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Minerva Dental and Oral Science Feb 2022The aim of the present article was to review and depict the main radiological features of odontogenic keratocysts (OKCs), thus helping the differential diagnoses from... (Review)
Review
INTRODUCTION
The aim of the present article was to review and depict the main radiological features of odontogenic keratocysts (OKCs), thus helping the differential diagnoses from other odontogenic cysts and neoplasms.
EVIDENCE ACQUISITION
A review of articles published between January 2000 and October 2020 using Medline and the MeSH Term "odontogenic keratocyst" in combination with the following terms "imaging," "radiology," "panoramic radiograph," and "computed tomography," was performed.
EVIDENCE SYNTHESIS
Radiographically, OKCs are well-defined unilocular or multilocular radiolucencies bounded by corticated margins. Most lesions are unilocular; instead, multilocular OKCs represent about the 30% of cases, mainly involving the posterior mandible. When, particularly in large lesions, OKCs display a multilocular presentation with adjacent satellite cysts (daughter cysts) a "soap-bubble appearance" can be recognized.
DISCUSSION
Panoramic radiograph and CT still play an important role in the diagnosis and treatment planning of OKCs. Unfortunately, it may not be easy to differentiate OKCs from other odontogenic lesions, especially when they are small and unilocular.
CONCLUSIONS
Histopathological findings are still necessary to obtain a definitive diagnosis.
Topics: Humans; Mandible; Odontogenic Cysts; Odontogenic Tumors; Radiography; Tomography, X-Ray Computed
PubMed: 34636215
DOI: 10.23736/S2724-6329.21.04582-4 -
Oral Diseases Nov 2023Compare recognized microscopic parameters, including variations in width, plaque-like thickenings, intra-epithelial microcysts, clefts, mucous, hob-nail, ciliated and...
OBJECTIVES
Compare recognized microscopic parameters, including variations in width, plaque-like thickenings, intra-epithelial microcysts, clefts, mucous, hob-nail, ciliated and clear cells, between glandular odontogenic cyst (GOC) and GOC-like cysts, investigate the extent of cyst circumference exhibiting these features, and inflammation.
MATERIALS AND METHODS
Archival records of cysts with histological features of GOC evaluated between 2000 and2020 were retrieved. Slides were revised, and the expression of features throughout the cyst wall was analyzed. Cysts with at least 5 features were classified as GOC, cysts with 3-4 features as GOC-like.
RESULTS
The study included 74 cysts, 47 males M, 25 females (2 unknown gender), aged 19-81 years, 62 (83.8%) GOC, 12 (16.2%) GOC-like. Mandible was involved in 44 (59.5%), maxilla in 30 (40.5%), 18 (25%) were associated with unerupted teeth. Cyst classified as GOC had significantly higher rates of all parameters investigated, (except ciliated and clear cells), than GOC-like cysts (p ≤ 0.05). 26 (40.6%) cases showed GOC features in >50% of cyst circumference, 21 (32.8%) involved 25-50%, 17 (26.6%) <25%. More than 50% circumference involvement was highly and independently predictive for a diagnosis of GOC, <25% was highly and independently predictive for GOC-like (p = 0.003). Hobnail cells (p = 0.008) and plaque-like thickenings (p = 0.038) were significantly more frequent in inflamed cysts.
CONCLUSION
Besides the number and type of histological features, GOC can be characterized by their distribution within the cyst circumference (focal Vs diffuse), and it may serve as a new diagnostic aid. It is suggested that GOC and GOC-like may represent a single spectrum.
Topics: Male; Female; Humans; Odontogenic Cysts; Mandible
PubMed: 36305228
DOI: 10.1111/odi.14415 -
Head and Neck Pathology Mar 2023Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that... (Review)
Review
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.
Topics: Humans; Diagnosis, Differential; Jaw Neoplasms; Odontogenic Cysts; Odontogenic Tumors; Ameloblastoma; Maxilla
PubMed: 36928736
DOI: 10.1007/s12105-023-01525-1 -
Oral and Maxillofacial Surgery Clinics... Feb 2016Odontogenic cysts represent a common form of pathology of the jaws, and the natural history, clinicopathologic findings, and appropriate management strategies are... (Review)
Review
Odontogenic cysts represent a common form of pathology of the jaws, and the natural history, clinicopathologic findings, and appropriate management strategies are important to the oral and maxillofacial surgeon. Odontogenic cysts in the pediatric populations are important pathologic entities given their potential impact on the growth and development of the maxillofacial complex. Inappropriate management strategies can severely affect the form and function of the growing child. Categorizing pediatric odontogenic cysts into inflammatory or developmental causes provides a convenient way of conceptualizing these various entities and helps facilitate the appropriate diagnosis and the subsequent management.
