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Oral Radiology Apr 2024Radicular cysts are the most common cystic lesions in the oral cavity, and have a rare occurrence in the primary dentition. We report a case of radicular cyst of...
Radicular cysts are the most common cystic lesions in the oral cavity, and have a rare occurrence in the primary dentition. We report a case of radicular cyst of mandible in child by multimodal imaging including panoramic radiography, CT, and MR imaging. A 7-year-old girl presented with swelling and without pain, and hypoesthesia on the right side of the mandible. On clinical examination, an expansive lesion with undulation was found to the buccal cortex of the right side of the mandible. Panoramic radiograph showed a unilocular radiolucency with well-defined margin, displaced tooth, and root resorption in the right mandible. Regarding CT imaging, axial soft tissue algorithm CT and bone tissue algorithm CT showed a low-attenuation internal structure and expansion of the buccal cortex of the right side of the mandible. Three-dimensional-CT showed expansion of the buccal cortex of the right side of the mandible. Multiplanar reformation imaging showed displaced tooth, root resorption, and expansion of the buccal cortex of the right side of the mandible. On T1-weighted image, the expansive lesion showed low signal intensity, and T2-weighted and STIR images revealed high signal intensity. A partial biopsy of the mandibular region was performed. Histopathological diagnosis was radicular cyst caused by apical periodontitis with abscess. This case suggests that multimodal imaging, especially CT and MR imaging, could be effective for evaluating mandibular lesions in child.
Topics: Child; Female; Humans; Radicular Cyst; Root Resorption; Mandible; Tooth, Deciduous
PubMed: 37731030
DOI: 10.1007/s11282-023-00714-6 -
Asian Journal of Surgery Dec 2023
Topics: Humans; Periodontal Cyst
PubMed: 37689518
DOI: 10.1016/j.asjsur.2023.08.204 -
Oral Diseases May 2024To determine the relative frequency, demographic and pathologic profiles of patients diagnosed with cysts of the jaws.
OBJECTIVES
To determine the relative frequency, demographic and pathologic profiles of patients diagnosed with cysts of the jaws.
MATERIALS AND METHODS
Biopsy records of the participating institutions from 2000 to 2020 were reviewed for lesions diagnosed in the cyst category. Demographic data, the location of the cysts and pathologic diagnoses were collected. Data were analyzed by appropriate statistics using IBM SPSS software version 28.0.
RESULTS
From 148,353 accessioned cases, 25,628 cases (17.28%) were diagnosed in the cyst category. Mean age of the patients ± SD = 42.62 ± 19.36 years. Paediatric patients (aged ≤ 16 years) accounted for 9.63%, while geriatric patients (aged ≥ 65) comprised 14.22% of all the patients. The male-to-female ratio was 1.27:1. The majority of the lesions were encountered in the mandible. The most prevalent cyst was radicular cyst followed by dentigerous cyst and odontogenic keratocyst. In the paediatric group, dentigerous cyst was the most prevalent, whereas in the geriatric group, radicular cyst was the most common.
CONCLUSIONS
In general, the results of this study are in accordance with previous studies. This study provides an invaluable database for clinicians when formulating clinical differential diagnoses as well as for pathologists in rendering the final diagnosis.
Topics: Humans; Male; Female; Adolescent; Child; Adult; Aged; Middle Aged; Young Adult; Jaw Cysts; Odontogenic Cysts; Child, Preschool; Dentigerous Cyst; Radicular Cyst; Aged, 80 and over; Retrospective Studies; Infant
PubMed: 37642034
DOI: 10.1111/odi.14722 -
Cureus Jul 2023Objective This cross-sectional study aimed to determine the frequency and types of periapical radiographic lesions (PARLs) associated with pulpitis in patients visiting...
