odontogenic cyst

牙源性囊肿
  • 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: 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
    There is a high incidence of chronic periapical periodontitis of deciduous teeth, however, there is a low incidence of the apical cyst. This paper reports a 7-year-old child with deciduous periodontitis caused by chronic periapical periodontitis of deciduous teeth. Through literature review, the etiology, imaging characteristics, diagnosis, differential diagnosis, and treatment methods were discussed to provide the basis for clinical diagnosis and treatment.
    乳牙慢性根尖周炎的发病率高,但是根尖囊肿发病率较低,本文报告1例7岁患儿因乳牙慢性根尖周炎导致的乳牙根尖囊肿,经文献查阅,对其病因、影像学特征、诊断、鉴别诊断、治疗方法进行探讨,为临床诊疗提供依据。.
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  • 文章类型: Journal Article
    目的:切除无症状的完全阻生第三磨牙的指征仍存在争议。在这项研究中,对无症状阻生下颌第三磨牙的牙囊进行了放射学和组织学研究,旨在为临床预防性拔牙提供参考。
    方法:包括下颌第三磨牙阻生患者,并在水平方向测量牙冠周围牙囊的最大宽度,锥形束计算机断层扫描的矢状和冠状切面。牙囊用苏木精-伊红染色,由病理学家分析并归类为正常,炎性或囊性。使用卡方检验来分析炎症和囊肿的发生率与下颌第三磨牙阻生的临床变量之间的关系。
    结果:37个样本为正常牙囊;52个样本显示炎性浸润,发生率为57.14%;2个样本最大牙囊宽度为2-3毫米,被诊断为牙源性囊肿,发病率为2.20%。炎症和囊性牙囊的发病率在男性和女性之间没有显著差异,或不同年龄组之间(P>0.05)。随着牙囊最大宽度的增加,慢性非特异性炎症的发生率和浸润程度均有上升.
    结论:无症状阻生下颌第三磨牙倾向于拔除,特别是对于在放射学检查中最大宽度为2-3毫米的牙齿。
    The indication for removal of asymptomatic fully impacted third molars is still controversial. In this study, radiological and histological investigation of the dental follicle of asymptomatic impacted mandibular third molars was performed, aiming to provide a reference for clinical prophylactic extraction of these teeth.
    Patients with impacted mandibular third molars were included and the maximum width of the dental follicle around the crown was measured in horizontal, sagittal and coronal sections by cone beam computed tomography. The dental follicles were stained with haematoxylin-eosin, analysed by a pathologist and classified as normal, inflammatory or cystic. A Chi-squared test was used to analyse the association of the incidence of inflammation and cysts with the clinical variables of the impacted mandibular third molars.
    Thirty-seven samples were normal dental follicles; 52 samples showed inflammatory infiltration with an incidence of 57.14%; 2 samples with a maximum dental follicle width of 2-3 mm were diagnosed as odontogenic cysts, and the incidence was 2.20%. There was no significant difference in the incidence of inflammatory and cystic dental follicles between males and females, or between different age groups (P > 0.05). With an increase of the maximum width of the dental follicle, there was a rise in the incidence and degree of infiltration of chronic nonspecific inflammation.
    Asymptomatic impacted mandibular third molars tend to be extracted, especially for teeth with a 2-3 mm maximum width of the dental follicle on radiological examination.
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  • 文章类型: Case Reports
    Mandibular buccal bifurcation cyst is a rare inflammatory odontogenic cyst. We reported two cases who complained of painful swelling of extraoral soft tissue. Intraoral examination revealed the partially erupted mandibular first molar. Cone beam computed tomography showed a well-defined cystic lesion surrounding the first molar. Histopathologic images showed the cyst wall was infiltrated by a large number of plasma cells, neutrophils and eosinophils, and lined with a thin layer of non-keratinized stratified squamous epithelium. Finally, the two patients were diagnosed as mandibular buccal bifurcation cyst and treated with cyst enucleation and curettage.
