-
Oral and Maxillofacial Surgery Sep 2020The purpose of this study is to find out if the biological behavior and the capacity of the odontogenic keratocyst (OKC) in maintaining pathologic cells alive are more...
The purpose of this study is to find out if the biological behavior and the capacity of the odontogenic keratocyst (OKC) in maintaining pathologic cells alive are more similar to the dentigerous cyst or to the ameloblastoma by assessing bcl-2. We searched MEDLINE, Web of Science, and Scopus for immunohistochemical studies reporting OKCs, dentigerous cysts, and ameloblastomas. Risk difference between the lesions expressing bcl-2 was the effect measure and a P value < 0.05 was considered to provide evidence to the effect estimates. OKCs have an estimated difference of 91% in the probability to express the bcl-2 over dentigerous cysts, but there is no difference in the expression of bcl-2 between OKCs and ameloblastomas. The present study demonstrated a great risk difference in the expression of bcl-2 between OKCs and dentigerous cysts and no risk difference between OKCs and ameloblastomas. OKC's growth may indirectly be attributed to the anti-apoptotic effect of bcl-2 in the cystic epithelium and not only to the increase of its intraluminal pressure. Therefore, the classification of this lesion into keratocystic odontogenic tumor should be carefully reconsidered.
Topics: Dentigerous Cyst; Humans; Immunohistochemistry; Jaw Neoplasms; Odontogenic Cysts; Odontogenic Tumors; Proto-Oncogene Proteins c-bcl-2
PubMed: 32488544
DOI: 10.1007/s10006-020-00856-5 -
Oral Surgery, Oral Medicine, Oral... Jul 2020This systematic literature review addresses the use of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) for the evaluation of...
OBJECTIVES
This systematic literature review addresses the use of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) for the evaluation of benign maxillomandibular odontogenic lesions.
STUDY DESIGN
Databases were searched, and original research studies or case report manuscripts up to April 2019 were included, using the keyword "diffusion," combined with the keywords "maxillofacial pathology," "oral pathology," "odontogenic tumors," "dental tissue neoplasms," "odontogenic cysts," and the histologic denomination of benign odontogenic lesions, according to the World Health Organization classification. Only English language articles and studies pertaining to DWI were selected.
RESULTS
Fifteen investigations (11 original articles and 4 case reports) of distinct benign odontogenic lesions were included. Most studies did not include exclusively odontogenic lesions in their samples.
CONCLUSIONS
It is too early to reach a conclusion that DWI and ADC can provide useful information in the differentiation of the histologic type of some benign odontogenic lesions on the basis of available data in the literature.
Topics: Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Imaging; Odontogenic Cysts; Odontogenic Tumors; Sensitivity and Specificity
PubMed: 32007494
DOI: 10.1016/j.oooo.2019.11.009 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2020A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. (Meta-Analysis)
Meta-Analysis
BACKGROUND
A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography.
MATERIAL AND METHODS
A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis.
RESULTS
Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few studies. The presence of periapical lesions (PALs) was significantly associated to TSM (OR=2.43 (95%CI:1.71-3.46); I2=34.5%) and to odontogenic maxillary sinusitis (OMS) (OR=1.77 (95%CI: 1.20-2.61); I2=35.5%).
CONCLUSIONS
The presence of PALs increases the probability of TSM and OMS up to 2.4-fold and 1.7-fold respectively. The risk differences suggests that about 58 and 37 of out every 100 maxillary sinuses having antral teeth with PALs are associated with an increased risk TSM and OMS respectively. The meta-evidence obtained in this study was of moderate certainty, and although the magnitude of the observed associations may vary, their direction in favor sinus disorders appearance, would not change as a result.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Maxillary Sinusitis; Odontogenesis; Paranasal Sinus Diseases
PubMed: 31880293
DOI: 10.4317/medoral.23172 -
Dento Maxillo Facial Radiology Mar 2020This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing maxillofacial radiolucent lesions. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing maxillofacial radiolucent lesions.
METHODS
A systematic review was conducted according to the statements of Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols and considering 10 databases, including the gray literature. Protocol was registered at the International Prospective Register of Systematic Reviews (CRD42018089945). The population, intervention, comparison and outcome strategy was used to define the eligibility criteria and only diagnostic test studies were included. Their risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal tool. Random-effects model meta-analysis was performed and heterogeneity among the included studies was estimated using the I statistic. The grade of recommendation, assessment, development, and evaluation (GRADE) tool assessed the quality of evidence and strength of recommendation across included studies.
