GOC) is a rare odontogenic cyst which is still controversial in regard to classification, terminology, and origin. The first Japanese case of GOC is reported. Immunohistochemical examination for expression of cytokeratins and epithelial membrane antigen by monoclonal antibodies suggested that the lining epithelium was of odontogenic origin with metaplastic mucus-laden cells. We have reviewed the literature and compared the clinicopathological findings of the reported case of GOC with those of botryoid odontogenic cysts (BOC). The anatomical location, age range, and sex of GOC cases were very similar to those of BOC. GOC appears to be a multiocular and mucoepidermoid variant of non-keratinizing odontogenic cysts, which also includes BOC. GOC should be separated from the other types of odontogenic cyst and central mucoepidermoid tumours of salivary gland origin.

Developmental odontogenic cysts. An update

This review paper reports recent advances in the subject of developmental odontogenic cysts, essentially those of the past decade, starting with reference to the new WHO classification (1). On keratocysts, the latest reported recurrence rates are assessed as are their mode of growth, immunocytochemistry, immunology, genetic studies, and work on specific keratocyst antigens. There is a critical account of the group of lesions which includes the gingival cyst of adults, lateral periodontal cyst, botryoid odontogenic cyst and glandular odontogenic cyst, and their possible relationship to one another. On dentigerous cysts, reference is made to the relationship between them and deciduous teeth, as well as to their immunocytochemistry and immunology. Recent work on the unicystic ameloblastomas, their classification and prognosis, is assessed, as is the calcifying odontogenic cyst and its relationship with solid odontogenic tumours.