odontogenic cyst

牙源性囊肿
  • 文章类型: Journal Article
    牙源性囊肿是颌骨中可以达到大尺寸的骨病变。减压,一种有助于手术治疗的技术,旨在缩小其尺寸。我们旨在对用于牙源性囊肿减压的主要类型的装置进行系统回顾,并分析适应症,类型,优势,以及所用设备的缺点。我们搜索了PubMed,科学直接,LILACS,EMBASE,和WebofScience,直到2023年2月,没有时间限制。我们考虑了至少有10名患者的研究,仅以英语发表,那些报告病例和病例系列的,牙源性囊肿减压的随机临床试验,以及减压期间使用的设备类型。所有报告的牙源性囊肿都必须在各自的出版物中通过活检证实。我们在选定的数据库中找到了713篇文章。删除重复项后,499只剩下。阅读标题和摘要后,我们排除了461篇文章,因此保留了38篇。选择了9项研究进行审查,共有244名患者。共发现206个病变,并通过解剖病理学检查证实:123个角化囊肿,40个牙轮囊肿,34根囊肿,一个上皮起源的囊肿,但没有规格,和八个单囊性成釉细胞瘤.虽然我们没有找出哪种装置最适合牙源性囊肿的减压,我们的研究结果表明,那些最有效的应该尽可能舒适,并应该留在原地。它们应该在口腔中具有稳定性并且易于患者清洁。
    Odontogenic cysts are bony lesions in the jaws that can reach large sizes. Decompression, a technique that helps in their surgical treatment, aims to reduce their size. We aimed to conduct a systematic review of the main types of device used for the decompression of odontogenic cysts and to analyse the indications, types, advantages, and disadvantages of the devices used. We searched PubMed, Science Direct, LILACS, EMBASE, and Web of Science until February 2023, with no time restriction. We considered studies with a minimum of 10 patients published only in English, those that reported cases and case series, randomised clinical trials of the decompression of odontogenic cysts, and the types of devices used during the decompression period. All reported odontogenic cysts had to have been confirmed by biopsy in their respective publications. We found 713 articles in the selected databases. After removing duplicates, 499 remained. After reading the titles and abstracts, we excluded 461 articles so 38 remained. Nine studies were selected for the review, totalling 244 patients. A total of 206 lesions were identified and confirmed by anatomopathological examination: 123 keratocysts, 40 dentigerous cysts, 34 radicular cysts, one cyst of epithelial origin but without specification, and eight unicystic ameloblastomas. Although we did not find out which device is best for the decompression of odontogenic cysts, our findings show that those that are most effective should be as comfortable as possible and should remain in place. They should have stability in the oral cavity and be easy for the patient to clean.
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  • 文章类型: Case Reports
    背景:神经纤维瘤是神经源性的良性肿瘤。如果这些肿瘤发生没有任何其他神经纤维瘤病的迹象,它们被归类为孤立的神经纤维瘤。口腔中的神经纤维瘤主要发生在软组织内,表明下颌骨中的孤立性骨内神经纤维瘤很少见。由于缺乏特定的临床表现,这些肿瘤的早期诊断和治疗难以实现。
    方法:一名37岁女性患者,因右侧下磨牙区牙龈麻木肿胀,持续半个月来我院就诊。患者的总体情况和口腔内检查未发现明显异常。她最初被诊断为右下颌骨囊性病变。然而,经过更彻底的检查,最终病理诊断为神经纤维瘤。进行完整的肿瘤切除和部分切除右侧下牙槽神经。在撰写本报告时,手术后9个月没有肿瘤复发的迹象.
    结论:本病例报告讨论了鉴别孤立性骨内神经纤维瘤与其他囊性病变的关键特征。
    BACKGROUND: Neurofibromas are benign tumors of a neurogenic origin. If these tumors occur without any other signs of neurofibromatosis, they are classified as isolated neurofibromas. Neurofibromas in the oral cavity mostly occur within soft tissues, indicating that solitary intraosseous neurofibromas in the mandible are rare. Due to the absence of specific clinical manifestations, early diagnosis and treatment of these tumors are difficult to achieve.
