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Cureus Oct 2023Keratocystic odontogenic tumor (KCOT) is a benign intraosseous cyst of the jaw. The diagnosis may be confirmed by the clinical finding, or histopathological report....
Keratocystic odontogenic tumor (KCOT) is a benign intraosseous cyst of the jaw. The diagnosis may be confirmed by the clinical finding, or histopathological report. Finally, treatment consists of surgical excision, and follow-up is characterized by a minor recurrence. The authors report a case of KCOT of the right mandibular region and review the various diagnoses, therapeutics, and follow-up aspects of this type of tumor. The following case report describes a case of a 55-year-old male patient with odontogenic keratocyst. It can show variable clinical-radiographic features and hence should be in differential diagnosis of intra-osseous oral lesions in old age. In elderly patients, because of physical disability, selection of treatment procedures and long-term follow-up after surgery is vital.
PubMed: 38021646
DOI: 10.7759/cureus.46963 -
Discover Oncology Apr 2024Odontogenic cysts/tumor can cause severe bone destruction, which affects maxillofacial function and aesthetics. Meanwhile, metabolic reprogramming is an important...
BACKGROUND
Odontogenic cysts/tumor can cause severe bone destruction, which affects maxillofacial function and aesthetics. Meanwhile, metabolic reprogramming is an important hallmark of diseases. Changes in metabolic flow affect all aspects of disease, especially bone-related diseases. At present, the researches on pathogenesis of odontogenic cysts/tumor are mainly focused on the level of gene regulation, but the effects of metabolic alterations on odontogenic cysts/tumor have still underexplored.
MATERIALS AND METHODS
Imaging analysis was used to evaluate the lesion size of different odontogenic lesions. Tartrate resistant acid phosphatase (TRAP) and immunohistochemistry (IHC) assays were utilized to detect the differences in bone destruction activity in odontogenic cysts and tumors. Furthermore, metabolomics and weighted gene co-expression network analysis (WGCNA) were conducted for the metabolomic features and key metabolite screening, respectively. The effect of ferroptosis inhibition on bone destruction was confirmed by IHC, immunofluorescence, and malondialdehyde colorimetric assay.
RESULTS
The bone destruction activity of ameloblastoma (AM) was the strongest and the weakest in odontogenic cysts (OC). High-throughput targeted metabolomics was used to map the metabolomic profiles of OC, odontogenic keratocyst (OKC) and AM. WGCNA and differential analysis identified L-cysteine in OKC and AM. Cystathionine γ-lyase (CTH) was further screened by Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The functions of L-cysteine were further validated. Finally, we confirmed that CTH affected destructive activities by regulating the sensitivity of epithelial cells to ferroptosis.
CONCLUSION
High-throughput targeted metabolomics performed on diseased tissue confirmed the unique alteration of metabolic profiles in OKC and AM. CTH and its metabolite L-cysteine are the key factors regulating destructive activities.
PubMed: 38589585
DOI: 10.1007/s12672-024-00959-5 -
Applied Immunohistochemistry &... Apr 2024Glandular odontogenic cysts (GOCs) and dentigerous cysts may show mucous metaplasia. Central mucoepidermoid carcinoma is very rare and mostly associated with dental...
Glandular odontogenic cysts (GOCs) and dentigerous cysts may show mucous metaplasia. Central mucoepidermoid carcinoma is very rare and mostly associated with dental cysts. It is hypothesized that odontogenic cysts showing mucus differentiation in their lining, have a propensity to transform into MEC. The present study is the first attempt to explore the relationship between odontogenic cysts [GOCs and dentigerous cysts with mucus metaplasia (DCMM)] and MEC by evaluating immunoexpression of MUC5AC and MUC2. Immunoexpression of MUC5AC and MUC2 was evaluated semiquantitatively in GOCs (20 cases), DCMMs (20 cases), and MECs (20 cases). The percentage of positive cells, intensity, and localization of immunoexpression were assessed for each marker in all cases. Of GOCs, DCMMs, and MECs cases, 85%, 70%, and 80%, respectively, were immunopositive for MUC5AC. Strong cytoplasmic immunoreactivity for MUC5AC was noted, particularly in mucous cells present diffusely within MECs. However, the immunoreactivity was limited to the epithelial lining of GOCs and DCMMs. Most of the MECs (60%) showed more than 25% positivity for MUC5AC, followed by GOCs, and the least in DMMCs. Mild cytoplasmic and nuclear positivity of MUC2 was noted only in epithelial lining cells of 70% GOCs and 45% DCMMs. Whereas, 55% of MECs displayed moderate to strong cytoplasmic and membranous immunopositivity for MUC2 exclusively within mucous cells. As MECs showed strong MUC5AC immunoreactivity in mucous cells, immunoexpression of MUC5AC in odontogenic cysts with mucus cells can possibly explain the pathogenesis of MEC from cysts. However, the variable expression of MUC2 did not give any strong evidence regarding its role as a marker.
