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Oral Diseases Nov 2022Ameloblastoma is a locally aggressive odontogenic tumor. Etiopathogenesis and locally aggressive growth properties of ameloblastoma can be attributed to a hypoxic...
Ameloblastoma is a locally aggressive odontogenic tumor. Etiopathogenesis and locally aggressive growth properties of ameloblastoma can be attributed to a hypoxic microenvironment conducive to tumor cell survival. Epithelial-derived follicular ameloblastoma cells (EP-AMCs) display enhanced basal autophagy, but the interplay of hypoxia and autophagy in EP-AMCs survival and ameloblastoma recurrence is unclear. We evaluated differential expression of autophagic markers in primary and recurrent ameloblastomas and hypothesized that hypoxia-induced autophagy supports EP-AMC survival. Primary and recurrent ameloblastomas were comparatively assessed for expression levels of pan-cytokeratin, Vimentin, and autophagic markers SQSTM1/p62, LC3, and pS6. EP-AMCs compared with human odontoma-derived cells (HODCs) were subjected to severe hypoxia to determine the interplay of hypoxia and autophagic process in posthypoxia survival. Pan-cytokeratin and SQSTM1/p62 were expressed by both primary and recurrent ameloblastoma epithelial cells while the ameloblastoma connective tissues displayed weak reactivity to vimentin. Under hypoxia, EP-AMC expression levels of hypoxia-inducible factor (HIF)-1α, p62, and LC3 were increased while pS6 was decreased posthypoxia. The combined decrease in pS6 and enhanced LC3 in EP-AMCs under hypoxia indicate that EP-AMCs re-establish basal autophagy under hypoxia. Taken together, these suggest a possible role of LC3-associated phagocytosis (LAP) in ameloblastoma cell survival.
Topics: Ameloblastoma; Autophagy; Cell Hypoxia; Cell Line, Tumor; Epithelial Cells; Humans; Hypoxia; Hypoxia-Inducible Factor 1, alpha Subunit; Keratins; Sequestosome-1 Protein; Tumor Microenvironment; Vimentin
PubMed: 33721362
DOI: 10.1111/odi.13848 -
Oral Radiology Jul 2021The Gubernaculum Dentis (GD) is an anatomical structure connecting the dental follicle of the permanent tooth to the overlying gingiva. It is composed of Gubernacular... (Review)
Review
The Gubernaculum Dentis (GD) is an anatomical structure connecting the dental follicle of the permanent tooth to the overlying gingiva. It is composed of Gubernacular cord (GCo) and a surrounding bony canal called as Gubernacular canal (GC) or Gubernacular Tract (GT). GD is a physiologic structure that has claimed to play some role in the eruption of teeth. GCo is a histologic structure, however, the surrounding GT can be identified radiographically. But due to its infinitesimal appearance, its differentiation with normal bone marrow spaces on conventional radiographs is extremely difficult and is the reason for its sporadic reference in the oral radiology literature. The advent of advanced imaging modalities such as Cone Beam Computed Tomography (CBCT) has led to its distinct identification in the recent studies not only in the normal erupting teeth but in teeth with altered eruption pattern, impacted teeth, supernumerary teeth, odontogenic cysts and tumors as well. The identification of GT on CBCT is usually an incidental finding and because of its physiologic nature, the imaging characteristics of GT have not been studied extensively. This pictorial review aims to demonstrate the imaging characteristics of GT in diverse relations with the normal teeth, impacted teeth, supernumerary teeth, odontomas and odontogenic cysts and tumors. This will help in understanding the various presentations of GT and will serve as a teaching guide for oral and maxillofacial radiologists for their easy identification and their possible causal association with various eruptive pathologies.
