-
Pathology, Research and Practice May 2023Radicular cysts are characterized by significant levels of changes in inflammatory biomarkers. Among them, interleukins and growth factors have been reported to be...
Radicular cysts are characterized by significant levels of changes in inflammatory biomarkers. Among them, interleukins and growth factors have been reported to be deregulated in radicular cyst tissues. Moreover, long non-coding RNAs are recently discovered non-coding RNA molecules that regulate various intracellular stimuli to keep homeostasis in balance. A growing body of evidence suggests that lncRNAs are significantly involved in the regulation of inflammation by targeting various inflammatory biomarkers. Accordingly, the present study was aimed to investigate the gene expression levels of inflammation-related lncRNAs in radicular cysts and show their possible roles in the development of radicular cysts. For the study, a total of 25 patients with a radiologically and pathologically confirmed radicular cyst were enrolled. For the determination of non-coding RNA expression levels, real-time qPCR was used. As a result of the current study, expression levels of PACER and THRIL were found to be significantly elevated in radicular cyst tissues compared to control tissue samples. However, MALAT1, ANRIL, and NEAT1 expression levels were not significantly altered in radicular cyst tissues compared to control tissue samples. In conclusion, long non-coding RNAs, PACER and THRIL, seem to have significant pathophysiological roles by acquiring molecular changes during inflammation and might be involved in the development and formation of radicular cysts.
Topics: Humans; Radicular Cyst; RNA, Long Noncoding; Inflammation; Biomarkers
PubMed: 37116367
DOI: 10.1016/j.prp.2023.154456 -
BMJ Case Reports Apr 2023Radicular cysts are the most common cystic lesions which affect the jaw. Traumatic dental injuries cause injury to the periodontal ligament and dental pulp often leads...
Radicular cysts are the most common cystic lesions which affect the jaw. Traumatic dental injuries cause injury to the periodontal ligament and dental pulp often leads to pulpal necrosis. The necrosed pulp eventually becomes the nidus of infection and irritates the periapical epithelial cell remnants, which in turn develops into a cyst eventually. This case report presents the successful conservative surgical management of a large infected radicular cyst which was associated with traumatised, necrotic, permanent maxillary lateral incisor with open apex by Partsch II surgical procedure followed by a combination of retrograde and orthograde root canal obturation. This report will guide the clinicians in the arena of surgical endodontics in a conservative approach.
Topics: Humans; Radicular Cyst; Incisor
PubMed: 37041037
DOI: 10.1136/bcr-2023-254561 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Feb 2023Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper... (Review)
Review
Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.
Topics: Humans; Incisor; Radicular Cyst; Abscess; Tooth Root; Root Canal Therapy; Maxilla; Cysts
PubMed: 36999478
DOI: 10.11817/j.issn.1672-7347.2023.220104 -
Histology and Histopathology Aug 2023Our aim was to investigate how bacterial lipopolysaccharide (LPS) is immunoexpressed in periapical lesions. By surprise we detected Rushton bodies (RBs) whose origin has...
AIM
Our aim was to investigate how bacterial lipopolysaccharide (LPS) is immunoexpressed in periapical lesions. By surprise we detected Rushton bodies (RBs) whose origin has been debatable to be positive for LPS.
METHODOLOGY
Samples of radicular cysts (N=70) were stained in order to identify variations in LPS immunoexpression indicating bacterial background. For immunostaining, we used an anti-LPS antibody from Escherichia coli, and for visualization Horse Radish Peroxidase labeled polymer as the secondary antibody.
RESULTS
RBs showed positivity for LPS in radicular cysts. After collection of radicular cyst samples (70 in total), we noted that all RBs (N=25) histologically detected in tissue samples were positive for LPS. Furthermore, calcification in the cyst capsule showed immunopositivity.
CONCLUSION
We demonstrate for the first time that LPS is present in RBs, indicating that host response to bacteria might be the initial cause of the formation of these hyaline bodies in the cyst epithelium and cyst capsule calcifications.
Topics: Humans; Radicular Cyst; Lipopolysaccharides; Epithelium; Calcinosis
PubMed: 36880590
DOI: 10.14670/HH-18-602 -
The Journal of Craniofacial SurgerySquamous cell carcinomas (SCCs) are common malignant tumors in the oral and maxillofacial region. However, SCCs secondary to marsupialization of odontogenic radicular...
