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Ko DE, Kim BC, Yoon JH, Yeom HG. Simple bone cyst with severe root resorption: a case report. BMC Oral Health 2025; 25:311. [PMID: 40011887 PMCID: PMC11866581 DOI: 10.1186/s12903-025-05648-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 02/12/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND A simple bone cyst (SBC) is a non-neoplastic intraosseous cavity without an epithelial lining. It is usually asymptomatic and has little effect on the surrounding structures. SBC associated with root resorption of the involved tooth has seldom been reported. CASE PRESENTATION A 63-year-old Korean woman was referred to our hospital for a cystic lesion of the left mandibular second molar. Radiographic examination revealed a well-demarcated radiolucent lesion with severe root resorption in the involved tooth. The tooth was extracted, and surgical exploration revealed an empty cavity with only a small amount of fibrous connective tissue. Histological examination revealed external root resorption in the left mandibular second molar and a cystic structure consisting of fibrous collagenous tissue devoid of an epithelial lining. CONCLUSIONS This case of SBC associated with root resorption offers valuable insight into the diagnostic process for radiolucent lesions accompanied by root resorption.
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Affiliation(s)
- Da-Eun Ko
- Department of Oral and Maxillofacial Pathology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Bong-Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jung-Hoon Yoon
- Department of Oral and Maxillofacial Pathology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Han-Gyeol Yeom
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea.
- Department of Oral and Maxillofacial Radiology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea.
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2
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Choi WJ, Lee P, Thomas PC, Rath TJ, Mogensen MA, Dalley RW, Wangaryattawanich P. Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification. World J Radiol 2024; 16:294-316. [PMID: 39239241 PMCID: PMC11372550 DOI: 10.4329/wjr.v16.i8.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 08/28/2024] Open
Abstract
Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies. These lesions can arise from various tissues, including bone, cartilage, and soft tissue, each presenting distinct challenges in diagnosis and treatment. While some pathologies exhibit characteristic imaging features that aid in diagnosis, many others are nonspecific. This overlap often necessitates a multimodal imaging approach, combining techniques such as radiographs, computed tomography, and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations. This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors, including updates on the 2022 World Health Organization classification of these tumors. The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.
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Affiliation(s)
- Woongsoon John Choi
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
- Department of Radiology, M&S Radiology Associates, San Antonio, TX 78217, United States
| | - Peggy Lee
- Division of Oral Radiology, University of Washington School of Dentistry, Seattle, WA 98195, United States
| | - Penelope C Thomas
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Tanya J Rath
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, United States
| | - Monique A Mogensen
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Roberta W Dalley
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Pattana Wangaryattawanich
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
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Otonari-Yamamoto M, Nakajima K, Sato H, Wada H, Matsumoto H, Nishiyama A, Hoshino T, Matsuzaka K, Katakura A, Goto TK. Dentigerous cysts suspected the other odontogenic lesions on panoramic radiography and CT. Oral Radiol 2024; 40:319-326. [PMID: 38165531 DOI: 10.1007/s11282-023-00732-4] [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: 05/25/2023] [Accepted: 11/26/2023] [Indexed: 01/03/2024]
Abstract
Dentigerous cysts are known as the second most common type of cyst in the jaws. The cyst is one of the lesions occurred frequently in the posterior body of the mandible and is often related to the unerupted third molar and forms around the crown of the unerupted tooth attaching at the cementoenamel junction. Such characteristic appearances are the diagnostic points differentiating from ameloblastoma or odontogenic keratocyst. However, it would be hard for us to diagnose it as a dentigerous cyst if the lesion does not show its typical appearance. We experienced two cases of dentigerous cysts which did not form around the crown of the unerupted tooth on radiologically. Both cysts were relatively large and resorbed adjacent teeth roots. Therefore, an ameloblastoma or an odontogenic keratocyst was suspected rather than a dentigerous cyst as the imaging diagnosis. The biopsy revealed that the lesion was a "dentigerous cyst" in one of the cases and "developmental cyst with inflammation" in another case. After the excision, the histopathological diagnosis was a dentigerous cyst with inflammation in both cases. This report shows the two cases of dentigerous cysts focusing on panoramic radiography and CT images. Also, we discuss the differential diagnosis by reconsidering those diagnostic points.
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Affiliation(s)
- Mika Otonari-Yamamoto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, Tokyo, Japan
| | - Hitomi Sato
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Hirotaka Wada
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Hideki Matsumoto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Akihiro Nishiyama
- Department of Oral Pathological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Teruhide Hoshino
- Department of Oral Pathological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | | | - Akira Katakura
- Department of Oral Pathological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Tazuko K Goto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
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4
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Imase R, Watanabe T. Maxillary unicystic ameloblastoma: a rare presentation. BMJ Case Rep 2022; 15:e250786. [PMID: 36414335 PMCID: PMC9685194 DOI: 10.1136/bcr-2022-250786] [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] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Unicystic ameloblastoma (UAM), a rare variant of ameloblastoma, is an odontogenic epithelial neoplasm typically appearing in the mandible. We report an extremely rare case of maxillary UAM with an impacted canine and supernumerary tooth. The patient was a woman in her late 30s who presented with a slight expansion of the left anterior maxilla due to a cystic lesion with impacted teeth. Under a clinical diagnosis of dentigerous cyst, the cystic lesion was completely enucleated by extracting the impacted teeth. Based on the clinical features and pathological findings, the final diagnosis was intraluminal UAM in the anterior maxilla. In the present case, despite the rarity of UAM with impacted teeth in the anterior maxilla, it should be considered during differential diagnosis. Careful clinical examination is required for diagnostic accuracy since the clinical findings of tooth-containing ameloblastoma and dentigerous cyst are very similar.
