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Cureus May 2024A radicular cyst is characterized as an odontogenic cyst of inflammatory origin that develops from Malassez epithelial rests in the periodontal ligament as the...
A radicular cyst is characterized as an odontogenic cyst of inflammatory origin that develops from Malassez epithelial rests in the periodontal ligament as the consequence of dental pulp inflammation. The cyst commenced in the carious tooth and spread to the periodontal and periapical regions. The majority of these lesions appear as precise radiolucencies and encompass their entire apex. The cystic lesion, which is also called a root-end cyst or periapical cyst, is sometimes referred to as a true cyst because it is lined by fluid epithelium. There are several treatment options to address radicular cysts, including surgical and nonsurgical methods. In this case study, we described the clinical observation of the cyst. The cyst typically manifests in later life due to its prolonged etiology. The maxillary anterior region is the most frequently utilized site.
PubMed: 38872665
DOI: 10.7759/cureus.60269 -
Case Reports in Dentistry 2019Lateral periodontal cyst (LPC) is an uncommon developmental odontogenic cyst arising on the lateral surface of tooth roots. Commonly reported in mandibular...
Lateral periodontal cyst (LPC) is an uncommon developmental odontogenic cyst arising on the lateral surface of tooth roots. Commonly reported in mandibular canine-premolar or maxillary anterior regions, it presents as a well-circumscribed or tear drop-shaped radiolucency with a sclerotic border. Associated teeth are asymptomatic and vital, and roots may be displaced without resorption. Histopathologically, cystic lining resembles reduced enamel epithelium along with glycogen-rich clear cells and epithelial plaques. Unilateral variant of LPC has low recurrence and is managed by enucleation. A 43-year-old male patient reported with asymptomatic swelling in the left mandibular canine and first premolar region. Both teeth were vital, and radiographs revealed well-circumscribed radiolucency between the roots. Following consent, surgical enucleation and guided bone regeneration (GBR) with xenograft and resorbable collagen membrane were done under local anesthesia. The immediate postoperative period was uneventful, and complete bone fill of cystic cavity and healing of periodontal tissues was observed after a one-year follow-up. Histopathologic examination confirmed the diagnosis. LPC should be a differential diagnosis in cystic lesions lateral to the surface of a tooth and without any associated inflammation. Based on this case report, unicystic LPC can be successfully managed through surgical enucleation with GBR for better periodontal healing.
PubMed: 31360553
DOI: 10.1155/2019/4591019 -
Journal of Endodontics Mar 2017Cone-beam computed tomographic (CBCT) analysis allows for 3-dimensional assessment of periradicular lesions and may facilitate preoperative periapical cyst screening....
INTRODUCTION
Cone-beam computed tomographic (CBCT) analysis allows for 3-dimensional assessment of periradicular lesions and may facilitate preoperative periapical cyst screening. The purpose of this study was to develop and assess the predictive validity of a cyst screening method based on CBCT volumetric analysis alone or combined with designated radiologic criteria.
METHODS
Three independent examiners evaluated 118 presurgical CBCT scans from cases that underwent apicoectomies and had an accompanying gold standard histopathological diagnosis of either a cyst or granuloma. Lesion volume, density, and specific radiologic characteristics were assessed using specialized software. Logistic regression models with histopathological diagnosis as the dependent variable were constructed for cyst prediction, and receiver operating characteristic curves were used to assess the predictive validity of the models. A conditional inference binary decision tree based on a recursive partitioning algorithm was constructed to facilitate preoperative screening.
RESULTS
Interobserver agreement was excellent for volume and density, but it varied from poor to good for the radiologic criteria. Volume and root displacement were strong predictors for cyst screening in all analyses. The binary decision tree classifier determined that if the volume of the lesion was >247 mm, there was 80% probability of a cyst. If volume was <247 mm and root displacement was present, cyst probability was 60% (78% accuracy).
CONCLUSIONS
The good accuracy and high specificity of the decision tree classifier renders it a useful preoperative cyst screening tool that can aid in clinical decision making but not a substitute for definitive histopathological diagnosis after biopsy. Confirmatory studies are required to validate the present findings.
Topics: Algorithms; Cone-Beam Computed Tomography; Decision Trees; Female; Humans; Imaging, Three-Dimensional; Logistic Models; Male; Multivariate Analysis; Observer Variation; Preoperative Care; ROC Curve; Radicular Cyst; Sensitivity and Specificity
PubMed: 28231977
DOI: 10.1016/j.joen.2016.10.046 -
Biotechnic & Histochemistry : Official... 2017The botryoid odontogenic cyst (BOC) is a rare, locally more aggressive variant of the usually indolent lateral periodontal cyst (LPC) and gingival cyst (GC). A recent...
Botryoid odontogenic cyst. Exploration of proliferative activity, apoptosis and expression of TP53 and BCL2 compared to the histologically identical lateral periodontal and gingival cysts.