    METHODS: A 37-year-old female patient visited our hospital due to numbness and swelling of the gums in the right lower molar area that had persisted for half a month. The patient\'s overall condition and intraoral examination revealed no significant abnormalities. She was initially diagnosed with a cystic lesion in the right mandible. However, after a more thorough examination, the final pathological diagnosis was confirmed to be neurofibroma. Complete tumor resection and partial removal of the right inferior alveolar nerve were performed. As of writing this report, there have been no signs of tumor recurrence for nine months following the surgery.
    CONCLUSIONS: This case report discusses the key features that are useful for differentiating solitary intraosseous neurofibromas from other cystic lesions.
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  • 文章类型: Systematic Review
    背景:CTNNB1基因编码β-连环蛋白,Wnt通路的转录激活因子参与牙源性病变的发病机理。虽然位于膜内,它易位到细胞质和细胞核可以触发细胞增殖,抑制细胞凋亡,肿瘤细胞的侵袭和迁移。
    方法:五个电子数据库,包括PubMed的MEDLINE,谷歌学者,Scopus,行程,彻底搜索了截至2023年1月1日的Cochrane图书馆和EMBASE,没有时间限制。纳入了在牙源性病变中鉴定CTNNB1突变和β-连环蛋白的那些文章进行审查。使用QUADAS2工具分析每个研究的偏倚风险,并使用ReviewManager5.3输出其结果。
    结果:纳入了34篇发表的文章进行数据综合。共评估1092例牙源性病变的CTNNB1突变和β-catenin表达。在成釉细胞瘤中观察到CTNNB1突变,牙源性钙化囊肿,钙化性囊性牙源性肿瘤和所有恶性牙源性肿瘤。β-catenin(核和胞浆)在牙源性角化囊肿和钙化性牙源性囊肿中表达最大。成釉细胞瘤中的表达是可变的,牙瘤中的膜质,所有恶性肿瘤中的钙化囊性牙源性肿瘤和核。
    结论:牙源性角化囊肿的高复发率和实性成釉细胞瘤和恶性牙源性肿瘤的侵袭性可能与β-连环蛋白的核易位有关。牙源性病变中CTNNB1突变和β-连环蛋白表达之间的差异提示β-连环蛋白激活的替代途径。审查结果支持β连环蛋白的独特定位,作为牙源性病变发病机理中的有用诊断因子。
    BACKGROUND: CTNNB1 gene encodes beta catenin, a transcriptional activator of Wnt pathway involved in the pathogenesis of odontogenic lesions. Though located intramembranously, its translocation into cytoplasm and nucleus could trigger cell proliferation, inhibition of apoptosis, invasion and migration of the tumour cell.
    METHODS: Five electronic databases including MEDLINE by PubMed, Google scholar, Scopus, Trip, Cochrane library and EMBASE until 1 January 2023 without period restriction were thoroughly searched. Those articles that identified CTNNB1 mutation and beta catenin in odontogenic lesions were included for review. Risk of bias was analysed for each study using QUADAS 2 tool and Review Manager 5.3 was used to output its result.
    RESULTS: Thirty four published articles were included for data synthesis. A total of 1092 cases of odontogenic lesions were assessed for both CTNNB1 mutation and beta catenin expression. CTNNB1 mutation was observed in ameloblastoma, calcifying odontogenic cyst, calcifying cystic odontogenic tumour and all malignant odontogenic tumours. The beta catenin expression (nuclear and cytoplasmic) was maximum in odontogenic keratocyst and calcifying odontogenic cyst. The expression was variable in ameloblastomas, membranous in odontomas, calcifying cystic odontogenic tumour and nuclear in all malignant tumours.
    CONCLUSIONS: High recurrence of odontogenic keratocyst and aggressiveness of solid ameloblastoma and malignant odontogenic tumours could be associated with the nuclear translocation of beta catenin. Disparity between CTNNB1 mutation and beta catenin expression within odontogenic lesions suggests alternate routes of beta catenin activation. The review results support the unique localisation of beta catenin as a helpful diagnostic factor in the pathogenesis of odontogenic lesions.
