1
|
Zhou Q, Xu L, Li H, Xia RH. Orthokeratinized odontogenic cyst (OOC): Clinicopathological and radiological features of a series of 48 Cases. Pathol Res Pract 2022; 236:153969. [DOI: 10.1016/j.prp.2022.153969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/17/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
|
2
|
Wang YJ, Zhang JY, Dong Q, Li TJ. Orthokeratinized odontogenic cysts: A clinicopathologic study of 159 cases and molecular evidence for the absence of PTCH1 mutations. J Oral Pathol Med 2022; 51:659-665. [PMID: 35569117 DOI: 10.1111/jop.13305] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/23/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Orthokeratinized odontogenic cyst (OOC), a newly designated entity of odontogenic cysts, is an intraosseous jaw cyst that is entirely or predominantly lined by orthokeratinized squamous epithelium. The aim of this study was to report a large series of OOC to substantiate its clinicopathologic profiles and to investigate PTCH1 mutations in OOCs. METHOD The clinicopathologic features of 167 OOCs from 159 patients were analyzed and the immunohistochemical expression of markers related to cell differentiation and proliferation was evaluated. Furthermore, PTCH1 mutations were analyzed in 14 fresh samples of OOC. RESULTS OOCs occurred mostly in the third and fourth decades (60.4%) with a male predilection (66.7%). The lesions developed more often in the mandible than maxilla, primarily in the posterior mandible and ramus. Eight patients (5.0%) showed multiple locations of either bilateral posterior mandible (n = 6) or both the maxilla and mandible. Radiographically, the majority of OOCs (91.2%) showed a well-demarcated, unilocular radiolucency with 14 multilocular cases (8.8%). A follow-up of 131 patients (123 treated by enucleation with or without marsupialization and eight by peripheral ostectomy) revealed no recurrence during an average period of 4.56 years after surgery. Immunohistochemistry indicated lower proliferative activity and a varying epithelial differentiation pattern in OOC compared with odontogenic keratocysts (OKC). No PTCH1 mutation was detected, except for three known single nucleotide polymorphisms. CONCLUSION The clinicopathological and molecular differences between OOC and OKC justified their separation, and unlike OKCs, OOCs did not harbor PTCH1 mutations, suggesting different pathogenesis underlying these two jaw cysts.
Collapse
Affiliation(s)
- Yan-Jin Wang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jian-Yun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, PR China
| | - Qing Dong
- School of Stomatology, North China University of Science and Technology, Qinhuangdao, PR China
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, PR China
| |
Collapse
|
3
|
Mahdavi N, Zavarei M, Derakhshan S, Nasab MH. Orthokeratinized odontogenic cyst: Report of eight cases and review of literature regarding its malignant transformation. J Oral Maxillofac Pathol 2021; 25:S11-S17. [PMID: 34083963 PMCID: PMC8123257 DOI: 10.4103/jomfp.jomfp_1_20] [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: 01/01/2020] [Revised: 07/28/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Orthokeratinized odontogenic cyst (OOC) is an uncommon odontogenic cyst. It has been categorized as a subtype of odontogenic keratocyst (OKC). In 2005, it was classified as a distinct entity. OOC should be histopathologically differentiated from OKC, which has a higher recurrence rate and lower malignant potential. In addition, OOC should be examined for malignant transformation. The epithelium of odontogenic cysts may rarely show malignant transformation. However, malignant transformation has been reported in inflammatory cysts such as the residual cyst and periapical cyst. The number of carcinomas arising from an OOC is low. This paper describes eight cases of OOC; out of which, two showed the development of squamous cell carcinoma from their epithelial lining.