Objective This cross-sectional study aimed to determine the frequency and types of periapical radiographic lesions (PARLs) associated with pulpitis in patients visiting a tertiary care hospital. Methodology A sample of patients diagnosed with pulpitis, aged 18 years or older, was recruited following a convenient sampling technique. Clinical examinations were conducted to confirm the diagnosis, and radiographic evaluations, including periapical (PA), occlusal, orthopantomogram (OPG), and cone beam computed tomography (CBCT) radiographs were obtained. The radiographs were evaluated for the presence of PA lesions, and the type, size, and location of the lesions were documented. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA). Results A total of 120 patients (equal gender ratio) with a mean age of 32.6 ± 6.39 years participated in the study. PA views were the most frequently performed radiographic view (86.7%), followed by occlusal views (8.3%). The most prevalent radiographic lesion was the (34.2%), followed by (17.5%) and (10.8%). The most frequently encountered diagnosis was (51.7%), followed by (25.8%). Education level, swelling, pus discharge, medicine history, and tooth wear showed statistically significant associations ( ≤ 0.05) with the variables under investigation. Conclusions The most common lesions observed were , , and . The findings contribute to the local epidemiological and clinical data, enriching the existing database. Understanding the prevalence and characteristics of PA lesions associated with pulpitis can aid in accurate diagnosis and treatment planning for patients with pulpal pathologies.
PubMed: 37637624
DOI: 10.7759/cureus.42529 -
Nigerian Journal of Clinical Practice Aug 2023Odontogenic cysts (OCs) are commonly encountered lesions affecting the human jaws having special clinical and radiographic features depending on cyst type. The aim of...
BACKGROUND
Odontogenic cysts (OCs) are commonly encountered lesions affecting the human jaws having special clinical and radiographic features depending on cyst type. The aim of this study was to determine the prevalence of odontogenic jaw cysts in a Libyan population in Benghazi and to compare these data with previously published reports from Libyan and other geographic areas.
MATERIALS AND METHODS
This is a descriptive study where screening of 2189 biopsies (retrieved from the archives of The Department of Oral Pathology/University of Benghazi, Libya) was performed for the sake of recognizing the three cysts chosen for the purpose of this study.
RESULTS
: Out of the screened lesions, 276 cases (12.6%) were diagnosed as odontogenic cysts in the period from 2006 to 2019. Of those, 67.39% were inflammatory and 32.61% were developmental in nature. Radicular cysts (60.5%) were the most frequent cysts followed by dentigerous cysts (14.8%) and keratocysts (14.5%). The mean ages of the patients were 32.3, 29.7, and 33.2 years, respectively. Occurrence of the cysts was noticed more in the maxilla than in the mandible (1.3:1). The overall male-to-female ratio was 1.1:1.
CONCLUSIONS
The prevalence of odontogenic cysts was similar to that reported in a previous study in Libya and other countries irrespective to WHO (2017) classification of odontogenic cysts.
Topics: Humans; Female; Male; Retrospective Studies; Prevalence; Odontogenic Cysts; Radicular Cyst; Biopsy
PubMed: 37635610
DOI: 10.4103/njcp.njcp_37_23 -
Alternative Therapies in Health and... Nov 2023To compare the effects of bone grafting versus non-bone grafting on implant stability and new bone formation in patients undergoing maxillary sinus floor lift combined...
Effects of Bone Grafting and Non-Bone Grafting on Implant Stability and New Bone Formation in Patients Undergoing Maxillary Sinus Floor Elevation Combined with Bicon Short Implants.
OBJECTIVE
To compare the effects of bone grafting versus non-bone grafting on implant stability and new bone formation in patients undergoing maxillary sinus floor lift combined with placement of a Bicon short dental implant.