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Affiliation(s)
- Ryo Imase
- Department of Oral and Maxillofacial Surgery, Uwajima City Hospital, Uwajima, Japan
| | - Takuma Watanabe
- Department of Oral and Maxillofacial Surgery, Kyoto University, Kyoto, Japan
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5
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Patel S, Saberi N, Pimental T, Teng P. Present status and future directions: Root resorption. Int Endod J 2022; 55 Suppl 4:892-921. [PMID: 35229320 PMCID: PMC9790676 DOI: 10.1111/iej.13715] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Root resorption is the loss of dental hard tissue because of odontoclastic action. In permanent teeth, it is undesirable and pathological in nature. Root resorption may occur on the inner aspect of the root canal (internal root resorption) or on the outer aspect of the root (external root resorption). Regardless of its location, root resorption is irreversible, and may result in discomfort for the patient, requires management and/or, in some cases, results in the premature loss of the affected tooth. Root resorption is often challenging to accurately diagnose and manage. The aim of this narrative review is to present the relevant literature on the aetiology, pathogenesis, diagnosis and management, as well as discuss the future directions of diagnosis and management of root resorption.
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Affiliation(s)
- Shanon Patel
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK,Specialist PracticeLondonUK
| | - Navid Saberi
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Tiago Pimental
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Peng‐Hui Teng
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
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6
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Ayalı A, Savtekin G. Management of an Infected Giant Dentigerous Cyst Associated with Maxillary Third Molar. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2020.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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7
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Noujeim Z, Nasr L. The prevalence, distribution, and radiological evaluation of dentigerous cysts in a Lebanese sample. Imaging Sci Dent 2021; 51:291-297. [PMID: 34621656 PMCID: PMC8479438 DOI: 10.5624/isd.20210075] [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: 03/27/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample. Materials and Methods It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed. Results Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients (52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%). Conclusion The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors.
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Affiliation(s)
- Ziad Noujeim
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.,Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
| | - Lara Nasr
- Dental Departments, Lebanese Army Military Medicine, Beirut, Lebanon
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8
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Fujita A, Ueyama Y, Nagatsuka H, Kawamata H. A case of large adenomatoid odontogenic tumor in the posterior region of the mandible showing root resorption. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2020053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin, and usually presents as a unilocular radiolucency in the maxillary anterior region in adolescent females. Observation: A 31-year-old Japanese male, having a large adenomatoid odontogenic tumor from the right molar region to the left anterior region of the mandible showing root resorption of the neighboring teeth, was presented to the hospital. The lesion was totally resected under general anesthesia. Commentary: AOT may cause displacement of the neighboring teeth. But root resorption is a very rare finding. AOTs are relatively small in size. Conclusion: The patient was under follow-up and had not shown any signs of recurrence 12 months after surgery.
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9
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Ranchod S, Titinchi F, Behardien N, Morkel J. Ameloblastoma of the mandible: analysis of radiographic and histopathological features. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction: Ameloblastoma is the most common benign tumour of odontogenic origin in Africa and presents five times more in the mandible than the maxilla. The presentation of ameloblastoma in the mandible is unique due to its anatomical variation and hence the aim of this study was to analyse the radiographic and histopathological features of ameloblastoma involving the mandible. Materials and methods: This was a retrospective, descriptive study of all histopathologically diagnosed ameloblastoma of the mandible over a period of 45 years. Patient demographics, radiographic and histopathological features were recorded and compared to previous studies. Results: A total of 148 lesions were included. The male to female ratio was nearly equal (1.05:1). The majority of patients were below 50 years of age (83.77%) and were black African (58.8%). The posterior region was the most affected site with majority of lesions presenting with multilocular appearance (68.24%) and root resorption (66.38%). Histologically, conventional ameloblastoma was the most common variant (48.65%). Conclusions: Mandibular ameloblastoma had a higher predilection for black African patients with higher prevalence of mixed density lesions when compared to previous studies. The size of lesions in this sample was considerably larger than those reported in previous studies. In addition, lesions in this sample also exhibited marked cortical expansion as well as root resorption.
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10
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Martins GG, Oliveira IAD, Consolaro A. The mechanism: how dental resorptions occur in ameloblastoma. Dental Press J Orthod 2019; 24:21-32. [PMID: 31508703 PMCID: PMC6733230 DOI: 10.1590/2177-6709.24.4.021-032.oin] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 06/28/2019] [Indexed: 11/22/2022] Open
Abstract
Knife-edge or blunt root resorptions characterize ameloblastomas and are pathognomonic for this tumor, because they differentiate ameloblastomas from simple bone cysts, odontogenic keratocysts and nasopalatine duct cysts, which do not lead to resorption of involved teeth. Despite the very high frequency and importance of these characteristics for a differential diagnosis, a microscopic examination should also be conducted before defining the diagnosis and the treatment plan for these cases. This paper describes a six-step hypothesis to explain the mechanism by which ameloblastomas promote the characteristic root resorptions found in association with these benign epithelial tumors, which have a fibrous capsule formed by islands and epithelial cords that mimic the dental lamina, invade neighboring tissues and release mediators (IL-1, EGF) of tooth and root resorption. This hypothesis may be one more explanation for the tooth resorptions sometimes found in orthodontic records, and may help differentiate the root resorptions that are specific to the orthodontic practice.