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  • 文章类型: Journal Article
    背景:干细胞与自我更新和可塑性相关,并已在各种牙源性病变中与其发病机理和生物学行为相关的研究中进行了研究。我们的目的是对干细胞标志物在牙源性肿瘤和囊肿中的表达进行系统评价。
    方法:通过MEDLINE/PubMed搜索文献,EMBASE通过OVID,WebofScience,通过EBSCO数据库和CINHAL,用于评估干细胞标志物在不同牙源性肿瘤/囊肿中表达的原始研究,或牙源性疾病组和对照组。这些研究的偏倚风险(RoB)是通过JoannaBriggs研究所批判性评估工具进行评估的。在至少两项研究中,对同一对牙源性肿瘤/囊肿中评估的标志物进行了荟萃分析。
    结果:29项研究报道了干细胞标志物的表达,例如,SOX2,OCT4,NANOG,CD44,ALDH1,BMI1和CD105,在各种牙源性病变中,通过免疫组织化学/免疫荧光,聚合酶链反应,流式细胞术,微阵列,和RNA测序。Low,中度,在七个人中观察到高RoB,九,和十三项研究,分别。Meta分析显示,SOX2对成釉细胞癌或牙源性角化囊肿的辨别能力优于成釉细胞瘤。
    结论:干细胞可能与牙源性病变的发病机制和临床行为有关,并且是未来个体化治疗的潜在靶标。
    BACKGROUND: Stem cells have been associated with self-renewing and plasticity and have been investigated in various odontogenic lesions in association with their pathogenesis and biological behavior. We aim to provide a systematic review of stem cell markers\' expression in odontogenic tumors and cysts.
    METHODS: The literature was searched through the MEDLINE/PubMed, EMBASE via OVID, Web of Science, and CINHAL via EBSCO databases for original studies evaluating stem cell markers\' expression in different odontogenic tumors/cysts, or an odontogenic disease group and a control group. The studies\' risk of bias (RoB) was assessed via a Joanna Briggs Institute Critical Appraisal Tool. Meta-analysis was conducted for markers evaluated in the same pair of odontogenic tumors/cysts in at least two studies.
    RESULTS: 29 studies reported the expression of stem cell markers, e.g., SOX2, OCT4, NANOG, CD44, ALDH1, BMI1, and CD105, in various odontogenic lesions, through immunohistochemistry/immunofluorescence, polymerase chain reaction, flow cytometry, microarrays, and RNA-sequencing. Low, moderate, and high RoBs were observed in seven, nine, and thirteen studies, respectively. Meta-analysis revealed a remarkable discriminative ability of SOX2 for ameloblastic carcinomas or odontogenic keratocysts over ameloblastomas.
    CONCLUSIONS: Stem cells might be linked to the pathogenesis and clinical behavior of odontogenic pathologies and represent a potential target for future individualized therapies.
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  • 文章类型: Journal Article
    牙源性囊肿有转化为肿瘤的潜力。然而,转化为肿瘤组织的特征尚未得到很好的描述,这种现象的确切原因尚不清楚。
    本研究旨在描述转化为肿瘤的牙源性囊肿的特征,并寻找其潜在的病因。
    在PubMed中索引的英文书面研究,科学直接,和Proquest使用由医学主题词验证的关键词进行评估:“牙源性囊肿”和“肿瘤细胞转化”。
    系统评价和荟萃分析(PRISMA)指南的首选报告项目被用作指南。
    按照PRISMA指南中的步骤,对19篇文章进行了全面审查(3例病例系列和16例病例报告),其中27名受试者为15至86岁的男性16人(59%)和女性11人(41%)。
    囊性起源是八个牙质囊肿,四个牙源性角化囊肿,两个残余囊肿,一个根性囊肿,一个钙化牙源性囊肿,一个滤泡囊肿,一个腺性牙源性囊肿,9个未明确的牙源性囊肿转化为成釉细胞瘤(3例)和癌(24例)。
    牙源性囊肿的肿瘤转化是由于牙源性囊肿去除不充分的上皮残留和感染引起的慢性炎症引起的。然而,他们转变的确切原因仍不清楚。
    因此,仔细切除牙源性囊肿和术后定期随访是预防复发和肿瘤转化的关键.需要进一步的研究来研究牙源性囊肿肿瘤转化的潜在原因。
    UNASSIGNED: Odontogenic cysts have the potential to transform into neoplasms. However, the characteristics of those which transformed to neoplastic tissues have not been well described and the exact causes of that phenomenon are not yet clear.
