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Beijing Da Xue Xue Bao. Yi Xue Ban =... Mar 2021To analyze the three-dimensional radiographic characteristics of maxillary radi-cular cysts using cone-beam computed tomography (CBCT) and spiral CT.
OBJECTIVE
To analyze the three-dimensional radiographic characteristics of maxillary radi-cular cysts using cone-beam computed tomography (CBCT) and spiral CT.
METHODS
Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 67 consecutive patients with maxillary radicular cysts were retrospectively acquired, and radiographic features, including size, shape, expansion, internal structure and relationship with the surrounding tissues, were analyzed. The lesions were divided into three types according to the involved tooth number, as follows: type Ⅰ (single tooth), the epicenter of the cyst was located at the apex of a nonvital tooth, without involvement of the neighbo-ring tooth; type Ⅱ (adjacent tooth involvement), the cyst was located at the apex of a nonvital tooth with involvement of the mesial and/or distal tooth root; and type Ⅲ (multi-teeth), the cyst involved the apexes of ≥4 teeth. Besides, these cysts were classified as another three types on sagittal views, as follows: centripetal, the root apex was oriented centripetally to the center of the cyst; palatal, the cyst was located mainly at the palatal side of the apex; and labial/buccal, the cyst was located mainly at the labial/buccal side of the apex.
RESULTS
Totally, 67 patients with maxillary radicular cysts were acquired, including 38 males and 29 females, and their ages ranged from 13 to 77 years. Among them, 46 lesions (68.7%) were located in the anterior maxilla and 65 (97.0%) were round or oval. Labial/buccal cortex expansion was present in 43 cases (64.2%) and palatal cortex expansion in 37 cases (55.2%). The nasal floor was invaded in 27 cases (40.3%), the maxillary sinus was invaginated in 26 cases (38.8%), and root resorption was present in 9 cases (13.4%). The average diameter of lesions was (20.89±8.11) mm mesio-distally and (16.70±5.88) mm bucco-palatally. In spite of the 4 residual cysts, the remaining 63 lesions included 14 type Ⅰ, 26 type Ⅱ and 23 type Ⅲ cysts according to the involved tooth number. Besides, the 63 lesions included 46 centripetal, 15 palatal and 2 buccal cysts on sagittal views.
CONCLUSION
The maxillary radicular cysts were frequently well-circumscribed round or oval radiolucency, with significantly different sizes. According to the involved tooth number, it can be divided into single tooth, adjacent tooth involvement and multi-teeth types. On sagittal views, the root-cyst relationship was centripetal in most cases, while a minority of cysts expanded palatally or buccally.
Topics: Adolescent; Adult; Aged; Cone-Beam Computed Tomography; Female; Humans; Male; Maxilla; Middle Aged; Radicular Cyst; Retrospective Studies; Tooth Root; Young Adult
PubMed: 33879917
DOI: 10.19723/j.issn.1671-167X.2021.02.027 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2012To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population.
OBJECTIVE
To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population.
STUDY DESIGN
A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayis University Dental School, Samsun, Turkey. Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included. In each case, we analyzed age, gender, type and number of cysts, and cyst location. Imaging patterns and pathologies associated with cystic lesions were also determined.
RESULTS
The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females. There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst. By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%.
CONCLUSION
The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies. In our study population, cysts were mainly inflammatory in origin.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Humans; Jaw Diseases; Male; Middle Aged; Nonodontogenic Cysts; Odontogenic Cysts; Prevalence; Retrospective Studies; Turkey; Young Adult
PubMed: 21743428
DOI: 10.4317/medoral.17088 -
Medicina Oral, Patologia Oral Y Cirugia... Dec 2007Botryoid odontogenic cyst (BOC) is considered as an unusual multilocular variant of lateral periodontal cyst (LPC). Review of the literature indicates that this lesion... (Review)
Review
OBJECTIVES
Botryoid odontogenic cyst (BOC) is considered as an unusual multilocular variant of lateral periodontal cyst (LPC). Review of the literature indicates that this lesion has higher risk of recurrence than LPC, but objective reasons are still unknown. The aim of this study is identify main clinical and pathological variables associated with the risk of recurrence.
STUDY DESIGN
A complete literature review about cases of BOC was made, from its first description up to the year 2006. A total of 67 cases of BOC were identified from year 1973 (first case) to the last publication in 2005.
