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Kim HY, Lee SM, Park JH, Kim SJ. Three-dimensional analysis of decompression efficacy and influencing factors in the maxillofacial cystic lesions: a retrospective study. J Korean Assoc Oral Maxillofac Surg 2024; 50:197-205. [PMID: 39211968 PMCID: PMC11372231 DOI: 10.5125/jkaoms.2024.50.4.197] [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: 05/14/2024] [Revised: 06/21/2024] [Accepted: 06/26/2024] [Indexed: 09/04/2024] Open
Abstract
Objectives To evaluate the effectiveness of decompression and various parameters that may affect volume change in cystic lesions. Patients and. Methods This retrospective study included patients who visited the Department of Oral and Maxillofacial Surgery at Ewha Womans University Medical Center between 2012 and 2022 for decompression of cystic lesions of the jaw. To measure volume changes, pre- and post-decompression cone-beam computed tomography was performed and reconstructed in three dimensions using Mimics 25.0 software (Materialise NV). A comparative analysis was performed based on sex, age, initial cyst volume, location, degree of cortical layer expansion, and pathologic diagnosis using the Mann-Whitney U and Kruskal-Wallis tests. Results In all 20 cases, the duration of decompression was 7.84±3.35 months, and all patients successfully completed the decompression period without any complications. Significant differences were observed in the reduction rate and shrinkage speed based on the degree of cortical layer expansion. However, only the shrinkage speed (not the reduction rate) showed a significant difference with respect to the initial cyst volume. Significant differences were not observed based on sex, age, location, or pathologic diagnosis. Conclusion Although the present study involved a small number of cases, the effectiveness of decompression was confirmed. In particular, 3D analysis overcame the shortcomings of previous studies of decompression and allowed earlier resection. Further studies with more patients are required to provide a rationale for these results and identify factors that influence decompression.
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Affiliation(s)
- Heon-Young Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sung Min Lee
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea
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Li Y, Xie Q, Li C, Yang Q, Zhang Z, Yang C, Xu G. Long-term investigation of minimally invasive alcohol-based therapy as the treatment of odontogenic keratocyst:A retrospective cohort study. J Craniomaxillofac Surg 2024; 52:324-333. [PMID: 38368215 DOI: 10.1016/j.jcms.2024.01.008] [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: 07/12/2022] [Revised: 12/05/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
The aim of this study was to evaluate the clinical efficacy of alcohol-based therapy for patients with large odontogenic keratocysts (OKCs). The study was implemented as a retrospective, single-center study. Patients treated with ethanol-based therapy for odontogenic keratocyst were retrospectively evaluated for baseline and postoperative data. The pre- and postoperative clinical situation and the extent of radiographic shrinkage were compared. The event is defined as the achievement of >50% reduction in cyst volume. The cyst reduction rate calculated on panoramic radiographs ranged from 7.4% to 99.9% (mean [standard deviation] 55.3% [27.9%]) and was statistically significant (P < 0.05). Specifically, it has been found that, radiographically, 47.6% of patients achieved >50% reduction in cyst volume within 12 months. The continuous cortical bone was rebuilt, and the cyst cavity was filled with regenerated trabecular bone. The 22 included patients presented with nonclinical problems, had no need for further intervention, and exhibited persistent impaction of the teeth. The results of this study demonstrated that ethanol-based therapy triggered marked radiographic reductions of large OKC, indicating that using this technique is efficient.