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Affiliation(s)
- Giovana Gonçalves Martins
- Mestre em Odontopediatria, Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto (Ribeirão Preto/SP, Brazil).,Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Programa de Pós-Graduação em Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Ingrid Araújo de Oliveira
- Hospital Infantil Dr. Juvêncio Mattos (São Luís/MA, Brazil).,Hospital Geral Tarquinio Lopes Filho, Serviço de Cirurgia e Traumatologia Bucomaxilofacial (São Luís/MA, Brazil)
| | - Alberto Consolaro
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Programa de Pós-Graduação em Odontopediatria (Ribeirão Preto/SP, Brazil).,Universidade de São Paulo, Faculdade de Odontologia de Bauru (Bauru/SP, Brazil)
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11
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KORKMAZ YT, CEZAİRLİ B, HOCAOĞLU TP. DEMOGRAPHICS AND CHARACTERISTICS OF PATIENTS WITH TRAUMATIC BONE CYSTS: A RETROSPECTIVE REVIEW. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.345926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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Kim Y, Choi BE, Ko SO. Conservative approach to recurrent calcifying cystic odontogenic tumor occupying the maxillary sinus: a case report. J Korean Assoc Oral Maxillofac Surg 2016; 42:315-320. [PMID: 27847742 PMCID: PMC5104876 DOI: 10.5125/jkaoms.2016.42.5.315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 11/09/2022] Open
Abstract
Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. Invasion into the maxillary sinus by a CCOT is not a typical, and the recurrence of the cystic variant of CCOT in the posterior maxilla is rare. This report describes a recurrent CCOT occupying most of the maxillary sinus of a 24-year-old male patient. As a treatment, marsupialization was carried out as a means of decompression, and the involved teeth were all endodontically treated. Afterward, surgical enucleation was performed. The size of the lesion continued to shrink after marsupialization, and the maxillary sinus restored its volume. This patient has been followed-up for 3 years after the surgery, and there have not been any signs of recurrence.
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Affiliation(s)
- Yongsoo Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Bo Eun Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Seung-O Ko
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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13
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Ookubo K, Ookubo A, Tsujimoto M, Sugimoto K, Yamada S, Hayashi Y. Scanning electron microscopy reveals severe external root resorption in the large periapical lesion. Microsc Res Tech 2016; 79:495-500. [PMID: 26957368 DOI: 10.1002/jemt.22652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 11/07/2022]
Abstract
The present study was designed to investigate the relationships between clinicopathological findings and the resorptive conditions of root apices of teeth with periodontitis. The samples included 21 root apices with large periapical radiolucent lesions. The preoperative computed tomography (CT) and intraoperative findings were correlated with the presence, extension, and the progression pattern of periapical resorption using a scanning electron microscope. The subjects' age, gender, chief complaint, type of tooth, percussion test results, size of periapical lesion using CT, and intraoperative findings were recorded. All apicoectomies were performed under an operative microscope for endodontic microsurgery. A significant large size was observed in cystic lesions compared with granulomatous lesions. The cementum surface at the periphery of the lesion was covered with globular structures (2-3 μm in diameter). Cementum resorption started as small defect formations at the surface. As the defect formation progressed, a lamellar structure appeared at the resorption area, and the size of globular structures became smaller than that of globules at the surface. Further resorption produced typical lacuna formation, which was particularly observed in fracture cases. The most morphologically severe destructive pattern of dentin resorption was observed in large cystic lesions. This study is the first report to elucidate the relationships between three clinical types of undesirable periapical lesions: (1) undertreatment, (2) periapical fracture, (3) macro-level resorption, and the microstructure of external root resorption including from small defects at the cementum surface to a significant destructive pattern inside the dentin. Microsc. Res. Tech. 79:495-500, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kensuke Ookubo
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Atsushi Ookubo
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Masaki Tsujimoto
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Kouji Sugimoto
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Shizuka Yamada
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Yoshihiko Hayashi
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
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14
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Abstract
This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.
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15
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Mohanty S, Gulati U, Mediratta A, Ghosh S. Unilocular radiolucencies of anterior mandible in young patients: A 10 year retrospective study. Natl J Maxillofac Surg 2013; 4:66-72. [PMID: 24163555 PMCID: PMC3800387 DOI: 10.4103/0975-5950.117885] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Mandibular anterior region is an uncommon site for occurrence of intrabony pathologies. Unilocular presentation of a lesion is again less common than multilocular appearance. Demographically, most lesions occur in middle to elderly age group. The study is designed to review the pathologies manifesting a combination of these rare demographic and radiological criteria. Materials and Methods: A retrospective analysis of patients with anterior unilocular radiolucencies of mandible in young patients was done. Records of past 10 years were searched. There were a total of 17 patients. Their clinical history and radiographs were reviewed from the case files and correlated with histopathological examination of the lesion. Results: Nine different pathologies constituted the sample size of 17. A wide array of lesions was found to manifest similar signs and symptoms and radiographic findings namely ameloblastoma (three), adenomatoid odontogenic tumor (AOT, four), odontogenic keratocyst (OKC, three), ossifying fibroma (OF, two), idiopathic bone cavity (IBC, one), dentigerous cyst (DC, one), radicular cyst (RC, one), central giant cell granuloma (CGCG, one), and calcifying odontogenic cyst (COC, one). Conclusion: Anterior mandible is a rare site for occurrence of intrabony pathologies. Majority of patients are females. Lesions acquire large size before they are detected. Growth occurs more in length than in width. Root resorption is not uncommon and root displacement is almost a consistent feature.
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Affiliation(s)
- Sujata Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India
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16
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Carli MLD, Pedreira FRDO, Guimarães EP, Dias NNDO, Pereira AAC, Hanemann JAC. Conservative surgical-orthodontic treatment of a young patient with a dentigerous cyst. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000500012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: The dentigerous cyst is a developmental odontogenic cyst, whose therapeutic approach depends on the size of the lesion. This paper describes the treatment performed on a 14-year-old male patient who presented with a large dentigerous cyst on the permanent mandibular left second molar. CASE REPORT: The permanent mandibular left first molar was extracted, and the lesion was decompressed and marsupialized by excision of the overlying mucosa, opening a window into the cystic cavity and suturing an acrylic resin drain to the oral mucosa. The specimen removed during surgery confirmed the diagnosis of a dentigerous cyst. Within ninety days of surgery, there was a significant reduction in lesion size. Orthodontic treatment was then started, and included traction of the impacted tooth and opening of adequate space with a fixed appliance, providing favorable tooth alignment and leveling. CONCLUSION: Marsupialization and orthodontic traction should be considered when planning the treatment of a dentigerous cyst, mainly in young patients with large lesions, to avoid damage to the surrounding structures.
