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Fan Y, Glied A. Medication Management of Selected Pathological Jaw Lesions. Oral Maxillofac Surg Clin North Am 2022; 34:179-87. [PMID: 34602322 DOI: 10.1016/j.coms.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Most jaw lesions are treated surgically. Areas of abnormal proliferation or destruction in bone are commonly treated by regional curettage, excision, or resection. However, surgery is invasive and leaves a defect where the lesion was removed. Surgical trauma to adjacent healthy tissue, including vital neurovascular bundles is often unavoidable, and can be especially traumatizing to the pediatric patient. Select jaw lesions with well-studied nonsurgical pharmaceutical treatments are presented here.
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Hallikeri K, Babu B, Sudhakaran A, Monteiro R. Cell Block and Its Impact in the Diagnosis of Jaw Lesions over Fine Needle Aspiration Cytology. Acta Cytol 2021; 65:361-367. [PMID: 34237724 DOI: 10.1159/000517166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/09/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. METHOD The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2-3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. RESULTS On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. CONCLUSION In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.
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Affiliation(s)
- Kaveri Hallikeri
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Biji Babu
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Archana Sudhakaran
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Roshni Monteiro
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India,
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Lu SY, Ma MC, Wang MC, Hsue SS. The status of jaw lesions and medication-related osteonecrosis of jaw in patients with multiple myeloma. J Formos Med Assoc 2021; 120:1967-1976. [PMID: 33551311 DOI: 10.1016/j.jfma.2021.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND/PURPOSE Myeloma jaw lesions are not uncommon. The study aimed to investigate the status of jaw lesions and medication-related osteonecrosis of jaw (MRONJ) in multiple myeloma (MM) patients. METHODS One hundred and twenty-two consecutive newly-diagnosed MM patients seeking dental care at a hospital of southern Taiwan was examined according to jaw lesions with complete follow-up data. RESULTS Median age of the patients was 67.8 years, and 88.5% of patients were of DS stage III and 41.0% were of ISS stage III at diagnosis. Median survival was 37.9 months for 43 (35.2%) patients with jaw lesions and 57.4 months for 79 patients without jaw lesions. 1-year, 5-year and >7-year overall survival rates for patients with jaw lesions versus patients without jaw lesions were 94.9%, 67.2%, 56.7% vs 83.7%, 51.8%, 26.8% respectively. Patients with jaw lesions had the worse survival (P = 0.03). Neither age nor stage affected survival. Jaw lesions involved the mandible more often than the maxilla and stopped progressing during remission, but did not repair. Jaw lesions were the first evidence or recurrent sign of MM in six (4.9%) patients. Long-term monthly antiresorptive therapy changed the radiographic patterns of jawbones and induced MRONJ developing in 16.7% (8/48) of patients. Five (62.5%) MRONJ sites spontaneously occurred without local risk factors. CONCLUSION Nearly one-third of MM patients develop osteolytic jaw lesions that seem to be associated with poorer survival. Jaw lesion is an independent prognostic predictor of survival in myeloma. Antiresorptive drugs at less frequent dosing regimen are crucial to minimize spontaneous MRONJ.
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Affiliation(s)
- Shin-Yu Lu
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Ming-Chun Ma
- Department of Hematology-Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Chung Wang
- Department of Hematology-Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shui-Sang Hsue
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Oda M, Staziaki PV, Qureshi MM, Andreu-Arasa VC, Li B, Takumi K, Chapman MN, Wang A, Salama AR, Sakai O. Using CT texture analysis to differentiate cystic and cystic-appearing odontogenic lesions. Eur J Radiol 2019; 120:108654. [PMID: 31539792 DOI: 10.1016/j.ejrad.2019.108654] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/16/2019] [Accepted: 08/26/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Cystic and cystic-appearing odontogenic lesions of the jaw may appear similar on CT imaging. Accurate diagnosis is often difficult although the relationship of the lesion to the tooth root or crown may offer a clue to the etiology. The purpose of this study was to evaluate CT texture analysis as an aid in differentiating cystic and cystic-appearing odontogenic lesions of the jaw. METHODS This was an IRB-approved retrospective study including 42 pathology-proven dentigerous cysts, 37 odontogenic keratocysts, and 19 ameloblastomas. Each lesion was manually segmented on axial CT images, and textural features were analyzed using an in-house-developed Matlab-based texture analysis program that extracted 47 texture features from each segmented volume. Statistical analysis was performed comparing all pairs of the three types of lesions. RESULTS Pairwise analysis revealed that nine histogram features, one GLCM feature, three GLRL features, two Laws features, four GLGM features and two Chi-square features showed significant differences between dentigerous cysts and odontogenic keratocysts. Four histogram features and one Chi-square feature showed significant differences between odontogenic keratocysts and ameloblastomas. Two histogram features showed significant differences between dentigerous cysts and ameloblastomas. CONCLUSIONS CT texture analysis may be useful as a noninvasive method to obtain additional quantitative information to differentiate cystic and cystic-appearing odontogenic lesions of the jaw.
