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Journal of Oral and Maxillofacial... May 2021To assess the prognostic findings of the carcinomatous transformation of odontogenic keratocyst (OKC).
PURPOSE
To assess the prognostic findings of the carcinomatous transformation of odontogenic keratocyst (OKC).
METHODS
A systematic review of all cases of carcinomatous transformation of OKC was completed, and a case report was included.
RESULTS
A total of 679 publications were screened, and 37 cases met inclusion criteria. The mean age for patients with malignant transformation of OKC was 45.1 years. Pain (67.5%) and swelling (78.3%) were the most common symptoms. The malignant transformation occurred with increased frequency in the posterior mandible and larger lesions that span greater than 2 subunits of the involved jaw. Resection was the definitive treatment in all cases and 14 cases (46%) utilized adjuvant treatment.
CONCLUSIONS
Patient outcomes and follow-up was variable in our study such that overall survival was difficult to determine. However, overall survival in malignant transformation of odontogenic cysts of all kinds ranges from 62 to 85% and 30 to 8% for 2 and 5 years, respectively.
Topics: Carcinoma; Cell Transformation, Neoplastic; Humans; Middle Aged; Mouth Neoplasms; Odontogenic Cysts; Odontogenic Tumors
PubMed: 33529609
DOI: 10.1016/j.joms.2020.12.046 -
Metastasizing Ameloblastoma: A 10 Year Clinicopathological Review with an Insight Into Pathogenesis.Head and Neck Pathology Sep 2021Ameloblastoma, a benign but locally aggressive odontogenic tumor, often demonstrates metastasis despite benign histological features and this variant is termed as...
Ameloblastoma, a benign but locally aggressive odontogenic tumor, often demonstrates metastasis despite benign histological features and this variant is termed as metastasizing ameloblastoma (METAM). It was classified under the malignant category in the 2005 WHO but has been re-classified under benign epithelial odontogenic tumors in the latest 2017 WHO classification. The present review aimed at gathering the available data on METAM to update the current cognizance about the pathology. Comprehensive search of the databases (viz., PubMed, Medline, SCOPUS, Web of Science, EMBASE and Google Scholar) was done for published articles on METAM following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 42 cases were extracted. The mean age of occurrence was 42.71 ± 15.87 years. A slight male predilection was noted. Mandibular cases showed more metastasis than maxillary cases. Follicular ameloblastoma was most frequently encountered at secondary site followed by plexiform type. Lungs were the most commonly affected secondary sites. METAM is a rare odontogenic tumor and the diagnosis is usually made in retrospect. Inadequate treatment may result in multiple recurrences and metastasis in rare instances. Metastasis in ameloblastoma appears to be multi-factorial in nature and needs further investigation in untapped territory like exploration of quantum effects at cellular and molecular levels.
Topics: Adult; Aged; Ameloblastoma; Female; Humans; Jaw Neoplasms; Male; Middle Aged
PubMed: 33394372
DOI: 10.1007/s12105-020-01258-5 -
Head and Neck Pathology Sep 2021Odontomas and ameloblastic fibro-odontomas (AFOs) are the result of a developmental anomaly of odontogenic tissues. A literature review of proteins immunoexpressed in...
Odontomas and ameloblastic fibro-odontomas (AFOs) are the result of a developmental anomaly of odontogenic tissues. A literature review of proteins immunoexpressed in odontomas and AFOs was conducted in order to determine which proteins are involved in the pathogenesis of these lesions. AFO was changed to early odontoma in the 2017 WHO classification and will also be discussed in this article. A literature search was performed in the following electronic databases: PubMed/MEDLINE, Web of Science, Scopus, EMBASE, Lilacs, Cochrane Collaboration Library, and Science Direct. The research question was developed according to the population, intervention, comparison, and outcome (PICO) framework: Which proteins are related to the differentiation of odontomas and what is their interrelationship with AFOs? Thirty articles met all inclusion criteria and were selected for this systematic review, totaling 355 cases of odontomas and 43 cases of AFO. Similar immunoexpression was observed in odontomas and AFOs. Immunoexpression of proteins involved in cell differentiation was higher in compound odontomas than in complex odontomas. Proteins involved in histodifferentiation and enamel formation were more frequent in odontomas. The immunoexpression of enamel matrix proteins differs between odontomas and tooth germs, with their persistence being related to the development of odontomas. Compound odontomas exhibit the highest immunoexpression of proteins involved in cellular histodifferentiation and the Wnt/beta-catenin pathway is involved in tumor formation.