    UNASSIGNED: This study aims to describe characteristics of odontogenic cysts that transformed into neoplasms and to look for their potential etiologies.
    UNASSIGNED: English-written studies indexed in PubMed, Science Direct, and Proquest were assessed using keywords verified by Medical Subject Headings: \'Odontogenic Cyst\' and \'Neoplastic Cell Transformation\'.
    UNASSIGNED: Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were used as guidance.
    UNASSIGNED: Following steps in PRISMA guidelines, 19 articles were fully reviewed (three case series and 16 case reports) with 27 subjects of 16 males (59%) and 11 females (41%) from 15 to 86 years old.
    UNASSIGNED: Cystic origins were eight dentigerous cysts, four odontogenic keratocysts, two residual cysts, one radicular cyst, one calcifying odontogenic cyst, one follicular cyst, one glandular odontogenic cyst, and nine unspecified odontogenic cysts that transformed to ameloblastoma (3 cases) and carcinoma (24 cases).
    UNASSIGNED: Neoplastic transformations of odontogenic cysts arose from epithelial remnants of inadequate odontogenic cyst removal and chronic inflammation due to infection. However, the exact causes of their transformations remain unclear.
    UNASSIGNED: Therefore, careful removal of odontogenic cysts and regular postoperative follow-ups are key to prevent recurrence and neoplastic transformation. Future studies are needed to investigate potential causes of neoplastic transformation of odontogenic cysts.
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  • 文章类型: Journal Article
    这项研究的目的是在文献中确定牙源性角化囊肿(OKCs)根治性切除术的临床病理指征,并根据这些发现制定OKCs治疗的临床指南。2021年9月在PubMed/Medline对文献进行了系统的综述,Scopus,WebofScience,谷歌学者,和Cochrane数据库。在搜索策略中使用了以下MeSH关键词术语:(牙源性角化囊肿)OR(角化囊性牙源性肿瘤)OR(原始囊肿)和(治疗)OR(根治性切除术)OR(OKC切除术)OR(治疗方法)。合格标准包括对接受根治性切除术的经组织学证实的OKC的临床研究出版物。使用少于5个OKC的研究,实验研究,流行病学研究,包括角化牙源性囊肿在内的研究,审查文件被排除在外。确定并定性分析了十项有关OKC报告节段或边缘切除的研究。在总共221例接受根治性切除术的OKC中,67个OKC是主要的,30人反复发作,其余患者尚不清楚是原发性还是复发性.在131个OKC中进行了节段性下颌骨切除术,87例OKC的边缘下颌骨切除术,并对3例OKCs进行了上颌骨部分切除术。根治性切除的主要指征是多房性外观,大OKC(>5厘米),多发性复发性OKCs伴或不伴皮质穿孔,恶性转化。总之,根治性切除术在OKC的治疗中占有一席之地。当存在伴有骨穿孔的侵袭性病变时,翼状肌或颅底受累,恶性转化。外科医生应致力于识别这些特征以适当地管理OKC并防止多次复发。提出了OKC管理的临床指南。
    The aim of this study was to identify clinico pathological indications for radical resection of odontogenic keratocysts (OKCs) in the literature and formulate clinical guidelines for the management of OKCs based on these findings. A systematic review of the literature was undertaken in September 2021 in PubMed/Medline, Scopus, Web of Science, Google Scholar, and Cochrane databases. The following MeSH Keywords terms were used in the search strategies: (odontogenic keratocyst) OR (keratocystic odontogenic tumor) OR (primordial cyst) AND (treatment) OR (Radical resection) OR (Resection of OKC) OR (Treatment methods). Eligibility criteria included publications of clinical studies on histologically confirmed OKCs which underwent radical resection. Studies with less than 5 OKCs, experimental studies, epidemiological studies, studies that included orthokeratinized odontogenic cyst, and review papers were excluded. Ten studies on OKCs reporting on segmental or marginal resections were identified and analyzed qualitatively. Of the total of 221 OKCs that underwent radical resection, 67 OKCs were primary, 30 were recurrent, and the remaining were unclear whether they were primary or recurrent. Segmental mandibulectomy was performed in 131 OKCs, marginal mandibulectomy in 87 OKCs, and 3 OKCs were treated by partial maxillectomy. The main indications for radical resection were multilocular appearance, large OKCs (> 5 cm), multiple recurrent OKCs with or without cortical perforation, and malignant transformation. In conclusion, radical resection has its place in the management of OKC. It is indicated when there is an aggressive lesion with bony perforation, involvement of the pterygoid musculature or skull base, and malignant transformation. The surgeon should aim to identify these features to manage OKC appropriately and to prevent multiple recurrences. Clinical guidelines for the management of OKCs are proposed.