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Affiliation(s)
- Yan Li
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Qianyang Xie
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Chenlin Li
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China; Shanghai Xuhui District Dental Center, Oral and Maxillofacial Surgery, 200011, PR China
| | - Qingran Yang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Zhiyuan Zhang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
| | - Chi Yang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
| | - Guangzhou Xu
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
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Niu G, Zhang G, Chen JM, Wang T, Wu Y, Lu YG, Lin LS. A 3-year follow-up clinical study on the preservation for vitality of involved tooth in jaw cysts through an innovative method. Sci Rep 2024; 14:128. [PMID: 38168126 PMCID: PMC10761841 DOI: 10.1038/s41598-023-50523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Jaw cysts commonly affect the oral and maxillofacial region, involving adjacent tooth roots. The management of these teeth, particularly regarding root canal therapy and apicoectomy, lacks consensus. This study introduces a novel treatment concept and refined surgical approach to preserve pulp viability in teeth involved in jaw cysts. The objective was to investigate the effectiveness and potential benefits of this approach over a 36-month follow-up period. A conservative management approach prioritized vitality preservation, reserving root canal treatment and apicectomy for cases with post-operative discomfort. A comprehensive follow-up of 108 involved teeth from 36 jaw cyst cases treated with the modified method was conducted. Clinical observation, X-ray imaging, cone-beam computed tomography (CBCT), and pulp vitality testing assessed changes in cyst size, tooth color, pulp vitality, root structure, and surrounding alveolar bone. After 36 months, our modified surgical approach successfully preserved tooth vitality in 84 involved teeth. Adverse symptoms in 19 teeth, such as redness, swelling, fistula, and pain, resolved with postoperative root canal therapy. Follow-up was lost for five teeth in two cases. No cyst recurrences were observed, and in 34 cases, the bone cavity gradually disappeared, restoring normal bone density during long-term follow-up. Our modified surgical method effectively preserves tooth vitality in jaw cysts. This innovative approach has the potential to improve the management of teeth involved in jaw cysts.
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Affiliation(s)
- Gang Niu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - GongHang Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- School of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Jia-Min Chen
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Tao Wang
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ye Wu
- Department of Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - You-Guang Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Preventive Dentistry, Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, China.
| | - Li-Song Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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The clinical importance of marsupialization treatment of the cystic lesion of the jaws: Analysis of the dental pulp vitality. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101305. [PMID: 36216033 DOI: 10.1016/j.jormas.2022.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/23/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Jaw cyst is the most common pathology in the oral and maxillofacial region. The management of the teeth involved in cystic lesions is highly controversial. However, if the teeth involved in the cystic lesion could be preserved with their pulp vitality, the life span of these teeth will be considerably lengthened to improve the masticatory function of these patients after surgery. The present retrospective study over 10 years; with 92 patients that had cystic lesions of the jaws aimed to evaluate the effect of marsupialization on the preservation of the vitality teeth involved in the cystic lesion before and after treatment taking. MATERIAL AND METHODS clinical retrospective study between January 2013 and January 2022, included 92 patients with a cystic lesion of jaw treated by marsupialization were carried out. The clinical data were collected; the number of teeth involved in the cystic lesion, the vitality of these teeth before and after marsupialization, the number of teeth that have undergone root canal treatment, the number of cases of failure (teeth that were extracted during surgery to open the cystic lesion and teeth that were extracted after surgery) as well as the duration of treatment for each patient were assessed. RESULTS Of 92 patients, 54 were men and 38 women with ages ranged from 7 years to 62 years were enrolled in this study.380 teeth were involved in the cystic lesion of that 352 teeth were positive and 28 teeth were negative before marsupialization. 28 teeth underwent root canal treatment before surgery. After surgery, 338 teeth were positive and 42 were negative. Among the 42 negative teeth, 31 teeth failed (extracted) and 11 teeth recovered their vitality before the end of the treatment.321 teeth were saved and preserved their pulp vitality. CONCLUSION The effect of marsupialization is good; it saves and preserves the vitality of the teeth involved in the cystic lesion and it reduces the cost of treatment for the patients.
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Koutrakis NE, Vasilyeva D, Friedman JM. Mandibular radiolucency in an 11-year-old girl. J Am Dent Assoc 2022; 154:530-534. [PMID: 35725659 DOI: 10.1016/j.adaj.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/03/2022] [Accepted: 05/22/2022] [Indexed: 11/28/2022]
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Farshidfar N, Agharokh M, Daneste H. Eruption of the Permanent First Premolar Associated with a Mandibular Keratocystic Odontogenic Tumor after Marsupialization in a 9-year-old Boy: A Case Report with 2 years of follow-up. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:144-148. [PMID: 34150952 PMCID: PMC8206598 DOI: 10.30476/dentjods.2020.85780.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/14/2020] [Accepted: 07/05/2020] [Indexed: 12/02/2022]
Abstract
Amongst odontogenic cysts, keratocystic odontogenic tumor (KOT) is a benign intra-osseous lesion, characterized by corrugated parakeratinized uniform stratified squamous epithelium, with potential for aggressive behavior and high tendency to recur. There are multiple treatment modalities for this cyst. Some surgeons prefer the conservative treatments such as marsupialization while the others prefer invasive treatments such as radical resection. The aim of this study was to present a case of KOT involving the right mandibular premolar area with an impacted tooth in a 9-year-old boy treated by marsupialization. The treatment resulted in eruption of the mandibular first premolar, and no signs of recurrence were observed after two years. Marsupialization was found to be an effective treatment in inducing the eruption of mandibular premolar associated with KOT in preadolescents and can be a reliable procedure to reduce recurrence tendency of KOT.
