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Albagieh H, Aldosari M, Alkhathlan A, Alfawaz N, Almutairi M. Radiolucent lesions that may resemble inflammatory periapical lesions: A review article. Saudi Dent J 2023; 35:916-919. [PMID: 38107039 PMCID: PMC10724350 DOI: 10.1016/j.sdentj.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Non-endodontic lesions (NEL) closely resemble lesions of endodontic origin. Its etiology can be odontogenic, non-odontogenic, neoplastic, or anatomic variations that can resemble inflammatory periapical lesions in the periapical area. Inflammatory periapical lesions are caused by pulpal pathoses and require endodontic treatment. Since numerous NEL may resemble inflammatory periapical lesions, they can lead to misdiagnosis and inappropriate management. Thus, a detailed review of the patients' medical and dental histories with clinical examination, including radiographic findings, is essential for the proper assessment of periapical lesions. Numerous cases of misdiagnoses of NEL have been reported in literature. Thus, this review aimed to strengthen the awareness of clinicians on periapical radiolucency, which may resemble inflammatory periapical lesions.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Nawaf Alfawaz
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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McLean AC, Vargas PA. Cystic Lesions of the Jaws: The Top 10 Differential Diagnoses to Ponder. Head Neck Pathol 2023; 17:85-98. [PMID: 36928736 PMCID: PMC10063769 DOI: 10.1007/s12105-023-01525-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/06/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that may be reactive or neoplastic in nature. While most cystic jaw lesions are benign, variability in biologic behavior makes distinction between these entities absolutely crucial. METHODS Review. RESULTS Two clinical cases are presented in parallel and are followed by an illustrated discussion of the ten most likely differential diagnoses that should be considered when confronted with a cystic jaw lesion. Strong emphasis is placed on the histologic differences between these entities, empowering readers to diagnose them with confidence. Perhaps even more importantly, the more common diagnostic pitfalls in gnathic pathology are discussed, recognizing that a definitive diagnosis cannot be rendered in every situation. The histologic diagnoses for the two clinical cases are finally revealed. CONCLUSION Cystic lesions of the maxilla and mandible may be odontogenic or non-odontogenic. The most common cystic lesions are the reactive periapical cyst, and the dentigerous cyst (which is developmental in nature). It is important to note that cystic neoplasms also occur in the jaws, and that the presence of inflammation may obscure the diagnostic histologic features of lesions like odontogenic keratocyst and unicystic ameloblastoma. Ancillary testing is of limited diagnostic value in most scenarios. However, both clinical and radiographic information (such as the location, size, duration, associated symptoms, and morphology of the lesion in its natural habitat) are significantly useful.
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Affiliation(s)
- Anne C McLean
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Clements University Hospital UT Southwestern Medical Center, 6201 Harry Hines Blvd, RM UH04.252, Dallas, TX, 75390, USA.
| | - Pablo A Vargas
- Department of Oral Diagnosis, The State University of Campinas, Piracicaba, São Paulo, Brazil
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Barrios-Garay K, Agudelo-Sánchez LF, Aguirre-Urizar JM, Gay-Escoda C. Critical assessment of the latest classification of jaw cysts proposed by the World Health Organization (2017). J Clin Exp Dent 2021; 13:e1147-e1153. [PMID: 34824702 PMCID: PMC8601698 DOI: 10.4317/jced.58764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background The fourth edition of the World Health Organization Classification of Head and Neck Tumors was published in January 2017, and includes a classification of odontogenic tumors and odontogenic cysts. The present review assesses the changes made in this new classification in relation to odontogenic and non-odontogenic jaw cysts.
Material and Methods An electronic search was conducted in the Cochrane Library, PubMed-MEDLINE and Scopus databases using the search terms: “odontogenic cyst” “WHO classification” “update”. Studies written in English and published between January 2005 and April 2020 with a high level of scientific evidence were included, while studies not published in English, epidemiological studies, and studies with a low level of scientific evidence were excluded.
