Odontogenic keratocyst

牙源性角化囊肿
  • 文章类型: Case Reports
    牙源性角化囊肿(OKC),一种上皮发育性囊肿,经常在下巴区域发现。它具有侵入性特征,如卫星囊肿,快速发展,和组织扩张。OKC通常偏爱下颌角和上升支。OKC症状包括疼痛,肿胀,相邻牙齿的位移或错位,和侵蚀或变薄的有限或没有bucco舌皮质扩张。有放射学证据表明,经常有扇形,具有特征性“肥皂泡”或“蜂窝状”外观的射线可透性病变。这篇文章报道了一位女性患者,40岁,主要关注下颌左侧的单侧疼痛和肿胀以及成釉细胞瘤的临时诊断。组织病理学检查后,患者最终诊断为OKC.本文还包括先前发表的有关OKC的鉴别诊断以及该病例的相关临床和放射学发现的文献。
    Odontogenic keratocyst (OKC), a type of epithelial developmental cyst, is frequently found in the jaw region. It has invasive characteristics such as satellite cysts, rapid progression, and tissue expansion. The OKC often favors the mandibular angle and ascending ramus. OKC symptoms include pain, swelling, displacement or malpositioning of adjacent teeth, and erosion or thinning of the limited or no bucco-lingual cortical expansion. There is radiographic evidence of a distinct, often scalloped, radiolucent lesion with a characteristic \"soap bubble\" or \"honeycomb\" appearance. This article reports a female patient, aged 40 years, with the main concern of unilateral pain and swelling of the mandibular left side and the provisional diagnosis of ameloblastoma. After histopathological examination, the final diagnosis of the patient was OKC. This article also includes previously published literature on OKC with differential diagnosis and relevant clinical and radiologic findings of the case.
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  • 文章类型: Journal Article
    Nevoid basal cell carcinoma syndrome (NBCCS), also known as basal cell nevus syndrome or Goltz-Gorlin syndrome, is a complex and rare autosomal dominant inherited disease. A large number of studies have confirmed that PTCH1 gene is associated with NBCCS. This study presents a case of NBCCS with anophthalmia of the left eye. It explores and delves deep into the syndrome while conducting a relevant literature review.
    痣样基底细胞癌综合征(NBCCS)又称基底细胞痣综合征或Goltz-Gorlin综合征,是一种复杂且罕见的常染色体显性遗传疾病,大量研究文献证实PTCH1基因与NBCCS有关。本文报道1例NBCCS伴先天性左眼缺失的病例,并结合相关文献探讨以进一步了解该综合征。.
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  • 文章类型: Review
    背景:用牙源性角化囊肿重建整个牙列是一个非常具有挑战性的难题。据报道,大多数牙源性角化囊肿是良性的,导致上颌和下颌牙列严重咬合差异。牙科X光片偶尔会显示一种罕见的,局部侵袭性发展中的囊肿称为牙源性角化囊肿,通常位于后颌。当这种囊肿发生在前部区域时,由于对牙髓活力测试缺乏反应,常被误诊为其他根尖周病变。
    方法:本临床病例描述了一名诊断为牙源性角化囊肿患者的牙髓治疗。一名37岁的印度男性患者向该部门报告,左下后牙的搏动性疼痛需要进行牙髓治疗。该患者还出现了颌骨前部区域的牙源性角化囊肿,为此他接受了手术康复。此病例报告重点介绍了诊断为牙源性角化囊肿的患者的牙髓治疗的临床方案。随访期后未发现咀嚼损伤,治疗结果成功。
    结论:本病例报告详细介绍了特征性射线照相发现,和牙源性角化囊肿极为罕见的患者的牙髓治疗。管理涉及康复的多学科方法。
    BACKGROUND: Reconstruction of the entire dentition with odontogenic keratocyst is a very challenging quandary. Most cases of odontogenic keratocyst are often reported to be benign, resulting in severe occlusal discrepancies with the maxillary and mandibular dentition. Dental radiographs occasionally reveal an uncommon, locally aggressive developing cyst termed as odontogenic keratocyst, which is typically located in the posterior jaw. When this cyst occurs in the anterior region, it is often misdiagnosed with other periapical lesions due to its lack of response to pulp vitality tests.
    METHODS: This clinical case scenario demarcates the endodontic management of a patient diagnosed with odontogenic keratocyst. A 37-year-old Indian male patient reported to the department with throbbing pain in the lower left posterior tooth requiring endodontic therapy. This patient also presented with odontogenic keratocyst in the anterior region of the jaw, for which he had undergone surgical rehabilitation. This case report highlights the clinical protocol for the endodontic therapy in patient diagnosed with ododntogenic keratocyst. Masticatory impairment was not visible after the follow-up period and the treatment outcome was successful.
