odontogenic

牙源性
  • 文章类型: Case Reports
    成釉细胞癌是一种罕见的恶性牙源性肿瘤,可进一步分为原发性或继发性,源于先前存在的良性成釉细胞瘤。它影响了三分之二的患者的下颌骨。该病变没有标准的治疗方案,但在大多数情况下,有或没有放射治疗的根治性手术切除报告。在本文中,我们介绍了一例22岁的男性,诊断为下颌骨成釉细胞癌,具有典型的侵袭性和广泛破坏的临床过程。切开的活检的组织病理学检查显示,角化的复层鳞状上皮具有潜在的纤维结缔组织基质。基质是高度粘液瘤,并表现出牙源性上皮岛和慢性炎症细胞浸润。牙源性上皮的交错链显示星状网状细胞和偶尔的鳞状化生区域,具有细胞和核多态性。此外,注意到有丝分裂图。与临床的相关性,射线照相,和组织学特征,该病变被诊断为成釉细胞癌。手术切除病灶,治疗后随访6个月,未发现恶性肿瘤复发。
    Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. There is no standard treatment protocol for this lesion but radicalsurgical excision with or without radiotherapy is reported in the majority of cases. In this paper, we present a case of a 22 year old male diagnosed with Ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive destruction. Histopathological examination of the incised biopsy showed a parakeratinized stratified squamous epithelium with underlying fibrous connective tissue stroma. The stroma is highly myxomatous and exhibits islands of odontogenic epithelium and chronic inflammatory cell infiltrates. Interlacing strands of odontogenic epithelium shows stellate reticulum-like cells and occasional areas of squamous metaplasia with cellular and nuclear pleomorphism. In addition, mitotic figures were noted. With the correlation of clinical, radiographic, and histological features, the lesion is diagnosed as ameloblastic carcinoma. The lesion was surgical excised and post-treatment follow-up for 6 months revealed no recurrence of the malignancy.
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  • 文章类型: Case Reports
    面部坏死性筋膜炎(NF)是一种罕见但严重的疾病,需要及时和全面的治疗。这种方法通常涉及各种医学专业的输入,如传染病专家,重症监护医生,还有外科医生.首要目标是尽早承认,积极的手术清创术,适当的抗生素治疗,和支持性护理。及时诊断至关重要,根据剧烈疼痛等症状,迅速蔓延的红斑,和全身感染的迹象。广谱抗生素是凭经验启动的,并根据文化结果进行调整。紧急手术清创至关重要,清除所有坏死组织。必须仔细考虑保护重要结构。密切监测和重症监护可能是必要的,特别是对于严重的病例。一旦感染得到控制,可以进行软组织重建,旨在恢复功能和美学。长期随访对观察并发症和复发至关重要。
    Necrotizing fasciitis (NF) of the face is a rare yet serious condition requiring prompt and comprehensive management. This approach typically involves input from various medical specialties such as infectious disease specialists, critical care physicians, and surgeons. The primary goals are early recognition, aggressive surgical debridement, appropriate antibiotic therapy, and supportive care. Prompt diagnosis is crucial, based on symptoms like severe pain, rapidly spreading erythema, and systemic signs of infection. Broad-spectrum antibiotics are initiated empirically, and adjusted based on culture results. Urgent surgical debridement is crucial, removing all necrotic tissue. Careful consideration must be given to preserve vital structures. Close monitoring and intensive care may be necessary, especially for severe cases. Soft tissue reconstruction may follow once the infection is controlled, aiming to restore function and aesthetics. Long-term follow-up is essential to observe for complications and recurrence.
