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Dental Clinics of North America Jan 2020Odontogenic cysts are epithelial-lined pathologic cavities and surrounded by fibrous connective tissue that originate from odontogenic tissues that occur in... (Review)
Review
Odontogenic cysts are epithelial-lined pathologic cavities and surrounded by fibrous connective tissue that originate from odontogenic tissues that occur in tooth-bearing regions of maxilla and mandible. Cystic conditions of the jaw cause bony destruction and may cause resorption or displacement of adjacent teeth. Odontogenic cysts have developmental or inflammatory origins. More cases have been published in the adult age group than the pediatric population. Periapical cyst and dentigerous cysts are frequently reported conditions in dental practice. Histopathologic examination remains the gold standard investigation. Odontogenic cysts are managed with enucleation or marsupialization procedures. Early recognition and referral to oral surgery minimize the extent of jaw bone destruction.
Topics: Adult; Child; Dental Caries; Dentigerous Cyst; Humans; Mandible; Maxilla; Odontogenic Cysts
PubMed: 31735221
DOI: 10.1016/j.cden.2019.08.002 -
International Journal of Molecular... Feb 2021The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized... (Review)
Review
The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized bone, but also dentine, cementum and enamel of our teeth. These are exposed to intense mechanical and chemical stress as well as to dense microbiologic colonization. Teeth are susceptible to damage, most commonly to caries, where microorganisms from the oral cavity degrade the mineralized tissues of enamel and dentine and invade the soft connective tissue at the core, the dental pulp. However, the pulp is well-equipped to sense and fend off bacteria and their products and mounts various and intricate defense mechanisms. The front rank is formed by a layer of odontoblasts, which line the pulp chamber towards the dentine. These highly specialized cells not only form mineralized tissue but exert important functions as barrier cells. They recognize pathogens early in the process, secrete antibacterial compounds and neutralize bacterial toxins, initiate the immune response and alert other key players of the host defense. As bacteria get closer to the pulp, additional cell types of the pulp, including fibroblasts, stem and immune cells, but also vascular and neuronal networks, contribute with a variety of distinct defense mechanisms, and inflammatory response mechanisms are critical for tissue homeostasis. Still, without therapeutic intervention, a deep carious lesion may lead to tissue necrosis, which allows bacteria to populate the root canal system and invade the periradicular bone via the apical foramen at the root tip. The periodontal tissues and alveolar bone react to the insult with an inflammatory response, most commonly by the formation of an apical granuloma. Healing can occur after pathogen removal, which is achieved by disinfection and obturation of the pulp space by root canal treatment. This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues, explains the different cell types involved in the immune response and discusses the mechanisms of healing and repair, pointing out the close links between inflammation and regeneration as well as between inflammation and potential malignant transformation.
Topics: Animals; Antigens, Neoplasm; Carcinogenesis; Carcinoma, Squamous Cell; Chemokines; Complement System Proteins; Dental Caries; Dental Pulp; Dentin; Fibroblasts; Humans; Intracellular Signaling Peptides and Proteins; Mesenchymal Stem Cells; Mouth Neoplasms; Nerve Net; Neuropeptides; Nitric Oxide; Odontoblasts; Periapical Granuloma; Periapical Periodontitis; Periapical Tissue; Pulpitis; Radicular Cyst
PubMed: 33540711
DOI: 10.3390/ijms22031480 -
Diagnostics (Basel, Switzerland) Nov 2022The use of cone-beam computed tomography (CBCT) has been increasing in dental practice. This narrative review summarized the relevance and utilizations of CBCT to... (Review)
Review
The use of cone-beam computed tomography (CBCT) has been increasing in dental practice. This narrative review summarized the relevance and utilizations of CBCT to visualize anatomical structures of the maxillary sinus and common pathologies found in the maxillary sinus. The detection/visualization rate, the location and the morphometric characteristics were described. For sinus anatomy, the reviewed features included the posterior superior alveolar artery, sinus pneumatization, sinus hypoplasia, sinus septa, and primary and accessory sinus ostia. For pathology, the following items were reviewed: membrane thickening associated with periapical lesions/periodontal lesions, mucous retention cyst, and antrolith. The visualization and assessment of the maxillary sinus is very important prior to procedures that take place in close proximity with the sinus floor, such as tooth extraction, implant insertion, and sinus floor elevation. Some sinus pathologies may be associated with odontogenic lesions, such as periapical diseases and periodontal bone loss.
PubMed: 36428879
DOI: 10.3390/diagnostics12112819 -
Dento Maxillo Facial Radiology Jan 2022In the last few years, artificial intelligence (AI) research has been rapidly developing and emerging in the field of dental and maxillofacial radiology. Dental...
