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Quintessence International (Berlin,... Sep 2023Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized... (Review)
Review
Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized by islands of ameloblastoma-like epithelial cells that resemble the enamel organ, the presence of ghost cells, and dentinoid material. This article reports a rare case of dentinogenic ghost cell tumor associated with an odontoma in an adult patient, with a review of the literature. To the best of the authors' knowledge, there have only been four case reports of DGCT associated with odontoma, all of which occurred in children and adults younger than 30 years old.
Topics: Adult; Child; Humans; Odontoma; Odontogenic Tumors; Odontogenic Cyst, Calcifying; Ameloblastoma
PubMed: 37313575
DOI: 10.3290/j.qi.b4157337 -
Anatomia, Histologia, Embryologia Mar 2024Changes in the expression of nuclear β-catenin are responsible for tumorigenesis. Beta-catenin acts synergistically with the TGF-β/BMPs pathway. This interaction leads...
Changes in the expression of nuclear β-catenin are responsible for tumorigenesis. Beta-catenin acts synergistically with the TGF-β/BMPs pathway. This interaction leads to greater dentin deposition and may explain the differences between distinct tooth morphologies and hamartomas. The aim of this study was to investigate the role of β-catenin, BMP4 and TGF-β in the development of odontomas. This cross-sectional, retrospective, immunohistochemical study evaluated 30 compound odontomas, 30 complex odontomas and 17 tooth germs. The results showed that BMP4 and TGF-β were more immunoexpressed in the ectomesenchyme of complex odontomas (median = 33.7, p < 0.001; median = 76.4, p = 0.002, respectively). Higher immunoexpression of BMP4 and TGF-β was also observed in the epithelium of tooth germs (median = 2.0, p < 0.001; median = 120.3, p < 0.001, respectively). TGF-β and BMP4 showed a positive and significant correlation (p < 0.001). Both TGF-β and BMP4 were positively correlated with nuclear β-catenin in ectomesenchyme (p = 0.047 and p = 0.023, respectively). Developing teeth exhibited higher concentrations of the proteins studied in odontogenic epithelium, especially during the bud and cap stages. Higher immunoexpression in odontomas occurred mainly in the ectomesenchyme. We therefore suggest that changes in the ectomesenchyme can lead to the development of odontomas.
Topics: Animals; Odontoma; beta Catenin; Transforming Growth Factor beta; Retrospective Studies; Cross-Sectional Studies
PubMed: 38409855
DOI: 10.1111/ahe.13024 -
International Journal of Surgery Case... Oct 2023Juvenile trabecular ossifying fibroma is a rare benign tumor of childhood affecting the facial bones rarely described in literature. Its aggressive growth and high...
INTRODUCTION AND IMPORTANCE
Juvenile trabecular ossifying fibroma is a rare benign tumor of childhood affecting the facial bones rarely described in literature. Its aggressive growth and high tendency of recurrence make it a real challenge for diagnosis and care.
CASE PRESENTATION
This article presents a case of an extensive juvenile trabecular ossifying fibroma of the maxilla in a 14-year-old boy, which required surgical intervention with immediate bone reconstruction using an autogenous graft (iliac crest). No recurrence has been found after two and a half years of follow-up.
CLINICAL DISCUSSION
Common symptoms of juvenile trabecular ossifying fibroma include painless swelling, facial asymmetry, jaw deformity and teeth displacement. Differential diagnosis should consider other forms like psammomatoid ossifying fibroma, osteofibrous dysplasia, fibrous dysplasia, ameloblastoma, odontoma, or even poorly differentiated carcinoma.
CONCLUSION
Currently, there is no recommendation or consensus for the treatment of juvenile trabecular ossifying fibroma. The objective of treatment is also to preserve growth and development and conserve the nervous structure and the function, as mastication, vision. Early diagnosis and appropriate care are essential to prevent morphological and functional defects in young patients. Regular and long-term follow-up is essential due to the high recurrence rate.
PubMed: 37703694
DOI: 10.1016/j.ijscr.2023.108620 -
Oral Surgery, Oral Medicine, Oral... Jun 2024Ameloblastic fibro-odontoma (AFO) is a rare, gnathic, benign, mixed odontogenic tumor that commonly presents in the first or second decade of life as a unilocular and...
Ameloblastic fibro-odontoma (AFO) is a rare, gnathic, benign, mixed odontogenic tumor that commonly presents in the first or second decade of life as a unilocular and rarely multilocular radiolucency with variable amounts of calcified material. Tumor progression is typically indolent, and generally accepted treatment is surgical enucleation and curettage. This case report describes an atypical presentation in a 14-year-old male with a multilocular, aggressive AFO requiring hemimandibulectomy with immediate osseous and dental "Jaw-in-a-Day" reconstruction. This report highlights the debate regarding whether AFO is a true neoplasm or an early-stage hamartoma in the continuum of complex odontoma formation. Regardless of the pathogenesis, maxillofacial surgeons and pathologists should be cognizant of the potential for AFO to develop locally aggressive behavior with considerable morbidity.
