Dentigerous cyst

牙科囊肿
  • 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
    骨内动静脉畸形(AVM)是罕见的高流量血管畸形,可影响上颌骨或下颌骨。AVM可能会出现特异性和误导性的体征和症状。诊断通常是偶然的,出血可能是首发症状。射线照相,特征性特征少,易误诊。在这里,我们报告了一例年轻男性,该男性在下颌骨右侧受到动静脉瘘的影响,最初被误诊为囊性病变。患者接受了血管畸形的经动脉栓塞,随后手术切除了病变。1年随访显示下颌骨完全愈合,无复发。骨内动静脉畸形是罕见的实体。然而,由于它们的危害性,临床医师和放射科医师都必须意识到这一类型的病变,在进行溶骨性病变的鉴别诊断时,应始终考虑这一类型的病变.
    Intraosseous arteriovenous malformations (AVM) are uncommon high-flow vascular malformation that can affect the maxilla or mandible. AVM may present with aspecific and misleading signs and symptoms. The diagnosis is often accidental and bleeding may represent the first symptom. Radiographically, there are few characteristic features and misdiagnosis is easy. Here we report the case of a young male affected by arteriovenous fistula on the right side of the mandible initially misdiagnosed as a cystic lesion. The patient underwent transarterial embolization of the vascular malformation and subsequently the lesion was surgically removed. 1-year follow-up showed complete healing of the mandibular bone and absence of recurrence. Intraosseous arteriovenous malformations are rare entities. However, due to their harmfulness, both clinicians and radiologists must be aware of this type of lesion and should always consider them in the differential diagnosis of osteolytic lesions.
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  • 文章类型: Journal Article
    背景:为了调查放射学和人口统计学特征,类型,分布,和治疗方法的牙科囊肿(DC)。
    方法:检查了根据2020年1月至2023年12月的活检结果诊断为DC的患者的全景X线照片和锥形束计算机断层扫描(CBCT)图像。在不同年龄段的患者中,数字,类型和位置,和DC的放射学特征,周围组织的相关变化,并对所采用的治疗方法进行综述。
    结果:在95例DC患者中(66例男性,29名女性),单个囊肿(n=86)和两个囊肿(n=9)的性别和年龄分布相当。在104个DC中,44是中央的,38是横向的,和22个是圆周的。DC类型受性别影响不显著,年龄组,或解剖位置。周向DC通常导致下颌管移位。虽然摘除是治疗中枢DC的首选方法,周围的DCs进行有袋化处理。
    结论:在这项研究中,这是第一个评估CBCT图像上的DC类型,中心型是最常见的。环状DCs大多采用有袋化处理。CBCT成像可以帮助确定DC类型,并可能为治疗计划提供指导。
    BACKGROUND: To investigate the radiological and demographic features, types, distribution, and treatment methods of dentigerous cysts (DC).
    METHODS: Panoramic radiographs and cone beam computed tomography (CBCT) images of patients diagnosed with DC based on biopsy results between January 2020 and December 2023 were examined. In patients from different age groups, the numbers, types and locations, and radiological features of DCs, associated changes in surrounding tissues, and treatment methods used were reviewed.
    RESULTS: Among 95 patients with DC (66 males, 29 females), sex and age distributions were comparable between those with a single cyst (n = 86) and those with two cysts (n = 9). Of 104 DCs, 44 were central, 38 were lateral, and 22 were circumferential. DC types were not significantly affected by sex, age group, or anatomical location. Circumferential DCs often caused displacement of the mandibular canal inferiorly. While enucleation was preferred for the treatment of central DCs, circumferential DCs were treated with marsupialization.
    CONCLUSIONS: In this study, which is the first to evaluate the DC types on CBCT images, the central type was the most common. Circumferential DCs were mostly treated with marsupialization. CBCT imaging can assist in determining DC types, and may provide guidance for treatment planning.
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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: Journal Article
    葡萄糖摄取可被认为是癌细胞生长和代谢的限速步骤。对GLUT1的研究表明,GLUT1参与健康和病理环境中的细胞存活和增殖。GLUT1表达被认为是发展局部侵略性的关键因素之一,肿瘤侵袭性,和转移,特别是在恶性肿瘤中。谷蛋白1在牙源性囊肿和肿瘤中的作用仍不确定。
    这项研究的目的是评估Glut1在牙质囊肿中的表达,牙源性角化囊肿,和成釉细胞瘤.