Collapse
Affiliation(s)
- Nazanin Mahdavi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Kashan, Iran
| | - Mona Zavarei
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Samira Derakhshan
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Kashan, Iran
| | - Mahboube Hashemi Nasab
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Kashan, Iran
| |
Collapse
|
4
|
Clinical and Cone-Beam Computed Tomography Features of Orthokeratinized Odontogenic Cysts and Odontogenic Keratocysts in the Mandible. J Oral Maxillofac Surg 2020; 79:1255-1261. [PMID: 33352113 DOI: 10.1016/j.joms.2020.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of the study was to compare the clinical and cone-beam computed tomography features of orthokeratinized odontogenic cysts (OOCs) and odontogenic keratocysts (OKCs) and to fully understand features of these 2 odontogenic cysts. MATERIALS AND METHODS This retrospective cross-sectional study included patients with mandibular OOCs and OKCs. The predictor variables included age at the time of diagnosis, sex, anatomical location of the cysts, lesion size, cortical bone expansion rate, and presence of cortical bone destruction, impacted tooth, tooth displacement, and root resorption. The outcome variable was the type of cystic lesion. A 1-way analysis of variance test was used to analyze the differences among the cases of OOCs and OKCs. The specificity and sensitivity of the radiological features were calculated to differentiate OOCs from OKCs. RESULT The sample was composed of 12 patients with OOCs and 36 patients with OKCs. The mean ages of the patients with OOCs (30.50 ± 6.14 years) and OKCs (38.39 ± 19.44 years) were concentrated in the third decade. The cystic lesions occurring in areas II and III accounted for 66.67 and 52.78% of the OOC and OKC cases, respectively. The cortical bone expansion rate of the OOC was larger than that of the unilocular OKC (OOC, 2.20 ± 1.05; OKC, 1.48 ± 0.50; P < .05). The specificity and sensitivity of unilocular or multiocular cysts to differentiate OOC from OKC were 100%, 42%, 95% confidence interval of 0.1479 to 0.3892 (P < .05) and tooth displacement were 100%, 3%, 95% confidence interval of 0.1479 to 0.3892 (P < .05). CONCLUSIONS The results of this study suggest clinical and radiological features of OOCs and OKCs mostly overlap, but OOC has distinctive characteristics. Most cystic lesions of OOC are unilocular cysts, rarely accompanied by tooth displacement. The cortical bone expansion rate is larger than that of unilocular cysts of OKC.
Collapse
|
5
|
Crane H, Da Forno P, Kyriakidou E, Speight PM, Hunter KD. Multiple Orthokeratinized Odontogenic Cysts: A Report of Two Cases and Review of the Literature. Head Neck Pathol 2019; 14:381-385. [PMID: 31119532 PMCID: PMC7235050 DOI: 10.1007/s12105-019-01042-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/13/2019] [Indexed: 11/29/2022]
Abstract
Orthokeratinized odontogenic cysts (OOC) are developmental odontogenic cysts characterised by an orthokeratinized stratified squamous epithelial lining. They were originally believed to be part of the spectrum of Odontogenic Keratocyst, but are now considered to be a distinct entity. They are rare, making up approximately 1% of all odontogenic cysts and they usually occur singly. In this paper we present two new cases of multiple OOCs, and compare them to previous case reports of multiple lesions. The clinical and pathological features are discussed, along with possible diagnostic pitfalls.
Collapse
Affiliation(s)
- Hannah Crane
- Academic Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK
| | | | - Elena Kyriakidou
- Academic Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK
| | - Paul M. Speight
- Academic Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK
| | - Keith D. Hunter
- Academic Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK
| |
Collapse
|
6
|
Kamat M, Kanitkar S, Datar U, Byakodi S. Orthokeratinized odontogenic cyst with calcification: A rare case report of a distinct entity. J Oral Maxillofac Pathol 2018; 22:S20-S23. [PMID: 29491599 PMCID: PMC5824511 DOI: 10.4103/jomfp.jomfp_207_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Orthokeratinized odontogenic cyst (OOC) is a relatively rare odontogenic cyst, distinct from odontogenic keratocyst (OKC). In the 4th edition of WHO Classification of Head and Neck Tumors (2017), OOC has been included as a separate entity in the category of developmental odontogenic cysts. It presents as a unilocular radiolucent lesion in the posterior mandible and is frequently related to impacted teeth, thus mimicking dentigerous cyst. Due to low local aggressiveness and no association with nevoid basal cell carcinoma syndrome, it does not show tendency to recur. When compared to OKC, OOC exhibits substantial number of differences with respect to clinical, pathological and behavioral features and treatment modalities. Hence, recognizing OOC as unique lesion is mandatory to avoid unnecessary overtreatment. This paper aims to report a rare case of OOC associated with impacted tooth, showing calcifications and emphasizes its differences from OKC. Furthermore, the recent concepts about OKC and OOC are discussed.
Collapse
Affiliation(s)
- Mamata Kamat
- Department of Oral Pathology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, Maharashtra, India
| | - Sampada Kanitkar
- Department of Oral Pathology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, Maharashtra, India
| | - Uma Datar
- Department of Oral Pathology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, Maharashtra, India
| | - Sanjay Byakodi
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, Maharashtra, India
| |
Collapse
|
7
|
Lalla K, Mahomed F, Meer S. Keratinizing odontogenic cysts with a spectrum of verrucoid morphology: investigation of a potential role of human papillomavirus. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:625-630. [PMID: 27765332 DOI: 10.1016/j.oooo.2016.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The role of human papillomavirus (HPV) in keratinizing odontogenic cysts (OC) has only rarely been studied. We describe the clinicopathologic findings in a series of OCs that had unusual keratinization patterns and were investigated for a possible HPV etiology. STUDY DESIGN Tissue samples from 29 patients with keratinizing OCs were studied for light microscopic features suggestive of HPV infection and by an HPV DNA polymerase chain reaction assay. RESULTS The mean age at presentation was 31.1 years; 79.3% of the OCs occurred in the mandible and 46.4% were associated with an impacted tooth. The phenotypic characteristics koilocytes, hypergranulosis, and a verrucous pattern of the cyst-lining epithelium were observed in 69%, 62.1%, and 17.2% of cases, respectively. These histomorphologic features did not, however, correlate with HPV infection. CONCLUSIONS HPV does not appear to play a role in keratinizing OCs and is not responsible for the wart-like histomorphologic features that may be seen in these lesions.
