Odontogenic cyst

牙源性囊肿
  • 文章类型: Journal Article
    背景技术由于牙冠和减少的釉质上皮之间的流体积聚而形成牙囊囊肿(DC)。由于不同的临床特征,例如关于其生物学起源的歧义以及及时诊断和检测这些病变的重要性,研究人员目前有动力进行进一步的调查。本研究的目的是评估DC患者的血清α-生育酚含量,并将其与正常人进行比较。健康的个体。方法本研究纳入总样本量n=34。A组,指定为对照组,由17名随机选择的健康受试者组成,而B组,DC诊断组,由17名患者组成。采集血样,和维生素E或α-生育酚的浓度进行评估,并以mg/mL表示。结果与健康对照组的平均维生素E水平(12.08±1.92mg/mL)相比,DC患者的平均维生素E水平(5.29±1.01mg/mL)显著降低(p<0.0001).结论DC患者维生素E水平低于健康个体。维生素E浓度的降低可能在囊性体积的扩大中起作用,因此对病理性病变的侵袭性产生影响。补充维生素E在降低DC侵袭性方面的治疗益处应在未来的研究中进行评估。
    Background Dentigerous cysts (DC) form due to fluid accumulation between the crown of the tooth and the reduced enamel epithelium. Due to the diverse clinical characteristics, such as ambiguity concerning their biological origins and the significance of timely diagnosis and detection of these lesions, researchers are presently motivated to undertake further investigations. The aim of the present study was to assess the amount of serum alpha-tocopherol in patients with DC and compare it with that of normal, healthy individuals. Methods A total sample size of n=34 was included in the current study. Group A, designated as the control group, comprised 17 randomly selected healthy subjects, while Group B, the DC diagnostic group, consisted of 17 patients. Blood samples were collected, and the concentration of vitamin E or alpha-tocopherol was evaluated and expressed in mg/mL. Results Compared to the mean vitamin E level in healthy controls (12.08 ± 1.92 mg/mL), patients with DC showed a statistically significant (p<0.0001) reduction in mean vitamin E levels (5.29 ± 1.01 mg/mL). Conclusion Patients with DC have lower levels of vitamin E than healthy individuals. The reduced concentration of vitamin E can have a role in the extension of cystic volume and thus have an impact on the aggressiveness of pathologic lesions. The therapeutic benefits of vitamin E supplementation in reducing the aggressiveness of DC should be evaluated in future research.
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  • 文章类型: Journal Article
    本研究通过回顾性比较全景和锥形束计算机断层扫描图像,并分析与下颌阻生第三磨牙(IMT)相关的病变特征,确定了病变之间的鉴别诊断因素。
    对2017年至2021年在我们机构同时接受IMT摘除术和相关良性肿瘤切除术或囊肿摘除术的患者进行了一项回顾性队列研究。为了比较每个组的特征,进行了两项比较分析。第一次比较考虑了与IMT相关的最常观察到的病变:牙囊囊肿,牙源性角化囊肿(OKC),和成釉细胞瘤.第二个比较涉及放置牙质囊肿,复发率相对较低,进入A组并放置OKC,成釉细胞瘤,和牙源性粘液瘤,复发率高,进入B组。
    在成釉细胞瘤的顺序中发现病变大小存在显著差异,OKC,牙质囊肿(P<0.05)。成釉细胞瘤的颊舌宽度与其他组明显不同,OKC和牙质囊肿之间没有显着差异(P=0.083)。
    患者年龄和病变大小在与IMT相关的病变类型之间存在显著差异,OKC和牙源性肿瘤的年龄较小,病变较大。OKCs的近端宽度可能大于含牙囊肿。成釉细胞瘤的颊舌宽度大于牙质囊肿和OKC。
    UNASSIGNED: This study identifies factors for differential diagnosis among lesions by retrospectively comparing panoramic and cone-beam computed tomography images and analyzing the characteristics of lesions associated with impacted mandibular third molars (IMTs).