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Affiliation(s)
- Nima Farshidfar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahya Agharokh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Daneste
- Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Kwon YJ, Ko KS, So BK, Kim DH, Jang HS, Kim SH, Lee ES, Lim HK. Effect of Decompression on Jaw Cystic Lesions Based on Three-Dimensional Volumetric Analysis. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E602. [PMID: 33182601 PMCID: PMC7696604 DOI: 10.3390/medicina56110602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 02/02/2023]
Abstract
Background and objectives: This study aimed to evaluate the effectiveness of decompression on jaw cysts according to various parameters by volumetric analysis using three-dimensional computed tomography. Materials and methods: Fifty patients who underwent surgical decompression of the jaw cystic lesion were selected, and their preoperative and postoperative computed tomography results between 3 and 27 months were collected. Volumetric analysis was performed to evaluate any differences in the rate of volumetric change according to the sex, age, initial volume of the lesion, duration, location of the lesion, tooth extraction, expansion of the cortical layer, and pathological diagnosis. Multiple linear regression and generalised linear mixed models were used for statistical analyses. Results: The mean reduction rate among all patients was 54.68%. Multiple linear regression analysis revealed that higher reduction rates were associated with a long decompression period, young patient age, and location of the cyst in the posterior maxilla. Generalised linear mixed models revealed that higher reduction rates were associated with a long decompression period and young patient age. Conclusions: Decompression was an effective treatment for reducing the cyst size in all patients. Its effectiveness increased with a long treatment duration, young patient age, and cyst location in the posterior maxilla three-dimensionally.
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Affiliation(s)
- Yeh-Jin Kwon
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
| | - Kyeong-Soo Ko
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
| | - Byung-Kyu So
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
| | - Dong-Hyuck Kim
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
| | - Hyon-Seok Jang
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Gyeonggi-do 15355, Korea;
| | - Soo-Ho Kim
- Department of Oral and Maxillofacial Surgery, Chungnam National University Hospital, Daejeon 35015, Korea;
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
| | - Ho-Kyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea; (Y.-J.K.); (K.-S.K.); (B.-K.S.); (D.-H.K.)
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Consolo U, Setti G, Tognacci S, Cavatorta C, Cassi D, Bellini P. Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enucleation. Med Oral Patol Oral Cir Bucal 2020; 25:e827-e833. [PMID: 33037805 PMCID: PMC7648911 DOI: 10.4317/medoral.23898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/03/2020] [Indexed: 01/18/2023] Open
Abstract
Background The purpose of this study was to evaluate whether marsupialization treatment induces changes in the histology of odontogenic keratocyst epithelium and to compare our experience with the literature.
Material and Methods A retrospective revision of histological samples was performed. 5 patients with odontogenic keratocyst treated with marsupialization follow by enucleation were selected. Histologic evaluation analyzed the changes in the keratocyst epithelium after marsupialization in terms of type of keratinization, thickness of the epithelium and connective tissue, the presence of acanthosis, the presence and grade of fibrosis, the type and grade of inflammation and the presence and number of mitotic figures and daughter cysts.
Results In our case series, a variation of para-keratinized into ortho-keratinized keratocyst was found in one case, and no significant increases were observed in the epithelium and capsule thickness, or even in the level of inflammation. However, we observed an increase in fibrosis and qualitative changes in inflammation type.
Conclusions Minor and major histological changes were associated with reduction in cyst volume, which resulted in a simpler and less invasive cystic enucleation after marsupialization. Key words:Keratocyst, marsupialization, enucleation, histology, histological changes.