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17
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Grecchi F, Zollino I, Candotto V, Gallo F, Rubino G, Bianco R, Carinci F. A case report of haemorrhagic-aneurismal bone cyst of the mandible. Dent Res J (Isfahan) 2013; 9:S222-4. [PMID: 23814588 PMCID: PMC3692178 DOI: 10.4103/1735-3327.109763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Haemorrhagic-aneurismal bone cysts (HABCs) are quite rare, benign, non-neoplastic, expansive, and vascular locally destructive lesions. They are generally considered sequelae of an earlier trauma causing an overflow of blood into the bone. HABCs are classified as pseudocysts and they should be differentiated from true cysts because their treatment is different. Since few of these cysts involve subjective symptoms, most are discovered accidentally during radiography, while a sure diagnosis is likely to be obtained only during surgery, on discovery of a non-epithelialised cavity. Here, we report a typical case of a haemorrhagic-mandibular cyst in a 13-year-old girl, which was treated by opening the cavity and scraping its walls following diagnostic arteriography and post-operative transcutaneous intralesional embolization. No further complications were recorded in the post-operative period, although the convalescence lasted for a time longer than expected, because of anemia. No further surgery was performed. She has been disease-free for two years. Evaluation of intralesional blood flow is important for HABCs because of the hemorrhagic risk in surgery. Embolization seems to be a useful procedure in the treatment of HABCs and could be tried as the treatment modality in the standard protocol for the treatment of HABCs.
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Affiliation(s)
- Francesco Grecchi
- Department of Maxillofacial Surgery, Galeazzi Hospital, Milan, Italy
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Park JH, Kim JW, Kwon TG, Kim CS. Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.3.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ji-Hoon Park
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Jin-Wook Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Tae-Geon Kwon
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Chin-Soo Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
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19
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Wakoh M, Okawa Y, Otonari-Yamamoto M, Kamio T, Sakamoto J, Yamamoto A, Sano T, Hashimoto K, Araki M. Reliance on Diagnostic Elements in Panoramic Imaging with Focus on Ameloblastoma and Keratocystic Odontogenic Tumor: Psychometric Study. THE BULLETIN OF TOKYO DENTAL COLLEGE 2011; 52:1-12. [DOI: 10.2209/tdcpublication.52.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sreeja R, Minal C, Madhuri T, Swati P, Vijay W. A scanning electron microscopic study of the patterns of external root resorption under different conditions. J Appl Oral Sci 2010; 17:481-6. [PMID: 19936530 PMCID: PMC4327678 DOI: 10.1590/s1678-77572009000500024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 10/15/2008] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of this study was to examine if there are qualitative differences in the appearance of external root resorption patterns of primary teeth undergoing physiologic resorption and permanent teeth undergoing pathological root resorption in different conditions. Material and Methods: A total of 40 teeth undergoing external root resorption in different conditions were divided into 4 groups and prepared for examination under scanning electron microscopy at magnifications ranging from 20x to 1000x. Group I: 10 primary molars exfoliated due to physiologic root resorption; Group II: 10 permanent teeth with periapical granulomas showing signs of resorption; Group III:10 permanent teeth therapeutically extracted during the course of orthodontic therapy with evidence of resorption, and Group IV: 10 permanent teeth associated with odontogenic tumors that showed evidence of resorption. Results: In Group I, the primary teeth undergoing resorption showed smooth extensive and predominantly regular areas reflecting the slow ongoing physiologic process. In Group II, the teeth with periapical granulomas showed the resorption was localized to apex with a funnel shaped appearance in most cases. Teeth in Group III, which had been subjected to a short period of light orthodontic force, showed the presence of numerous resorption craters with adjoining areas of cemental repair in some cases. Teeth associated with odontogenic tumors in Group IV showed many variations in the patterns of resorption with extensive loss of root length and a sharp cut appearance of the root in most cases. Conclusion: Differences were observed in the patterns of external root resorption among the studied groups of primary and permanent teeth under physiologic and pathological conditions.
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Affiliation(s)
- Ravindran Sreeja
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College, Maharashtra, India
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21
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Relationship between the prevalence of the dentigerous cyst and the odontogenic keratocyst tumor and the current etiologic hypothesis. J Craniofac Surg 2010; 20:2036-40. [PMID: 19881373 DOI: 10.1097/scs.0b013e3181be8773] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cysts are considered as nonneoplastic benign lesions that, when present for a long period of time, can cause some discomfort, especially related to the treatment form. Among the types of cysts of the maxilla, the dentigerous cyst (DC) presents substances between the dental follicle and the crown of the tooth with high potential for resorption, and the odontogenic keratocyst tumor (OKT) characterizes for its noticed rapid growth pattern and the possibility to develop carcinomas in the lesion wall. The DC is the most common type among the developing odontogenic cystic lesions, while the OKT represents 10% of these lesions. The prevalence of the OKT found in the current study was superior to the DC, opposing data of the evaluated literature, as well as the predominance in relation to the age group. Dentigerous cyst cases were found mostly in younger individuals, whereas the OKT was observed mainly in individuals between the third and fourth decades of life. This fact reflects the fragility of these features while establishing the presumptive diagnosis and insinuates the strong relation with a probable genetic predisposition. In relation to sex and race, the findings in this article were similar to those found in the literature, highlighting the possibility of a hormonal involvement. However, the anatomopathologic examination remains essential to define the main diagnosis of the lesions observed by means of imaging examinations, providing for safer diagnoses to plan the treatment.
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Abstract
Damage to the dentition or tooth follicle is often cited as a potential complication of Distraction Osteogenesis (DO). The authors describe a case of a dentigerous cyst that developed following DO of the mandible. The possible histogenic mechanisms and the management are outlined. Understanding the causes of dentigerous cysts as well as the anatomy of the neonatal mandible may help avoid such a complication in the future.