    UNASSIGNED: A retrospective cohort study was conducted in patients who simultaneously underwent IMT extraction surgery and related benign tumor resection or cyst enucleation at our institution from 2017 to 2021. To compare the characteristics of each group, two comparative analyses were conducted. The first comparison considered the most frequently observed lesions associated with IMTs: dentigerous cysts, odontogenic keratocysts (OKCs), and ameloblastoma. The second comparison involved placing dentigerous cysts, which have a relatively low recurrence rate, into group A and placing OKC, ameloblastoma, and odontogenic myxoma, which have high recurrence rates, into group B.
    UNASSIGNED: Significant differences in the size of the lesion were found in the order of ameloblastoma, OKC, and dentigerous cyst (P <0.05). The buccolingual width of ameloblastoma differed significantly from that of the other groups, with no significant difference observed between the OKCs and dentigerous cysts (P=0.083).
    UNASSIGNED: Patient age and lesion size differed significantly among lesion types associated with IMTs, with younger age and larger lesions for OKCs and odontogenic tumors. OKCs are likely to have a larger mesiodistal width than dentigerous cysts. The buccolingual width of ameloblastomas was larger than those of dentigerous cysts and OKCs.
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  • 文章类型: Journal Article
    非炎性囊肿与细菌相关的根尖周脓肿相比,根尖切除术后逆行充盈的必要性存在争议。这项研究旨在研究在根尖切除术中是否存在逆行充盈对炎症性和非炎症性囊肿的长期预后影响。
    这项回顾性研究包括2013年至2022年在颌骨囊肿摘除术期间接受牙尖切除术的患者,并接受了至少6个月的随访锥形束计算机断层扫描。在随访期间根据囊肿类型评估牙齿的预后,是否存在逆行填充,下颌骨或上颌骨,和位置。
    本研究共纳入147颗牙齿。所有手术牙齿都接受了牙髓专家的术前根管治疗。对119个炎性囊肿和28个非炎性囊肿进行了根尖切除术。对22颗具有炎性囊肿的牙齿和3颗具有非炎性囊肿的牙齿进行逆行填充。所有牙齿在3.5年的随访中幸存下来(范围,1.0-9.1年)。然而,1颗具有炎性囊肿的牙齿在手术后1年出现并发症,需要重新进行牙髓治疗。
    在囊肿摘除过程中,通过根尖切除术治疗而没有逆行充填的牙齿的预后是有利的,不管囊肿类型。
    UNASSIGNED: The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts.
    UNASSIGNED: This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location.
    UNASSIGNED: A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment.
    UNASSIGNED: The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.
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  • 文章类型: Case Reports
    最常见的牙源性囊肿是根性囊肿,通常由于牙髓坏死后的炎症而从牙周膜中的上皮残留物发展而来。我们报告了一例49岁的男性患者,主诉上颌前区无痛性肿胀,结果是根性囊肿.经临床检查,一个柔软的,发现了波动的非招标性肿胀。影像学检查发现根尖周病变。根据临床和放射学特征初步诊断为根性囊肿。治疗计划包括摘除,骨移植修复缺损,和抗生素牙髓治疗。在手术切除囊性病变后进行牙髓治疗。通过组织病理学分析验证了根性囊肿的诊断。本病例报告强调了多学科方法对成功治疗神经根囊肿的重要性,这也强调了需要全面的临床和影像学评估才能准确诊断。及时识别和适当的干预对于避免可能的并发症和确保成功的治疗结果至关重要。
    The most prevalent kind of odontogenic cysts is radicular cysts, which usually develop from the epithelial remnants in the periodontal ligament as a result of inflammation that follows pulp necrosis. We report a case of a 49-year-old male patient who complained of painless swelling in the maxillary anterior region, which turned out to be a radicular cyst. Upon clinical examination, a soft, nontender swelling that fluctuated was found. A periapical lesion was found upon radiographic assessment. A radicular cyst was tentatively diagnosed based on clinical and radiological features. The treatment plan included enucleation, restoration of the defect with bone graft, and endodontic therapy with antibiotics. Endodontic therapy was administered after the cystic lesion was surgically removed. The diagnosis of a radicular cyst was validated by histopathological analysis. The significance of a multidisciplinary approach for the successful management of radicular cysts is emphasized in this case report, which also underscores the need for a comprehensive clinical and radiographic evaluation for accurate diagnosis. Prompt identification and suitable intervention are essential to avert possible complications and guarantee successful treatment results.