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Affiliation(s)
- U Consolo
- University of Modena and Reggio Emilia Modena, Italy
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Alsaegh MA, Altaie AM, Zhu S. p63 Expression and its Relation to Epithelial Cells Proliferation in Dentigerous Cyst, Odontogenic Keratocyst, and Ameloblastoma. Pathol Oncol Res 2019; 26:1175-1182. [PMID: 31187467 DOI: 10.1007/s12253-019-00680-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
The current controversy about the classification of odontogenic keratocyst reflects the shortage in the understanding of the odontogenic cysts and tumors. The aim of the present study was to investigate p63 immunoexpression and its relation to the proliferation of the epithelial lining in dentigerous cyst (DC), odontogenic keratocyst (OKC), and follicular type of ameloblastoma (AB). The study involved 36 samples, which are DC (n = 12), OKC (n = 9), and AB (n = 15). p63 protein expression was evaluated by immunohistochemistry. The results on Ki-67 expression were obtained from our previous studies and correlated with p63 expressions. p63 was expressed differently in the studied lesions with various distribution in different study samples. Statistical analysis using Kruskal-Wallis test showed a significant difference in the expression of p63 protein among DC, OKC, and AB (p = 0.048). Subsequently, Mann-Whitney U test revealed the expression of p63 protein was significantly higher in OKC than DC (p = 0.018). Interestingly, Spearman's correlation analysis showed a positive correlation between the expression of p63 and Ki-67 in the odontogenic epithelium of DC (σ = 0.757, P = 0.004) and OKC (σ = 0.741, P = 0.022). While no such a positive correlation was found between the two studied markers in AB group (σ = 0.006, P = 0.983). In conclusion, the present results indicated various expression and correlation of p63 with the proliferation of odontogenic epithelial cells in DC, OKC, and AB. This diversity could reflect a different role and pathways of ΔNp63 in odontogenic tumor than that in odontogenic cyst. These together will help in better understanding the pathogenesis and biological behavior of odontogenic cysts and tumors.
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Affiliation(s)
- Mohammed Amjed Alsaegh
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Science and Technology of Fujairah, Al-Hulifat, Fujairah, 2202, United Arab Emirates. .,Department of Oral and Maxillofacial Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
| | - Alaa Muayad Altaie
- Sharjah Medical Research Institute, Medical College, Sharjah University, Sharjah, United Arab Emirates
| | - Shengrong Zhu
- Department of Oral and Maxillofacial Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
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Alsaegh MA, Altaie AM, Zhu S. Expression of keratin 15 in dentigerous cyst, odontogenic keratocyst and ameloblastoma. Mol Clin Oncol 2019; 10:377-381. [PMID: 30847177 DOI: 10.3892/mco.2019.1802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/15/2019] [Indexed: 02/01/2023] Open
Abstract
The etiology and pathogenesis of odontogenic lesions are poorly understood. Keratin 15 (K15) is a type I cytoskeletal protein that provides structural support to the cells and has been considered to be a stem cell marker. The aim of the present study was to evaluate the expression of K15 in the epithelial lining of dentigerous cysts (DCs), odontogenic keratocysts (OKCs) and ameloblastomas (ABs). The study included 41 samples of DCs (n=13), OKCs (n=12), and AB tissues (n=16). K15 protein expression was evaluated via immunohistochemistry and data were statistically analyzed using a Kruskal-Wallis test. K15 was expressed in the majority of the studied lesions with various distributions in the different study samples. The Kruskal-Wallis test revealed non-significant differences in the expression of K15 among the three odontogenic lesions (P=0.380). The present study confirmed the high expression of K15 in the different epithelial layers of DC, OKC and AB. This type of expression excludes the reliability of regarding K15 as a stem cell marker in DC, OKC and AB. However, K15 may reflect the abnormal differentiation of pathological epithelial cells in these lesions.