Squamous cell carcinomas (SCCs) are common malignant tumors in the oral and maxillofacial region. However, SCCs secondary to marsupialization of odontogenic radicular cysts are extremely rare. The authors report an unusual case of a 43-year-old male presented with dull pain in the right molar region of the mandible without numbness of lower lips, who had a long history of smoking, alcohol consumption, and betel nut chewing. Computerized tomography revealed a round well-defined unilocular radiolucent at the apex of lower right premolars, 2 nonvital teeth. The clinical diagnosis was the radicular cyst of the right mandible. The patient was initially treated with root canal therapy of the teeth followed by marsupialization with a mandibular vestibular groove incision. While the patient did not follow the instruction of irrigation of the cyst and had no regular follow-up. The reexamination of computerized tomography indicated a round well-defined unilocular radiolucent at the apex of lower right premolars and filled with a soft tissue without clear boundary with buccal muscles at 31 months follow-up. There were no masses or ulcer around the mandibular vestibular groove incision and the patient had no sign of numbness of lower lips. The clinical diagnosis was the radicular cyst of right mandible with infection. A curettage was performed. However, the pathologic diagnosis was well-differentiated SCC. An extended radical surgical resection including segmental resection of the right mandible was performed. The histopathology was well-differentiated SCC without the cyst epithelium and invasion of bone, which can be distinguished from primary intraosseous SCC. The case indicates that marsupialization performed in patients with a history of smoking, alcohol consumption, and betel nut chewing, has a risk of suffering from oral SCC.
Topics: Male; Humans; Adult; Radicular Cyst; Mouth Mucosa; Hypesthesia; Odontogenic Cysts; Mandible; Carcinoma, Squamous Cell; Epithelium
PubMed: 36872521
DOI: 10.1097/SCS.0000000000009217 -
The expression of cyclic GMP-AMP synthase in human apical periodontitis: A laboratory investigation.International Endodontic Journal Jun 2023As a key DNA sensor, cyclic GMP-AMP synthase (cGAS) has emerged as a major mediator of innate immunity and inflammation. Human apical periodontitis has yet to be studied...
AIM
As a key DNA sensor, cyclic GMP-AMP synthase (cGAS) has emerged as a major mediator of innate immunity and inflammation. Human apical periodontitis has yet to be studied for the presence of cGAS. This investigation was conducted to determine if cGAS is involved in the pathological process of human apical periodontitis.
METHODOLOGY
Sixty four human periapical lesions, comprising 20 periapical granulomas and 44 radicular cysts, were employed in this investigation. Healthy gingiva (n = 6), dental pulp (n = 3), and apical papilla (n = 3) were used as control samples. The expression of cGAS in the periapical tissues was discovered using immunohistochemical staining. mRNA-Sequencing and qRT-PCR were utilized to determine the differentially expressed genes (DEGs) associated with DNA-sensing signalling in periapical lesions compared to the healthy control. Immunofluorescence labelling was used to identify the co-expression of cGAS, interleukin-1β, and interleukin-18.
RESULTS
A significantly greater expression level of cGAS was discovered in the periapical lesions, with no significant difference between radicular cysts and periapical granulomas. mRNA-Sequencing analysis and qRT-PCR identified differentially expressed mRNA, such as cGAS and its downstream DEGs, between periapical lesions and healthy control tissues. Immunofluorescence labelling further revealed that cGAS, interleukin-1, and interleukin-18 were co-localized.
CONCLUSIONS
These observations imply that along with the synthesis of interleukin-1 and interleukin-18, cGAS may be involved in the aetiology of apical periodontitis.
Topics: Humans; Periapical Granuloma; Radicular Cyst; Interleukin-18; Periapical Periodontitis; Nucleotidyltransferases
PubMed: 36806027
DOI: 10.1111/iej.13904 -
Archives of Oral Biology Apr 2023The aim of the present study was to reveal the effects of hypoxia-associated signaling in odontogenic cysts.
OBJECTIVE
The aim of the present study was to reveal the effects of hypoxia-associated signaling in odontogenic cysts.