In the last few years, artificial intelligence (AI) research has been rapidly developing and emerging in the field of dental and maxillofacial radiology. Dental radiography, which is commonly used in daily practices, provides an incredibly rich resource for AI development and attracted many researchers to develop its application for various purposes. This study reviewed the applicability of AI for dental radiography from the current studies. Online searches on PubMed and IEEE Xplore databases, up to December 2020, and subsequent manual searches were performed. Then, we categorized the application of AI according to similarity of the following purposes: diagnosis of dental caries, periapical pathologies, and periodontal bone loss; cyst and tumor classification; cephalometric analysis; screening of osteoporosis; tooth recognition and forensic odontology; dental implant system recognition; and image quality enhancement. Current development of AI methodology in each aforementioned application were subsequently discussed. Although most of the reviewed studies demonstrated a great potential of AI application for dental radiography, further development is still needed before implementation in clinical routine due to several challenges and limitations, such as lack of datasets size justification and unstandardized reporting format. Considering the current limitations and challenges, future AI research in dental radiography should follow standardized reporting formats in order to align the research designs and enhance the impact of AI development globally.
Topics: Artificial Intelligence; Dental Caries; Humans; Radiography; Radiography, Dental, Digital; Radiology
PubMed: 34233515
DOI: 10.1259/dmfr.20210197 -
European Endodontic Journal Jan 2023Inflammatory radicular cysts (IRCs) are chronic lesions that follow the development of periapical granulomas (PGs). IRCs result from multiple inflammatory reactions led... (Review)
Review
Inflammatory radicular cysts (IRCs) are chronic lesions that follow the development of periapical granulomas (PGs). IRCs result from multiple inflammatory reactions led initially by several pro-inflammatory interleukins and growth factors that provoke the proliferation of epithelial cells derived from epithelial cell rests of Malassez present in the granulomatous tissue, followed by cyst formation and growth processes. Multiple theories have been proposed to help explain the molecular process involved in the development of the IRC from a PG. However, although multiple studies have demonstrated the presence of epithelial cells in most PGs, it is still not fully understood why not all PGs turn into IRCs, even though both are stages of the same inflammatory phenomenon and receive the same antigenic stimulus. Histopathological examination is currently the diagnostic gold standard for differentiating IRCs from PGs. Although multiple studies have evaluated the accuracy of non-invasive or minimally invasive methods in assessing the histopathological nature of the AP before the intervention, these studies' results are still controversial. This narrative review addresses the biological insights into the complex molecular mechanisms of IRC formation and its histopathological features. In addition, the relevant inflammatory molecular mediators for IRC development and the accuracy of non-invasive or minimally invasive diagnostic approaches are summarised. (EEJ-2022-03-041).
Topics: Humans; Radicular Cyst; Epithelial Cells; Inflammation; Periapical Granuloma; Intercellular Signaling Peptides and Proteins
PubMed: 36748442
DOI: 10.14744/eej.2022.26918 -
Australian Journal of General Practice Sep 2020An orthopantomogram (OPG) is a common radiograph used to identify the hard tissues of the oral cavity and surrounding skeletal structures. It is an extra-oral...
BACKGROUND
An orthopantomogram (OPG) is a common radiograph used to identify the hard tissues of the oral cavity and surrounding skeletal structures. It is an extra-oral radiograph that approximates the focal trough of the mandible. Although resolution is not as detailed as intra-oral radiographs for examination of the teeth, gross changes in calcification of the dental structures, and changes in ossification of the underlying mandible and maxilla can aid in identification of dental disease such as caries (decay), periodontal bone loss, and abscess and cyst formation.
OBJECTIVE
This article outlines key anatomical features identifiable in an OPG and illustrates some common pathology that may be seen.
DISCUSSION
The large amount of data visible on an OPG may appear daunting to the viewer unless a systematic approach is used to examine structures present. Distortion due to flattening of the curve of the mandible and dentition will give an overall view of these structures and requires the viewer to reinterpret these in their mind for a three-dimensional appreciation of the image.
Topics: Humans; Mandible; Maxilla; Radiography, Panoramic
PubMed: 32864665
DOI: 10.31128/AJGP-07-20-5536 -
Pediatric and Developmental Pathology :... 2023Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic... (Review)
Review
Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.
Topics: Humans; Child; Dentigerous Cyst; Odontogenic Cysts; Radicular Cyst; Odontogenic Tumors; Epithelium
PubMed: 37212213
DOI: 10.1177/10935266231176245 -
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 -
Dentistry Journal Dec 2023Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth.... (Review)
Review
Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.
PubMed: 38132419
DOI: 10.3390/dj11120281