Nonodontogenic Cysts

  • 文章类型: Journal Article
    背景:散发性研究报道了上颌前路植入物手术后鼻腭管囊肿的发生,治疗方法仍存在临床不确定性。
    目的:我们报告了一种潜在的治疗方法,该方法成功治疗了无牙周病拔除后上颌前牙种植体放置一年后发展和扩大的鼻腭管囊肿。
    方法:鼻腭囊肿手术治疗,不切除植入物。皮瓣手术期间,囊肿被完整切除,和暴露的植入物的表面被彻底清创过氧化氢(H2O2)冲洗,甘氨酸空气抛光,和盐水冲洗。处理由囊肿引起的显著骨缺损,应用牛多孔骨矿物质注射富血小板纤维蛋白(BPBM-i-PRF)复合物来填充缺损,遵循可吸收的胶原膜覆盖。
    结果:手术后7年,未观察到囊肿复发,骨移植区的骨再生稳定。植入物功能良好,没有移动性。
    结论:对于与种植牙相关的鼻腭管囊肿,完整的手术清创和纵向稳定的骨再生可能通过再生手术获得,而无需移除植入物。
    BACKGROUND: Sporadic studies have reported the occurrence of nasopalatine duct cysts after maxillary anterior implant surgery, and the treatment methods still have clinical uncertainty.
    OBJECTIVE: We report a potential therapy method that successfully treated a nasopalatine duct cyst that developed and expanded one year after maxillary anterior implant placement following periodontally hopeless teeth extraction.
    METHODS: The nasopalatine cyst was treated surgically without removing implants. During flap surgery, the cyst was removed intact, and the exposed implant\'s surface was debrided thoroughly by hydrogen peroxide (H2O2) rinsing, glycine air polishing, and saline rinsing. To deal with the significant bone defect caused by the cyst, a bovine porous bone mineral injected platelet-rich fibrin (BPBM-i-PRF) complex was applied to fill the defect, following a resorbable collagen membrane to cover.
    RESULTS: 7 years after surgery, no cyst recurrence was observed, and bone regeneration in the bone graft area was stable. The implants functioned well without mobility.
    CONCLUSIONS: For nasopalatine duct cysts associated with dental implant placement, complete surgical debridement and longitudinal stable bone regeneration are possibly accessible by regenerative surgery without implant removal.
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  • 文章类型: Case Reports
    我们介绍了一名35岁女性的鼻腭管囊肿。根据仅存在一种临床症状且无明显临床体征而诊断为囊肿。这是相对罕见的。然而,该病变的影像学和组织学表现为典型的鼻腭管囊肿。因此,本病例报告旨在强调鼻腭突囊肿的各种表现,经常被误诊为牙髓感染。
    We present a case of nasopalatine duct cyst in a 35-yearold female. The cyst was diagnosed based on the presence of only one clinical symptom and no obvious clinical signs, which is a relatively rare occurrence. However, the radiographic and histological presentation of this lesion was typical of a nasopalatine duct cyst. Therefore, this case report aims to highlight the variable presentations of the nasopalatine cyst, which is often misdiagnosed and treated as an endodontic infection.
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  • 文章类型: Journal Article
    手术纤毛囊肿主要发生在上颌窦根治性手术后的上颌中。我们报告了首例手术纤毛囊肿,该囊肿在患者遭受严重面部创伤25年后在颞下窝发展。患者主诉下颌疼痛和张口受限。通过LeFortI截骨术进行袋袋化后5个月,患者的病情完全缓解。通过正确的诊断和侵入性较小的手术,可以最大程度地减少手术发病率。
    Surgical ciliated cysts occur primarily in the maxilla after radical maxillary sinus surgery. We report the first case of a surgical ciliated cyst that developed in the infratemporal fossa 25 years after the patient sustained severe facial trauma. The patient complained of mandibular pain and limited mouth opening. The patient\'s condition was completely resolved 5 months after marsupialization via Le Fort I osteotomy. Surgical morbidities can be minimized by proper diagnosis and less invasive surgery.