    CONCLUSIONS: This case report details the presentation, characteristic radiographic findings, and endodontic management of a patient with an extremely rare condition of odontogenic keratocyst. The management involves multidisciplinary approach for the rehabilitation.
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  • 文章类型: Case Reports
    Gorlin-Goltz综合征(GGS)是一种罕见的多系统疾病,具有常染色体显性性状,其中描述了许多基底细胞癌的存在以及多器官异常。在生命的头十年,牙医可以通过常规的影像学检查来早期诊断这种综合征。因为角化囊性牙源性肿瘤通常是该综合征的最初表现之一。本文包括GGS关于其历史的病例报告,发病率,病因学,特点,调查,诊断标准,角化囊性牙源性肿瘤和治疗方式。
    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, which depicted presence of numerous basal cell carcinoma in conjunction with multiorgan abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the keratocystic odontogenic tumour are usually one of the first manifestations of the syndrome. This article includes a case report of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumour and treatment modalities.
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  • 文章类型: Case Reports
    牙源性角化囊性肿瘤(OKT)或目前也称为牙源性角化囊性肿瘤(OK)是一种良性病理,源自具有可变数量的脱皮角蛋白的牙层残留物。它通常是孤立的或存在卫星囊肿的,这些卫星囊肿的出现通常与OK的可能复发有关,根据文献,这种复发可以在0-50%之间变化。至于(OKT)的治疗阶段,可以说,目前有一个明确的组织学和临床标准,这有助于它的识别和治疗。根据文献,有几种治疗方法可以分为非保守治疗或根治性治疗和伴随辅助方法的保守治疗。在非保守或激进治疗中,我们发现整块切除术,这是治疗角化囊肿最积极的方法;然而,这是避免复发的最有效方法。在保守治疗中,有袋化,减压,描述了有或没有辅助治疗的摘除。最重要的是要知道如何识别不同类型的治疗(OKT),因为这将受到多种因素的制约,例如考虑到可能涉及牙齿结构的附近骨骼结构的位置和病变的大小。目标是寻求尽可能低风险的治疗,这避免了复发,并最终结束了这种病理。
    The odontogenic keratocystic tumor (OKT) or also currently known as odontogenic keratocyst (OK) is a benign pathology derived from the remains of the dental lamina characteristic for possessing variable amounts of desquamated keratin. It usually rises as solitary or with the presence of satellite cysts, the appearance of these satellite cysts is frequently related to the possible recurrence of OK, according to the literature, this recurrence can vary between 0 - 50%. As for the treatment stage of (OKT), it can be mentioned that at present there is a well-defined histological and clinical criterion, which facilitates its recognition and therefore its treatment. According to the literature, there are several treatment procedures that can be classified into non-conservative or radical treatments and conservative treatments accompanied by adjuvant methods. Within the non-conservative or radical treatments, we find en bloc resection, which is the most aggressive way to treat a keratocyst; however, it is the most effective way to avoid recurrence. Within the conservative treatments, marsupialization, decompression, and enucleation with or without adjuvant therapy are described. It is paramount to know how to recognize the different types of treatment for (OKT) since this will be conditioned by multiple factors, such as the location of nearby bone structures and the size of the lesion considering the possible involvement of dental structures. The objective is to seek the lowest-risk treatment possible, which avoids recurrence and finally puts an end to this pathology.
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  • 文章类型: Case Reports
    很少报道印度人的Gorlin-Goltz综合征(GGS)。自1960年以来,在印度人口中仅发现38例Gorlin-Goltz综合征患者48例。早期诊断这种疾病至关重要,因为它可能与纤维肉瘤等恶性病变有关,平滑肌肉瘤或横纹肌肉瘤。该病例系列中的四名患者在2019年至2023年之间在我们部门进行了鉴定和治疗。患者平均年龄约为20岁。颌骨肿胀和牙齿移动是两个最典型的问题。牙源性角化囊肿(100%),Palmer坑(100%),足底坑(50%),大脑镰状钙化(50%),和肋骨异常(50%),是最普遍的特征。这些病人都没有基底细胞癌,唇裂,或者髓母细胞瘤.3例患者出现多发性牙源性角化囊肿,而在一名患者中发现了单个牙源性角化囊肿(OKC)。患者接受有袋化或眼球摘除治疗,取决于囊肿的大小。使用改良的闭孔器对2例囊肿大小较大的病例进行了有袋化。对2例小囊肿病例进行了囊肿摘除,然后进行化学烧灼。在两个病例中发现了复发。在一个病人中,我们注意到一个新的囊肿的形成。可以通过对患者进行系统评估来进行GGS诊断。在每个组织病理学诊断的OKC病例中,都应对患者进行彻底检查。这将有助于错过综合征病例。治疗部分应保守,比如在一个大囊肿里有一个闭孔的有袋化.闭塞器有助于保持患者卫生并防止定期访问更换敷料。小尺寸囊肿可以通过摘除和化学烧灼来管理。应避免根治性切除。
    Gorlin-Goltz syndrome (GGS) among Indians is rarely reported. Since 1960, only 38 cases having 48 patients of Gorlin-Goltz syndrome have been identified in the Indian population. It is crucial to diagnose this illness early because it can be connected to a malignant lesion like fibrosarcoma, leiomyosarcoma or rhabdomyosarcoma. The four patients in this case series were identified and treated in our department between 2019 and 2023. The average patient age was around 20 years old. Jaw swelling and tooth movement were the two most typical presenting concerns. Odontogenic keratocysts (100%), palmer pits (100%), plantar pits (50%), calcification of falx cerebri (50%), and rib abnormalities (50%), were the most prevalent characteristics. None of the patients had basal cell cancer, cleft lip, or medulloblastoma. Multiple