The botryoid odontogenic cyst (BOC) is a rare, locally more aggressive variant of the usually indolent lateral periodontal cyst (LPC) and gingival cyst (GC). A recent case of BOC provided an opportunity for an exploratory study on the causes of its more aggressive behavior. The limited objective was to see if the BOC was sufficiently different from the other cysts to warrant an investment in a large study. Sections of neutral buffered formalin fixed, paraffin-embedded tissues from the BOC and archival specimens of four GCs, four LPCs and three odontogenic keratocysts (OKCs) were stained using immunohistochemistry for Ki-67, a marker of proliferating cells, caspase-3, a marker of cells undergoing apoptosis, tumor suppressor p53, and the apoptosis inhibitor BCL2. The mean labeling index (LI) of immunoreactive cyst epithelial cells was computed for each antibody and type of cyst. Compared to the LPCs and GCs, the BOC exhibited a moderately larger Ki-67/caspase-3 LI difference, which indicates that the BOC had a net higher rate of growth. We found a much higher level of LI, therefore likely dysregulation of p53. We also found a much higher LI of BCL2. The LIs of p53 and BCL2 in the BOC were similar to and more than twice that of the OKCs, respectively. Although meaningful statistical analysis was precluded by our use of only one case of BOC and a small number of the other cysts, the high p53 and very high BCL2 labeling indices of the BOC offer a potential explanation for its reportedly more aggressive behavior that clearly is worthy of further investigation.
Topics: Apoptosis; Cell Proliferation; Epithelium; Gingival Diseases; Humans; Immunohistochemistry; Odontogenic Cysts; Periodontal Cyst; Proto-Oncogene Proteins c-bcl-2; Tumor Suppressor Protein p53
PubMed: 28910164
DOI: 10.1080/10520295.2017.1367231 -
Frontiers in Cellular and Infection... 2023Entamoeba is an anaerobic protozoan that is strongly associated with inflamed periodontal pockets. It is able to invade the mucosal epithelium of the human host, where...
BACKGROUND
Entamoeba is an anaerobic protozoan that is strongly associated with inflamed periodontal pockets. It is able to invade the mucosal epithelium of the human host, where it can feed on epithelial cells and elicit a severe innate immune response. Unlike other species, it is considered that cannot form cysts, because it is a non-infectious protozoan. The lack of encystation capability would make it susceptible to periodontal treatment. However, it is not clear how the human host becomes infected with trophozoites. We investigated the ability of to encapsulate in response to an unfavorable environment .
METHODS
Different strains of , isolated from inflamed periodontal pocket samples, were cultured for 8 days in the presence or absence of the antimicrobials amoxycillin and metronidazole. To reveal cyst formation, we investigated the morphology and ultrastructure of the amoeba by light, fluorescence, transmission and scanning electron microscopy. We also used the fluorescent dye calcofluor white M2R to demonstrate chitin present in the cyst wall.
RESULTS
We observed exocysts and an intra-cystic space separating the encapsulated trophozoite from the environment. Remarkably, cysts showed a smooth surface, polygonal edges and smaller size compared to free-living trophozoites. In addition, encapsulated trophozoites that detached from the cyst wall had a dense cytoplasma without phagocytic vesicles. The cyst walls consisted of chitin as in other species. The encapsulated trophozoids were mononuclear after antibioticinduced encapsulation.
DISCUSSION
We conclude that cyst formation has significant implications for dissemination and infection and may explain why established treatment approaches often fail to halt periodontal tissue destruction during periodontitis and peri-implantitis.
Topics: Animals; Humans; Entamoeba; Trophozoites; Cysts; Anti-Bacterial Agents; Chitin
PubMed: 37469604
DOI: 10.3389/fcimb.2023.1201394 -
Journal of Applied Oral Science :... Jun 2018This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis...
OBJECTIVE
This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed.
MATERIAL AND METHODS
Apical periodontitis lesions' data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data.
RESULTS
Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas.
CONCLUSIONS
There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.
Topics: Adult; Aged; Cone-Beam Computed Tomography; Cytokines; Female; Humans; Immunohistochemistry; Male; Middle Aged; Periapical Granuloma; Radicular Cyst; Reference Values; Statistics, Nonparametric; Treatment Outcome
PubMed: 29898177
DOI: 10.1590/1678-7757-2017-0455 -
Journal of Endodontics Oct 2021Semaphorin 7A (SEMA7A) is a membrane-bound or secretory protein exerting multiple functions in the regulation of inflammation, neural degradation, and cancer...
INTRODUCTION
Semaphorin 7A (SEMA7A) is a membrane-bound or secretory protein exerting multiple functions in the regulation of inflammation, neural degradation, and cancer progression. Human periapical lesions are chronic and infectious diseases mainly caused by bacteria. However, the involvement of SEMA7A in human periapical lesions is still unclear. This study aimed to explore the expression of SEMA7A in human periapical lesions accompanied by the potential association of SEMA7A with matrix metalloproteinase (MMP)-1 and MMP-3 during the progression of apical periodontitis.