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23
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Abu El-Naaj I, Emodi O, Peled M. Metachronous ameloblastomas in the maxilla and mandible: report of a case. J Craniomaxillofac Surg 2005; 33:349-51. [PMID: 16129610 DOI: 10.1016/j.jcms.2005.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2004] [Accepted: 03/27/2005] [Indexed: 11/23/2022] Open
Abstract
Ameloblastoma is a locally aggressive tumour of odontogenic origin, with an unknown aetiology. Metachronous ameloblastoma in the maxilla and the mandible is rare. In this report, a case of a 63 year-old man is described with a solid ameloblastoma in the posterior part of the upper jaw. After surgical treatment, the patient returned 8 years later with a similar lesion in the anterior lower jaw. Both ameloblastomas were of the solid type but differed in their histological patterns. No evidence of recurrence was found in either of the surgical sites for the last 4 years.
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Affiliation(s)
- Imad Abu El-Naaj
- Department of Oral and Maxillofacial Surgery, Rambam Medical Centre, Bruce Rappoport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
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Abstract
The calcifying odontogenic cyst is an uncommon lesion that occurs in both jaws, however involvement of the maxillary sinus is rare. The accepted mode of treatment is enucleation with curettage since it is generally believed that recurrence following such treatment is extremely rare. Of the reported cases of recurrent calcifying odontogenic cysts, none have involved the maxillary sinus. This report is of a large recurrent calcifying odontogenic cyst involving the maxillary sinus, eroding the orbital floor as well as anterior and medial walls of the maxillary sinus and displacing an impacted upper canine into the nasal cavity, in a 45-year-old male patient, 8 years after the initial enucleation.
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25
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MacDonald-Jankowski DS, Yeung R, Lee KM, Li TK. Ameloblastoma in the Hong Kong Chinese. Part 2: systematic review and radiological presentation. Dentomaxillofac Radiol 2004; 33:141-51. [PMID: 15371313 DOI: 10.1259/dmfr/28001874] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this part of the study was to determine the radiological presentation on conventional radiographs of central ameloblastomas in the Hong Kong Chinese and compare them with other reported series by a systematic review (SR). METHODS The study had two elements, that of a complete series of all ameloblastomas presenting at a major Chinese maxillofacial surgical unit and a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for ameloblastoma cases. The relevant literature was identified by electronic databases, review of citation lists and handsearching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS Only 13 reports gave any radiological details. The present study of the Hong Kong Chinese contained 61 cases. With the exception of radiodensity and shape of radiolucency, the majority of the 13 other reports did not record the other radiological features that could be important in the diagnosis. The present study agreed with the synthesis of the 13 reports with regards to complete radiolucency and cortication of ameloblastomas, but disagreed with regards to other important features. The present study had a significantly higher proportion of unilocular lesions, better marginal definition, and more frequent perforation of the cortex and buccolingual expansion. Nine of the ten maxillary lesions straddled both anterior and posterior sextants with four crossing the midline, whereas only 13 of the 51 mandibular cases affected both sextants, of which eight crossed the midline. The unicystic form, which was most prevalent, appeared significantly more frequently as unilocular radiolucencies in comparison with the non-unicystic forms. The frequencies of unicystic forms and unilocular presentations were significantly greater in the young. The lesions in the young were significantly sited solely in the posterior sextant. The lower border of the mandible was reached and affected by ameloblastoma in 36 cases in the present report. It was displaced and thinned in 15 cases whereas in just five it was at least partially undisplaced with the lesion expanding down past it either buccally or lingually to it. The unicystic form was significantly more associated with root resorption, tooth displacement and crowns of unerupted teeth. CONCLUSIONS Radiologically, ameloblastomas in the Hong Kong Chinese differ significantly with regards to many features. This can be in part explained by the higher proportion of the unicystic form.
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Affiliation(s)
- D S MacDonald-Jankowski
- Division of Oral and Maxillofacial Radiology, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.
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26
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27
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Li L, Jäkel KT, Friedrich RE. [Calcifying epithelial odontogenic tumor of the maxilla (Pindborg tumor)]. ACTA ACUST UNITED AC 2004; 8:46-50. [PMID: 14991421 DOI: 10.1007/s10006-003-0517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A male patient presented with an extraordinarily large calcifying epithelial odontogenic tumor (CEOT or Pindborg-tumor) that affected the maxilla. The disease became evident due to alterations in the facial aspect, in particular of the perioral region, caused by the expanding tumor. CEOT is characterised by the slowly growing mass of part of the jaws. Multilocular or extraosseous manifestations are extremely rare. Malignant transformation with metastases is rare. Radiography depicts characteristic, but not obligatory, areas of calcification inside the tumor. The surgical therapy for CEOT is complete local resection with safe margins. If tooth bearing parts of the jaws are affected, these teeth almost always have to be removed. The prognosis is excellent for overall survival. Local recurrences have rarely been reported but may be found even decades after primary treatment. Three years following surgical therapy there is no evidence of local recurrence. A long-term follow-up control is recommended.
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Affiliation(s)
- L Li
- Klinik und Poliklinik für Zahn-, Mund-, Kiefer- und Gesichtschirurgie (Nordwestdeutsche Kieferklinik), Universität Hamburg
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Abstract
Cystic lesions appearing in the maxilla and mandible have been shown with their typical radiographic features. In addition, this article has presented radiographic techniques used to diagnose these lesions. Cysts of the jaws are classified into two categories: odontogenic and nonodontogenic. Key features to differentiate among these cysts have been discussed. Finally, the article discussed the differentiation of jaw cysts from benign tumors that appear in the jaws.
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Affiliation(s)
- Kazunori Yoshiura
- Department of Oral Radiology, Faculty of Dental Science, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
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29
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Abstract
Pericoronal radiolucencies are common radiographic findings encountered in general dental practice. They usually represent a normal or enlarged dental follicle that requires no intervention; alternatively they may represent a pathological entity that requires appropriate management and histopathological interpretation. A pericoronal space of greater than 2.5mm on an intraoral radiograph and greater than 3mm on a rotational panoramic radiograph should be regarded as suspicious. Although many pathological processes may present radiographically as pericoronal radiolucencies associated with unerupted teeth, the most common is the dentigerous cyst. These lesions may enlarge considerably if allowed to develop unchecked, and have the potential for pathological transformation. In this report we present four cases of large pericoronal radiolucencies associated with unerupted teeth, and highlight the importance of early detection and management of such lesions.