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  • 文章类型: Journal Article
    引言药物相关性颌骨坏死(MRONJ)由牙源性感染发展。然而,也有一些MRONJ从没有牙齿的部位发育的病例,无根管病变,或者没有牙周病.本研究旨在回顾性回顾MRONJ病例的影像学图像,并检查怀疑与牙齿感染有关的MRONJ(牙源性MRONJ)和没有牙齿受累或原因不明的MRONJ(非牙源性MRONJ)之间的特征差异。材料与方法在关西医科大学医院和关西医科大学医学中心诊断为MRONJ的一百四十五名患者。调查了以下变量:性别,年龄,原发疾病,MRONJ网站,身体质量指数,吸烟习惯,糖尿病,皮质类固醇,类型的抗吸收剂,管理期间,CT检查结果(分离死核,骨质溶解,骨膜反应,和骨硬化),触发器,白细胞,中性粒细胞,中性粒细胞-淋巴细胞比率,血清白蛋白,和血清肌酐水平.结果在单变量分析中,在原发疾病为恶性肿瘤的患者中发现牙源性和非牙源性MRONJs之间存在显着差异,接收denosumab(DMB),并且抗吸收剂的给药时间短,没有骨质溶解,骨膜反应,和血清肌酐水平.在多变量分析中,非牙源性MRONJ在无骨质溶解和有骨膜反应的患者中更为常见.结论非牙源性MRONJ在接受大剂量DMB治疗的患者中更易发生,无骨质溶解或骨膜反应的非溶骨性MRONJ病例明显增多。
    Introduction Medication-related osteonecrosis of the jaw (MRONJ) develops from odontogenic infection. However, there are also some cases of MRONJ developing from sites with no teeth, no root canal lesions, or no periodontal disease. This study aimed to retrospectively review radiographic images of MRONJ cases and examine the differences in characteristics between MRONJ suspected to be related to dental infection (odontogenic MRONJ) and MRONJ that occurred without dental involvement or of unknown cause (non-odontogenic MRONJ). Materials and methods One hundred and forty-five patients were diagnosed with MRONJ at Kansai Medical University Hospital and Kansai Medical University Medical Center. The following variables were investigated: sex, age, primary disease, MRONJ site, body mass index, smoking habit, diabetes, corticosteroids, type of antiresorptive agent, administration period, CT findings (separation of sequestrum, osteolysis, periosteal reaction, and osteosclerosis), trigger, leukocytes, neutrocytes, neutrophil-lymphocyte ratio, serum albumin, and serum creatinine levels. Results In the univariate analysis, significant differences between odontogenic and non-odontogenic MRONJs were found in patients whose primary disease was malignancy, receiving denosumab (DMB), and with short administration period of antiresorptive agent, no osteolysis, periosteal reaction, and serum creatinine level. In multivariate analysis, non-odontogenic MRONJ was significantly more common in patients with no osteolysis and with periosteal reaction. Conclusion Non-odontogenic MRONJ tends to occur more frequently in patients treated with high-dose DMB, and there were significantly more cases of non-osteolytic MRONJ without radiographic evidence of osteolysis or with periosteal reactions.
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  • 文章类型: Case Reports
    牙源性粘液瘤(OMs)代表无症状,具有侵袭性生物学行为的缓慢扩张的颌骨病变。尽管OMs的光谱仍然是经典的,具有多房性射线可透性,并且存在嵌入粘液样基质中的星状细胞,它们可能在影像学或组织病理学上模仿许多其他病变。我们在此讨论一名28岁女性的OM病例,特别强调发病机理和鉴别诊断。
    Odontogenic myxomas (OMs) represent asymptomatic, slowly expanding gnathic lesions with aggressive biological behaviour. Though the spectrum of OMs remains classical with multilocular radiolucency and presentation of stellate-shaped cells embedded in a mucoid stroma, they may mimic many other lesions radiographically or histopathologically. We hereby discuss a case of OM in a 28-year-old woman with special emphasis on pathogenesis and differential diagnosis.
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  • 文章类型: Journal Article
    犬的成釉细胞瘤通常具有高度保守的棘皮瘤细胞形态,被认为是犬棘皮瘤成釉细胞瘤(CAA),而常规成釉细胞瘤(CA)构成了较小但形态多样的上皮牙源性肿瘤组。在人类中,一种罕见的促纤维化组织学亚型具有独特的临床,放射学,微观特征。促纤维化成釉细胞瘤(DA)以前没有在狗中描述过,尽管它在兽医文献中很少被引用。这是对狗DA病例系列的首次全面描述,并描述了临床表现,诊断成像结果,诊断的组织病理学特征,和治疗结果。临床上,DA通常表现为中年至老年犬的头骨下颌骨或上颌骨中的肿块或肿胀。关于诊断成像,病变具有射线可透或混合模式,边界明确且位置可变。作为一个固体,牙源性上皮模糊的纤维瘤,DA在组织学诊断方面具有挑战性,并且可以模拟其他几种口腔肿瘤,良性和恶性。作为成釉细胞瘤,DA的生物学行为具有局部破坏性,但良性,手术切除后预后良好。
    Ameloblastoma in dogs most often has a highly conserved acanthomatous cell morphology and is recognized as canine acanthomatous ameloblastoma (CAA) while conventional ameloblastoma (CA) makes up a smaller yet morphologically diverse group of epithelial odontogenic tumors. In humans, a rare desmoplastic histological subtype has distinctive clinical, radiological, and microscopic features. Desmoplastic ameloblastoma (DA) has not previously been described in dogs, although it has been rarely referenced in the veterinary literature. This is the first thorough description of a case series of DA in dogs and describes clinical presentation, diagnostic imaging findings, histopathological features for diagnosis, and treatment outcome. Clinically, DA most often presents as a mass or swelling in the rostral mandible or maxilla of middle age to older dogs. On diagnostic imaging, the lesion has a radiolucent or mixed pattern with well-defined borders and variable loculation. As a solid, fibrous tumor with obscured odontogenic epithelium, DA is challenging to diagnose histologically and can mimic several other oral tumors, both benign and malignant. As an ameloblastoma, the biological behavior of DA is locally destructive yet benign and prognosis is favorable following surgical excision.