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Affiliation(s)
- Masafumi Oda
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States; Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Pedro V Staziaki
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States
| | - Muhammad M Qureshi
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States; Deparment of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, United States
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States
| | - Baojun Li
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States
| | - Koji Takumi
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States; Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Margaret N Chapman
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States
| | - Albert Wang
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States
| | - Andrew R Salama
- Deparment of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, United States; Department of Oral & Maxillofacial Surgery, Boston Medical Center, Boston University Henry M. Goldman School of Dental Medicine, United States
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, United States; Deparment of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, United States; Deparment of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, United States.
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Kaya GŞ, Özalp Ö, Özbudak İH. Synchronous occurrence of multiple distinct jaw lesions in Simpson-Golabi-Behmel Syndrome: A case report. J Stomatol Oral Maxillofac Surg 2018; 120:483-488. [PMID: 30553040 DOI: 10.1016/j.jormas.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/21/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
Simpson-Golabi-Behmel Syndrome (SGBS) is an X-linked overgrowth syndrome characterized by pre- and post-natal overgrowth, typical facial appearance and multiple visceral, skeletal, and neurological anomalies. There is only few information in the current literature, on clinical and particularly dentofacial findings due to recent identification of the syndrome and its clinical overlap with other overgrowth syndromes. The aim of this case report is to present dentofacial findings in a 16-year-old boy who had been diagnosed with SGBS. Following comprehensive clinical, radiographic and histopathological examinations, six pathologically distinct lesions including odontogenic keratocyst, ameloblastoma, lateral periodontal cyst, dentigerous cyst and mucous retention cyst in both mandible and maxilla were identified. The clinical report is followed by a discussion aimed to clarify unique features of this condition and how practitioners should consider similar cases.
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Affiliation(s)
- Göksel Şimşek Kaya
- Associate Professor, Department of Oral and Maxillofacial Surgery, Akdeniz University, Faculty of Dentistry, Antalya, Turkey.
| | - Öznur Özalp
- Specialist, Department of Oral and Maxillofacial Surgery, Akdeniz University, Faculty of Dentistry, Antalya, Turkey
| | - İrem Hicran Özbudak
- Associate Professor, Department of Pathology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
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Abstract
Most pathologic lesions of the jaws or of oral mucosa are treated successfully by surgical interventions. For treatment of the central giant cell lesion, aneurysmal bone cysts, histiocytosis of the mandible, hemangioma, odontogenic keratocyst, Paget disease, oral submucous fibrosis, and oral lichen planus, medical management consisting of intralesional injections, sclerosing agents, and systemic bisphosphonates is as successful as surgical procedures with fewer complications. Pharmacology of agents used and protocols are presented.
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Affiliation(s)
- Orrett E Ogle
- Mona Dental Program, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica; Oral and Maxillofacial Surgery, Woodhull Medical Center, Brooklyn, NY, USA.
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Khan N, Afroz N, Haider A, Hasan SA, Hashmi SH. Fine needle aspiration biopsy of intra-osseous lesions of the mandible and maxilla. Indian J Otolaryngol Head Neck Surg 2008; 60:128-32. [PMID: 23120520 DOI: 10.1007/s12070-008-0036-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
This study was done with an aim to assess the reliability and diagnostic accuracy of fine needle aspiration biopsy of intraosseous jaw lesions. Of the 42 cases, adequate material for cytologic evaluation was obtained in 35 cases. Malignant cells were found in 9 of 35 cases. FNAB diagnosis was confirmed by histopathology in all 9 of these specimens (100% accuracy). The FNAB diagnosis of benign lesions was confirmed in 19 of 26 cases (73% accuracy). The most common benign lesions were odontogenic cysts, followed by fibro-osseous and giant cell lesions. Incorrect diagnosis was related to lack of architectural context of the FNAB material, inadequate quantity of the aspirate and sampling of a non-representative part of a large lesion. Thus FNAB is a useful, simple, fairly reliable and outpatient procedure for diagnosis of intra-osseous jaw lesions, especially to distinguish between malignant and benign jaw lesions.
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