The radicular cyst is the most common odontogenic cyst and is caused by inflammation. It can become atypically large, although the size of the radiographic osteolysis says nothing about the entity of the lesion. This case shows an unusually large multilocular radicular cyst expanding buccally from tooth 46 in a patient with severe autism who can only be treated under general anesthesia. The clinical and radiological picture as well as the intraoperative situation was more indicative of an aggressive cyst or benign tumor. The lesion was surgically completely removed and the teeth 46, 47 and 48 were extracted because of poor compliance and prognosis. Histopathology revealed a radicular cyst. There were no postoperative complications. After eight months, the lesions had almost completely reossified.

One of the most frequent pathologies of jaw bone is a bacteria-induced inflammation at the apices of teeth with subsequent bone resorption that typically presents as a radiolucency in radiographs. Usually, corresponding clinical and radiographic findings correlate and allow for an accurate diagnosis. However, occasionally an unexpected and completely different diagnosis presents as documented in this case report. In a 55-year-old female patient, a radicular cyst was suspected in her right maxillary bone. The treatment plan included a cystectomy as well as apical surgery of the adjacent and root-canal filled teeth 15 and 16. However, the intraoperative finding absolutely did not fit a radicular cyst but rather a mucous retention cyst, as could be confirmed subsequently by histopathology. The diagnosis of a mucous retention cyst within the jaw bone is extraordinary and as such has never been described before in the literature.

Odontogenic keratocysts (OCT) are odontogenic cysts and are among the most common jaw cysts after radicular and follicular cysts. They occur in over 80% of cases in the mandible, especially in the posterior part of the mandible and ascending ramus. OMCs occur in all age groups, with a higher incidence in the second to third decade of life and in patients between 50 and 70 years of age (bimodal age distribution). After having been classified as an odontogenic tumor, i.e. a true neoplasm, for over a decade, the WHO has listed it as an odontogenic cyst again since 2017.

BACKGROUND: Reverse shoulder arthroplasty (RSA) is a reliable, long-term treatment option for degenerative shoulder pathology. However, the functional outcomes degrade around the fifth year postoperation, particularly for internal and external rotation. Long-term radiographic changes have been reported around the humeral stem, depending on the fixation method.
OBJECTIVE: The primary objective was to compare the clinical outcomes of RSAs by fixation method-cemented vs. press-fit-after a minimum follow-up of 5 years. We hypothesized that proximal humeral osteolysis impacts the functional outcomes.
METHODS: Our study compared 2 matched cohorts: 56 RSAs with cemented stems and 56 RSAs with press-fit stems. We evaluated all the patients using the Constant-Murley score (CMS) and range of motion (ROM), which we measured preoperatively and at the final follow-up visit. We evaluated radiographs from the final follow-up visit to look for proximal humeral osteolysis with tuberosity resorption, signs of stress shielding, periprosthetic radiolucent lines, and scapular notching.
RESULTS: At a mean follow-up of 9.5 years (5-21), regardless of the fixation method, the RSA procedure helped to improve the CMS and active joint ROM postoperatively, except for internal and external rotation with elbow at side in the press-fit group. Shoulder ROM was significantly better in the group with cemented stems for anterior elevation (P < .001), abduction (P = .006), and external (P = .02) and internal rotation with elbow at side (P = .02). The CMS did not differ between groups. The presence of tuberosity resorption or scapular notching had no effect on the CMS and active ROM in either group. Osteopenia, which was more prevalent in the press-fit group, had no impact on the functional outcome.
CONCLUSIONS: There was no significant difference between groups in the CMS, although the active shoulder ROM was significantly worse in the press-fit group. This difference could be attributed to more frequent tuberosity resorption in this group.