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  • 文章类型: Case Reports
    牙源性肉瘤极为罕见,占所有颌面肉瘤的不到5%。它通常影响年轻人口。后下颌骨是最常见的受累部位。射线照相,它似乎是一个大的破坏性射线可透损伤,边缘不明确。组织病理学诊断通常很困难。手术是主要的治疗方法。化疗和放疗的作用尚不清楚。这里,我们提供了一个30岁的女性患者的案例研究,该患者被诊断患有牙源性肉瘤,并侵犯了她的气道。将详细讨论治疗和术后过程。
    Odontogenic sarcomas are exceedingly rare and account for less than 5% of all Maxillofacial Sarcomas. It usually affects the younger population. The posterior mandible is the most commonly affected site. Radiographically, it appears as a large destructive radiolucent lesion with ill-defined margins. Histopathological diagnosis is usually difficult. Surgery is the mainstay treatment. The role of chemotherapy and radiation therapy is not clear. Here, we present a case study of a 30-year-old female patient diagnosed with odontogenic sarcoma that impinged on her airway. The treatment and postoperative course will be discussed in detail.
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  • 文章类型: Case Reports
    牙源性角化囊肿是牙源性起源的良性骨内病变,其特征在于其侵袭性。它通常存在于下颌后部区域,虽然它也可以在上颌骨找到,特别是在犬科地区。我们讨论了上颌窦中涉及27和28区域的OKC的独特示例。由于类似的临床症状,这种病变更容易被误认为是上颌窦的其他病变,如鼻窦炎或息肉。在另一边,这种良性疾病有可能发展为成釉细胞瘤或鳞状细胞癌。因此,良好的预后取决于早期识别,精确诊断,适当的治疗,和后续行动。
    Odontogenic keratocyst is a benign intraosseous lesion of odontogenic origin which is characterized by its aggressive nature. It is usually present in the mandibular posterior area, although it can also be found in the maxilla, particularly in the canine region. We discuss a unique example of OKC in the maxillary sinus involving the 27&28 region. Due to comparable clinical signs, this lesion is more prone to be mistaken for other lesions of the maxillary sinus, such as sinusitis or polyps. On the other side, this benign disease has the potential to develop into Ameloblastoma or squamous cell carcinoma. A favorable prognosis thus depends on early identification, precise diagnosis, appropriate treatment, and follow-ups.
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  • 文章类型: Journal Article
    目的是评估生化标志物的功效(WBC,CRP和纤维蛋白原)和50例患者牙源性间隙感染的病程。
    在术前和术后第0天、第4天、第8天和第12天取血样用于测量所有三种生物标志物的水平。观察生物标志物的趋势,并与评估参数(如牙科病因)进行比较。涉及的牙齿数量,涉及的空间数量,张开嘴和疼痛。活跃的脓液排出,吞咽困难,对声音嘶哑和肿胀进行了评估和评分。
    数据经过配对\'t\'检验,McNemar和Pearson的双变量相关性视情况而定。统计分析发现标记物的实验室值与用于测量感染严重程度的参数之间存在很强的相关性。所有三种生物标志物(WBC,CRP和纤维蛋白原)是住院时间的显着标志物(p<0.01)。前瞻性分析表明,不能仅使用一种生物标志物来排除特定的诊断。
    本研究中评估的三种生化标志物的组合(WBC,CRP和纤维蛋白原)应作为评估预后的因素,患者治疗方案的临床严重程度和疗效,因为这些可以可靠地预测牙源性感染的临床病程。
    UNASSIGNED: The objective was to evaluate the efficacy of biochemical markers (WBC, CRP and fibrinogen) and the course of odontogenic space infections in 50 patients.