Collapse
Affiliation(s)
- Kalpesh Lalla
- Department of Oral Pathology, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Farzana Mahomed
- Department of Oral Pathology, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Shabnum Meer
- Department of Oral Pathology, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
8
|
Lesions of the jaws presenting as radiolucencies on cone-beam CT. Clin Radiol 2016; 71:972-985. [DOI: 10.1016/j.crad.2016.05.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/28/2016] [Accepted: 05/25/2016] [Indexed: 11/23/2022]
|
9
|
|
10
|
|
11
|
Sarvaiya B, Vadera H, Sharma V, Bhad K, Patel Z, Thakkar M. Orthokeratinized odontogenic cyst of the mandible: A rare case report with a systematic review. J Int Soc Prev Community Dent 2014; 4:71-6. [PMID: 24818100 PMCID: PMC4015167 DOI: 10.4103/2231-0762.131265] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Orthokeratinized odontogenic cyst (OOC) is an odontogenic cyst was initially termed as the uncommon orthokeratinized type of odontogenic keratocyst by the World Health Organization. It usually occurs in mandible. Various studies have shown that OOC has typical characteristic clinicopathologic features when compared to other developmental odontogenic lesions such as dentigerous cyst and the keratocystic odontogenic tumor (KCOT). Rare recurrence was noted after surgical removal of the lesion. The purpose of this article is to present a case of OOC arising in the posterior mandible and emphasize on differentiating it from the KCOT and dentigerous cyst.
Collapse
Affiliation(s)
- Bhumi Sarvaiya
- Department of Pedodontics and Preventive Dentistry, faculty of dental science, Dharmsinh Desai University, Nadiad, India
| | - Hitesh Vadera
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India
| | - Vimal Sharma
- Department of Orthodontics and Dentofacial Orthopedics, faculty of dental science, Dharmsinh Desai University, Nadiad, India
| | - Kaustubh Bhad
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India
| | - Zinal Patel
- Department of BDS, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India
| | - Mimansa Thakkar
- Department of BDS, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India
| |
Collapse
|
12
|
Orthokeratinized odontogenic cysts presenting as a periapical lesion: report of a case and literature review. J Endod 2013; 40:455-8. [PMID: 24565671 DOI: 10.1016/j.joen.2013.09.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 09/29/2013] [Accepted: 09/30/2013] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Inflammatory cysts, granulomas, abscesses, and fibrous scars represent most periapical radiolucencies. However, other less common lesions, such as orthokeratinized odontogenic cysts (OOCs), can be found at this region, and they deserve to be discussed because the prognosis for an OOC is different from that expected for the ordinary inflammatory periapical diseases. METHODS An interesting case of OOC associated with a nonvital tooth in a 40-year-old woman is described. After a previous clinical diagnosis of a radicular cyst, the tooth was extracted, and the lesion was enucleated and submitted to microscopy examination. RESULTS Because of the detection of an orthokeratinized epithelium lining, a diagnosis of OOC was concluded. After 2 years of periodic follow-up, no signs of recurrence were detected. CONCLUSIONS The presence of keratin in radicular lesions must be carefully evaluated to eliminate the diagnosis of lesions with more aggressive behavior, such as an OOC or even a keratocystic odontogenic tumor. Hence, histopathologic examination is mandatory to confirm the type of lesion and to differentiate other pathologic conditions, therefore establishing patients' prognoses precisely.
Collapse
|
13
|
Rajalakshmi R, Sreeja C, Vijayalakshmi D, Leelarani V. Orthokeratinised odontogenic cyst mimicking periapical cyst. BMJ Case Rep 2013; 2013:bcr-2013-200883. [PMID: 24099763 DOI: 10.1136/bcr-2013-200883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth.