Results The initial search identified 311 articles, and after the deletion of duplicates, 7 studies were selected for full-text assessment. After excluding two studies that failed to provide relevant information and had a low level of scientific evidence, 5 articles were finally included and stratified according to their level of scientific evidence based on the SORT (Strength of Recommendation Taxonomy) criteria.
Conclusions The incorporation of odontogenic and non-odontogenic cysts to the head and neck tumors classification underscores the recognition of the WHO of these important disorders of the jaws. Based on the current evidence, there is controversy as to whether odontogenic keratocysts should be regarded as cystic lesions or as neoplasms, though there is no such controversy in relation to calcifying odontogenic cysts. On the other hand, orthokeratinized odontogenic cysts have been included in the classification as a single entity differentiated from odontogenic keratocysts, while residual cysts have been removed from the classification. Key words:Odontogenic cyst, WHO classification, pseudocyst.
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Affiliation(s)
- Kevin Barrios-Garay
- Dentistry student. Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - José-Manuel Aguirre-Urizar
- MD, DDS, PhD. Chairman and Professor of Oral Medicine, Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country/EHU, Leioa, Spain
| | - Cosme Gay-Escoda
- MD, DDS, MS, PhD, EBOS, OMFS. Chairman and Professor of Oral and Maxillofacial Surgery, Faculty of Medicine and Health Sciences, University of Barcelona. Director of the Master Degree Program in Oral Surgery and Implantology (EHFRE International University/FUCSO). Coordinator/Researcher at the IDIBELL Institute. Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
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Lima LB, de Freitas Filho SA, Barbosa de Paulo LF, Servato JP, Rosa RR, Faria PR, Loyola AM, Cardoso SV. Simple bone cyst: description of 60 cases seen at a Brazilian School of Dentistry and review of international literature. Med Oral Patol Oral Cir Bucal 2020; 25:e616-e625. [PMID: 32683391 PMCID: PMC7473432 DOI: 10.4317/medoral.23638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/03/2020] [Indexed: 11/11/2022] Open
Abstract
Background The aim of this study was to describe the relative frequency and the main demographic and clinic-radiographic features related to patients diagnosed with Simple bone cyst (SBC) in an Oral Diagnosis Service in Southeast Brazil and present a review and discussion of international literature on this topic.
Material and Methods SBC cases from our service encompassing the period between 1978 and 2017 were selected. In addition, a literature search was performed in the Pubmed/MEDLINE online electronic database published between 1951 and 2019.
Results A total of 2,459 cystic lesions were documented in our service, thus 60 patients were diagnosed with the SBC representing 2.4% of all jaw cystic. Most of cases were asymptomatic. Multiple SBC lesions were seen in two patients (3.4%) and association with cemento-osseous dysplasia was seen in one female patient (1.7%). A total of 793 cases were enrolled in this literature review.
Conclusions The SBC is an asymptomatic lesion often discovered in routine image exams in young patients. The unilocular, well defined margin with scalloped appearance is characteristic and helps the definition of diagnosis. This review suggests a different epidemiologic trend concerning to the sex and it confirms the posterior region of mandible as the more frequent location. The conservative treatment with limited exploration and curettage remains as the gold-standard treatment. Key words:Simple bone cyst, idiopathic bone cavity, traumatic bone cyst, conservative treatment.