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Affiliation(s)
- Mohammed Amjed Alsaegh
- Department of Oral and Maxillofacial Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China.,Department of Oral and Maxillofacial Surgery, College of Dentistry, Ajman University, Fujairah Campus, Al-Hulifat, Fujairah 2202, United Arab Emirates
| | - Alaa Muayad Altaie
- Sharjah Medical Research Institute, Medical College, Sharjah University, Sharjah 27272, United Arab Emirates
| | - Shengrong Zhu
- Department of Oral and Maxillofacial Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
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11
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Park JH, Kwak EJ, You KS, Jung YS, Jung HD. Volume change pattern of decompression of mandibular odontogenic keratocyst. Maxillofac Plast Reconstr Surg 2019; 41:2. [PMID: 30671423 PMCID: PMC6321831 DOI: 10.1186/s40902-018-0184-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives This study was aimed to analyze the reducing pattern of decompression on mandibular odontogenic keratocyst and to determine the proper time for secondary enucleation. Materials and methods Seventeen patients with OKC of the mandible were treated by decompression. Forty-five series of CT data were taken during decompression and measured by using InVivo software (Anatomage, San Jose, Calif) and were analyzed. Results The expected relative volume during decompression is calculated using the following formula: V(t) = V initial × exp.(at + 1/2bt 2) (t = duration after decompression (day)). There was no significant directional indicator in the rate of reduction between buccolingual and mesiodistal widths. Conclusion The volume reduction rate gradually decreased, and 270 days were required for 50% volume reduction following decompression of OKC. The surgeon should be aware of this pattern to determine the timing for definitive enucleation. Clinical relevance The volume reduction rate and pattern of decompression of the OKC can be predicted and clinicians should be considered when treating OKC via decompression.
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Affiliation(s)
- Jin Hoo Park
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea
| | - Eun-Jung Kwak
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea
| | - Ki Sung You
- 3Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Indiana, USA
| | - Young-Soo Jung
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea.,2Oral Science Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hwi-Dong Jung
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 Korea.,2Oral Science Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
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Kortegaard HE, Reiter AM, Legendre L, Eriksen T, Buelund LE, Gorrel C. Marsupialization Followed by Curettage of an Extensive Periapical Cyst in the Incisive and Maxillary Bone in a Dog. J Vet Dent 2018. [DOI: 10.1177/0898756418813645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 7-year-old male intact border terrier (8.5 kg) was presented with a large, painless mass apical to the right maxillary incisors. Diagnostic imaging and histopathology confirmed the diagnosis of periapical cyst due to a nonvital maxillary incisor. Extensive cysts are often multilocular and therefore difficult to debride without risk of iatrogenic damage. Complete resection can cause damage to adjacent structures and may compromise function. Due to the large size of the cyst, it was decided to perform staged treatment with extraction of the nonvital tooth and marsupialization. Following marsupialization, gradual bone regrowth caused size reduction. The stoma from the marsupialization was kept open for 8.5 months before the cyst was curetted and the wound closed. Complete obliteration of the cyst cavity was seen at short- and long-term follow-up examinations (7 and 24 months after curettage, respectively).
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Affiliation(s)
- Hanne E. Kortegaard
- Department of Clinical Veterinary Sciences, Faculty of Health Sciences, Copenhagen University, Frederiksberg C, Denmark
| | - Alexander M. Reiter
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Loic Legendre
- West Coast Veterinary Dental Services Ltd, Vancouver, British Columbia, Canada
| | - Thomas Eriksen
- Department of Clinical Veterinary Sciences, Faculty of Health Sciences, Copenhagen University, Frederiksberg C, Denmark
| | - Lene E. Buelund
- Department of Clinical Veterinary Sciences, Faculty of Health Sciences, Copenhagen University, Frederiksberg C, Denmark
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Cakarer S, Isler SC, Keskin B, Uzun A, Kocak Berberoglu H, Keskin C. Treatment For The Large Aggressive Benign Lesions Of The Jaws. J Maxillofac Oral Surg 2017; 17:372-378. [PMID: 30034157 DOI: 10.1007/s12663-017-1060-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/22/2017] [Indexed: 01/10/2023] Open
Abstract
Objectives Our aim was to evaluate the clinical outcome of the conservative management of the significantly large benign aggressive lesions of the jaws. Subjects and Methods Twenty-two patients were reviewed regarding the demographic, radiographic, and operative findings. Patients were treated by decompression followed by curettage or only with curettage. Results No bone grafts were used. Mean follow-up time was 56.2 months. The mandible was more affected than the maxilla. Two of the ameloblastoma, two of the keratocystic odontogenic tumours, and one odontogenic myxoma were recurred. Conclusions Despite the low number of the patients, it is concluded that the conservative management is predictable for the management of the benign aggressive lesions in order to reduce morbidity instead of directly performing radical surgery. The life during follow-up is mandatory in the situation of performing conservative surgery for the management of large aggressive lesions with high recurrence rate.