Topics: Gubernaculum; Humans; Spiral Cone-Beam Computed Tomography; Tooth Eruption; Tooth, Impacted; Tooth, Supernumerary
PubMed: 32607940
DOI: 10.1007/s11282-020-00461-y -
Head and Neck Pathology Sep 2022Peripheral or extraosseous odontogenic tumors are rare oral soft tissue enlargements which demonstrate the same histologic features of their intraosseous counterparts... (Review)
Review
Peripheral or extraosseous odontogenic tumors are rare oral soft tissue enlargements which demonstrate the same histologic features of their intraosseous counterparts but emerge in gingiva and mucosa. In this paper we report a case of peripheral odontoma in a 12-years-old female patient presented asymptomatic swelling in the palatal site. After the clinical and radiographic examination, excisional biopsy was applied to the lesion located entirely in the soft tissue of maxillary incisors. Histopathologically presence of tooth-like structures containing dentin with regular canals and partly enamel matrix were observed. Our aim is to present the extremely rare case of peripheral odontoma and to review the literature for demonstrating the frequency and clinicopathologic features of this entity.
Topics: Biopsy; Child; Face; Female; Humans; Odontogenic Tumors; Odontoma
PubMed: 35119618
DOI: 10.1007/s12105-022-01421-0 -
Journal of Oral Pathology & Medicine :... Jan 2022Hybrid odontogenic lesions combine histopathological characteristics of two or more odontogenic cysts and/or tumours. The aim of this study was to evaluate the available... (Review)
Review
BACKGROUND
Hybrid odontogenic lesions combine histopathological characteristics of two or more odontogenic cysts and/or tumours. The aim of this study was to evaluate the available data on hybrid odontogenic lesions (HOL) and to analyse their epidemiological/clinical features and biological behaviour.
METHODS
An electronic search was done in January 2021 using multiple databases. Eligibility criteria encompassed publications with sufficient clinical and histological information to confirm the tumours' diagnoses.
RESULTS
A total of 147 articles were included in this study, comprising 203 cases. Calcifying odontogenic cyst associated with odontoma (COC/OD) (37/18.2%) was the most common HOL. Females were more affected with a mean age of 24.9 years. Lesions presented as asymptomatic swellings, with a mean evolution time of 8.2 months (0.3-96), and mean tumour size of 4.8 cm (0.3-7). Radiographic aspects frequently showed radiolucent (139/68.4%) and unilocular (52/25.6%) images with well-defined limits (48/23.6%). The lesions mostly affected mandibular pre-molars (69/34%) and mandibular molars (69/34%) regions. Enucleation (89/43.8%) and surgical excision (59/29%) were the most common treatment modalities. The mean follow-up time was 33.8 months (0.5-216 months) and recurrences were observed in four cases (1.9%), all of which were central odontogenic fibroma associated with central giant cell granuloma (COF/CGCG).
CONCLUSION
COC/OD is the most common HOL and recurrence is a rare event, being usually associated with the diagnosis of COF/CGCG.
Topics: Adult; Female; Granuloma, Giant Cell; Humans; Odontogenic Cyst, Calcifying; Odontogenic Cysts; Odontogenic Tumors; Odontoma; Young Adult
PubMed: 34469012
DOI: 10.1111/jop.13238 -
Journal of Clinical Medicine Jul 2021The eruption pathway from the dental follicle to the gingiva for permanent teeth is known as the gubernaculum tract (GT), a physiologic structure thought to play a role... (Review)
Review
The eruption pathway from the dental follicle to the gingiva for permanent teeth is known as the gubernaculum tract (GT), a physiologic structure thought to play a role in tooth eruption. Cone beam computed tomography and multi-detector computed tomography have recently been used to visualize the GT, with the results indicating that this structure might be related to the normal eruption of teeth. By contrast, curved and/or constricted GTs may lead to abnormal tooth eruption. In addition, complex odontomas have been reported from within the GT or dental sac of unerupted permanent teeth. If an odontoma occurs within the GT, the tooth will not erupt normally. Moreover, the imaging characteristics of the GT from the top of the odontogenic mass to the alveolar crest are extremely useful for making a differential pathological diagnosis and for differentiating between odontogenic and non-odontogenic masses. Therefore, radiological studies on the GT have been attracting increasing attention. Given this background, the present review aims to clarify the imaging characteristics and review recent studies on the GT considering the importance of the research.