odontogenic keratocysts were present in three cases, whereas a single odontogenic keratocyst (OKC) was seen in one patient. Patients were managed with either marsupialization or enucleation, depending on the size of the cyst. Two cases with a large cyst size were marsupialized by using a modified obturator. Two cases with small cysts were managed with enucleation of the cyst followed by chemical cauterization. Recurrence was seen in two cases. In one patient, we noticed the formation of a new cyst. A GGS diagnosis can be made by having a systemic evaluation of the patient. A thorough examination of the patient should be performed in every histopathology-diagnosed case of OKC. This will help to miss the syndromic cases. The treatment part should be conservative, like marsupialization with an obturator in a large cyst. The obturator helps maintain patient hygiene and prevents regular visits for changing dressings. Small-sized cysts can be managed with enucleation and chemical cauterization. Radical resection should be avoided.
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  • 文章类型: Case Reports
    Gorlin-Goltz综合征(GGS)具有广泛的表达能力,大多数病例是根据口腔检查结果首次诊断的。早期干预可以减轻其严重程度。
    所有患者的主诉是疼痛和肿胀。放射学和组织病理学评估的临床检查证实了诊断。
    本系列介绍了在五年(2018-2022年)的时间框架内治疗的六例GGS。
    治疗范围从摘除,化学烧灼和外周骨切除术,以积极的方式,如切除和重建。
    该系列包括6名年龄在12至42岁之间的患者,其中四个是女性,两个是男性,对高度侵略性的形式表现得很少,并且经常表现出不可预测的表现。
    这强调了长期定期随访和遗传筛查对早期发现的重要性,从而降低疾病的强度和侵袭性。
    UNASSIGNED: Gorlin-Goltz syndrome (GGS) has a wide range of expressivity, with a majority of cases being first diagnosed from the oral findings. Early intervention can reduce its severity.
    UNASSIGNED: The primary complaints of all the patients were pain and swelling. Clinical examination with radiological and histopathological evaluation confirmed the diagnosis.
    UNASSIGNED: This series presents the six cases of GGS treated over a time frame of five years (2018-2022).
    UNASSIGNED: The treatments range from enucleation, chemical cauterisation and peripheral ostectomy to aggressive modalities such as resection and reconstruction.
    UNASSIGNED: This series comprises of six patients with ages ranging from 12 to 42 years, four of which were female and two were male presenting minimal expression to highly aggressive forms and its unpredictable frequent manifestation.
    UNASSIGNED: This emphasises the significance of long-term periodic follow-up and genetic screening for early detection, thereby reducing the intensity and aggressiveness of the disease.
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  • 文章类型: Case Reports
    1956年,Philipsen首次描述了牙源性角化囊肿(OKC)。它们是牙源性良性囊肿,表现积极,复发率高。本病例报告描述了OKC的异常表现,是前下颌骨的多房性病变。一名14岁的男性患者被其正畸医生转诊到Tabuk专业牙科中心的口腔颌面外科诊所,以评估在OPG检查期间在其下前牙中发现的射线可透性病变。患者在医学上健康,并且先前有多个牙科修复。口内检查显示,颊侧的囊性病变有少量骨扩张。全景X线照片显示左下犬科区域明确的多房性放射性,尽管没有牙齿吸收;然而,牙齿之间有轻微的差异。进行了切除活检,随后的组织病理学检查发现囊性病变被诊断为牙源性角化囊肿。6个月的随访OPG显示该部位完全愈合,没有任何病变复发。OKC可以出现在任何年龄,不分性别。当牙齿不重要时,鉴别诊断包括牙周外侧囊肿或根性囊肿。在这种情况下,手术后六个月的OPG随访显示没有复发,尽管由于复发率高,建议密切随访。
    An odontogenic keratocyst (OKC) was first described by Philipsen in 1956. They are benign cysts of odontogenic origin that behave aggressively and have a high recurrence rate. The present case report describes an unusual presentation of OKC as a multi-locular lesion in the anterior mandible. A 14-year-old male patient was referred to the oral maxillofacial surgery clinic in Tabuk Specialist Dental Centre by his orthodontist to evaluate a radiolucent lesion that had been identified in his lower anterior teeth during an OPG examination. The patient was medically fit and had multiple previous dental restorations. An intraoral examination revealed a small bony expansion in the cystic lesion on the buccal side. The panoramic radiograph showed well-defined multi-locular radiolucencies in the lower left canine area, despite there being no tooth resorption; however, there was a slight divergence noted between the teeth. An excisional biopsy was performed, and the subsequent histopathological examination revealed a cystic lesion diagnosed as an odontogenic keratocyst. The six-month follow-up OPG showed that the site had completely healed without any lesions recurring. OKCs can present at any age, irrespective of gender. The differential diagnosis included a lateral periodontal cyst or a radicular cyst when the tooth was not vital. In this case, the six-month follow-up OPG following surgery revealed no recurrence, although a close follow-up is recommended because of the high recurrence rate.
