unicystic

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  • 文章类型: Journal Article
    透明化的诱导作用及其对成釉细胞瘤变体的生物学行为的影响代表了口腔病理学的一个几乎没有研究的领域。牙源性设备内诱导效应的复杂性,外胚层和中胚层组织都参与其中,负责不同的组织病理学特征,透明质化是主要特征。本研究旨在首次推断三种单囊性成釉细胞瘤(UA)变种的透明质化(SOH)严重程度与复发之间的相关性。即,腔内(UA-IL),腔(UA-L)和壁(UA-M)。回顾性诊断的UA-IL档案病例(n=08),评估UA-L(n=22)和UA-M(n=30)的SOH及其与复发的相关性。还进行了亚组比较(UA-IL/UA-L和UA-M之间)。还从文件中分析了患者的临床参数与复发的临床病理相关性。结果:上皮下透明化(SEH)与UA-L和UA-M的复发显着相关(p=0.001)。当组织学类型(UA-L和UA-ILvs.对UA-M)进行分组,并检查SOH与复发的相关性,观察到两组(p=0.001)显示出强的统计学相关性.UA-M病变与多房性放射性(p=0.001)也显示出与复发的显着相关性。SOH可以是UA复发和侵袭性生物学行为的可靠组织学预测指标。本研究表明,透明质化与UA的生物学行为存在显着关联。通过免疫组织化学研究的进一步研究可以验证透明质化的存在并确定透明质化产物在UA中的起源。
    The inductive effect of hyalinisation and its influence on the biologic behaviour of ameloblastoma variants represent a scarcely researched domain of oral pathology. The complexity of the induction effects within the odontogenic apparatus, with the involvement of both ectodermal and mesodermal tissues, is responsible for diverse histopathological characteristics, hyalinisation being the major feature. The present study aims to deduce for the first time the correlation between the severity of hyalinisation (SOH) and recurrence in three unicystic ameloblastoma (UA) variants, namely, intra-luminal (UA-IL), luminal (UA-L) and mural (UA-M). Retrospectively diagnosed archival cases of UA-IL (n = 08), UA-L (n = 22) and UA-M (n = 30) were assessed for SOH and its correlation with recurrence. A subgroup comparison (between UA-IL/UA-L and UA-M) was also performed. The clinical parameters of the patients were also analysed from files for clinicopathological correlation with recurrence. Results: sub-epithelial hyalinisation (SEH) significantly correlated with the recurrence of UA-L and UA-M (p = 0.001). When the histologic types (UA-L and UA-IL vs. UA-M) were grouped and the correlation of SOH with recurrence was checked, it was observed that both groups (p = 0.001) showed strong statistical correlation. UA-M lesions with multilocular radiolucency (p = 0.001) also showed significant correlation with recurrence. SOH can be a reliable histological predictor of recurrence and of aggressive biologic behaviour in UA. The present study shows a significant association of hyalinisation with the biologic behaviour of UA. Further studies with immunohistochemical investigations could validate the presence of hyalinisation and identify the origin of the hyalinised product in UAs.
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  • 文章类型: Journal Article
    单囊性成釉细胞瘤(UA)是成釉细胞瘤的一种罕见变体,其行为与成釉细胞瘤(SMA)的固体多囊性变体完全不同;此外,UA的组织学亚组在增殖方面也表现出不同的行为。本多中心研究旨在介绍单囊性成釉细胞瘤(UA)的临床病理特征,并比较两种流行的组织学分类系统。从印度北部的四所牙科教学学校中检索到80例令人满意的UA病例,并对其临床病理参数进行了评估。使用改良的Reichart和Philipsen系统以及Marx和Stern系统对病例进行分类,然后比较观察者之间的变异性。结果采用SPSS软件进行分析。平均发病年龄为30.79±16.49岁。男性人数超过女性(M:F::1.67:1)。大多数病例发生在第三个十年,不分性别。大多数病例发现于下颌骨的体角支区域。修改后的Reichart和Philipsen分类产生了更好的观察者间一致性(kappa值0.845)。修改后的Reichart和Philipsen分类可产生更好的评分者之间的一致性,并且易于在口腔病理学家中复制。更简单,手术外科医生可以很容易地理解它,以获得更好的治疗结果。
    Unicystic ameloblastoma (UA) is an uncommon variant of ameloblastoma and behaves totally different from the solid multicystic variant of ameloblastoma (SMA); furthermore the histological subgroups of UA also show varied behavior regarding proliferation. The present multi-centric study was designed to present the clinicopathological features of unicystic ameloblastoma (UA) and to compare the two popular histological classifications systems. 80 satisfactory cases of UA were retrieved and evaluated for clinicopathological parameters from four teaching dental schools of North India. The cases were classified using modified Reichart and Philipsen system and Marx and Stern system followed by comparison of inter-observer variability. The results were analyzed using SPSS software. The mean age of occurrence was 30.79 ± 16.49 years. Males outnumbered females (M:F::1.67:1). The majority of cases occurred in the third decade irrespective of the gender. Most cases were found in body-angle-ramus region of the mandible. The modified Reichart and Philipsen classification yielded better interobserver agreement (kappa value 0.845). The modified Reichart and Philipsen classification yields better inter-rater agreement and is easy to reproduce amongst oral pathologists. Being simpler it may easily be understood by the operating surgeon for better treatment outcome.