PubMed: 34300216
DOI: 10.3390/jcm10143051 -
Journal of Cutaneous Pathology Aug 2020Peripheral odontoma is a very rare odontogenic hamartoma arising in soft tissues. Here, we report a case of peripheral odontoma in a pediatric patient and review the... (Review)
Review
Peripheral odontoma is a very rare odontogenic hamartoma arising in soft tissues. Here, we report a case of peripheral odontoma in a pediatric patient and review the cases published in the literature. An 11-year-old male patient presented a nodular lesion in the anterior region of the palate for over 1 year. Under the clinical hypothesis of fibroma, an excisional biopsy was performed. Histopathological examination revealed the presence of tooth-like structures, formed by enamel, and dentin matrix, occasionally associated with the dental papilla and surrounding pulp tissue, thus, the histopathological diagnosis of peripheral odontoma was established. The patient has been undergoing follow-up for 6 months without any signs of lesion recurrence. Peripheral odontomas are uncommon lesions that usually affect young patients and display a preference for the maxilla and limited growth potential. The recognition of the clinical and histopathological features of the peripheral odontoma is indispensable for the establishment of its diagnosis.
Topics: Adolescent; Adult; Biopsy; Child; Child, Preschool; Female; Fibroma; Follow-Up Studies; Hamartoma; Humans; Infant; Male; Margins of Excision; Odontoma; Palate; Tooth Abnormalities; Treatment Outcome
PubMed: 32134132
DOI: 10.1111/cup.13676 -
Congenital Anomalies Sep 2023Forensic odontology plays a crucial role in establishing the identity in mass disasters and criminal cases with high accuracy. Dental anomalies and features help in such... (Review)
Review
Forensic odontology plays a crucial role in establishing the identity in mass disasters and criminal cases with high accuracy. Dental anomalies and features help in such situations. Congenital and developmental dental anomalies can be easily documented to establish distinctive and individualistic characteristics of an individual. The location, number of teeth involved, and the type of anomaly vary between individuals. Similarly, dental malformations also assist greatly in the identification process. Many types of dental anomalies have been studied in the past for their individualistic characteristics in forensic examinations. One such dental anomaly is odontoma, which is a benign odontogenic malformation. This malformation may also help in the identification of the deceased, when recorded and examined accurately. An odontome is a malformed teeth-like structures consisting of enamel, dentin, and pulpal tissue, formed due to the growth of completely differentiated epithelial and mesenchymal cells. If antemortem (AM) dental records incorporate information regarding odontomes and other dental anomalies, including in radiographs, orthopantomograms or microradiographs, positive identification may be established by comparison of these records with postmortem (PM) records. In the present communication, a rare case of compound composite odontoma in the anterior mandible with multiple denticles has been discussed with a brief overview of congenital and developmental dental anomalies. The authors emphasize the importance of such rare dental anomalies and malformations which may be used for identifying the deceased in mass disasters and forensic identification.
Topics: Humans; Odontoma; Forensic Dentistry; Radiography, Panoramic; Tooth; Mandible
PubMed: 37503819
DOI: 10.1111/cga.12533 -
The Journal of Craniofacial Surgery May 2022Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its...
BACKGROUND
Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its classification of maxillofacial bone pathology in 2017. Using these updated guidelines, a systematic review of common maxillofacial bone lesions in the pediatric population was performed.
METHODS
A PubMed search was conducted capturing English language articles from inception to July 2020. Thirty-one articles were identified that described the frequency of maxillofacial bone pathology. Data were extracted and organized using the WHO 2017 classification of odontogenic and maxillofacial bone tumors. Prevalence data were analyzed among diagnostic categories and geographical regions. The SAS version 9.4 was used to complete statistical analyses.
RESULTS
The articles included patients from birth to a maximum age of 14 to 19 years. The most common odontogenic cysts included radicular cyst (42.7%) and dentigerous cyst (39.0%) followed by odontogenic keratocyst (15.0%). Among odontogenic bone tumors, odontoma (49.3%) was most common followed by ameloblastoma (29.1%). The most common nonodontogenic bone tumor was fibrous dysplasia (42.4%), and the most common malignant bone tumor was osteosarcoma (75.0%). Significant variations were found by geographic region, with dentigerous cyst more common than radicular cyst, and ameloblastoma more common than odontoma in African and Asian countries (P < 0.0001).
