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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 -
BMJ Case Reports May 2014Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Most of these lesions involve the apex of offending tooth and appear as...
Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst, ameloblastoma, odontogenic keratocyst, periapical cementoma and Pindborg tumour. The present case report documents a massive radicular cyst crossing the midline of the palate. Based on clinical, radiographical and histopathological findings, the present case was diagnosed as an infected radicular cyst. The clinical characteristics of this cyst could be considered as an interesting and unusual due to its giant nature. The lesion was surgically enucleated along with the extraction of the associated tooth; preservation of all other teeth and vital structures, without any postoperative complications and satisfactory healing, was achieved.
Topics: Adult; Humans; Male; Maxillary Diseases; Radicular Cyst; Radiography
PubMed: 24792022
DOI: 10.1136/bcr-2014-203678 -
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 -
Swiss Dental Journal Mar 2018
Topics: Humans; Radicular Cyst; Radiography, Dental; Root Canal Filling Materials; Root Canal Therapy
PubMed: 29557585
DOI: No ID Found -
Journal of Clinical and Experimental... Jan 2022This article describes an unusual clinical-radiographic presentation of a lateral periodontal cyst, as a differential diagnosis of a residual cyst, following the 'CARE...
This article describes an unusual clinical-radiographic presentation of a lateral periodontal cyst, as a differential diagnosis of a residual cyst, following the 'CARE guidelines for case reports'. The radiolucent lesion was identified on the imaging exam of a 53-year-old male patient. Based on radiographic findings and aspiration puncture, the probable diagnosis was a residual cyst; however, histological analysis revealed a thin, non-inflamed fibrous capsule covered by some epithelial layers in most of the lesion. The definitive diagnosis was a lateral periodontal cyst with unusual clinical and radiographic features. The cyst was surgically enucleated and local bone neoformation was observed, with no signs of recurrence after 12 months. The results of this study suggest that a radiolucent lesion, suggestive of a residual cyst or keratocyst in the maxilla, may correspond to a lateral periodontal cyst. In this context, the histopathological analysis of the cyst is essential for the definitive diagnosis. Cysts, odontogenic cysts, periapical cysts, periodontal cysts.
PubMed: 35070130
DOI: 10.4317/jced.58668 -
Case Reports in Dentistry 2022Intraosseous unicystic ameloblastoma (UA) is a rare subtype of a true neoplasm of odontogenic epithelial origin: ameloblastoma. Despite its rareness, dealing with UA is...
Intraosseous unicystic ameloblastoma (UA) is a rare subtype of a true neoplasm of odontogenic epithelial origin: ameloblastoma. Despite its rareness, dealing with UA is problematic. It is usually mistaken for an odontogenic cyst, and biopsy is rarely relevant because of its multiple growth patterns. The biggest challenge remains the treatment choice. When we are faced with a mural UA presenting strong similarities with a lateral periodontal cyst and having high rates of recurrence, how is the balance found between the young age, psychological fragility, postoperative process, and need for diagnostic biopsy? That was our dilemma. Our patient is a 23-year-old man with a mural unicystic ameloblastoma, diagnosed with general anxiety disorder. The final decision was to turn to a simple enucleation because of the small size of the lesion, and its radiological features strongly evoked a lateral periodontal cyst. Besides, his young age, psychological condition, and UA's proximity to the surrounding soft tissues guided us toward simple enucleation. Two years later, no sign of radiological recurrence was noted. However, we are aware of a later possibility of resection in case of recurrence.
PubMed: 35198251
DOI: 10.1155/2022/8197837