Topics: Biopsy; Child; Diagnostic Imaging; Humans; Jaw Diseases; Odontogenic Cysts
PubMed: 26614698
DOI: 10.1016/j.coms.2015.07.003 -
Oral Radiology Jan 2022Calcifying odontogenic cysts (COC) and adenomatoid odontogenic tumors (AOT) have similar radiographic findings. We examined the radiographic and computed tomography (CT)...
OBJECTIVES
Calcifying odontogenic cysts (COC) and adenomatoid odontogenic tumors (AOT) have similar radiographic findings. We examined the radiographic and computed tomography (CT) images of patients histologically diagnosed with COC or AOT and identified their characteristic findings.
METHODS
The subjects included 12 patients histologically diagnosed with COC or AOT (one female and five males per group), who underwent CT at our hospital between Nov 1998 and Jun 2019. The location of the lesion, impacted tooth, bone expansion, root resorption, tooth migration, calcified body, and presence or absence of a high-intensity zone in the marginal area of the lesion were examined.
RESULTS
In patients with COC, five patients with COC exhibited bone expansion toward the buccal side. The lesion encompassing the crown was attached to the cement-enamel junction and contained a radiopaque lesion with a calcified body. In 6 patients with COC, irregularly shaped calcified bodies were observed with small tooth-like structures. In patients with AOT, all six patients with AOT exhibited bone expansion toward the buccal and lingual sides. The lesion encompasses a part of the tooth root or the entire tooth. Punctate calcification was observed within the lesion and the marginal area in three patients, and a high-intensity zone was observed in the marginal area of the lesion in two patients.
CONCLUSION
We report imaging findings that may be characteristic of COC and AOT, suggesting that CT findings may be useful for differentiating between COC and AOT.
Topics: Ameloblastoma; Diagnosis, Differential; Female; Humans; Male; Odontogenic Cyst, Calcifying; Odontogenic Cysts; Odontogenic Tumors; Tomography, X-Ray Computed
PubMed: 33907948
DOI: 10.1007/s11282-021-00531-9 -
Brazilian Dental Journal 2021The aim of this study was to assess and compare RANK, RANKL, and OPG immunoexpression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The protocol was... (Meta-Analysis)
Meta-Analysis
The aim of this study was to assess and compare RANK, RANKL, and OPG immunoexpression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The protocol was registered in PROSPERO (CRD42018105543). Seven databases (Embase, Lilacs, LIVIVO, PubMed, Scopus, SciELO, and Web of Science) were the primary search sources and two databases (Open Grey and Open Thesis) partially captured the "grey literature". Only cross sectional studies were included. The JBI Checklist assessed the risk of bias. A meta-analysis with random effects model estimated the values from the OPG and RANKL ratio reported by the individual studies and respective 95% confidence intervals. The heterogeneity among studies was assessed with I2 statistics. Only nine studies met the inclusion criteria and were considered in the analyses. The studies were published from 2008 to 2018. Two studies presented low risk of bias, while seven studies presented moderate risk. The meta-analysis showed the highest OPG>RANKL ratio for dentigerous cyst (ES=43.3%; 95% CI=14.3-74.8) and odontogenic keratocyst (ES=36.8%; 95% CI=18.8-56.7). In contrast, the highest OPG
odontogenic epithelial region. The results may explain the aggressive potential of ameloblastoma from the higher OPG cyst and odontogenic keratocyst. Topics: Ameloblastoma; Cross-Sectional Studies; Dentigerous Cyst; Humans; Odontogenic Cysts; Odontogenic Tumors
PubMed: 33913997
DOI: 10.1590/0103-6440202103387 -
Pathology, Research and Practice Aug 2022To demonstrate the clinicopathological and radiological features of orthokeratinized odontogenic cysts (OOCs), and analyze the epithelial cell proliferative activity...
OBJECTIVES
To demonstrate the clinicopathological and radiological features of orthokeratinized odontogenic cysts (OOCs), and analyze the epithelial cell proliferative activity between OOCs and odontogenic keratocysts (OKCs).
MATERIALS AND METHODS
Clinicopathological and radiological analyses were performed in all OOC cases. The expression of cell proliferation markers, Ki-67 and cyclin D1, was detected by immunohistochemistry.
RESULTS
A total of 48 OOC patients, 28 males and 20 females, were included. The mean age was 33.50 years, with a range of 13-61 years. The mandible was affected five times as frequently as the maxilla (mandible 40, maxilla 8). All OOCs were unilocular radiolucencies with well-defined margins, and 30 of 36 showed loss of continuity of the buccal or lingual cortices based on computed tomography (CT) images. Three cases exhibited root resorption; tooth displacement occurred in 4 cases. The average volume of the cysts on CT was 7794.25 ± 6952.98 mm. All cysts were treated by enucleation or enucleation after decompression. The average follow-up time was 32.50 ± 27.58 months (ranging from 6 to 65 months), and the overall recurrence rate was 4.44% (2 of 45). Compared with OKCs, Ki-67 and cyclin D1 expression were significantly lower in OOCs (P < 0.001).