CONCLUSIONS
This systematic review uses the WHO 2017 guidelines to classify common odontogenic and nonodontogenic maxillofacial bone lesions around the world. Pathogenesis, presentation, and available treatment options for the most common maxillofacial bone lesions are reviewed.
Topics: Adolescent; Adult; Ameloblastoma; Child; Dentigerous Cyst; Humans; Odontogenic Cysts; Odontogenic Tumors; Odontoma; Radicular Cyst; Young Adult
PubMed: 34560739
DOI: 10.1097/SCS.0000000000008201 -
Frequency of Odontogenic Tumors: A Single Center Study of 1089 Cases in Japan and Literature Review.Head and Neck Pathology Jun 2022Several attempts have been made to classify odontogenic tumors; however, the need for a uniform international classification system led the World Health Organization... (Review)
Review
Several attempts have been made to classify odontogenic tumors; however, the need for a uniform international classification system led the World Health Organization (WHO) to present a classification of odontogenic tumors in 1971. We aimed to evaluate the number and types of odontogenic tumors examined at the Tokyo Dental College Hospital in Japan to determine the frequency and types of odontogenic tumors, based on the 2017 WHO classification system, as this information has not been reported previously in Japan. We also compared the results of our evaluation with those reported in previous studies. We conducted a clinicopathological evaluation of odontogenic tumors examined at the Tokyo Dental College Hospital between 1975 and 2020. This included an analysis of 1089 cases (malignant, n = 10, 0.9%; benign, n = 1079, 99.1%) based on the 2017 World Health Organization Classification of Head and Neck Tumors. We identified 483 (44.3%), 487 (44.7%), and 109 (10.0%) benign epithelial odontogenic, mixed odontogenic, and mesenchymal tumors, respectively. The most common tumor types were odontoma (42.5%) and ameloblastoma (41.9%). Of the 1089 cases, 585 (53.7%) and 504 (46.3%) were male and female patients, respectively. Ameloblastoma and ameloblastic fibroma occurred more commonly in male patients, whereas odontogenic fibroma and cemento-ossifying fibroma affected female patients primarily. The age at diagnosis ranged from three to 87 (mean, 29.05) years. In 319 (29.3%) patients, the age at diagnosis ranged from 10 to 19 years. Ameloblastoma and odontoma were the most common tumor types among patients in their 20s and those aged 10-19 years, respectively. In 737 (67.7%) and 726 (66.7%) patients, the tumors were located in the mandible and posterior region, respectively. Ameloblastoma was particularly prevalent in the posterior mandible. Odontogenic tumors are rare lesions and appear to show a definite geographic variation.
Topics: Ameloblastoma; Female; Fibroma, Ossifying; Humans; Japan; Male; Odontogenic Tumors; Odontoma; Retrospective Studies
PubMed: 34716904
DOI: 10.1007/s12105-021-01390-w -
Acta Clinica Croatica Mar 2021Odontomas are benign odontogenic tumors formed from epithelial and mesenchymal cells. They are mostly associated with disorders of tooth eruption, causing impaction... (Review)
Review
Odontomas are benign odontogenic tumors formed from epithelial and mesenchymal cells. They are mostly associated with disorders of tooth eruption, causing impaction and/or delayed tooth eruption, and are an accidental finding on routine radiological examination. The aim of this paper is to present current findings in the etiology and treatment of odontomas, as well as the clinical and radiographic features, describing a case that is rarely found in the literature. A case of multiple complex odontoma in the mandible of an 11-year-old boy is presented, causing impaction of the first permanent right molar, 46. The treatment consisted of surgical enucleation of the multiple complex odontoma with preservation of the impacted tooth, monitoring clinically and radiologically its spontaneous eruption followed by final orthodontic alignment. Odontomas are not an everyday part of clinical practice and given that they are most commonly associated with permanent tooth impaction, it is extremely important to have knowledge of their clinical and radiological features. Early diagnostics and appropriate treatment result in better diagnosis, thus increasing the possibility of preserving the impacted teeth.
Topics: Child; Humans; Male; Odontoma; Radiography; Tooth, Impacted; Treatment Outcome
PubMed: 34588736
DOI: 10.20471/acc.2021.60.01.22