    该研究在GSL牙科学院进行。研究设计为再前瞻性免疫组织化学研究。
    福尔马林固定,组织学确诊病例的石蜡包埋块(n=50),10例牙源性角化囊肿,牙质囊肿,固体成釉细胞瘤,成釉细胞瘤单性,和每个牙齿卵泡。棕色染色被认为是GLUT1的阳性染色。通过计数标记细胞的数量进行定量分析,并通过分配免疫染色强度评分进行半定量分析。
    卡方检验用于比较各组之间的差异。P值≤0.05被认为具有统计学意义。
    牙源性角化囊肿和单囊性成釉细胞瘤显示≥50%的标记细胞具有强染色强度。牙源性角化囊肿和实体成釉细胞瘤在细胞质和膜中显示出染色的亚细胞定位。牙囊囊肿表现为合并核,细胞质,和染色的膜亚细胞定位。
    成釉细胞瘤的发展,牙源性角化囊肿,和牙质囊肿似乎受GLUT-1的影响。其表达的变化可能有助于解释这些病变的生物学活性的某些差异。
    UNASSIGNED: Glucose uptake may be considered the rate-limiting step for the growth and metabolism of the cancer cell. Studies on GLUT1 have shown that GLUT1 is involved in cell survival and proliferation in both healthy and pathological circumstances. GLUT1 expression is regarded as one of the crucial elements in the development of local aggressiveness, tumour invasiveness, and metastasis, particularly in malignant tumours. The role of glut1 in odontogenic cysts and tumours has remained uncertain.
    UNASSIGNED: The aim of the study is to assess the expression of Glut1 in dentigerous cysts, odontogenic keratocysts, and ameloblastoma.
    UNASSIGNED: The study was conducted in GSL Dental College. The study design was a resprospective immunohistochemical study.
    UNASSIGNED: Formalin-fixed, paraffin-embedded blocks of histologically confirmed cases (n = 50), 10 cases of odontogenic keratocysts, dentigerous cysts, ameloblastomas solid, ameloblastomas unicystic, and dental follicles each. Brown colour staining was considered as positive staining for GLUT1. Quantitative analysis was performed by counting the number of labelled cells, and semi-quantitative analysis was conducted by assigning immunostaining intensity scores.
    UNASSIGNED: Chi-square test was used to compare differences between the groups. A P value of ≤0.05 was considered as statistically significant.
    UNASSIGNED: Odontogenic keratocysts and unicystic ameloblastoma showed ≥50% of label cells with strong intensity of staining. Odontogenic keratocysts and solid ameloblastoma showed sub-cellular localisation of staining in the cytoplasm and membrane. Dentigerous cysts exhibited combined nucleus, cytoplasm, and membrane sub-cellular localisation of staining.
    UNASSIGNED: The development of ameloblastomas, odontogenic keratocysts, and dentigerous cysts appears to be influenced by GLUT-1. Variation in its expression may aid in explanation of some of the differences in biological activity of these lesions.
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  • 文章类型: Case Reports
    这是在上颌窦内壁检测到的牙质囊肿的图像,提到的囊肿的罕见位置,强调了病变部位的影像学特征的优越性。此外,尽管病变扩大,但本例未显示面部不对称。
    This is the image of dentigerous cyst detected in the medial wall of maxillary sinus, a rare location for the mentioned cyst, which emphasizes the superiority of radiographic features from the site of the lesion. Moreover, the present case showed no facial asymmetry despite the extension of the lesion.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    颌骨囊肿是口腔颌面外科中的重要问题。颌骨囊肿手术是口腔手术中常见的干预措施,在多学科患者的情况下,口腔外科医生需要与其他专家会面。囊肿是由于上皮细胞增殖而导致的上皮内衬囊,含有液体和/或半固体物质。变性,和液化;高渗溶液从周围组织中抽出液体,而内部压力在囊肿壁上施加相等的强度。牙源性囊肿是继根性囊肿之后第二常见的牙源性囊肿,通常很少或没有症状报告。然而,牙质囊肿最常见的诊断是受影响的牙齿萌出或意外诊断。通常,牙质囊肿可能与阻生第三磨牙有关;在阻生第三磨牙和牙质囊肿的情况下,在相同的干预措施中,应将牙齿与囊肿一起移除。下颌牙囊肿常见于儿童和成人,而牙质囊肿是老年患者中罕见的新形成。治疗通常包括去除整个囊肿和相关的未萌出的牙齿。如果囊肿很大,这种干预可能会更困难,第三磨牙与下颌神经接触,和/或患者具有可能代表相对或绝对禁忌症的病史。我们介绍了在达比加群治疗中的老年患者中罕见的牙质囊肿症状表现的病例;用于治疗老年人的牙质囊肿,我们建议采用多学科方法,包括组织学检查和仔细随访.
    Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up.