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  • 文章类型: Journal Article
    下颌颊分叉囊肿是一种罕见的炎性牙源性囊肿。我们报告了两例抱怨口外软组织疼痛肿胀的病例。口内检查显示下颌第一磨牙部分萌出。锥形束计算机断层扫描显示第一磨牙周围明确的区域与囊性病变一致。组织病理学图像显示大量浆细胞,嗜中性粒细胞和嗜酸性粒细胞浸润,以及一层薄薄的非角化复层鳞状上皮。结合症状,放射学和病理学检查,2例患者均诊断为下颌颊分叉囊肿。
    The mandibular buccal bifurcation cyst is a rare type of inflammatory odontogenic cyst. We reported two cases complaining of an extraoral soft tissue painful swelling. Intraoral examination revealed partially erupted mandibular first molar. Cone beam computed tomography showed well-defined areas surrounding the first molar consistent with cystic lesions. Histopathologic images showed a large number of plasma cells, neutrophils and eosinophils infiltrated, as well as a thin layer of non-keratinized stratified squamous epithelium. Combined with symptoms, radiological and pathological examinations, the two patients were diagnosed as mandibular buccal bifurcation cyst.
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  • 文章类型: Case Reports
    未经证实:腺性牙源性囊肿(GOC)是一种极其罕见的发育性颌骨囊肿,由于其攻击性行为而倾向于复发。没有报道GOC与牙瘤同时存在的病例。我们介绍了与牙瘤相关的GOC病例,并特别参考了诊断影像学和组织病理学特征。
    未经证实:一名42岁的中国男子在过去3个月中出现了前下颌骨肿胀和疼痛。全景扫描显示较大的多眼界限良好的放射透明度,并伴有牙样形态异常。组织学发现证实了与牙瘤相关的GOC。
    未经证实:此病例证明GOC具有多种临床谱,与牙瘤的联系可能会增强对这种罕见的颌骨囊肿的现有知识。
    UNASSIGNED: Glandular odontogenic cyst (GOC) is an extremely rare developmental jawbone cyst, tending to recurrence owing to its aggressive behavior. There has been no reported case of presence of GOC simultaneous with odontoma. We presented a case of GOC associated with odontoma with special reference to the diagnostic imaging and the histopathological features.
    UNASSIGNED: A 42-year-old Chinese man presented with swelling and pain in the anterior mandible for the past 3 months. Panoramic scan showed a large multiocular well-circumscribed radiolucency accompanied by toothlike morphological abnormality. Histological findings confirmed a GOC associated with odontoma.
    UNASSIGNED: This case demonstrates GOC with multiple clinical spectrum, and its association with odontoma might enhance the existing knowledge of this rare jawbone cyst.
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  • 文章类型: Journal Article
    OBJECTIVE: To characterize the radiographic features of maxillary ameloblastoma (AM), odontogenic keratocyst (OKC) and dentigerous cyst (DC) comparatively by using spiral CT and cone beam CT (CBCT).
    METHODS: Clinical records, histopathological reports, and nonenhanced spiral CT or CBCT images of 191 consecutive patients with primary maxillary AMs, OKCs, or DCs were retrospectively acquired, and radiographic features were analyzed.
    RESULTS: The study included 118 males and 73 females (age: 5-84 years). 72.0% of AMs and 84.3% of OKCs originated from the posterior maxilla, while 69.6% of DCs occurred in the anterior maxilla. Among 25 AMs, 44.0% were of desmoplastic type, with honey-combed appearance. 84.0% of AMs were circular or oval in shape, 84.0% expanded buccally, and 36.0% invade the nasal floor. Among 89 OKCs of 88 patients, 61.8% were circular or oval, 58.4% expanded buccally, 49.4% were dentigerous, 41.6% nearly filled the maxillary sinus, and 13.5% invaded the nasal floor. 93.7% (74/79) of DCs enveloped a single tooth, and the tooth-cyst relationship was centripetal in 35, eccentric in 30, and circumferential in 9. Moreover, 98.2% (55/56) of the cysts enveloping a supernumerary tooth were DCs, while 80.9% (38/47) of the cysts enveloping the third molar were OKCs.
    CONCLUSIONS: Maxillary AMs tend to grow with buccal expansion and invade the nasal floor, and DAs with honey-combed lobularity are common. Maxillary OKCs have variant shapes and tend to invaginate the maxillary sinus. The tooth-cyst relationship of dentigerous OKCs and DCs can be centripetal, eccentric, or circumferential.
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