    UNASSIGNED: Blood samples were taken preoperatively and postoperatively at day 0, day 4, day 8 and day 12 for measuring the levels of all three biomarkers. The trends of the biomarkers were observed and compared with assessment parameters such as dental etiology, number of teeth involved, number of spaces involved, mouth opening and pain. Active pus discharge, dysphagia, hoarseness and swelling were assessed and scored accordingly.
    UNASSIGNED: The data were subjected to paired \'t\' test, McNemar\'s and Pearson\'s bivariate correlation as appropriate. Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection. All three biomarkers (WBC, CRP and fibrinogen) are significant markers for hospital stay (p < 0.01). Prospective analysis indicates that only one biomarker cannot be used to rule out specific diagnosis.
    UNASSIGNED: The combination of three biochemical markers assessed in the present study (WBC, CRP and fibrinogen) should be used as prognostic factor in assessment, clinical severity and efficacy of treatment regime for patients as these can reliably predict the clinical course of odontogenic infection.
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  • 文章类型: Journal Article
    简介头颈部牙源性脓肿可导致严重的并发症,甚至导致死亡。这要求医疗保健专业人员对可用于诊断和治疗的所有炎症标志物有很好的了解。我们在日常医疗实践中使用的此类标记是白细胞(WBC),中性粒细胞(Neu),和C反应蛋白(CRP)。不知何故,背景是降钙素原(PCT),在这种化脓性感染中尚未详细研究。本研究的目的是调查和分析女性人群中头颈部牙源性化脓性感染的PCT,并将其与已经证实的炎症标志物如CRP进行比较。WBC,Neu。在文献中第一次,根据我们的知识,灵敏度,特异性,当使用PCT作为炎症的独立指标时,可以确定PCT的可预测性,并在患有头颈部牙源性脓肿的女性中确定其截止参考值。材料和方法这是一项前瞻性研究,其中CRP,WBC,Neu,对30例平均年龄为47岁(18-81岁)的头颈部牙源性脓肿妇女的PCT进行了检查和分析。作为对照组,我们纳入了30名平均年龄为48(18-80)岁的健康女性,在过去三个月中,没有记忆和物理证据表明存在任何感染。对于对照组也测量了四种标记。结果在临床的女性头颈部牙源性脓肿组中,CRP的平均值,WBC,Neu,与健康女性对照组相比,PCT和PCT显着升高(p<0.0001);CRP:95.46±76.41mg/lvs.0.63±0.37毫克/升,WBC:10.44±2.97x103/Lvs.6.5±1.49x103/L,Neu:7.92±2.93x103/Lvs.4.03±1.07x103/L,PCT:0.74±0.69ng/mlvs.0.14±0.08ng/ml。讨论PCT,以及CRP,WBC,Neu,在患有头颈部牙源性脓肿的女性中增加其血浆浓度,并且与之呈极正相关,与CRP高度相关,与WBC和Neu显著相关。此外,PCT与其他标志物相比具有许多优势;它开始更快地增加其血浆浓度,更快地达到其最大血浆浓度,感染消退后其浓度更快地正常化,并仅在细菌感染发生时增加其血液水平。结论PCT作为炎症标志物不仅与CRP呈正相关,WBC,还有Neu,凭借它比他们的优势,它似乎是诊断中最准确的指标,治疗,并在不久的将来随访牙源性头颈部脓肿;不仅在女性,而且在男性和儿童人群中。它的灵敏度,特异性,作为炎症的独立指标的可预测性是80%,76.7%,83%,分别,其临界值为0.225ng/ml,低于一般公认的0.5ng/ml。
    Introduction Odontogenic abscesses of the head and neck can lead to serious complications and even end in death. This requires healthcare professionals to have a good knowledge of all the markers of inflammation that can be used in their diagnosis and treatment. Such markers that we use in our daily medical practice are leukocytes (WBC), neutrophils (Neu), and C-reactive protein (CRP). Somehow, in the background is procalcitonin (PCT), which has not been studied in detail in this type of purulent infection. The aim of the present study is to investigate and analyze PCT in odontogenic purulent infections of the head and neck in the female population and to compare it with already proven markers of inflammation such as CRP, WBC, and Neu. For the first time in the literature, as per our knowledge, the sensitivity, specificity, and predictability of PCT were determined when using it as an independent indicator of inflammation, and its cut-off reference values were determined in women with odontogenic abscesses of the head and neck. Materials and methods This is a prospective study, in which the CRP, WBC, Neu, and PCT of 30 women with odontogenic abscesses of the head and neck with a mean age of 47 (18-81) years were examined and analyzed. As a control group, we included 30 healthy women with a mean age of 48 (18-80) years, in whom there was no anamnestic and physical evidence of the presence of any infection in the last three months. The four