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  • 文章类型: Case Reports
    由两个或多个独立的牙源性囊肿组成的牙源性病变并不常见。钙化牙源性囊肿(COC)和牙源性角化囊肿(OKC)是牙源性囊肿,表现出一些肿瘤特征。这些病变的并发极为罕见。我们报告了一例罕见的COC合并OKC患者,并系统地回顾了相关文献。
    方法:在本文中,我们提供1例病例报告,其中1例18岁无病史的男童患者的主诉为面部不对称.观察到后下颌骨右侧无痛肿胀。组织病理学和影像学检查显示,牙源性病变由发炎的OKC和COC组成。
    关于OKC和COC的真实性质的持久辩论,无论是囊性还是肿瘤性,到目前为止已经存在。它们的遗传衍生机制可以证明这些囊肿在患者中同时发生。该病变的治疗计划包括减压后摘除,刮宫,以及Carnoy\的解决方案的应用。
    结论:我们报道了一例罕见的OKC炎症,具有COC样特征。根据文献,这两个牙源性囊肿的巧合在这里已经是第三次报道了。
    UNASSIGNED: Odontogenic lesions composed of two or more separate odontogenic cysts are uncommon. The calcifying odontogenic cyst (COC) and odontogenic keratocyst (OKC) are odontogenic cysts that exhibit some neoplastic features. Concurrence of these lesions is extremely rare. We report a rare case of COC combined with OKC in a patient and review the relevant literature systemically.
    METHODS: In this article, we present a case report of an 18-year-old boy patient with no medical history whose chief complaint was facial asymmetry. A painless swelling in the right side of the posterior mandible was observed. Histopathological and radiographic investigations revealed a combined odontogenic lesion composed of inflamed OKC with COC.
    UNASSIGNED: Long-lasting debates on the true nature of OKC and COC, whether cystic or neoplastic, has been existed so far. Their genetic-derived mechanisms can justify the concurrent occurrence of these cysts in a patient. The treatment plan for this lesion included decompression followed by enucleation, curettage, and application of Carnoy\'s solution.
    CONCLUSIONS: We reported a rare case of an inflamed OKC with COC-like features. Based on the literature, the coincidence of these two odontogenic cysts has been reported for the third time here.