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  • 文章类型: Case Reports
    涉及口腔底部的先天性囊性肿胀包括各种病变,例如发育性囊肿(例如,皮样和表皮样囊肿),ranulas,血管畸形等.然而,这些条件的共存,可能有因果关系,是罕见的。本病例报告的目的是介绍一例罕见的先天性表皮样囊肿与新生儿粘液滞留性囊肿有关。
    一名6个月大的女婴被转诊到雅典的口腔医学诊所,希腊于2019年10月评估口腔底部肿胀,她出生后第一次被她的儿科医生注意到。临床上,与左下颌下腺管口密切相关的淡黄色“珍珠状”结节,观察到向后过渡到口底的弥漫性蓝色囊性肿胀。临时诊断为皮样囊肿和/或ranula,在全身麻醉下进行手术切除。
    组织病理学,一个定义明确的,角蛋白填充,在前部观察到由角化分层鳞状上皮衬里的囊腔,而在后部和附近,由圆柱形衬里的扩张的唾液导管,注意到立方体或假复层上皮。最终诊断为表皮样囊肿与颌下腺导管的粘液滞留囊肿(ranula)密切相关。
    口腔底部两个囊性病变并存,具有表皮样和粘液滞留囊肿的特征,分别,是罕见的,其发病机理很有趣,尤其是新生儿。
    UNASSIGNED: Congenital cystic swellings involving the floor of the mouth include various lesions such as developmental cysts (e.g., dermoid and epidermoid cysts), ranulas, vascular malformations etc. However, coexistence of such conditions, possibly with a cause-and-effect- relationship, is rare. The purpose of this case report is to present a rare case of a congenital epidermoid cyst associated with a mucous retention cyst in a newborn.
    UNASSIGNED: A 6-month-old female infant was referred to an Oral Medicine Clinic in Athens, Greece on October 2019 for evaluation of a swelling at the floor of the mouth, first noticed by her paediatrician just after birth. Clinically, a yellowish \"pearly\" nodule in close association with the orifice of the left submandibular duct, posteriorly transitioning to a diffuse bluish cystic swelling of the left floor of the mouth was observed. With a provisional diagnosis of a dermoid cyst and/or ranula, a surgical excision was performed under general anaesthesia.
    UNASSIGNED: Histopathologically, a well-defined, keratin-filled, cystic cavity lined by orthokeratinized stratified squamous epithelium was observed in the anterior aspect while posteriorly and in close proximity, a dilated salivary duct lined by cylindrical, cuboidal or pseudostratified epithelium was noted. A final diagnosis of an epidermoid cyst intimately associated with a mucus retention cyst (ranula) of the submandibular duct was rendered.
    UNASSIGNED: The coexistence of two cystic lesions in the floor of the mouth with features of epidermoid and mucous retention cyst, respectively, is rare and its pathogenesis intriguing, especially in a newborn.
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    文章类型: Journal Article
    This article presents a case of an epidermoid cyst that mimicked a thyroglossal duct cyst in a pediatric patient. An 8-year-old boy was referred for evaluation of a volumetric increase in the median cervical region with an evolution of about 4 years. The skin in the submental region was healthy and normal colored. Palpation revealed a mobile, well-circumscribed nodular lesion of soft consistency. Computed tomography of the neck showed an expansive hypodense formation extending from the base of the tongue to the upper portion of the hyoid bone, suggesting a thyroglossal duct cyst. Considering the diagnostic hypothesis, cystic enucleation via the Sistrunk procedure was planned. However, no ductal structure was identified during the surgical procedure, and the lesion was only near, but not attached to, the hyoid bone. Simple excision of the lesion was therefore performed. At the most recent follow-up examination, about 3 months postoperatively, the patient demonstrated satisfactory clinical progress. The epidermoid cyst close to the hyoid bone presented diagnostic difficulty due to its similarity to a thyroglossal duct cyst. Computed tomography provides limited information for diagnosing this type of lesion, and ultrasonography is the preferred test. In view of the uncertain diagnosis in this case, the extent of the excision was determined during the surgery, and simple excision was a satisfactory treatment associated with a good prognosis.
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  • 文章类型: Journal Article
    背景:鼻腭管囊肿(NDC)是口腔中最常见的非牙源性囊肿。临床上,根据临床和影像学表现来怀疑这些病变并不难。然而,由于这些病变的形态多样性,组织病理学诊断可能很困难。目的是分析巴西东北部两个口腔颌面病理服务机构诊断的NDC的临床病理特征。
    方法:进行回顾性临床病理研究。分析了来自巴西两个口腔颌面病理学服务机构的18,121例口腔病变临床记录(2000-2020年)。所有NDC病例都经过修订,人口统计学,临床,射线照相,并收集组织病理学数据。
    结果:在口腔病理学服务的18,121次诊断中,45(0.2%)为NDC。该系列包括24名男性(53.3%)和21名女性(46.7%),平均年龄43.2岁.大多数病变无症状(n=27,60%),平均大小为2.1cm。微观上,非角化复层鳞状上皮最常见(66.7%).然而,在88.9%的病例中,上皮内膜变化,由两种或两种以上类型的上皮组成。上皮的类型和囊肿的大小之间没有显着关联(p=0.389)。神经,血管,出血,和慢性炎症浸润常见。相比之下,粘液腺体的频率很低,皮脂腺,胆固醇裂口,多核巨细胞.