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  • 文章类型: Journal Article
    狗的未萌出的牙齿相当常见,可能会发生牙源性囊肿,导致周围骨骼的破坏并影响相邻的牙齿。我们分析了大量狗中与未萌出牙齿相关的囊肿的组织学报告。在10年期间(2012-2022年),从在私人转诊兽医牙科诊所治疗的所有犬中评估了与未萌出牙齿相关的囊肿的医疗记录和组织病理学结果。该研究包括总共192只狗,其中279只囊肿与一颗或多颗未萌出的牙齿有关。短脑品种过多。受影响最大的是有58只狗(30%)的西藏猎犬和有48只狗(25%)的拳击手。最常见的受影响牙齿是下颌第一前磨牙,有238个(84%)囊肿。在总共279个囊肿中,208(75%)进行了组织病理学检查。检查的囊肿均无恶变。基于这208个囊肿,在狗群中发现有恶变的囊肿的可能性为0-1.4%(置信区间95%)。
    Unerupted teeth in dogs are fairly common and may develop an odontogenic cyst that causes destruction of the surrounding bone and affect adjacent teeth. We analyzed histological reports of cysts associated with unerupted teeth in a large population of dogs. Medical records and histopathological results of cysts associated with unerupted teeth were evaluated from all dogs treated at a private referral veterinary dental clinic over a 10-year period (2012-2022). A total of 192 dogs with 279 cysts associated with one or more unerupted teeth were included in the study. Brachycephalic breeds were overrepresented. The most affected were Tibetan Spaniels with 58 dogs (30%) and Boxers with 48 dogs (25%). The most common affected tooth was the mandibular first premolar tooth with 238 (84%) cysts. Of the total of 279 cysts, 208 (75%) were histopathologically examined. None of the cysts examined contained malignant changes. Based on these 208 cysts, the probability of finding a cyst with malignant changes in a population of dogs is 0-1.4% (confidence interval 95%).
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  • 文章类型: Case Reports
    神经根囊肿是颌骨中最常见的囊肿形式。它们是由牙髓坏死后根尖周感染引起的牙周膜上皮残留形成的。这种情况通常是无症状的,主要影响牙齿的顶点。它主要影响非生命牙齿,并以炎症为特征。囊肿发育是根尖周感染后炎症过程的最后阶段;因此,它经常发生在以后的生活中。上颌骨的囊肿偶尔会扩散到上颌窦。根性囊肿可以用外科牙髓治疗,去除有问题的牙齿,初次闭合摘除,或有袋化和摘除。此病例报告讨论了感染的根性囊肿的成功手术治疗。
    Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection following pulpal necrosis. This condition is typically asymptomatic and mostly affects the tooth\'s apices. It primarily affects non-vital teeth and is characterized by inflammation. Cyst development is the final stage of the inflammatory process after a periapical infection; hence, it often occurs later in life. A cyst in the maxilla can occasionally spread across the maxillary sinus. Radicular cysts can be treated with surgical endodontics, the removal of the problematic tooth, enucleation with primary closure, or marsupialization and enucleation. This case report discusses a successful surgical therapy for an infected radicular cyst.