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  • 文章类型: Case Reports
    骨内溶骨性病变主要累及椎骨干phy端和长骨,诊断为动脉瘤性骨囊肿(ABCs)。Further,ABC被称为骨化性血肿。它被认为是一种不断扩大的溶骨性病变,由大小可变的充满血液的空间组成,这些空间被包含类骨组织和破骨细胞的小梁的结缔组织隔片隔开。据报道,它经常涉及长骨;然而,仅1.9%的患病率见于颌骨。它占所有非牙源性肿瘤的很小百分比。ABC显示年龄患病率的变化,其临床表现可能对外科医生具有挑战性。此外,ABC可能与骨化性纤维瘤等其他原发性骨病理有关,纤维发育不良,和巨细胞瘤;这些实体被称为ABC+病变。在这里,我们提出了一个ABC加病变的经典病例。
    The intraosseous osteolytic lesions mainly involving the metaphyseal region of vertebrae and long bones were diagnosed as aneurysmal bone cysts (ABCs). Further, an ABC was known as an ossifying hematoma. It is considered an expanding osteolytic lesion consisting of blood-filled spaces of variable sizes separated by connective tissue septa containing trabeculae of osteoid tissue and osteoclast giant cells. It is frequently reported to involve long bones; however, only 1.9% prevalence is seen in jaw bones. It represents a very small percentage of all non-odontogenic tumors. ABC shows variations in age prevalence and its clinical presentation may be challenging to the surgeon. In addition, ABC may occur in association with other primary bone pathologies like ossifying fibroma, fibrous dysplasia, and giant cell tumor; such entities are known as ABC plus lesions. Here we present a classic case of ABC plus lesion.
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  • 文章类型: Case Reports
    粘液表皮样癌(MEC)它可以起源于下颌牙源性囊肿。我们报告了一例63岁的男子,患有下颌骨右后磨牙三角的MEC。我们进行了广泛的下颌骨切除术,并立即用腓骨游离皮瓣进行了重建。
    Mucoepidermoid Carcinoma (MEC) it can origin from a mandibular odontogenic cyst. We report the case of a 63-year-old man with MEC of the right retromolar trigonum of the mandibula. We performed a wide mandibular excision and immediate reconstruction with a fibula bone free flap.
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  • 文章类型: Case Reports
    本临床报告的目的是记录一名13岁女孩上颌前区钙化牙源性囊肿(COC)的罕见病例。COC是一个非常不寻常的发展,牙源性实体,占牙源性囊肿的0.3%-0.8%。病变表现为一系列不同的放射学和临床病理特征和生物学属性,并存在三种组织形态学模式-良性囊性,实体(肿瘤)和侵袭性(恶性)形式。因此,已经提出了一些术语和分类来解释临床实体的性质。然而,关于病变的确切性质的歧义仍然普遍存在。由于非特异性的临床影像学特征,组织病理学解释仍然是诊断的关键。我们报告了一名13岁女性的COC罕见情况,该女性向我们的门诊部报告无症状的右面部中部肿胀。临床和影像学检查结果考虑腺瘤样牙源性肿瘤和牙源性囊肿。考虑了摘除病变的决定,组织病理学特征与COC的诊断相符。随访1年,发现骨化复发。COC是一种不寻常的发育牙源性囊肿,可在临床和放射学上模拟其他更常见的下颌实体。全面了解此类病变的奇异表现和生物学属性对于早期诊断和明确治疗至关重要。提倡长期随访以防止复发。
    The aim of this clinical report is to document a rare and unusual case of calcifying odontogenic cyst (COC) in the maxillary anterior region in a 13-year-old girl. A COC is an extremely uncommon developmental, odontogenic entity and accounts for 0.3%-0.8% of odontogenic cysts. The lesion presents as an array of varied radiographic and clinicopathological characteristics and biological attributes and exists in three histomorphologic patterns - benign cystic, solid (neoplastic) and aggressive (malignant) forms. Thus, several nomenclatures and classifications have been put forth to explain the nature of the clinical entity. However, ambiguities regarding the exact nature of the lesion still prevail. Due to nonspecific clinicoradiographic features, histopathological interpretation remains the key for diagnosis. We report an uncommon occurrence of COC in a 13-year-old female who reported to our Outpatient Department with an asymptomatic right midfacial swelling. The clinical and radiographic findings were suggestive of adenomatoid odontogenic tumor and dentigerous cyst. The decision to enucleate the lesion was considered, and histopathological features were compatible with the diagnosis of COC. Re-ossification with no recurrence was noticed after a 1-year follow-up. COC is an unusual developmental odontogenic cyst that clinically and radiologically simulates other more common jaw entities. Thorough knowledge of the bizarre presentation and biological attributes of such lesions are imperative for an early diagnosis and definitive treatment. Long-term follow-up is advocated to prevent recurrences.
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