Topics: Humans; Carcinoma, Mucoepidermoid; Dentigerous Cyst; Odontogenic Cysts; Epithelial Cells; Metaplasia; Mucin 5AC; Mucin-2
PubMed: 38478391
DOI: 10.1097/PAI.0000000000001192 -
Applied Immunohistochemistry &... Mar 2024Odontogenic keratocysts (OKCs) are aggressive cystic jaw lesions with a high epithelial turnover rate and increased propensity for recurrence. Sometimes, the...
Odontogenic keratocysts (OKCs) are aggressive cystic jaw lesions with a high epithelial turnover rate and increased propensity for recurrence. Sometimes, the characteristic histopathological features of OKCs are either completely lost or seen focally due to previous marsupialization or inflammation. This research aimed to determine whether specific patterns of CK14 and Bcl-2 staining could assist in diagnosing OKCs with altered epithelial features and provide clues in elucidating their aggressive nature. CK14 expression was restricted to basal and suprabasal layers near satellite cysts and in areas showing subepithelial split. The entire epithelial lining showed CK14 expression in areas of inflammation and after marsupialization. The typical basal/suprabasal staining of Bcl-2 was lost in areas of inflammation and intensity is decreased in OKCs after marsupialization. These new findings could offer a hint into the biological nature and pathogenesis of OKCs. Because of its therapeutic consequences and high recurrence rate, proper recognition and diagnosis are essential for treatment planning.
Topics: Humans; Odontogenic Cysts; Odontogenic Tumors; Inflammation
PubMed: 38146077
DOI: 10.1097/PAI.0000000000001182 -
Journal of Clinical Medicine Mar 2024Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a... (Review)
Review
Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up.
PubMed: 38592423
DOI: 10.3390/jcm13051499 -
Journal of Dentistry (Shiraz, Iran) Dec 2023Hybrid lesions of jaws are rare entities defined as two different lesions co-occurring in the same location, with identical histopathological origin. Ameloblastoma,...
Hybrid lesions of jaws are rare entities defined as two different lesions co-occurring in the same location, with identical histopathological origin. Ameloblastoma, calcifying cystic odontogenic tumor and odontoma are among the most common lesions that have been reported to combine with other lesions. In this study, a hybrid lesion of odontogenic keratocyst (OKC) and odontoma in the mandible of a forty-five years old male reported. Additional to the rarity of this hybrid lesion, the present case had unique radiologic features, including atypical location and extension of the lesion and profound knife-edge root resorption of the teeth in the area, which was not a common feature for any of the two lesions. The surgical procedure was marsupialization to reduce the size of the lesion. As a result of the surgery, the healing of the surgical wound was uneventful. In addition, careful follow-up for the patient was conducted, which had no recurrence till now (after 15 months).
PubMed: 38149227
DOI: 10.30476/dentjods.2023.98278.2066 -
Journal of Endodontics Nov 2023Radiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be...
INTRODUCTION
Radiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be low, they often mimic periapical pathoses, and consequently, histopathologic examinations after surgical revisions are nurtured.
METHODS
Biopsies submitted to the College of Dentistry between 2003 and 2021 were reviewed. Clinicopathologic characteristics were collected, including age, sex, medical history, location, sensibility tests, and clinic impressions from each specimen. Histopathologic diagnosis and gross description were also part of our database.