DESIGN
The expression levels of genes involved in the hypoxia-associated signaling pathway were determined by quantitative Polymerase Chain Reaction (PCR) method.
RESULTS
As a result, it was found that phosphatase and tensin homolog (PTEN) expression was low (p = 0.037), and the expression levels of phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) (p = 0.0127), hypoxia inducible factor 1 alpha (HIF1A) (p < 0.001), and HIF1A antisense RNA 1 (HIF1A-AS1) (p = 0.0218) were higher in cyst tissue compared to normal tissue. HIF1A gene expression was found to be significantly altered according to the pathologic subtypes of odontogenic keratocyst, dentigerous cyst, and radicular cyst.
CONCLUSIONS
Odontogenic cysts were found to have higher expression of HIF1A and HIF1A-AS1, which may be related to the increased hypoxia in these lesions. In addition, PI3K/Akt signaling may be stimulated by increased PIK3CA and decreased PTEN expression, which promote cell survival and support the mechanism of cyst formation.
Topics: Humans; Dentigerous Cyst; Phosphatidylinositol 3-Kinases; Odontogenic Cysts; Radicular Cyst; Hypoxia
PubMed: 36796289
DOI: 10.1016/j.archoralbio.2023.105639 -
European Endodontic Journal Jan 2023In addition to pathogenic teeth associated with cysts, the roots of adjacent teeth are often included in the cystic cavity. Whether these teeth require elective...
In addition to pathogenic teeth associated with cysts, the roots of adjacent teeth are often included in the cystic cavity. Whether these teeth require elective endodontic treatment followed by cystic enucleation remains unclear. In the case presented herein, we aimed to preserve the pulp of the teeth included in the cystic lesion. Unfortunately, the sensibility of the included teeth was negative after endodontic surgery, including cystic enucleation. However, the sensibility recovered after 1 year and was maintained throughout a 4.5-year follow-up. Therefore, we suggest that elective endodontic treatment of the included teeth should be avoided, and further research should be conducted regarding this issue. (EEJ-2022-05-063).
Topics: Humans; Radicular Cyst; Follow-Up Studies; Dental Pulp; Cysts
PubMed: 36748445
DOI: 10.14744/eej.2022.30085 -
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 -
The Journal of Arthroplasty Jul 2023Aseptic loosening following total knee arthroplasty remains one of the leading causes of long-term failure. Radiographic identification of loose implants can be...
BACKGROUND
Aseptic loosening following total knee arthroplasty remains one of the leading causes of long-term failure. Radiographic identification of loose implants can be challenging with standard views. The purpose of this study was to compare the incidence of novel radiographic findings of anterior heterotopic bone formation and medial or lateral cyst formation in patients who have aseptic loosening to patients who have well-fixed implants.
METHODS
A retrospective radiographic review was performed on 48 patients' revised secondary to aseptic tibial loosening. This cohort was compared to two additional cohorts; 48 patients returning for routine postoperative follow-up (control 1), and 48 patients revised secondary to infection or instability who had well-fixed implants (control 2).
RESULTS
There were 41 of 48 (85%) patients who had implant loosening and were noted to have anterior heterotopic bone formation compared to 1 of 48 (2%) patients in control 1 and 3 of 48 (6%) patients in control 2 (P ≤ .0001). There were 43 of 48 (90%) patients who had implant loosening and had medial cyst formation compared to 3 of 48 (6%) patients in control 1 and 5 of 48 (10%) in control 2 (P ≤ .0001). There were 42 of 48 (88%) patients who had implant loosening and had lateral cyst formation compared to 2 of 48 (4%) patients in control 1 and 4 of 48 (8%) in control 2 (P ≤ .0001).
CONCLUSION
In this study, we describe novel radiographic findings of anterior heterotopic bone formation and cysts that develop in patients who have aseptic loosening following primary total knee arthroplasty. We believe that these radiographic features may lead to easier identification of aseptic loosening.
Topics: Humans; Knee Prosthesis; Knee Joint; Retrospective Studies; Prosthesis Failure; Periodontal Cyst; Reoperation
PubMed: 36716899
DOI: 10.1016/j.arth.2023.01.031