CONCLUSIONS
OOCs occur more frequently in mandible with a slight male predilection and have a lower proliferative activity than OKCs. Radiologically, OOCs are more likely associated with buccolingual expansion and destruction of cortical bone. Due to the lower aggressiveness and recurrence rate, enucleation or decompression combined with enucleation is the first treatment choice for OOC.
Topics: Adolescent; Adult; Cyclin D1; Female; Humans; Immunohistochemistry; Ki-67 Antigen; Male; Middle Aged; Odontogenic Cysts; Young Adult
PubMed: 35696769
DOI: 10.1016/j.prp.2022.153969 -
Der Pathologe Feb 2018Cystic lesions of the jaws comprise a spectrum of inflammatory, developmental and neoplastic changes that can clinically appear strikingly similar. Squamous cell... (Review)
Review
Cystic lesions of the jaws comprise a spectrum of inflammatory, developmental and neoplastic changes that can clinically appear strikingly similar. Squamous cell metaplasia due to superinfection can further blur the histologic hallmarks of the individual lesions. In this article an overview of the most important differential diagnoses and the novelties of the latest World Health Organisation (WHO) classification on head and neck tumours released in early 2017 is provided. In contrast to the previous edition, odontogenic cysts have been re-introduced and several changes in terminology and taxonomy have been complemented.
Topics: Ameloblastoma; Diagnosis, Differential; Head and Neck Neoplasms; Humans; Jaw; Jaw Neoplasms; Odontogenic Cysts
PubMed: 29322252
DOI: 10.1007/s00292-017-0402-x -
Journal of the American Dental... May 2022Buccal bifurcation cyst is an inflammatory odontogenic cyst and constitutes up to 5% of all odontogenic cysts. The aim of this study was to report a series of cases,... (Review)
Review
INTRODUCTION
Buccal bifurcation cyst is an inflammatory odontogenic cyst and constitutes up to 5% of all odontogenic cysts. The aim of this study was to report a series of cases, review the recent literature, and facilitate recognition and proper treatment of this entity.
METHODS
With institutional review board approval, the authors retrieved all archival cases of buccal bifurcation cyst from the oral pathology biopsy service from 1994 through 2018. Patient age and sex, cyst location, clinician's impression, radiographic appearance, diagnosis, and treatment data were recorded.
RESULTS
A total of 10 cases were identified. Average patient age was 9 years. A slight male predilection was observed (n = 6, 60%). One hundred percent of cases were in the mandible, including 3 (30%) bilateral cases.
CONCLUSIONS
Mandibular buccal bifurcation cyst is an important entity in pediatric patients but may be less likely to be recognized by clinicians not regularly treating children. The results of this study are mostly consistent with the literature. Treatment is typically via enucleation or even more conservative modalities, and extraction should be avoided if possible.
PRACTICAL IMPLICATIONS
Buccal bifurcation cysts should be treated via enucleation or even more conservative methods. If possible, the affected teeth should be preserved.
Topics: Biopsy; Child; Humans; Male; Mandible; Molar; Odontogenic Cysts; Periodontal Cyst
PubMed: 35125168
DOI: 10.1016/j.adaj.2021.10.002 -
Gene Mar 2021Ameloblastoma (AB), dentigerous cyst (DC) and Odontogenic keratocyst (OKC) are odontogenic lesions with propensity to malignant transformation or local invasion. The... (Review)
Review
Ameloblastoma (AB), dentigerous cyst (DC) and Odontogenic keratocyst (OKC) are odontogenic lesions with propensity to malignant transformation or local invasion. The molecular mechanisms of development of these lesions are not fully understood. However, some researches have reported dysregulation of tumor suppressor genes or oncogenes in these lesions. Down-regulation of P53 gene has been reported in AB, DC and OKC. Moreover, several long non-coding RNAs such as ENST00000512916 and KIAA0125 have been dysregulated in AB tissues. Single nucleotide polymorphisms within a variety of genes have been associated with certain types of odontogenic lesions. In the current review, we summarize the current data about the expression pattern of genes in these lesions and the observed association between genetic polymorphisms and development of these lesions.
Topics: Ameloblastoma; Dentigerous Cyst; Gene Expression Regulation; Genetic Markers; Genetic Predisposition to Disease; Humans; Odontogenic Cysts; Polymorphism, Single Nucleotide; RNA, Long Noncoding; Tumor Suppressor Protein p53
PubMed: 33346102
DOI: 10.1016/j.gene.2020.145369