Collapse
Affiliation(s)
- R Rajalakshmi
- Department of Paedodontics, Adhiparasakthi Dental College & Hospital, Melmaruvathur, Tamil Nadu, India
| | | | | | | |
Collapse
|
14
|
Orthokeratinized odontogenic cyst: a report of three clinical cases. Case Rep Dent 2013; 2013:672383. [PMID: 24191203 PMCID: PMC3804142 DOI: 10.1155/2013/672383] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/05/2013] [Indexed: 11/17/2022] Open
Abstract
The orthokeratinized odontogenic cyst (OOC) is a rare developmental odontogenic cyst that has been considered as a variant of the keratocystic odontogenic tumour (KCOT) until Wright (1981) defined it as a different entity. Surgery is the usual treatment, and recurrence or association with Gorlin-Goltz syndrome has rarely been described. In this report, we presented three cases of this pathology, and we review the principal clinical, histological, radiological, and therapeutic aspects. Case 1. A 73-year-old female presents with a slight swelling on the right mandible, associated with an unilocular well-defined radiolucent lesion. Case 2. A 27-year-old female presents with a painful mandibular swelling associated with an unilocular radiolucent lesion posterior to the 4.8. Case 3. A 61-year-old male was casually detected presents with an unilocular radiolucent lesion distal to the 4.8. Conclusion. The OOC is a specific odontogenic clinicopathological entity that should be differentiated from the KCOT as it presents a completely different biological behaviour.
Collapse
|
15
|
MacDonald D, Gu Y, Zhang L, Poh C. Can clinical and radiological features predict recurrence in solitary keratocystic odontogenic tumors? Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:263-71. [DOI: 10.1016/j.oooo.2012.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 10/23/2012] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
|
16
|
Carvalho CHPD, Aquino ARLD, Nonaka CFW, Silva JSPD, Germano ADR, Pinto LP. Infected orthokeratinized odontogenic cyst: a rare cause of facial cellulitis. Braz Dent J 2013; 23:612-6. [PMID: 23306244 DOI: 10.1590/s0103-64402012000500025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 09/26/2012] [Indexed: 11/22/2022] Open
Abstract
Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facial cellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed.
Collapse
|
17
|
Two-stage treatment protocol of keratocystic odontogenic tumour in young patients with Gorlin-Goltz syndrome: marsupialization and later enucleation with peripheral ostectomy. A 5-year-follow-up experience. Int J Pediatr Otorhinolaryngol 2011; 75:1565-71. [PMID: 21978905 DOI: 10.1016/j.ijporl.2011.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 09/08/2011] [Accepted: 09/09/2011] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Keratocystic odontogenic tumour (KCOT) is a benign uni- or multicystic intraosseous odontogenic tumour with potential for local destruction and tendency for multiplicity, especially when associated with Gorlin-Goltz syndrome. We suggest a conservative surgical treatment based on marsupialization and later enucleation with peripheral ostectomy in order to preserve jaw's integrity in young patients. METHODS Three young patients affected of nevoid basal cell carcinoma syndrome (NBCCS or Gorlin-Goltz syndrome) presented large and multiple KCOTs, which have been treated following a two-stage surgical strategy. Initially marsupialization was performed and after a mean period of 10 months, contextually to evident reduction in radiological size image, enucleation with peripheral ostectomy was carried out. RESULTS All the patients showed high collaboration in daily self-irrigation of the stomia with chlorhexidine 0.2% during the period of marsupialization. Definitive surgical intervention led to complete healing and no signs of recurrence have been observed during a 5-year-follow-up. CONCLUSIONS The main advantage of this modality is the preservation of important anatomical structures involved in the lesion and jaw's continuity. Therefore in a selected group of cooperative patients, especially those affected of Gorlin-Goltz syndrome, the surgical protocol exposed allows for a less invasive approach with excellent results avoiding extensive disfiguring procedures.
Collapse
|
18
|
|
19
|
Macdonald-Jankowski DS. Orthokeratinized odontogenic cyst: a systematic review. Dentomaxillofac Radiol 2011; 39:455-67. [PMID: 21062939 DOI: 10.1259/dmfr/19728573] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The aims of the review were to evaluate the principal clinical and conventional radiographic features of orthokeratinized odontogenic cyst (OOC) by systematic review (SR), and to compare the frequency of OOC between four global groups. METHODS The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of OOCs that occurred in a consecutive series of OOCs in the reporting authors' caseload were considered. RESULTS 37 reports on 36 case series were included in the SR. OOC affected males twice as frequently and the mandible almost 2.5 times as frequently. Although the mean age at first presentation was 35 years, the largest proportion of cases first presented in the third decade for the Western, East Asian and Latin American global groups. Seven reports included details of at least one clinical finding. 11 reported case series included at least 1 radiological feature. All OOCs were radiolucent, 93% were unilocular and 68% were associated with unerupted teeth. 28% of the reported case series included follow up. 4% of OCC recurred and all of these were in the Western global group. CONCLUSIONS Although one feature of OOCs is that they are unlikely to recur, some do. Not only is there a lack of long-term follow up of large series with long-term outcomes of OOC, but there is a paucity of clinical and radiological details of OOC at initial presentation.
Collapse
Affiliation(s)
- D S Macdonald-Jankowski
- Division of Oral & Maxillofacial Radiology, Faculty of Dentistry, UBC, 2199 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| |
Collapse
|