RESULTS
85.2% of the BOCs were located in the jaw, affecting to women (54.8% of the cases) in the fifth decade of the life. This lesion shows a well- circumscribed unilocular (60%) or multilocular (40%) radiolucency. Recurrence rate of cases with follow-up data was 32,4%.
CONCLUSIONS
Size and multilocular patterns could be the main factors associated to recurrence in BOC.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Odontogenic Cysts; Recurrence; Risk Factors
PubMed: 18059246
DOI: No ID Found -
Journal of Oral and Maxillofacial... 2018Mast cells (MCs) have been discovered over 130 years ago; their function was almost exclusively linked to allergic affections. At the time being, it is well known that... (Review)
Review
Mast cells (MCs) have been discovered over 130 years ago; their function was almost exclusively linked to allergic affections. At the time being, it is well known that MCs possess a great variety of roles, in both physiologic and pathologic conditions. In the oral tissues, MCs release different pro-inflammatory cytokines and tumor necrosis factor-alpha that promote leukocyte infiltration in various inflammatory states of the oral cavity. These cells play a key role in the inflammatory process and, as a consequence, their number changes in different pathologic conditions of the oral cavity, such as gingivitis and periodontitis. By understanding the role of MCs in the pathogenesis of different inflammatory diseases of the oral cavity, these cells may become therapeutic targets that could possibly improve the prognosis. Therefore, this review summarizes the current understanding of the role of MCs in various inflammatory pulpal, periapical and periodontal pathophysiological conditions.
PubMed: 29731563
DOI: 10.4103/jomfp.JOMFP_278_17 -
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 -
BMJ Case Reports Oct 2013Lateral periodontal cyst, developmental in origin, typically is observed in the cuspid-bicuspid region of the mandible and less frequently in the maxilla. It may arise... (Review)
Review
Lateral periodontal cyst, developmental in origin, typically is observed in the cuspid-bicuspid region of the mandible and less frequently in the maxilla. It may arise initially as a dentigerous cyst developing by expansion of the follicle along the lateral surface of the crown which eventually comes to lie on the lateral aspect of the root if tooth eruption is normal. Alternatively, it may arise from the cell rests of malassez. The incidence of lateral periodontal cysts has been reported to be less than 1% and these cysts represent nearly 0.8% of all central cysts of the maxillary bone. Here we present one such case with unusual findings.
Topics: Bicuspid; Biopsy, Fine-Needle; Cuspid; Diagnosis, Differential; Follow-Up Studies; Humans; Male; Maxillary Diseases; Middle Aged; Periodontal Cyst
PubMed: 24108771
DOI: 10.1136/bcr-2013-200852 -
Contemporary Clinical Dentistry Jul 2012Botryoid odontogenic cyst (BOC) is considered to be a polycystic variant of the lateral periodontal cyst (LPC) as the specimen resembled a cluster of grapes. It is a...
Botryoid odontogenic cyst (BOC) is considered to be a polycystic variant of the lateral periodontal cyst (LPC) as the specimen resembled a cluster of grapes. It is a non-inflammatory odontogenic cyst. The BOCs can be unicystic or multicystic. These cysts have potential to extend in the bone and become multilocular and they have a high recurrence rate. Till now, only 73 cases of BOC have been reported. The pathogenesis of BOC is still debatable. We review different pathogenesis proposed for BOC and discuss a rare case of BOC developing from lining of an abnormally large LPC which showed aggressive behaviour in terms of growth and size.
PubMed: 23293492
DOI: 10.4103/0976-237X.103629 -
Journal of Indian Society of... 2022Paradental cyst is classified as an inflammatory cyst, and its occurrence in the anterior maxillary region is very rare. Several hypotheses have been put forward on the...
Paradental cyst is classified as an inflammatory cyst, and its occurrence in the anterior maxillary region is very rare. Several hypotheses have been put forward on the etiopathogenesis among which the formation of cyst secondary to inflammatory destruction of the periodontium and alveolar bone can be attributed to the present case. A 26-year-old male patient reported with loosened maxillary anterior teeth. After clinical and radiological examination, extraction of teeth #12, #11, #21, and #22 followed with immediate implant placement was planned. During extraction of #21, incidentally, a cyst was noted to be attached to the apices of #21 tooth. Implants were placed at #12, #11, and #22 sites, and socket of #21 was debrided thoroughly, followed by the placement of graft. A histopathological study of the cyst revealed it to be a paradental cyst. The patient was followed up for 6 months, and no recurrence of cystic lesion was noted. When immediate implant placement is being planned, considerations to the periodontal and periapical disease status of the teeth being extracted are crucial to achieve better treatment outcomes.