RESULTS
A total of 72,055 pathology reports were reviewed, of which 10,031 lesions (13.9%) met the criterion of being intraosseous lesions at the periradicular area. Among those 10,031 lesions, 7.94% (n = 796) were of non-endodontic origin, 7153 were documented as non-vital, and 2.36% (n = 169) of these non-vital teeth were diagnosed with a non-endodontic origin. A total of 5707 lesions were obtained from surgeries within the periapical tissues, primarily performed by endodontists (94.02%). Non-endodontic lesions were reported in 1.09% of the cases. Odontogenic keratocyst was the most common non-endodontic diagnosis, followed by nasopalatine duct cyst and benign fibro-osseous lesion, respectively.
CONCLUSIONS
Pathologic findings of the periradicular tissues are not always from endodontic origin. The probability of encountering non-endodontic lesions is almost 8%. Even in clinically reported teeth with pulp necrosis, 1%-3% of biopsies were confirmed as non-endodontic lesions.
Topics: Humans; Retrospective Studies; Male; Female; Biopsy; Adult; Middle Aged; Adolescent; Periapical Diseases; Young Adult; Aged; Child; Aged, 80 and over
PubMed: 37543187
DOI: 10.1016/j.joen.2023.07.023 -
International Journal of Clinical... 2023This case report aims to describe the importance of early diagnosis, various clinical features, and management of radicular cyst with primary mandibular molar.
AIM
This case report aims to describe the importance of early diagnosis, various clinical features, and management of radicular cyst with primary mandibular molar.
BACKGROUND
Radicular cyst is an odontogenic inflammatory cyst in origin seen more frequently in permanent dentition and rarely in the primary dentition. It can develop due to pulp injuries or pulp necrosis caused by deep dental caries or dental trauma. It may adversely affect the normal development and eruption of the permanent succedaneous teeth.
CASE DESCRIPTION
We report a case of radicular cyst in association with the primary mandibular molar and its therapeutic management.
CONCLUSION
The efforts in diagnosing and managing radicular cyst when associated with primary teeth hold a good impact on a child's oral health status. Good amount of bone healing and development of the succedaneous permanent tooth bud in its normal position were observed when managed appropriately.
CLINICAL SIGNIFICANCE
Early diagnosis, proper treatment planning, appropriate management, and regular follow-ups of radicular cyst in primary dentition hold great importance for pediatric dentists as well as general dentists in routine dental practice.
PubMed: 38162247
DOI: 10.5005/jp-journals-10005-2679 -
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 -
Metabolomics : Official Journal of the... Feb 2024Odontogenic keratocysts (OKCs) are locally aggressive and have a high rate of recurrence, but the pathogenesis of OKCs is not fully understood. We aimed to investigate...
INTRODUCTION
Odontogenic keratocysts (OKCs) are locally aggressive and have a high rate of recurrence, but the pathogenesis of OKCs is not fully understood. We aimed to investigate the serum metabolomic profile of OKCs and discover potential biomarkers.
METHODS
Metabolomic analysis was performed on 42 serum samples from 22 OKC patients and 20 healthy controls (HCs) using gas chromatography‒mass spectrometry to identify dysregulated metabolites in the OKC samples. LASSO regression and receiver operating characteristic (ROC) curve analyses were used to select and validate metabolic biomarkers and develop diagnostic models.
RESULTS
A total of 73 metabolites were identified in the serum samples, and 24 metabolites were dysregulated in the OKC samples, of which 4 were upregulated. Finally, a diagnostic panel of 10 metabolites was constructed that accurately diagnosed OKCs (sensitivity of 100%, specificity of 100%, area under the curve of 1.00).
CONCLUSION
This study is the first to investigate the metabolic characteristics and potential metabolic biomarkers in the serum of OKC patients using GC‒MS. Our study provides further evidence to explore the pathogenesis of OKC.
Topics: Humans; Metabolomics; Odontogenic Cysts; Biomarkers; Gas Chromatography-Mass Spectrometry; ROC Curve
PubMed: 38416246
DOI: 10.1007/s11306-024-02101-6