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Affiliation(s)
- L-B Lima
- Universidade Federal de Uberlândia Faculdade de Odontologia - Área de Patologia Av. Pará, 1720 - Campus Umuarama CEP 38400-902 - Uberlândia / MG, Brazil
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Aburas S, Bandura P, Al-Ibraheem A, Berger S, Meier M, Turhani D. A large maxillary cemento-ossifying fibroma superimposed with solitary bone cyst documented over 18 years: A case report. Int J Surg Case Rep 2020; 68:257-262. [PMID: 32199251 PMCID: PMC7082601 DOI: 10.1016/j.ijscr.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/28/2020] [Accepted: 03/02/2020] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Cemento-ossifying fibromas are rare, benign lesions of the head and neck regions. The origin of these lesions can be traced to the periodontal ligament, because its cells are able to form cement, lamellar bone, or fibrous tissue. CASE PRESENTATION A rare case report of a young Caucasian female with a COF is described including follow-ups. She remained untreated for several years despite early radiographic findings of the lesion without a definitive diagnosis. The patient ultimately underwent radical surgery and the whole lesion was removed. The subsequent histological examination confirmed the clinical diagnosis of a COF. Since then, the patient has been under regular clinical and radiological follow-ups. DISCUSSION This rare case report of a COF, documented over 18 years, shows the importance of consecutive therapy after radiologic and clinical findings, as such lesions continue growing and may subsequently lead to severe medical conditions. Therefore, complete surgical resection of COFs is advised to achieve good results in terms of health and recurrence. CONCLUSION Long-term follow-up of patients is required as recurrences can occur for up to 10 years following treatment. Well-planned radical and wide surgical resection of these lesions has proven not only to be effective in eliminating the aetiological factors, but can also achieve decent bone regeneration and aesthetic results with almost no deformation in the surgical site.
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Affiliation(s)
- Sarmad Aburas
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Patrick Bandura
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Ali Al-Ibraheem
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Sebastian Berger
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Marius Meier
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Dritan Turhani
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria.
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Mortazavi H, Baharvand M, Safi Y, Behnaz M. Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid. Imaging Sci Dent 2019; 49:79-86. [PMID: 31281784 PMCID: PMC6597375 DOI: 10.5624/isd.2019.49.2.79] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/06/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. Materials and Methods General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. Results About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. Conclusion When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Baharvand
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Behnaz
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Álvarez-Martínez EDC, Posso-Zapata MV, Flórez-Arango VA, Lopera-Valle JS, Ardila CM. Aneurysmal bone cyst of the mandible with conservative surgical management: A case report. J Clin Exp Dent 2019; 11:e561-e564. [PMID: 31346378 PMCID: PMC6645265 DOI: 10.4317/jced.55771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/02/2019] [Indexed: 11/17/2022] Open
Abstract
The aneurysmal bone cyst is a nonneoplastic, osteolytic and locally destructive lesion that mainly affects the metaphyseal area of long bones and only 2% of it is diagnosed in the maxillofacial skeleton. Although surgical treatment is the most common option, it is associated to high morbidity rates. The case of an aneurysmal bone cyst of a considerable size in a 27-year-old male patient illustrating a conservative surgical approach with preservation of the dental structures in the mandible to limit aesthetic and functional side effects is presented. Two-year clinical follow-up was performed with no evidence of recurrence.
Key words:Aneurysmal bone cyst; curettage, conservative treatment, mandibular osteotomy.
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Affiliation(s)
| | | | | | | | - Carlos-Martín Ardila
- Periodontist, Ph.D. in Epidemiology, Coordinator of the Biomedical Stomatology Research Group. Medellín, Colombia
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Rosario MS, Yamamoto N, Hayashi K, Takeuchi A, Kimura H, Miwa S, Higuchi T, Inatani H, Abe K, Taniguchi Y, Aiba H, Tsuchiya H. An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change. World J Surg Oncol 2017; 15:102. [PMID: 28506249 PMCID: PMC5433014 DOI: 10.1186/s12957-017-1166-8] [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: 02/17/2017] [Accepted: 04/23/2017] [Indexed: 01/30/2023] Open
Abstract
Background Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now. Case presentation A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively. Conclusions The authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.
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Affiliation(s)
- Mamer S Rosario
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan.,Department of Orthopaedics, East Avenue Medical Center, East Avenue, Diliman, 1101, Quezon City, Metro Manila, Philippines
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan.
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Takashi Higuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroyuki Inatani
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Kensaku Abe
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Yuta Taniguchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hisaki Aiba
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
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