Topics: Animals; Humans; Odontogenesis; Odontoma; Proteomics
PubMed: 33394370
DOI: 10.1007/s12105-020-01260-x -
Medicina Oral, Patologia Oral Y Cirugia... May 2021This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts.
BACKGROUND
This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts.
MATERIAL AND METHODS
A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD [Blinding]). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool.
RESULTS
Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates.
CONCLUSIONS
The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible.
Topics: Computers; Dentigerous Cyst; Humans; Odontogenic Cysts; Odontogenic Tumors; Radicular Cyst
PubMed: 33247568
DOI: 10.4317/medoral.24238 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2021The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex...
BACKGROUND
The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex OKC) and comprehensively improve the understanding of this disease.
MATERIAL AND METHODS
We retrospectively investigated five cases of PIOSCC ex OKC at Peking University School and Hospital of Stomatology. We also conducted a systematic review of studies on PIOSCC ex OKC by using online databases from their inception until February 2020.
RESULTS
In our series of five cases, all lesions were located in the mandible. Three cases (60%) showed recurrent OKCs and two cases (40%) showed primary OKCs. During the follow-up period, one patient died of local relapse. No patients developed metastasis. On the basis of our literature survey, we selected 22 articles reporting 29 patients with PIOSCC ex OKC. Seven of these patients (24.1%) showed local recurrence, three patients (10.3%) developed cervical metastasis, three patients (10.3%) developed distant metastasis (in the pleura in one case and in the lung in two cases), and seven patients died from the disease during the follow-up period. The disease-specific 5-year survival rate in the study group was 53.2%. Through univariate and multivariate analysis, local recurrence was identified as the only significant independent prognostic factor for survival (P < 0.05).
CONCLUSIONS
The results suggest that PIOSCC ex OKC is a rare intermediate-grade malignancy. Although elective neck dissection is typically unnecessary, adequate therapy should be applied to achieve the lowest local recurrence rate possible to ensure a favorable survival rate.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Neoplasm Recurrence, Local; Odontogenic Cysts; Retrospective Studies
PubMed: 33037806
DOI: 10.4317/medoral.23947 -
Acta Odontologica Scandinavica Mar 2021Central giant cell granuloma (CGCG) can coexist with other benign lesions of the jaw. These hybrid lesions are diagnostically challenging to both oral pathologists and...
OBJECTIVE
Central giant cell granuloma (CGCG) can coexist with other benign lesions of the jaw. These hybrid lesions are diagnostically challenging to both oral pathologists and radiologists. This work systematically reviews the clinical and radiographic features of hybrid-CGCG lesions in the jaws.
MATERIALS AND METHODS
Three reviewers conducted an electronic search of five databases for histologically diagnosed hybrid-CGCG lesions in human jaws.
RESULTS
Thirty-four of 1224 articles met the inclusion criteria. Of 39 hybrid-CGCG lesions, 14 (35.9%) were central odontogenic fibroma, 11 (28.2%) were central ossifying fibroma, seven (17.9%) were fibrous dysplasia, and seven (17.9%) were other bone conditions. There were 22 females and 17 males with a mean age of 30.5 ± 19.9 years. 89.5% of hybrid-CGCG lesions were well defined, 57.9% were non-corticated, 60.5% were radiolucent, and 66.7% were in the posterior mandible. Most hybrid lesions affected the cortical plates by thinning, expansion, or perforation (93.1%), displaced, or resorbed teeth (60%).
CONCLUSION
The radiographic features of hybrid-CGCG lesions vary according to the concurrent bony lesion. Hybrid-CGCG lesions altered the radiographic appearance with the following entities: fibrous dysplasia, melorheostosis, and Paget's disease. Optimal imaging modalities are crucial to detail radiographic features and direct representative biopsy of suspicious sites that may host a CGCG hybridisation.
Topics: Adolescent; Adult; Biopsy; Child; Female; Fibroma, Ossifying; Granuloma, Giant Cell; Humans; Male; Mandible; Middle Aged; Odontogenic Tumors; Young Adult
PubMed: 32730731
DOI: 10.1080/00016357.2020.1797160 -
Journal of Stomatology, Oral and... Apr 2021Ameloblastoma is a benign odontogenic tumor which undergoes malignant transformation to ameloblastic carcinoma. However, rarely it metastasizes without undergoing...