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Affiliation(s)
- C S Farah
- Oral Biology and Pathology, The University of Queensland, Brisbane.
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30
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Ord RA, Blanchaert RH, Nikitakis NG, Sauk JJ. Ameloblastoma in children. J Oral Maxillofac Surg 2002; 60:762-70; discussion, 770-1. [PMID: 12089689 DOI: 10.1053/joms.2002.33242] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The purpose of this report was 1) to report the experience of the University of Maryland, Department of Oral and Maxillofacial Surgery (OMS Department) in the treatment of ameloblastoma in children and 2) to review the world literature on the treatment of ameloblastoma in children from 1970 to 2001. METHODS AND MATERIALS This study first reviews the experience of the OMS Department of the University of Maryland with ameloblastomas in children and then reviews the literature on this subject. The first part of the study was undertaken by a retrospective chart review of all patients with a diagnosis of ameloblastoma in the OMS Department between May 1991 and December 1999. The literature on ameloblastoma in Western societies and Africa was separately reviewed from 1970 through 2001. Reports earlier than 1970 were not reviewed, as the histologic diagnosis of ameloblastoma was not well defined before that period. RESULTS In the Maryland series, 11 patients under the age of 20 years with ameloblastoma were treated. Eight patients were seen primarily, and 3 presented with recurrent lesions. The average age was 15.5 years; 5 of 11 patients were black, and 9 of 11 tumors were unicystic ameloblastomas. The literature review showed 85 children in the Western reports and 77 reported from Africa. The average ages were 14.3 and 14.7 years, respectively, but unicystic ameloblastomas accounted for 76.5% of the Western and only 19.5% of the African children, with an increased frequency of occurrence in the mandibular symphisis in African (44.2%) versus Western (5.8%) patients. Analysis of recurrence after enucleation of unicystic ameloblastomas in 20 children followed at least 5 years or until recurrence showed a recurrence of 40%. CONCLUSIONS Ameloblastomas in children differ from adults, with a higher percentage of unicystic tumors. African children appear to resemble the adult pattern. Although enucleation has been claimed to give acceptable recurrence rates in unicystic ameloblastoma, there are no large series with long follow-up in children. The histologic pattern that exhibits mural invasion in unicystic ameloblastoma suggests that more aggressive surgery is necessary.
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Affiliation(s)
- R A Ord
- Oral and Maxillofacial Surgery, Baltimore College of Dental Surgery, University of Maryland Medical Systems, Baltimore, MD, USA.
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31
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O'Reilly M, O'Reilly P, Todd CE, Altman K, Schafler K. An assessment of the aggressive potential of radiolucencies related to the mandibular molar teeth. Clin Radiol 2000; 55:292-5. [PMID: 10767189 DOI: 10.1053/crad.1999.0346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The purpose of this study was to outline the radiographic appearance of radiolucent lesions related to the molar teeth and to determine which features indicate aggressive lesions. PATIENTS AND METHODS Panoramic radiographs were reviewed in 66 patients with radiolucencies related to the molar teeth. The radiographic appearances of the lesions were assessed with regard to location and size, and the relationship to the molar teeth. Radiographic evidence of aggression was assessed and pathology reviewed. RESULTS Nineteen patients had aggressive and 47 had non-aggressive radiolucent lesions. The aggressive lesions included keratocysts, unicystic ameloblastoma, adenoid cystic carcinoma, giant cell granuloma, myxofibroma, chondroblastic osteosarcoma, mestastases and squamous cell carcinoma of the tongue invading the mandible. CONCLUSION The differential diagnosis of radiolucent lesions in the mandible can be difficult using panoramic radiographs alone. Helpful features in determining aggression were older patients, larger lesions, Lodwick type IC tumour border, condition of the mandibular cortex, movement of adjacent teeth and the relationship of the inferior alveolar canal.
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Affiliation(s)
- M O'Reilly
- Departments of Radiology, Kingston Hospital, Galsworthy Road, Kingston on Thames, Surrey, KT2 7QB, U.K
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Das S, Bhowmick A, Mukherjee S, Ghosh LM, Banerjee S. Giant dentigerous cyst. Indian J Otolaryngol Head Neck Surg 1999; 51:66-8. [PMID: 23119550 PMCID: PMC3451054 DOI: 10.1007/bf02996535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Dentigerous cyst - a cyst of dental origin, though common in lower jaw is relatively uncommon in upper jaw. Here a 14 years, F, presented with huge swelling of unilateral maxilla and clinicoradiologically diagnosed as dentigerous cyst is being reported along with brief review of literature.
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Affiliation(s)
- S Das
- Medical college, Calcutta
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33
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Nohl FS, Gulabivala K. Odontogenic keratocyst as periradicular radiolucency in the anterior mandible: two case reports. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 81:103-9. [PMID: 8850493 DOI: 10.1016/s1079-2104(96)80157-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The differential diagnosis of periradicular radiolucencies is broad. Unusual clinical or radiographic features or failure to resolve after quality root canal treatment should be viewed with suspicion and a biopsy specimen should be submitted for histologic examination. Two cases are reported in which the presence of radiolucent lesions could have been mistaken for those of pulpal origin but were subsequently found to be odontogenic keratocysts.
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Affiliation(s)
- F S Nohl
- Department of Conservative Dentistry, Eastman Dental Institute, London, U.K
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Yoshiura K, Higuchi Y, Ariji Y, Shinohara M, Yuasa K, Nakayama E, Ban S, Kanda S. Increased attenuation in odontogenic keratocysts with computed tomography: a new finding. Dentomaxillofac Radiol 1994; 23:138-42. [PMID: 7530666 DOI: 10.1259/dmfr.23.3.7530666] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
An increased attenuation area (IAA) is sometimes seen in the cystic cavity of odontogenic keratocysts (OKCs) on CT scans. The significance of IAA was compared radiologically and histologically in 26 cysts in which a provisional diagnosis of OKC had been made. First, the presence of IAA in the cystic cavity was assessed. Then, relationship between the presence of IAA and data obtained from the cysts, including the CT and histological findings and the visual appearance of the cyst contents, was evaluated. An IAA was frequently seen in large multilocular cysts. There was no relationship between the presence of IAA and aggressive features of the cyst on CT or the cyst contents. Histologically, subepithelial inflammation was often observed in the cysts with IAA. In order to ascertain whether the IAA was due to the keratin mass, a CT scan of a bundle of hair in a water bath was performed and shown to have a similar density. Our study demonstrated that IAA in cystic cavities results from desquamated keratin. Since this seems to occur in long-standing or inflamed multilocular OKCs, it could be used as a significant finding in the diagnosis of OKC.