METHODS
We recruited 60 patients with posterior maxillary tooth loss and insufficient jaw bone mass from December 2017 to December 2019, and the patients were divided into 2 groups in accordance with the surgical method: the bone grafted group (n = 32) and the non-bone grafted group (n = 28). Both groups underwent maxillary sinus floor elevation combined with Bicon short dental implant placement. No bone-grafting materials were used in the non-bone grafted group, and autologous bone chips mixed with Bicon bone substitute were used for bone grafting in the bone grafted group. The 2 groups were compared for their peri-implant index and periodontal bleeding index immediately after the operation, as well as at 3, 6, and 12 months postoperatively. The study also compared the sub-sinus-membrane height, peri-implant bone density, implant stability quotient, and alveolar bone height in the implant area at 3, 6, and 12 months after the operation, as well as the implant survival rate and complications (infection, bleeding, mucosal perforation, sinus-floor cyst, and bone-graft displacement) 12 months after the operation.
RESULTS
The peri-implant index and periodontal bleeding index immediately after the operation in the bone grafted group were higher than those in the non-bone grafted group (all P < .05), but there were no significant differences in the 2 indices between the 2 groups at 3, 6, and 12 months after the operation (all P > .05). The sub-sinus-membrane height, peri-implant bone density, implant stability quotient, and alveolar bone height in the bone grafted area were higher in the bone grafted group than in the non-bone grafted group at 3, 6, and 12 months after the operation (all P < .05). Although the implant survival rate in the bone grafted group was slightly higher than that in the non-bone grafted group at 12 months after the operation, the difference was not statistically significant (P > .05). One case of mucosal perforation occurred in the bone grafted group, but there was no significant difference in the complication rate between the 2 groups (P > .05).
CONCLUSION
The findings of this study support the use of autologous bone chips mixed with Bicon bone substitute in maxillary sinus floor elevation combined with Bicon short dental implant placement for improved implant stability and new bone formation. Further research is needed to evaluate long-term outcomes and potential complications associated with this technique.
Topics: Humans; Bone Transplantation; Sinus Floor Augmentation; Maxillary Sinus; Osteogenesis; Bone Substitutes; Dental Implants; Treatment Outcome
PubMed: 37573595
DOI: No ID Found -
Oral Diseases May 2024There is little knowledge about oxidative stress-induced senescence involvement in apical periodontitis. Here, we explored its molecular mechanism in periapical lesions.
OBJECTIVES
There is little knowledge about oxidative stress-induced senescence involvement in apical periodontitis. Here, we explored its molecular mechanism in periapical lesions.
METHODS
Ten cases of radicular cysts and five cases of periapical granulomas were randomly selected. Immunohistochemical analysis was performed to detect the expression and correlation between Senescence-associated factor polymerase I and transcript release factor (PTRF) and Akt/FoxO1 signaling. Human periodontal ligament cells (hPDLCs) pretreated with LY294002 were exposed to HO-induced oxidative stress conditions and then cell proliferation, senescence, apoptosis, and associated signaling were evaluated by EdU labeling, β-galactosidase assay, RT-qPCR, and western blot analysis, respectively.
RESULTS
Polymerase I and transcript release factor and Akt/FoxO1 signaling were more frequently expressed in the radicular cyst than in periapical granulomas. Notably, cells in radicular cysts showed Akt activation, FoxO1 phosphorylation, and cytoplasmic translocation. In vitro, prominent HO-induced senescence was observed in hPDLCs. LY294002, a PI3K inhibitor, attenuated the expression levels of senescence (Klotho, P16INK4), apoptosis (Bad, Fas), phosphorylated Akt, and phosphorylated FoxO1; however, did not affect cell proliferation.
CONCLUSIONS
Our data indicated that senescence is present in clinical periapical lesions, and Akt/FoxO1 signaling is involved in the HO-induced cellular senescence, which could serve as a potential therapeutic target.
Topics: Humans; Forkhead Box Protein O1; Proto-Oncogene Proteins c-akt; Signal Transduction; Cellular Senescence; Oxidative Stress; Hydrogen Peroxide; Periodontal Ligament; Morpholines; Radicular Cyst; Periapical Granuloma; Apoptosis; Cell Proliferation; Chromones; Cells, Cultured; Adult; Male
PubMed: 37530471
DOI: 10.1111/odi.14703 -
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 -
Scientific Reports Jul 2023Recently, 1-nonadecene and L-lactic acid were identified as unique metabolites in radicular cysts and periapical granuloma, respectively. However, the biological roles...