RESULTS
Out of 715 identified citations, four papers, published between 2009 and 2017, fulfilled the criteria and were included in this systematic review. A total of 191 lesions, classified as periapical granuloma and cyst, dentigerous cyst or keratocystic odontogenic tumor, were analyzed. All selected articles scored low risk of bias. The pooled accuracy estimation, regardless of the classification method used, was 88.75% (95% CI = 85.19-92.30). Heterogeneity test reached moderate values (I = 57.89%). According to the GRADE tool, the analyzed outcome was classified as having low level of certainty.
CONCLUSIONS
The overall evaluation showed all studies presented high accuracy rates of computer-aided diagnosis systems in classifying radiolucent maxillofacial lesions compared to histopathological biopsy. However, due to the moderate heterogeneity found among the studies included in this meta-analysis, a pragmatic recommendation about the use of computer-assisted analysis is not possible.
Topics: Biopsy; Dentigerous Cyst; Diagnosis, Computer-Assisted; Humans; Image Processing, Computer-Assisted; Odontogenic Tumors
PubMed: 31709811
DOI: 10.1259/dmfr.20190204 -
Journal of Dentistry (Shiraz, Iran) Sep 2019Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two... (Review)
Review
Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two different conservative surgical techniques for the treatment of KOTs. This study aimed at comparing the recurrence rate between marsupialization and decompression in the treatment of KOTs with or without adjunctive treatments. This is a systematic review study. The research sources utilized were PubMed (MEDLINE), Google scholar, Ovid MEDLINE and Cochrane Library. The keywords which were selected based on Medical Subject Heading (MeSH) terms and PICOS criteria were odontogenic keratocyst, keratocyst odontogenic tumor AND marsupialization OR decompression OR cystectomy OR enucleation OR curettage. Statistical analyses were performed to compare the recurrence rate between marsupialization and decompression with or without adjunctive treatments, regarding various follow-up times. The number of subjects that underwent marsupialization was 182. There was a significant difference for the recurrence rate between the marsupialization and decompression groups without considering adjunctive treatments (= 0.001). However, considering adjunctive treatments, there was no difference between marsupialization and the decompression groups (= 0.18). It appears that decompression without any adjuvant treatment may have a lower recurrence rate than marsupialization. The recurrence rate was not different when enucleation or cystectomy was performed after decompression and marsupialization.
PubMed: 31579687
DOI: 10.30476/DENTJODS.2019.44899 -
Journal of Stomatology, Oral and... Apr 2020Odontogenic lesions have been described in several syndromes. Despite multiple reports of ameloblastoma's association with various syndromes, it has not been added to...
Odontogenic lesions have been described in several syndromes. Despite multiple reports of ameloblastoma's association with various syndromes, it has not been added to the diagnostic criteria for any syndrome. Thus, the aim of this systematic review was gathering such cases' data. An electronic search in PubMed Central's database was performed. The search strategy was limited to human studies (case reports and case series), full-text English articles published from first of January 1975 until the end of 2018. Irrelevant articles or articles with inadequate information were omitted. Associated syndrome, patients' age and sex, lesions' location, radiographic features, and treatment modality were collected and analyzed. Ameloblastoma was reported in association with Gorlin syndrome (6 cases), epidermal nevus syndrome (2 cases), Gardner syndrome (2 cases), Simpson-Golabi-Behmel syndrome (1 case), and Williams syndrome (1 case). The commonest associated syndrome was Gorlin syndrome (50%) with maxillary and female predilections. Both cases of epidermal nevus syndrome (ENS) were female with mandibular involvement. In syndromes that odontogenic lesions are one of the diagnostic criteria, it is important to rule out ameloblastic changes. Although the relationship between ameloblastoma and these syndromes is not well known, any related information may be helpful in understanding the pathogenesis and the nature of this neoplasm.
Topics: Ameloblastoma; Basal Cell Nevus Syndrome; Female; Gardner Syndrome; Gigantism; Humans; Mandible
PubMed: 31336213
DOI: 10.1016/j.jormas.2019.07.010