Topics: Humans; Male; Adolescent; Odontoma; Mandibular Neoplasms; Diagnosis, Differential; Radiography, Panoramic
PubMed: 38575451
DOI: 10.1016/j.oooo.2023.11.014 -
Cureus Jul 2023Odontomas are the most common odontogenic neoplasms. They are generally small and asymptomatic. This article presents an unusual case of a giant maxillary complex...
Odontomas are the most common odontogenic neoplasms. They are generally small and asymptomatic. This article presents an unusual case of a giant maxillary complex odontoma, which obscured a part of the maxillary antrum and impacted a tooth. This was discovered during an episode of maxillofacial cellulitis. In this case, surgical excision of the lesion was performed under general anesthesia, and the closure was performed with a fat pad pedicled flap. A brief review of the literature was performed to analyze the characteristics of this clinical entity and their implication in the treatment.
PubMed: 37637586
DOI: 10.7759/cureus.42546 -
Frontiers in Oral Health 2023Enamel Renal Syndrome (ERS) (OMIM # 204690) is a rare genetic condition characterised by hypoplastic amelogenesis imperfecta, failed tooth eruption, intra-pulpal...
Enamel Renal Syndrome (ERS) (OMIM # 204690) is a rare genetic condition characterised by hypoplastic amelogenesis imperfecta, failed tooth eruption, intra-pulpal calcifications, gingival enlargement and occasionally nephrocalcinosis. In this case series, we report on four unrelated patients with a confirmed molecular diagnosis of ERS ( pathogenic variants) from Sub-Saharan Africa. The pathognomonic oral profile of ERS was mostly fulfilled in these patients, with the notable addition of an odontoma in one patient. The cases presented a spectrum of phenotypic severity both dentally and systemically. One patient presented with nephrocalcinosis and abnormal kidney function, one had reduced kidney size with normal kidney function, and two had no renal abnormalities. Patients presenting with the oral profile of ERS should receive a prompt referral to a nephrologist and a geneticist. They should receive long-term management from a multidisciplinary medical and dental team.
PubMed: 37675434
DOI: 10.3389/froh.2023.1228760 -
International Dental Journal Jun 2024The aim of this scoping review on infant oral mutilation (IOM) was to study the prevalence, dental complications, and immediate and long-term effects of this practice,...
OBJECTIVE
The aim of this scoping review on infant oral mutilation (IOM) was to study the prevalence, dental complications, and immediate and long-term effects of this practice, in addition to providing a systematic overview on existing knowledge and analysis of identified knowledge gaps on IOM.
METHODS
Five electronic bibliographic databases (OVID/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, SCOPUS, and Global Index Medicus) were searched for relevant studies. Data were entered in a bespoke data-charting form. The risk of bias was assessed by 2 independent reviewers.
RESULTS
A total of 478 studies were identified from the search, out of which 42 studies were included in this review. Of the 42 studies, 19 were prevalence studies published between 1969 and 2019 which were additionally assessed for the risk of bias. We found the prevalence of IOM in Uganda was 2% to 30%; Ethiopia, 12% to 86%; Sudan, 10%; Kenya, 61% to 87%; and Tanzania 0% to 24%. Based on the prevalence studies, we observed that the most common factor motivating IOM was diarrhoea. The immediate effects of IOM were found to be infection, bleeding, anaemia, pneumonia, septicaemia, osteomyelitis, meningitis, tetanus, and blood-borne diseases, with some infants dying from these effects. Missing canines, enamel hypoplasia, malformations, abnormal eruption of permanent teeth, occlusal discrepancies, midline shift, chronic periapical infections, rotations, canine transposition, or odontomas were the long-term effects found in relation to IOM.
CONCLUSIONS
IOM is a practice with serious immediate and long-term consequences that is mainly performed in East Africa (or by people originated from this region) in children aged 4 to 8 months. Most frequently affected are the deciduous canines and mostly the mandibular teeth. It is important to create professional and public awareness of the procedure in low- and high-income countries. Furthermore, there is a need for more research on the prevalence of IOM in Africa and other areas of the world to determine the long-term consequences of the practice.
Topics: Humans; Infant; Prevalence; Tooth Diseases
PubMed: 38238211
DOI: 10.1016/j.identj.2023.11.012 -
Journal of Stomatology, Oral and... Jan 2024To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a Brazilian population over a 49 years-period.
BACKGROUND
To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a Brazilian population over a 49 years-period.
METHODS
A retrospective cross-sectional study was performed, and data regarding demographic and clinical aspects were obtained from the medical records of a [removed for blind peer review] referral center (1970-2019). The collected data were submitted to descriptive analysis and Pearson's chi-square, Fisher's exact, and Kruskal-Wallis tests (p ≤ 0.05).
RESULTS
In a total of 16,412 medical records analyzed, 300 (1.83 %) were hamartomatous, 2 (0.01 %) choristomatous, and 1 (0.01 %) teratoid lesions. Hamartomas were most diagnosed in females and adults. Statistical significance was observed between hamartoma and age group (p < 0.001). Odontoma was the most frequent hamartomatous lesion. In choristomatous and teratoid lesions, there was no occurrence in males. The jaws were the most affected anatomical site by hamartoma. Choristomas were observed on the mandible and tongue, while a teratoid lesion was seen on the floor of the mouth.