METHODS
Samples of periapical lesions and healthy controls were collected. Total RNA and protein were extracted respectively for quantitative real-time polymerase chain reaction and Western blot analysis. Additionally, 6 healthy samples and 27 periapical lesion samples were fixed, dehydrated, and embedded for further histologic and immunochemical analysis. The expression of SEMA7A was quantified by average integrated optical density. Immunofluorescence analysis was conducted to explore the colocalization of SEMA7A/MMP-1 and SEMA7A/MMP-3.
RESULTS
Compared with healthy controls, the messenger RNA and protein expression of SEMA7A was markedly up-regulated in periapical lesions. A stronger expression of MMP-1, MMP-3, and inflammatory cytokines was exhibited in periapical lesions than in healthy groups. An increasing expression of SEMA7A can be observed in both the periapical granuloma group and the radicular cyst group compared with the normal group (P < .01). Immunofluorescence results showed the colocalization of SEMA7A with both MMP-1 and MMP-3 in vascular vessels and extracellular matrix.
CONCLUSIONS
SEMA7A was up-regulated in periapical periodontitis and might be involved in the tissue destruction and infiltration of immune cells in periapical lesions.
Topics: Antigens, CD; GPI-Linked Proteins; Humans; Inflammation; Periapical Granuloma; Periapical Periodontitis; Radicular Cyst; Semaphorins
PubMed: 34126161
DOI: 10.1016/j.joen.2021.06.005 -
Journal of Oral and Maxillofacial... 2018Mast cells (MCs) have been discovered over 130 years ago; their function was almost exclusively linked to allergic affections. At the time being, it is well known that... (Review)
Review
Mast cells (MCs) have been discovered over 130 years ago; their function was almost exclusively linked to allergic affections. At the time being, it is well known that MCs possess a great variety of roles, in both physiologic and pathologic conditions. In the oral tissues, MCs release different pro-inflammatory cytokines and tumor necrosis factor-alpha that promote leukocyte infiltration in various inflammatory states of the oral cavity. These cells play a key role in the inflammatory process and, as a consequence, their number changes in different pathologic conditions of the oral cavity, such as gingivitis and periodontitis. By understanding the role of MCs in the pathogenesis of different inflammatory diseases of the oral cavity, these cells may become therapeutic targets that could possibly improve the prognosis. Therefore, this review summarizes the current understanding of the role of MCs in various inflammatory pulpal, periapical and periodontal pathophysiological conditions.
PubMed: 29731563
DOI: 10.4103/jomfp.JOMFP_278_17 -
Quintessence International (Berlin,... Feb 2022Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with an excellent prognosis, often seen in children and young adults. The aim was to examine the...
OBJECTIVE
Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with an excellent prognosis, often seen in children and young adults. The aim was to examine the spectrum of clinical, radiographic, and histologic attributes of AOT and assess clinician recognition of this entity. In addition, diagnostic considerations and treatment modalities were explored.
METHOD AND MATERIALS
With Institutional Review Board approval, archival cases of AOT from the University of Florida Oral Pathology Biopsy Service (1994-2019) were examined. Clinical and demographic data along with accompanying radiographs and original slides were reviewed.
RESULTS
A total of 28 cases of AOT were identified. These were all solitary in nature, with a mean age of 20.6 years (range 12-67 years). Most patients were under 20 (75.0%) with a definite female predilection (64.3%). Anterior jaws remained the most common location (85.2%), with a higher maxillary predilection (57.1%). Clinical impression included odontogenic lesions such as dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst.
CONCLUSION
The spectrum of features of AOT is described. As clinicians were unfamiliar with AOT, highly characteristic features of AOT and more unique variants are discussed extensively to improve diagnostic aptitude. Clinicians must remain aware of this entity, as treatment is minimal compared to other odontogenic entities.
Topics: Adolescent; Adult; Aged; Ameloblastoma; Biopsy; Child; Female; Humans; Maxilla; Middle Aged; Odontogenic Tumors; Young Adult
PubMed: 34709771
DOI: 10.3290/j.qi.b2218723 -
Chinese Medical Sciences Journal =... Jun 2022Mandibular buccal bifurcation cyst is a rare inflammatory odontogenic cyst. We reported two cases who complained of painful swelling of extraoral soft tissue. Intraoral...
Mandibular buccal bifurcation cyst is a rare inflammatory odontogenic cyst. We reported two cases who complained of painful swelling of extraoral soft tissue. Intraoral examination revealed the partially erupted mandibular first molar. Cone beam computed tomography showed a well-defined cystic lesion surrounding the first molar. Histopathologic images showed the cyst wall was infiltrated by a large number of plasma cells, neutrophils and eosinophils, and lined with a thin layer of non-keratinized stratified squamous epithelium. Finally, the two patients were diagnosed as mandibular buccal bifurcation cyst and treated with cyst enucleation and curettage.
Topics: Humans; Leukocyte Count; Mandibular Diseases; Molar; Odontogenic Cysts; Periodontal Cyst
PubMed: 35796341
DOI: 10.24920/003957