PubMed: 36582954
DOI: 10.4103/jisp.jisp_625_21 -
Journal of Dentistry Aug 2023Dentists and oral surgeons often face difficulties distinguishing between radicular cysts and periapical granulomas on panoramic imaging. Radicular cysts require...
OBJECTIVES
Dentists and oral surgeons often face difficulties distinguishing between radicular cysts and periapical granulomas on panoramic imaging. Radicular cysts require surgical removal while root canal treatment is the first-line treatment for periapical granulomas. Therefore, an automated tool to aid clinical decision making is needed.
METHODS
A deep learning framework was developed using panoramic images of 80 radicular cysts and 72 periapical granulomas located in the mandible. Additionally, 197 normal images and 58 images with other radiolucent lesions were selected to improve model robustness. The images were cropped into global (affected half of the mandible) and local images (only the lesion) and then the dataset was split into 90% training and 10% testing sets. Data augmentation was performed on the training dataset. A two-route convolutional neural network using the global and local images was constructed for lesion classification. These outputs were concatenated into the object detection network for lesion localization.
RESULTS
The classification network achieved a sensitivity of 1.00 (95% C.I. 0.63-1.00), specificity of 0.95 (0.86-0.99), and AUC (area under the receiver-operating characteristic curve) of 0.97 for radicular cysts and a sensitivity of 0.77 (0.46-0.95), specificity of 1.00 (0.93-1.00), and AUC of 0.88 for periapical granulomas. Average precision for the localization network was 0.83 for radicular cysts and 0.74 for periapical granulomas.
CONCLUSIONS
The proposed model demonstrated reliable diagnostic performance for the detection and differentiation of radicular cysts and periapical granulomas. Using deep learning, diagnostic efficacy can be enhanced leading to a more efficient referral strategy and subsequent treatment efficacy.
CLINICAL SIGNIFICANCE
A two-route deep learning approach using global and local images can reliably differentiate between radicular cysts and periapical granulomas on panoramic imaging. Concatenating its output to a localizing network creates a clinically usable workflow for classifying and localizing these lesions, enhancing treatment and referral practices.
Topics: Humans; Periapical Granuloma; Radicular Cyst; Deep Learning; Radiography; Neural Networks, Computer
PubMed: 37295547
DOI: 10.1016/j.jdent.2023.104581 -
Journal of Medical Case Reports Aug 2010The lateral periodontal cyst, as the name implies, occurs on a lateral periodontal location and is of developmental origin, arising from cystic degeneration of clear...
INTRODUCTION
The lateral periodontal cyst, as the name implies, occurs on a lateral periodontal location and is of developmental origin, arising from cystic degeneration of clear cells of the dental lamina. A botryoid odontogenic cyst is considered to be a rare multilocular variant of a lateral periodontal cyst.
CASE PRESENTATION
We report the clinical and histopathologic features of a rare case of botryoid odontogenic cyst found in an edentulous area corresponding to the right lower canine of a 64-year-old African-American woman. A multilocular radiolucency was observed, and surgical removal of the lesion revealed a nodule of rubber-like consistency measuring about 1.5 cm in diameter. Cross-sectioning of the nodule showed that it consisted of various cystic compartments. Histologically, various voluminous periodic acid-Schiff-negative clear cells randomly distributed throughout the cystic epithelium were observed, as well as cell layers showing thickenings generally formed by oval, sometimes entangled plaques. The capsule consisted of fibrous connective tissue and showed rare and discrete foci of a perivascular mononuclear inflammatory infiltrate and reactive bone-tissue fragments. The final diagnosis was botryoid odontogenic cyst.
CONCLUSION
We provide data that allow the reader to establish the differences between botryoid odontogenic cyst, glandular odontogenic cyst, and lateral periodontal cyst, helping with the differential diagnosis. The reader will have the opportunity to review botryoid odontogenic cyst clinical and histopathologic features, including treatment.
PubMed: 20698969
DOI: 10.1186/1752-1947-4-260