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  • 文章类型: Case Reports
    背景:牙源性角化囊肿是最常见的良性牙源性肿瘤之一,复发率高。它的切除有可能导致下颌节段性缺陷。在这个案例报告中,我们描述了一名牙源性角化囊肿患者,该患者接受了根治性切除术,使用一种新型的牵张成骨(DO)方法重建下颌骨节段缺损。
    方法:本病例报告描述了一名19岁的女性,患有下颌骨牙源性角化囊肿,多次刮除后复发,最终需要进行根治性切除。使用一种新颖的DO方法重建根治性切除术后的下颌骨节段缺损,该方法涉及直接接触缺损的节段末端而无需运输盘。然而,干扰物在保留期间破裂,并使用成型钛板进行固定。这种新颖的牵引方法实现了下颌骨的重建,并恢复了下颌骨的功能和轮廓。
    BACKGROUND: Odontogenic keratocyst is one of the most common benign odontogenic neoplasms with a high recurrence rate. Its resection has the potential to lead to mandibular segmental defects. In this case report, we describe a patient with odontogenic keratocyst who underwent radical resection using a novel distraction osteogenesis (DO) method to reconstruct mandibular segmental defect.
    METHODS: This case report describes a 19-year-old woman with odontogenic keratocyst of the mandible that recurred after multiple curettages and eventually necessitated radical resection. Mandibular segmental defect after radical resection was reconstructed using a novel DO method that involved directly contacting the segment ends of the defect without the transport disk. However, the distractor broke during the retention period, and a molding titanium plate was used for fixation. This novel distraction method achieved mandibular reconstruction and restored mandibular function and contour.
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  • 文章类型: Case Reports
    cuniculatum(CC)在上颌骨中极为罕见。这里,我们报告了一例由口窦瘘(OAF)引起的CC病例。患者是一名70岁的日本男子,他接受了非封闭OAF的随访。尽管没有基于口内检查的发现,随访对比增强计算机断层扫描和磁共振成像显示,上颌骨靠近OAF处有22毫米的肿块。组织学上,鳞状上皮的囊性和内生乳头状增生,具有丰富的角质化,模仿兔洞穴占据了牙槽骨。该肿瘤与OAF覆盖上皮的非典型增殖直接相关。肿瘤细胞表现出轻度的细胞学异型性和少数有丝分裂。最后,患者被诊断为由OAF引起的CC。CC经常被误诊;尽管如此,独特的内生植物,分支,隧道状结构是这种肿瘤的标志。我们提出了第一个有据可查的由OAF引起的CC案例,讨论它的诊断特征,并强调其与其他常见良性和恶性病理实体的差异。
    Carcinoma cuniculatum (CC) is extremely rare in the maxilla. Here, we report a case of CC arising from an oroantral fistula (OAF). The patient was a 70-year-old Japanese man who was followed up for a non-closing OAF. Although there were no findings based on an intraoral examination, follow-up contrast-enhanced computed tomography and magnetic resonance imaging showed a 22-mm mass in the maxilla close to the OAF. Histologically, cystic and endophytic papillary proliferation of squamous epithelium with abundant keratinization mimicking rabbit burrows occupied the alveolar bone. This tumor was directly connected to the atypical proliferation of the covering epithelium of the OAF. The tumor cells showed mild cytological atypia and a few mitoses. Finally, the patient was diagnosed with CC arising from an OAF. CC is often misdiagnosed; nonetheless, the unique endophytic, branching, and tunnel-like structure is a hallmark of this tumor. We present the first well-documented case of CC arising from an OAF, discuss its diagnostic features, and highlight its differences from other common benign and malignant pathological entities.
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