Ameloblastoma is a benign odontogenic tumor which undergoes malignant transformation to ameloblastic carcinoma. However, rarely it metastasizes without undergoing cytological malignant changes, an entity referred to as Metastasizing Ameloblastoma (MA). Through this study, we aimed to review cases of MA reported since 2000 to explore the impact of clinico-demographic variables on its prognosis. Based on PRISMA guidelines, a review of relevant literature from PubMed/Medline, Science Direct and Cochrane database was performed from January 2000 to March 2019. A total of 65 cases were considered for further evaluation as per predefined inclusion and exclusion criteria. Results showed that lungs followed by lymph nodes were the most common sites for benign metastatic deposits. Multiple recurrences and inadequate surgical removal increase the probability of distant metastatic spread. Despite having benign cytological features, tumor recurrence and metastasis were associated with an unfavorable clinical outcome in MA.
Topics: Ameloblastoma; Cell Transformation, Neoplastic; Humans; Neoplasm Recurrence, Local; Odontogenic Tumors; Prognosis
PubMed: 32659412
DOI: 10.1016/j.jormas.2020.07.001 -
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 -
Journal of Stomatology, Oral and... Sep 2020Primordial odontogenic tumour (POT) is a novel entity that was described in 2014 and that is included in the group of benign mixed epithelial and mesenchymal odontogenic...
BACKGROUND
Primordial odontogenic tumour (POT) is a novel entity that was described in 2014 and that is included in the group of benign mixed epithelial and mesenchymal odontogenic tumours. In recent years, several papers have added new cases with some clinical and histopathological aspects that slightly differ from those described in the original report. The aim of this systematic review is to update all available data on POT published in the literature and to identify those features of the neoplasm that require further investigation.
MATERIALS AND METHODS
A systematic review of literature was conducted using PubMed, Embase, Web of Science and Scopus. Additional sources were also checked. Publications reporting cases with enough clinicopathological information were included, without any time or language restrictions. Histopathological or radiological studies were considered for qualitative analysis.
RESULTS
A total of 30 publications were included. Seventeen papers were used for quantitative analysis while 13 papers were used only for qualitative analysis. A total of 18 cases of POT were identified. Some clinical, radiographic, histopathological and therapeutic features were common in all reported cases, while other aspects of the neoplasm were inconsistent through published cases. This inconsistency was particularly remarkable when dealing with the histopathological features of the neoplasm.
DISCUSSION
Some issues about POT remain unclear and deserve to be clarified by future reports. The description of the odontogenic epithelium covering the ectomesenchyme is often contradictory, while it remains debatable whether peripheral ameloblastic epithelial islands or hard dental tissue deposition can occasionally occur within the tumour.
Topics: Epithelium; Humans; Odontogenic Tumors
PubMed: 32145435
DOI: 10.1016/j.jormas.2020.02.008 -
European Journal of Clinical... Apr 2020Odontogenic myxoma (OM) is a rare neoplasm, which originates from odontogenic ectomesenchyme. There is no study in the literature that analyses the best standards for OM...
BACKGROUND
Odontogenic myxoma (OM) is a rare neoplasm, which originates from odontogenic ectomesenchyme. There is no study in the literature that analyses the best standards for OM diagnosis and how the treatment modalities may influence the recurrence rates.
OBJECTIVE
To evaluate the best standards for odontogenic myxoma (OM) diagnosis and treatment, and how these may influence the recurrence rates.
STUDY DESIGN
Two independent researchers performed a systematic review in many databases. Fifty-two eligible studies were included for qualitative analysis. Bias analysis was conducted according to Oxford Centre for Evidence-Based Medicine.
RESULTS
A total of 1363 OM cases were reported on, and female gender with average age of 27 years is the most common patient profile. Conventional microscopic findings were observed in 93.43% of the reported cases. In 57.49% of the cases, multilocular radiographic appearance was present, followed by unilocular appearance (32.87%). Posterior mandible was the site with the major prevalence, while surgical resection was the most common treatment modality, followed by enucleation. Recurrence rates for both treatment modalities were approximately close (13.04% and 25.0%, respectively).
CONCLUSION
The correct diagnosis of OM relies on the association of clinical, radiographic and microscopic findings. About imaging examinations, panoramic radiography and computed tomography are sufficient for the evaluation of OM. Recurrence rates were closely among the two most used surgery treatments. So according to some clinical-radiological aspects, conservative surgery may be preferred than aggressive surgery modalities.
Topics: Bias; Humans; Jaw Neoplasms; Magnetic Resonance Imaging; Myxoma; Neoplasm Recurrence, Local; Odontogenic Tumors; Radiography, Panoramic; Tomography, X-Ray Computed
PubMed: 32048275
DOI: 10.1111/eci.13214