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  • 文章类型: Journal Article
    引言颌面部囊肿是继粘膜病变之后的头颈部最常见的病变之一。射线照相术为早期诊断和分类提供了必要的线索,但它仍在继续,因为它被用于评估治疗后的结果。然而,手工分析容易出错。在这种情况下,射线照相中的分形分析(FA)使用数学方法来分析给定射线照相图像中灰度的变化。牙源性囊肿中的FA用于表征其复杂性,发现隐藏的模式,监测治疗反应,并可能提供预后信息。本文旨在评估神经根囊肿(RC)的分形特征,牙质囊肿(DC),使用锥形束计算机断层扫描(CBCT)和牙源性角化囊肿(OKC)。目的是计算每个囊肿中表达的分形维数(FD)值,这可能被证明是诊断上述囊肿的放射学辅助手段。材料和方法由于这是一项回顾性研究,2021年6月至2023年12月的CBCT图像档案是从经RC组织病理学诊断和确认的患者获得的,DC,OKC使用ImageJSoftware(美国国立卫生研究院贝塞斯达,斐济)。使用阈值化技术对皮质和松质骨进行分割,并将其转换为二进制图像。然后比较三个平面的平均FD,以建立特定牙源性囊肿的独特分形特征。使用统计产品和服务解决方案(SPSS)(23.0版;IBMSPSSStatisticsforWindows,Armonk,NY)以确定RC的FD值之间的差异,DC,和OKC的显著性水平小于0.05。结果DC的FD值,RC,OKC分别为1.33±0.17、1.08±0.16和1.65±0.12。结果表明,OKC比DC和RC具有更高的FD值,这意味着与DC和RC相比,OKC的骨破坏较小。推断统计表明,单因素方差分析用于比较三组FD数据的均值。当计算三组时,F统计值为7.29,P值为0.03,95%置信区间具有统计学意义(p<0.05).结论我们在牙源性囊肿中使用FD和FA进行的CBCT骨小梁模式分析研究揭示了不同囊肿类型之间骨参数的明显变化。与其他囊肿类型相比,OKC中FD值较高的可能性是由于OKC中皮质骨破坏较小。这些发现对诊断有潜在的意义,治疗,和预测牙源性囊肿。
    Introduction The cysts of the maxillofacial region account for one of the most common pathologies of the head and neck region after the mucosal pathologies. Radiography provides an essential clue in early diagnosis and triaging, but it continues further as it is used to evaluate the post-treatment outcome. However, manual analysis is prone to errors. In this scenario, fractal analysis (FA) in radiographs uses mathematical methods to analyse the changes in grey scales in a given radiographic image. FA in odontogenic cysts is used to characterise their complexity, uncover hidden patterns, monitor treatment response, and potentially provide prognostic information. This paper aimed to assess the fractal characteristics of the radicular cyst (RC), dentigerous cyst (DC), and odontogenic keratocyst (OKC) using cone beam computed tomography (CBCT). The objective was to calculate fractal dimension (FD) values expressed in each of these cysts, which could prove to be a radiological adjunct in diagnosing the above cysts. Materials and methods As this is a retrospective study, the archives of CBCT images from June 2021 to December 2023 were obtained from patients diagnosed and confirmed with a histopathological diagnosis with RC, DC, and OKC. The FA was performed using Image J Software (Ver 1.51, National Institute of Health Bethesda, Fiji). The cortical and cancellous bones were segmented using thresholding techniques and converted to binary images. The mean FD of the three planes was then compared to establish the distinctive fractal characteristic for the specific odontogenic cysts. A one-way ANOVA was performed using the Statistical Product and Service Solutions (SPSS) (version 23.0; IBM SPSS Statistics for Windows, Armonk, NY) to determine the difference between FD values of RC, DC, and OKC with a significance level less than 0.05. Results The FD values of DC, RC, and OKC were 1.33 ± 0.17, 1.08 ± 0.16, and 1.65 ± 0.12, respectively. The results indicated that OKC had higher FD values than DC and RC, which means that OKC had lesser bone destruction compared to DC and RC. Inferential statistics showed that the one-way ANOVA was used to compare the means of the three groups of FD data. When calculated for the three groups, the F-statistic value was at 7.29, which yielded a P value of 0.03, making it statistically significant for a 95% confidence interval (p<0.05). Conclusion Our CBCT study on bone trabecular pattern analysis using FD and FA in odontogenic cysts reveals distinct alterations in bone parameters among different cyst types. The probability of higher FD values in OKC is because of lesser cortical bone destruction in OKC compared to the other cyst types. These findings have potential implications for diagnosing, treating, and prognosticating odontogenic cysts.
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