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Affiliation(s)
- Sirmahan Cakarer
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - S Cemil Isler
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - Basak Keskin
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - Aysenur Uzun
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - Hulya Kocak Berberoglu
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
| | - Cengizhan Keskin
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review. Int J Surg Case Rep 2017; 34:119-122. [PMID: 28388515 PMCID: PMC5384295 DOI: 10.1016/j.ijscr.2017.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 11/24/2022] Open
Abstract
Keratocystic odontogenic tumours (KCOTs) are rare, benign lesions of the jaw. We present a 49-year-old woman with a rare, large KCOT of the mandible. We describe a treatment method involving enucleation with Carnoy’s solution plus inserting a titanium plate. Although the patient showed recurrence once, she has not shown recurrence since 2010. Our approach was effective for the treatment of a large KCOT with tooth preservation.
Introduction Keratocystic odontogenic tumours (KCOTs) are benign lesions of the jaw that are characterised by expansive growth and high rates of recurrence. Herein, we present a novel minimally invasive method for the surgical treatment of KCOTs. Case presentation We present a 49-year-old woman with a rare, large KCOT of the mandible extending from tooth 37 to tooth 47. A single enucleation procedure was selected as the surgical technique combined with a titanium plate. Teeth interfering with the cystic lumen were preserved. The bone surrounding the cyst was partially removed and rinsed with Carnoy’s solution. Recurrence was observed 1 year later between teeth 43 and 45, and was treated by single enucleation with Carnoy’s solution. After the second operation, the teeth interfering with the KCOT still elicited a positive response to dental pulp testing. No further signs of recurrence were observed after a total observation period of 7 years. Discussion Various surgical interventions have been described for KCOTs. However, a general guideline for a specific surgical intervention has not yet been established owing to the heterogeneity of these tumours. Conclusion Immediate enucleation in combination with a titanium plate offers an effective surgical approach for the treatment of large KCOTs of the mandible without the need for radical tooth removal or resection of the afflicted side.
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Asutay F, Atalay Y, Turamanlar O, Horata E, Burdurlu MÇ. Three-Dimensional Volumetric Assessment of the Effect of Decompression on Large Mandibular Odontogenic Cystic Lesions. J Oral Maxillofac Surg 2016; 74:1159-66. [DOI: 10.1016/j.joms.2015.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/26/2015] [Accepted: 12/14/2015] [Indexed: 11/25/2022]
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Barry JY, Le CH, Baumann J, Skinker L, Chiu AG, Chang EH. Endoscopic resection of maxillary sinus keratocystic odontogenic tumors. Laryngoscope 2016; 126:2216-9. [PMID: 26972016 DOI: 10.1002/lary.25920] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/17/2016] [Accepted: 01/19/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Jonnae Y Barry
- Department of Otolaryngology-Head and Neck Surgery, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A..
| | - Christopher H Le
- Department of Otolaryngology-Head and Neck Surgery, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Jessica Baumann
- Department of Pathology, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Linda Skinker
- Department of Pharmacology, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Alexander G Chiu
- Department of Otolaryngology-Head and Neck Surgery, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Eugene H Chang
- Department of Otolaryngology-Head and Neck Surgery, the University of Arizona College of Medicine, Tucson, Arizona, U.S.A
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Lee HG, Rhee SH, Noh CA, Shin SH. Enucleation of large keratocystic odontogenic tumor at mandible via unilateral sagittal split osteotomy: a report of three cases. J Korean Assoc Oral Maxillofac Surg 2015; 41:208-12. [PMID: 26339581 PMCID: PMC4558191 DOI: 10.5125/jkaoms.2015.41.4.208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/07/2015] [Accepted: 04/14/2015] [Indexed: 11/07/2022] Open
Abstract
Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible.
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Affiliation(s)
- Hyeong-Geun Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Seung-Hyun Rhee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Chung-Ah Noh
- 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
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