    结论:临床,射线照相,在这项研究中观察到的微观发现与文献中报道的相似。由于NDC的形态多样性,需要将其组织病理学特征与临床和影像学检查结果相关联,以建立正确的诊断。
    BACKGROUND: Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast.
    METHODS: A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected.
    RESULTS: Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells.
    CONCLUSIONS: The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopathological features with the clinical and radiographic findings to establish a correct diagnosis.
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  • 文章类型: Case Reports
    Nasopalatine duct cysts (NPDCs) and other nonodontogenic lesions of the oral cavity may mimic odontogenic pathoses. We present a case of a 22-year-old man with a history of dental trauma and a lesion displaying the typical clinical and radiographic signs of a chronic apical abscess- a buccal sinus tract that was traced to a radiolucent area in the periapex of a maxillary central incisor. A comprehensive diagnostic process that included a cone-beam computed tomographic scan and a histopathologic examination of the lesion after complete enucleation led to the final diagnosis of an infected NPDC. The adjacent tooth was vital at the 1-year posttreatment follow-up, and a radiograph demonstrated complete healing of the periradicular structures. This case demonstrates the ability of NPDCs to present clinical and radiographic signs similar to apical inflammatory lesions and the need for a meticulous diagnostic process in order to avoid unnecessary endodontic intervention. The article also discusses the differential diagnoses of nonodontogenic lesions in the premaxillary area.
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  • 文章类型: Journal Article
    目的:本研究的目的是探讨经口唇下入路改良纵向切口切除鼻前庭囊肿的临床效果。
    方法:28例,经口唇下入路通过改良的纵向切口切除鼻前庭囊肿。视觉模拟评分用于评估鼻翼和上唇的麻木。记录术后并发症。医学照片用于评估。
    结果:对于所有患者,手术后一周切口达到临床一级愈合。所有患者术后均无血肿,感染,口鼻瘘和畸形。在手术后的第一周和第一个月,少数病例记录到鼻翼和上唇麻木。随访2~57个月无复发。
    结论:经口唇下入路改良纵切切口切除鼻前庭囊肿是一种微创、简单的手术方法,并发症少,恢复快。
    OBJECTIVE: The aim of this study was to investigate the clinical effect of the removal of nasal vestibular cysts through a modified longitudinal incision via a transoral sublabial approach.
    METHODS: In 28 cases, a nasal vestibular cyst was removed through a modified longitudinal incision via a transoral sublabial approach. A visual analogue scale score was used to evaluate the numbness of the nasal alar and upper lip. Post-operative complications were recorded. Medical photographs were used for assessment.
    RESULTS: For all patients, incisions reached clinical primary healing one week after surgery. All patients were free of post-operative haematoma, infection, oronasal fistula and malformation. In the first week and the first month after surgery, numbness of the nasal alar and upper lip was recorded in few cases. The patients were followed up for 2-57 months without recurrence.
    CONCLUSIONS: Removal of nasal vestibular cysts via a transoral sublabial approach with a modified longitudinal incision is a minimally invasive and simple surgical method with few complications and a quick recovery.
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  • 文章类型: Case Reports
    This article reports on the management of a large median symmetrical lesion of the anterior palate, which was clinically and radiographically diagnosed as an infected nasopalatine duct cyst. However, histopathology demonstrated it to be a radicular cyst of endodontic origin.
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  • 文章类型: Journal Article
    This article focuses on describing nonodontogenic cysts of the oral and maxillofacial region. The lesions described include nasopalatine duct canal cyst, nasolabial cyst, traumatic bone cyst, Stafne bone cyst, aneurysmal bone cyst, focal osteoporotic bone marrow defect, dermoid cyst, epidermoid cyst, pilar cyst, and sebaceous cyst. The intent of this article is to make general dentists aware and knowledgeable of the nonodontogenic cysts they may encounter in everyday practice, so they can adequately manage or make an appropriate referral to improve treatment outcomes and reduce patient morbidity.
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