CONCLUSIONS
Low occurrence of choristomatous and teratoid lesions over hamartomatous lesions and a heterogeneous occurrence profile regarding sex, age group, and anatomic site were observed. Hamartomas are relatively common and benign conditions that may cause damage and require special care during dental treatment. Thus, the dentist needs to be able to identify and treat them appropriately. Likewise, although choristomas and teratomas present no risk to patients and have a lower occurrence than hamartomas, they also require treatment.
PubMed: 38218332
DOI: 10.1016/j.jormas.2024.101765 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Feb 2024To analyze the three-dimensional radiographic characteristics of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography...
OBJECTIVE
To analyze the three-dimensional radiographic characteristics of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography (CT) and cone-beam computed tomography (CBCT).
METHODS
Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 19 consecutive patients with calcifying odontogenic cyst (COC) and 16 consecutive patients with calcifying epithelial odontogenic tumor (CEOT) were retrospectively acquired, and radiographic features, including location, size, expansion, internal structure and calcification, were analyzed.
RESULTS
Among the 19 COC cases (12 males and 7 females, with an average age of 27 years), 89.5% (17/19) of the lesions originated from the anterior and premolar areas, 100.0% of them exhibited cortex expansion, and 78.9% had discontinued cortex. Among the 16 CEOT cases (3 males and 13 females, with an average age of 36 years), 81.3% (13/16) of the lesions were in the premolar and molar areas, 56.3% of them exhibited cortex expansion, and 96.8% had discontinued cortex. According to the distribution of internal calcifications, these lesions were divided into: Ⅰ (non-calcification type): absence of calcification; Ⅱ (eccentric marginal type): multiple calcifications scattered along one side of the lesion; Ⅲ (diffused type): numerous calcifications diffusely distributed into the lesion; Ⅳ (plaque type): with a ≥ 5 mm calcified patch; Ⅴ (peri-coronal type): multiple calcifications clustered around impacted teeth. Calcifications were present in 73.7% of COC lesions, including 9 type Ⅱ, 3 type Ⅲ and 2 type Ⅳ lesions, and 42.8% of CEOT lesions had calcification images, including 2 type Ⅲ and 5 type Ⅴ lesions. Six COC lesions had odontoma-like images. Moreover, 8 of 9 type Ⅰ CEOTs were histologically Langerhans cell-rich subtype, which had a smaller size (with an average mesiodistal diameter of 17.8 mm) and were not associated with impacted teeth.
CONCLUSION
COC lesions tended to originate from the anterior part of the jaw and exhibit cortex expansion, and were sometimes associated with odontoma. CEOT commonly occurred in the posterior jaw and had discontinued cortex. Two lesions had significantly different calcification map. Over 70% of COC lesions had calcification images, which were mostly scattered along one side of the cysts, far from the impacted teeth. Approximately 60% of CEOT lesions exhibited smaller size and non-calcification, and the remaining CEOT cases often had calcification images clustered around the impacted teeth.
Topics: Male; Female; Humans; Adult; Odontogenic Cyst, Calcifying; Odontoma; Retrospective Studies; Tooth, Impacted; Odontogenic Tumors; Odontogenic Cysts; Calcinosis; Skin Neoplasms
PubMed: 38318907
DOI: 10.19723/j.issn.1671-167X.2024.01.020 -
Minerva Dental and Oral Science Feb 2024The objectives of the study are to employ modified Gallego staining in pathology and to specifically evaluate the hard tissue apposed to odontogenic epithelium in order...
BACKGROUND
The objectives of the study are to employ modified Gallego staining in pathology and to specifically evaluate the hard tissue apposed to odontogenic epithelium in order to aid in the diagnosis.
METHODS
Lillie's modification of Gallego's stain was utilized as a reference to create a fresh batch of the stain. The archival and running cases of 2021-2022 was screened for odontogenic pathologies, yielding approximately 46 cases, among these four cases were selected which required evaluation of the hard tissue matrix apposed to odontogenic epithelium for its characterization. The modified Gallego staining was employed in the soft tissue sections of these cases under controlled environment. The staining results were evaluated.
RESULTS
The stain was used in cases to stain dentinoid deposition as green color in hybrid ameloblastoma, archegonous cystic odontoma, dentinogenic ghost cell tumor and also in other cases like calcifying odontogenic cyst. Bone presented as green in color, cells as pink color and collagen as green-pink. This helped in the correct diagnosis of these cases facilitating the correct treatment modality.
CONCLUSIONS
In the field of oral pathology, there are a multitude of lesions which are odontogenic with the diagnosis of few of them hinging on the characterization of hard tissue matrix found in close approximation to odontogenic epithelium implying an inductive capability to the odontogenic epithelium. This particular modified Gallego stain has been able to help in diagnosis of few such cases in our repertoire of cases.
Topics: Odontogenic Tumors; Ameloblastoma; Odontoma; Odontogenic Cyst, Calcifying; Staining and Labeling; Citrus
PubMed: 37310195
DOI: 10.23736/S2724-6329.23.04809-X