markers were measured for the control group too. Results In the clinical group of women with odontogenic abscesses of the head and neck, the average values of CRP, WBC, Neu, and PCT were significantly higher (p<0.0001) compared to the same in the control group of healthy women; CRP: 95.46±76.41 mg/l vs. 0.63±0.37 mg/l, WBC: 10.44±2.97x103/L vs. 6.5±1.49x103/L, Neu: 7.92±2.93x103/L vs. 4.03±1.07x103/L, PCT: 0.74±0.69 ng/ml vs. 0.14±0.08 ng/ml. Discussion PCT, as well as CRP, WBC, and Neu, increases its plasma concentration in women with odontogenic abscesses of the head and neck and is extremely well positively correlated with them, with a high correlation with CRP and a significant correlation with WBC and Neu. In addition, PCT has a number of advantages over the other markers; it begins to increase its plasma concentration faster, reaches its maximum plasma concentration faster, normalizes its concentration faster after the infection subsides, and increases its blood level only in bacterial infection genesis. Conclusions PCT as a marker of inflammation not only positively correlates well with CRP, WBC, and Neu but also, with its advantages over them, it appears to be the most accurate indicator in the diagnosis, treatment, and follow-up of odontogenic head and neck abscesses in the near future; not only in women but also in the male and children\'s population. Its sensitivity, specificity, and predictability as an independent indicator of inflammation are 80%, 76.7%, and 83%, respectively, and its cut-off value of 0.225 ng/ml is lower than the generally accepted 0.5 ng/ml.
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  • 文章类型: Journal Article
    目的小儿牙囊肿可能因地区和人群而异。大的囊性病变通常在摘除前用袋袋化术治疗,以减压病变并减小其体积;然而,在小儿囊性病变中,保守的有袋化和减压可用于控制病情,而无需额外的摘除。本研究的目的是介绍一系列儿科牙轮囊肿,并讨论与混合牙列相关的囊性病变的保守治疗。方法对2016年至2023年确诊的囊性病变患者进行回顾性队列分析。临床数据,放射学,病态,收集牙源性原因。在所有情况下都进行了有袋化方法。还检查了患者的人口统计信息,并进行了文献综述以确定可比病例。结果16例青年患者诊断为牙轮囊肿,临床证实了这一点,放射学,和病理检查。女性占56.2%,右侧占主导地位(62.5%)。与病变相关的乳牙在所有情况下都可以正常拔除。所有相关的恒牙在干预后迅速萌出。结论袋状化技术应用于目前混合牙列相关的牙囊囊肿是非常成功的。所有恒牙阻生,没有任何囊性复发。
    Objectives The pediatric dentigerous cysts might vary by region and population group. Large cystic lesions are typically treated with marsupialization before enucleation in order to decompress the lesion and reduce its volume; however, in pediatric cystic lesions, conservative marsupialization and decompression can be used to manage the condition without additional enucleation. The current study\'s objectives were to present a case series of pediatric dentigerous cysts and discuss the conservative management of these cystic lesions associated with mixed dentition. Methods A retrospective cohort analysis of patients diagnosed with cystic lesions between 2016 and 2023 was identified. Data on clinical, radiological, pathological, and odontogenic causes were collected. The marsupialization approach was performed in all cases. Patient demographic information was also examined, and a literature review was carried out to identify comparable cases. Results Sixteen young patients were diagnosed with dentigerous cysts, and this was confirmed by clinical, radiological, and pathological examinations. Females comprised 56.2% of the cases, with the right side predominating (62.5%). Deciduous teeth related to the lesion could be extracted normally in all cases. All associated permanent teeth erupted rapidly after the intervention. Conclusion The marsupialization technique used in the current cases of dentigerous cysts associated with mixed dentition was highly successful, and all permanent impacted teeth erupted without any cystic recurrence.
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