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  • 文章类型: Journal Article
    牙源性角化囊肿(OKC)是一种侵袭性复发性囊肿,具有有趣的特征。涉及到各种因素,如外科手术,某些组织学特征导致其复发。我们评估了临床,射线照相,和OKC的组织病理学数据,以更好地理解该囊肿的真实性质。
    共评估了58个病变,包括4例与结节状基底细胞癌综合征(NBCCS)相关的病例。评估了上皮和包膜内的影像学特征和组织病理学特征。
    72%的病例见于男性,28%见于女性。43%的病例见于下颌支,65%的人表现出单眼射线透过性。95%显示真正的角化。在41.3%的病例中可见立方体基底细胞形态,在60%的病例中可见极性反转。基础出芽,rete钉,在上皮内也观察到有丝分裂。在55例(94.9%)中,上皮在基底下水平和基底上水平显示分离。
    基底细胞出芽等特征,鼻上有丝分裂活性,上基底分裂,局部炎症,上皮下透明化,卫星囊肿通常与复发性囊肿相关。许多较新的遗传和分子假说为理解OKC生物学做出了开创性的贡献。在这些因素的指导和帮助下,可以预期术后结果的改善。
    UNASSIGNED: Odontogenic keratocyst (OKC) is an aggressive recurrent cyst with intriguing features. Various factors such as the surgical procedure are involved, and certain histological features contribute to its recurrence. We assessed the clinical, radiographic, and histopathological data of OKCs to better comprehend the true nature of this cyst.
    UNASSIGNED: A total of 58 lesions including four cases in association with nevoid basal cell carcinoma syndrome (NBCCS) were assessed. Radiographic features and histopathological features within the epithelium and capsule were assessed.
    UNASSIGNED: 72% of cases were seen in males and 28% in females. 43% of cases were seen in the mandibular ramus, and 65% exhibited unilocular radiolucency. 95% showed true parakeratinization. Cuboidal basal cell morphology was seen in 41.3% of cases and reversal of polarity in 60%. Basal budding, rete pegs, and mitosis were also observed within the epithelium. The epithelium showed separation at the subbasal level and suprabasal levels in 55 (94.9%) cases.
    UNASSIGNED: Features such as basal cell budding, suprabasal mitotic activity, suprabasal split, localized inflammation, subepithelial hyalinization, and satellite cysts were commonly associated with recurrent cysts. Many newer genetic and molecular hypotheses have generated path-breaking contributions to the understanding of the biology of OKC. With the guidance and help of such factors, improved post-surgery results can be anticipated.
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  • 文章类型: Case Reports
    钙化性牙源性囊肿(COCs)表现出多样化的临床过程,通常在生命的第二个和第三个十年之间发展,没有性别偏好。正在观察一名没有病史的15岁女性上颌骨混合病变与受累牙齿有关。她因突然发作和左中脸肿胀恶化而被送往急诊科。全景X线照片和CT扫描的影像学发现显示,位于左上颌骨的界限清楚的混合病变,延伸到左上颌窦并到达眶底。囊肿并发感染后,病人住院了,接受了静脉注射抗生素,并在全身麻醉下进行手术干预。在同一位置结合两个或多个牙源性肿瘤或单个囊肿的组织学特征的病变称为杂合牙源性病变。这种类型的病变对病理学家和外科医生都构成了挑战,因为它有争议的组织起源和对临床进化知之甚少。这些病变中最常见的是与牙瘤相关的COCs。我们的病例代表了牙源性囊肿中极为罕见的实体。
    Calcifying odontogenic cysts (COCs) exhibit a diverse clinical course, commonly developing between the second and third decades of life, displaying no gender predilection. A 15-year-old female without medical history was under observation for a mixed lesion in the maxilla associated with an impacted tooth. She presented to the emergency department with sudden onset and worsening swelling of the left midface. Radiographic findings in the panoramic radiograph and a CT scan revealed a well-circumscribed mixed lesion localized in the left maxilla, extending into the left maxillary sinus and reaching the orbital floor. After an intercurrent infection of the cyst, the patient was hospitalized, received intravenous antibiotics, and went for surgical intervention under general anesthesia. Lesions that combine histological characteristics of two or more odontogenic tumors or individual cysts in the same location are called hybrid odontogenic lesions. This type of lesion poses a challenge for both pathologists and surgeons, because of its controversial histogenesis and poorly understood clinical evolution. The most common of these lesions are COCs associated with odontoma. Our case represents an exceptionally rare entity among odontogenic cysts.
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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: 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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