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  • 文章类型: Journal Article
    目的:本研究旨在评估单囊性成釉细胞瘤年轻患者的临床疗效,通过各种保守治疗方式,如袋袋化,骨刮除术和帮助建立合理的治疗指南。
    方法:有15例单囊性成釉细胞瘤患者,在过去的6年(2010-2015年)中,他向我们部门介绍了所有患者中选择的保守治疗方法。此外,增加了一项关于2001年至2015年过去15年中青年年龄组(<20岁)单囊性成釉细胞瘤治疗研究的系统文献综述.
    结果:注意到保守治疗后骨再生更快,由于年轻和成长潜力。平均随访4年,顺利的二次愈合,在任何病例中均未发现复发的临床或影像学证据,也未发现明显的畸形.
    结论:单囊性成釉细胞瘤是良性的,年轻的局部侵袭性牙源性肿瘤可以在牙齿形成阶段发展,因此它的早期开始和大量增殖在这个年龄段并不少见,因此,它可以长成一个巨大的病变,导致显著的发病率。保守性手术治疗可能是降低发病率并增加年轻人群中继发愈合和骨再生的可能性的可行选择。
    OBJECTIVE: The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines.
    METHODS: A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010-2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added.
    RESULTS: Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases.
    CONCLUSIONS: Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.
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  • 文章类型: Case Reports
    目的:成釉细胞瘤是一种局部侵袭性良性肿瘤,通常发生在下颌骨。虽然已经报道了多囊性或丛状变异的巨大成釉细胞瘤,作者报告了一例罕见的腔内变异的巨大单囊性成釉细胞瘤,通过房室切除术治疗,并计划延迟重建。
    方法:一名46岁的男性患者向口腔外科门诊部报告,左侧下颌骨区域肿胀2年。他接受了阿育吠陀治疗,但没有改善。出现时病变的大小约为9×12cm。
    方法:房室切除并计划进行二次重建,经过适当的随访期。
    结论:虽然正在探索保守治疗作为单囊性成釉细胞瘤的治疗选择,无论巨大病变的组织病理学亚型如何,切除仍是治疗标准.
    OBJECTIVE: Ameloblastoma is a locally aggressive benign tumor, commonly occurring in the mandible. While giant ameloblastoma of multicystic or plexiform variant have been reported, the authors report a rare case of giant unicystic ameloblastoma of luminal variant, which was treated by compartmental resection and planned for delayed reconstruction.
    METHODS: A 46 year old male patient reported to the oral surgery out-patient department with a swelling of the left side mandible region of 2 years duration. He had undergone ayurvedic treatment for the same with no improvement. The size of the lesion on presenting was approximately 9 × 12 cm.
    METHODS: Compartmental resection with plan for secondary reconstruction, after adequate follow up period.
    CONCLUSIONS: While conservative management is being explored as a treatment option for unicystic ameloblastoma, resection is still the standard of care regardless of the histopathological subtype for giant lesions.
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  • 文章类型: Journal Article
    目的:这项研究的目的是在成釉细胞病变周围引起必要的安全界限,以防止进一步复发。
    方法:本研究包括25例下颌骨成釉细胞瘤。诊断基于临床和放射学分析,并通过组织病理学报告证实。术前进行了切开活检以确认诊断。计划对所有病例进行分段切除。切除后,术后对标本进行全景X线片,然后对其边缘进行组织病理学检查以检测肿瘤细胞浸润。
    结论:在我们所有的案例中,成釉细胞瘤本质上是浸润的。10年的随访期显示既没有复发也没有植入失败。在我们的研究中,我们根据切除标本的组织病理学报告得出我们对于成釉细胞瘤浸润性变异型的安全界限.
    OBJECTIVE: The purpose of this study is to elicit the amount of safety margin necessary around the ameloblastic lesion in view of preventing further recurrence.
    METHODS: The study consisted of 25 cases of mandibular ameloblastoma. Diagnosis was based on clinical and radiological analysis and confirmed by histopathological report. An incisional biopsy was done preoperatively to confirm the diagnosis. Segmental resection was planned for all the cases. After the resection, postoperative panoramic radiograph of the specimen was taken followed by histopathological examination of its margin to detect tumor cell infiltration.
    CONCLUSIONS: In all our cases, the ameloblastoma was infiltrating in nature. A follow-up period of 10 years showed neither recurrence nor implant failure. In our study, we conclude our safe margin for infiltrating variant of ameloblastoma based on histopathological report of the resected specimen.
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  • 文章类型: Journal Article
    OBJECTIVE: To assess the cases of ameloblastoma retrospectively for various parameters.
    METHODS: Ninety-one previously reported cases of ameloblastoma from Government Dental College and Hospitals, Nagpur, were included in this study. Data were collected considering parameters such as age, sex, symptoms, radiographic, histopathology, treatment modalities, and recurrence. Our findings were also compared with world literature.
    RESULTS: The average age was 32.5 years. Mostly men complained of an asymptomatic swelling and duration of less than one year. Posterior segment and vertical ramus of mandible was the frequently involved site. Radiographically, multilocular appearance was noted more than 60% of the cases. Plexiform and unicystic ameloblastoma occurred frequently. Surgery was the treatment of choice in this review. Recurrence was noted in more than 10% of the cases.
    CONCLUSIONS: There are variations in our review in comparison to reported literature.
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