Recently, 1-nonadecene and L-lactic acid were identified as unique metabolites in radicular cysts and periapical granuloma, respectively. However, the biological roles of these metabolites were unknown. Therefore, we aimed to investigate the inflammatory and mesenchymal-epithelial transition (MET) effects of 1-nonadecene, and the inflammatory and collagen precipitation effects of L-lactic acid on both periodontal ligament fibroblasts (PdLFs) and peripheral blood mononuclear cells (PBMCs). PdLFs and PBMCs were treated with 1-nonadecene and L-lactic acid. Cytokines' expression was measured using quantitative real-time polymerase chain reaction (qRT-PCR). E-cadherin, N-cadherin, and macrophage polarization markers were measured using flow cytometry. The collagen, matrix metalloproteinase (MMP)-1, and released cytokines were measured using collagen assay, western blot, and Luminex assay, respectively. In PdLFs, 1-nonadecene enhances inflammation through the upregulation of some inflammatory cytokines including IL-1β, IL-6, IL-12A, monocyte chemoattractant protein (MCP)-1, and platelet-derived growth factor (PDGF) α. 1-Nonadecene also induced MET through the upregulation of E-cadherin and the downregulation of N-cadherin in PdLFs. 1-Nonadecene polarized macrophages to a pro-inflammatory phenotype and suppressed their cytokines' release. L-lactic acid exerted a differential impact on the inflammation and proliferation markers. Intriguingly, L-lactic acid induced fibrosis-like effects by enhancing collagen synthesis, while inhibiting MMP-1 release in PdLFs. These results provide a deeper understanding of 1-nonadecene and L-lactic acid's roles in modulating the microenvironment of the periapical area. Consequently, further clinical investigation can be employed for target therapy.
Topics: Humans; Radicular Cyst; Periapical Granuloma; Leukocytes, Mononuclear; Virulence; Cytokines; Inflammation; Lactic Acid; Tumor Microenvironment
PubMed: 37400519
DOI: 10.1038/s41598-023-37945-w -
Academic Radiology Oct 2023This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular...
RATIONALE AND OBJECTIVES
This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular cysts from granulomas.
MATERIALS AND METHODS
This study included 109 teeth with periapical lesions of endodontic origin from 109 patients scheduled for apical microsurgery. Ultrasonic outcomes were analyzed and categorized after thorough clinical and radiographic examinations using US. B-mode US images reflected the echotexture, echogenicity, and lesion margin, while color Doppler US assessed the presence and features of blood flow of interested areas. Pathological tissue samples were obtained during apical microsurgery and subjected to histopathological examination. Fleiss' κ was used to measure interobserver reliability. Statistical analyses were performed to assess the diagnostic validity and the overall agreement between US and histological findings. The reliability of US compared to histopathological examinations was assessed based on Cohen's κ.
RESULTS
The percent accuracy of US for diagnosing cysts, granulomas, and cysts with infection based on histopathological findings was 89.9%, 89.0%, and 97.2%, respectively. The sensitivity of US diagnoses was 95.1% for cysts, 84.1% for granulomas, and 80.0% for cysts with infection. The specificity of US diagnoses was 86.8% for cysts, 95.7% for granulomas, and 98.1% for cysts with infection. The reliability for US compared to histopathological examinations was good (κ = 0.779).
CONCLUSION
The echotexture characteristics of lesions in US images correlated with their histopathological features. US can provide accurate information on the nature of periapical lesions based on the echotexture of their contents and the presence of vascularity. It can help improve clinical diagnosis and avoid overtreatment of patients with apical periodontitis.
Topics: Humans; Radicular Cyst; Periapical Granuloma; Reproducibility of Results; Granuloma; Ultrasonography
PubMed: 37394410
DOI: 10.1016/j.acra.2023.05.039