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Affiliation(s)
- K Yoshiura
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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35
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Kaffe I, Buchner A, Taicher S. Radiologic features of desmoplastic variant of ameloblastoma. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1993; 76:525-9. [PMID: 8233435 DOI: 10.1016/0030-4220(93)90023-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Desmoplastic variant of ameloblastoma is a newly described variant characterized by unique histologic and radiographic features. This study reviews and analyzes the clinical and radiographic features of 15 cases of desmoplastic variant of ameloblastoma (14 cases from the literature and one case from our files). Desmoplastic variant of ameloblastoma shows a predilection for the maxilla and has a tendency to occur in the anterior region of the mandible and maxilla. Radiographically, almost all desmoplastic variant of ameloblastomas exhibit a mixed radiolucent-radiopaque appearance. Most show poorly defined or diffused borders and are mistakenly diagnosed as fibro-osseous lesions.
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Affiliation(s)
- I Kaffe
- Maurice and Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Israel
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36
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Abstract
Calcifying odontogenic cyst is a rare benign lesion of the jaws, with no particular specificity for age, sex or site. Three new cases are presented together with a review of the radiological literature. There appear to be no pathognomonic radiological features, although a superficial location on the affected bone and the presence of internal calcification may be useful signs. The role of radiology appears to be limited to determining lesion extent prior to surgery.
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Affiliation(s)
- H Devlin
- Department of Restorative Dentistry, University Dental Hospital, Manchester
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37
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Gollard RP, Slavkin HC, Snead ML. Polyoma virus-induced murine odontogenic tumors. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1992; 74:761-7. [PMID: 1336839 DOI: 10.1016/0030-4220(92)90405-f] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Neonatal mouse pups were injected subcutaneously with polyoma virus to induce odontogenic tumors. This treatment resulted in a spectrum of tumors that arose in organs dependent upon epithelial-mesenchymal interactions for their organogenesis, which included the teeth, salivary glands, thymus, and lacrimal glands. In addition, several odontogenic tumors with a histologic resemblance to ameloblastoma were identified and analyzed with respect to the presence of markers specific for various stages of ameloblast differentiation. Immunodetection analyses of the odontogenic tumors identified fibronectin and laminin, typical of basement membrane organization during early tooth organogenesis. These same tumors failed to express amelogenin, a gene whose expression is limited to differentiated ameloblasts. In contrast, a 47 kDa enamelin-like polypeptide was identified with the use of an antienamelin antibody. These data were interpreted to suggest that the polyoma virus truncated the differentiation pathway for these odontogenic tissues at an early stage of their development and retained the expression of basement membrane components and the enamelin-like polypeptides, yet excluded expression of amelogenin gene products. This observation suggests that polyoma viral transformation may dysregulate odontogenic tissue interactions and produce tumors composed of cells arrested at a specific stage in their development.
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Affiliation(s)
- R P Gollard
- University of Southern California, Los Angeles 23146
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38
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Higuchi Y, Nakamura N, Ohishi M, Tashiro H. Unusual ameloblastoma with extensive stromal desmoplasia. J Craniomaxillofac Surg 1991; 19:323-7. [PMID: 1752974 DOI: 10.1016/s1010-5182(05)80341-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A clinicopathological study of 5 cases of unusual ameloblastoma was performed. Three cases were characterized by marked stromal desmoplasia. The lesions occurred in the tooth-bearing areas of the anterior or premolar regions of the jaw. They were relatively small and showed a honeycomb appearance radiographically. Histologically, the islands of tumour cells were small and discrete in the widely extended desmoplastic stroma. They lacked obvious ameloblastic polarity in many parts. The other 2 cases were hybrid lesions of desmoplastic and conventional types. The former appeared in the alveolar part and the latter in the lower part of the mandible. It was concluded that the desmoplastic variant of ameloblastoma could be categorized as a new distinct type histologically, clinically and radiographically.
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Affiliation(s)
- Y Higuchi
- First Department of Oral Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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40
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Nortjé CJ, Wood RE. The radiologic features of the nasopalatine duct cyst. An analysis of 46 cases. Dentomaxillofac Radiol 1988; 17:129-32. [PMID: 3271698 DOI: 10.1259/dmfr.1988.0017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Tanimoto K, Tomita S, Aoyama M, Furuki Y, Fujita M, Wada T. Radiographic characteristics of the calcifying odontogenic cyst. Int J Oral Maxillofac Surg 1988; 17:29-32. [PMID: 3127486 DOI: 10.1016/s0901-5027(88)80225-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
4 additional cases of calcifying odontogenic cysts (COC) were reported, together with the radiographic interpretation of 138 cases from the literature. From the review of the literature and of our own cases, the root resorption is one of the most common diagnostic findings as is cystic radiolucency accompanied by radiopacities. Other radiographic characteristics, such as loculation, tooth divergency and bone resorption were emphasized.
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Affiliation(s)
- K Tanimoto
- Department of Oral Radiology, Hiroshima University, School of Dentistry, Japan
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Partridge M, Towers JF. The primordial cyst (odontogenic keratocyst): its tumour-like characteristics and behaviour. Br J Oral Maxillofac Surg 1987; 25:271-9. [PMID: 3476151 DOI: 10.1016/0266-4356(87)90065-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The clinical behaviour of primordial cysts frequently mimics that of benign tumours. They are characterised by aggressive growth and a tendency to recur following surgical treatment. Displacement of teeth, resorption of the roots of teeth, 'seeding' of the cyst into soft tissue and pathological fracture of the mandible exemplify this behaviour. These features are described and fully illustrated by examples from a series of 60 cases. The results of various surgical procedures are evaluated.
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Abstract
Nasopalatine duct cysts in 70 patients were reexamined clinically and radiographically. 50 of them were also reexamined histopathologically. 20 specimens of normal duct tissue were likewise examined. More than half of the cysts showed clinical symptoms. The form on the radiograph was usually spherical or oval. Only 1 of 5 cysts was heart-shaped; 1 of 10 was unilateral. The mesiodistal width of the cysts ranged from 4-40 mm, with 75% from 6-12 mm. 3 of 4 showed pronounced radiolucency. Every 2nd cyst was completely surrounded by a thin radiopaque border. The histopathological investigation showed small cysts to be present in 1 of 4 clinically and radiographically normal nasopalatine ducts. More than 1 of 4 clinically and radiographically diagnosed cysts lacked histopathological characteristics of a cystic cavity. The type of epithelium in the cysts was independent of the vertical position in the duct.
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Sasakura H, Yoshida T, Murayama S, Hanada K, Nakajima T. Root resorption of upper permanent incisor caused by impacted canine. An analysis of 23 cases. INTERNATIONAL JOURNAL OF ORAL SURGERY 1984; 13:299-306. [PMID: 6434449 DOI: 10.1016/s0300-9785(84)80037-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Unusual root resorption of 12 central and 11 lateral upper permanent incisors in 11 patients is described. The degree of resorption ranged from loss of the apical 1/4 to almost complete loss of root structure. Excepting 1 case, permanent canines were partially or completely impacted and their crowns were in close apposition to the resorbed surfaces of the incisors. The roots of the canines were either in the process of formation or completely formed. The findings suggest that the pressure from the canine which persists in moving downward despite the lack of space to permit normal eruption could cause root resorption of adjacent incisors even in the absence of systemic factors. Of 14 extracted incisors, 10 were replaced orthodontically by the impacted canines, whereas the spaces of the extracted incisors were restored by prosthetic means in the 4 other cases. 6 incisors were preserved without any treatment and 2 with the aid of a sapphire dento-osseous anchor pin. Since the resorbed incisors were mostly free of pain, early detection by radiographic examination is essential to establish a proper diagnosis.
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Clinical and Histological Aspects of Oral Malignancies, Excluding Squamous Cell Carcinomas and Salivary Gland Tumours. Oral Oncol 1984. [DOI: 10.1007/978-1-4613-2845-2_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Nagao T, Nakajima T, Fukushima M, Ishiki T. Calcifying odontogenic cyst: a survey of 23 cases in the Japanese literature. JOURNAL OF MAXILLOFACIAL SURGERY 1983; 11:174-9. [PMID: 6579149 DOI: 10.1016/s0301-0503(83)80042-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The clinical, radiographic and histological characteristics of the calcifying odontogenic cyst were studied in 23 well-documented cases in the Japanese literature. The cysts occurred equally in males and females whose mean age was 21 years. The appeared as a painless swelling with cortical expansion and involved the maxilla three times more often than the mandible. There was no report of the lesion involving the soft tissues. Radiographically, the lesions were unilocular in most cases and contained aggregates or dispersed foci in the radiolucencies which were diagnosed as odontomes in 5 cases. Unerupted teeth and root resorption of the adjacent teeth were noted in approximately half of the cases. Except for one case, they were simply enucleated under a diagnosis of cyst or odontome and recurrence was encountered in no case. The excised specimens consisted of cystic sacs mostly containing calcified materials with or without tooth-like structures which were histologically diagnosed as odontomes in 10 cases. An intimate relationship between the cysts and the unerupted teeth was observed in 4 out of 10 cases. The pathogenesis of the lesion is discussed.
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Yokobayashi Y, Yokobayashi T, Nakajima T, Oyama T, Fukushima M, Ishiki T. Marsupialization as a possible diagnostic aid in cystic ameloblastoma. Case report. JOURNAL OF MAXILLOFACIAL SURGERY 1983; 11:137-41. [PMID: 6576089 DOI: 10.1016/s0301-0503(83)80033-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Two cases of cystic ameloblastoma are described in which the diagnosis was established after marsupialization. Although the clinical and radiographic findings strongly suggested the diagnosis of ameloblastoma, the initial incisional biopsy specimens consisted of cystic walls lined with squamous epithelium which showed in both cases no evidence of ameloblastic proliferation. Marsupialization could be a diagnostic aid in these cases since relief of intracystic pressure may trigger regeneration of a solid mass of tumour in a monocystic ameloblastoma with cells possessing potentiality for spontaneous proliferation.
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Nagao T, Nakajima T, Fukushima M, Ishiki T. Calcifying odontogenic cyst with complex odontoma. J Oral Maxillofac Surg 1982; 40:810-3. [PMID: 6958843 DOI: 10.1016/0278-2391(82)90180-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Voorsmit RA, Stoelinga PJ, van Haelst UJ. The management of keratocysts. JOURNAL OF MAXILLOFACIAL SURGERY 1981; 9:228-36. [PMID: 6172530 DOI: 10.1016/s0301-0503(81)80049-5] [Citation(s) in RCA: 170] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The clinical and histological data of 106 keratocysts from the files of the Department of Oral and Maxillofacial Surgery in Nijmegen and Arnhem, The Netherlands, formed the basis of this study. There was a wide age range with a male predominance and with the mandibular third molar area and ramus being the most common sites involved. Special attention has been drawn to the various ways in which recurrent keratocysts may develop. In the present study the recurrence rate of two groups of patients, treated according to two different concepts in the surgical management of keratocysts, are compared. As a result of a 21-year follow-up on 92 keratocysts a rational approach to the surgical treatment to eliminate a high recurrence rate is suggested.
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