Hyperplastic Dental Follicles Research Articles

Developmental Anomalies in Human Teeth: Odontoblastic Differentiation in Hamartomatous Calcifying Hyperplastic Dental Follicles Presenting with DSP, Nestin, and HES1.

Hyperplastic dental follicles (HDFs) represent odontogenic hamartomatous lesions originating from the pericoronal tissues and are often associated with impacted or embedded teeth. These lesions may occasionally feature unique calcifying bodies, known as calcifying whorled nodules (CWNs), characterized by stromal cells arranged in a whorled or spiral fashion. CWNs are typically observed in multiple calcifying hyperplastic dental follicles or regional odontodysplasia. In our study, we examined 40 cases of HDFs, including nine instances with characteristics of CWNs, referred to as calcifying hyperplastic dental follicles (CHDFs), which are infrequently accompanied by odontodysplasia. The median ages of the HDFs and CHDFs were 16 (ranging from 3 to 66) and 15 (ranging from 11 to 50) years, respectively. The lower third molars were the most frequently affected by HDSFs and CHDFs, followed by the upper canines. A histological examination was conducted on all 40 cases, with an immunohistochemical analysis performed on 21 of them. Among the cases with CWN, nine affected a single embedded tooth, with one exception. CWNs exhibited diverse calcifications featuring sparse or entirely deposited psammoma bodies, and some displayed dentinoid formation. Immunohistochemically, the stromal cells of HDFs were frequently positive for CD56 and nestin. By contrast, CWNs were negative for CD56 but positive for nestin as well as hairy and enhancer split 1 (HES1), with a few dentin sialoprotein (DSP)-positive calcified bodies. Our results revealed that hamartomatous CHDFs can impact multiple and single-embedded teeth. CWNs composed of nestin and HES1-positive ectomesenchymal cells demonstrated the potential to differentiate into odontoblasts and contribute to dentin matrix formation under the influence of HES1. This study is the first report documenting odontoblastic differentiation in HDFs. The rare occurrence of HDFs and CHDFs contributes to limited comprehension. To prevent misdiagnosis, a better understanding of these conditions is necessary.

Pediatric Oral Pathology: Odontogenic Cysts.

Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.

Role of Collagen Fibers in Predicting the Biologic Behavior of Dentigerous Cyst, Normal Dental Follicle, and Hyperplastic Dental Follicle Using Special Stains

Role of Collagen Fibers in Predicting the Biologic Behavior of Dentigerous Cyst, Normal Dental Follicle, and Hyperplastic Dental Follicle Using Special Stains

ORAL PRESENTATION—CASE REPORT. REGIONAL ODONTODYSPLASIA: A CASE REPORT OF 10-YEAR FOLLOW-UP

The present report aims to describe a follow-up presentation of bone sclerosis found in a 6-year-old girl with regional odontodysplasia (RO) and presence of calcifications in a hyperplastic dental follicle (HDF), highlighting their clinical, cone beam computed tomography (CBCT), and histopathologic characteristics. A 16-year-old patient was referred to our service to evaluate the presence of a presumable cystic lesion involving the crown of the tooth #13 and also to evaluate a sclerotic lesion in the right mandible. She had a history of RO, presenting both dentitions with characteristics compatible with “ghost teeth.” The sclerotic lesion was asymptomatic, not expansive, and not related to the RO affected bone, which had 10 years of follow-up. The lesions were submitted to CBCT and histopathologic analysis, rendering the diagnosis of an HDF and idiopathic osteosclerosis. The knowledge of the existence of calcifications in HDF in patients with RO can contribute to the correct identification and diagnosis. The present report aims to describe a follow-up presentation of bone sclerosis found in a 6-year-old girl with regional odontodysplasia (RO) and presence of calcifications in a hyperplastic dental follicle (HDF), highlighting their clinical, cone beam computed tomography (CBCT), and histopathologic characteristics. A 16-year-old patient was referred to our service to evaluate the presence of a presumable cystic lesion involving the crown of the tooth #13 and also to evaluate a sclerotic lesion in the right mandible. She had a history of RO, presenting both dentitions with characteristics compatible with “ghost teeth.” The sclerotic lesion was asymptomatic, not expansive, and not related to the RO affected bone, which had 10 years of follow-up. The lesions were submitted to CBCT and histopathologic analysis, rendering the diagnosis of an HDF and idiopathic osteosclerosis. The knowledge of the existence of calcifications in HDF in patients with RO can contribute to the correct identification and diagnosis.

A Hyperplastic Dental Follicle That Arose During the Follow-up Period After Odontoma Removal

A Hyperplastic Dental Follicle That Arose During the Follow-up Period After Odontoma Removal

Odontogenic and Developmental Oral Lesions in Pediatric Patients.

This article reviews odontogenic and developmental oral lesions encountered in the gnathic region of pediatric patients. The process of odontogenesis is discussed as it is essential to understanding the pathogenesis of odontogenic tumors. The clinical presentation, microscopic features, and prognosis are addressed for odontogenic lesions in the neonate (dental lamina cysts/gingival cysts of the newborn, congenital (granular cell) epulis of the newborn, melanotic neuroectodermal tumor, choristoma/heterotopia, cysts of foregut origin), lesions associated with unerupted/erupting teeth (hyperplastic dental follicle, eruption cyst, dentigerous cyst, odontogenic keratocyst/keratocystic odonogenic tumor, buccal bifurcation cyst/inflammatory collateral cyst) and pediatric odontogenic hamartomas and tumors (odontoma, ameloblastic fibroma, ameloblastoma, adenomatoid odontogenic tumor, primordial odontogenic tumor). Pediatric odontogenic and developmental oral lesions range from common to rare, but familiarity with these entities is essential due to the varying management implications of these diagnoses.

Multiple calcifying hyperplastic dental follicles: a major diagnostic consideration in multiple pericoronal lesions\xa0- report of two cases

BackgroundPericoronal radiolucent lesions are a common radiographic finding, but it is rare that they occur in multiple forms. Multiple calcifying hyperplastic dental follicles (MCHDF) are entities with few cases described to date; nevertheless, they appear to have a very particular phenotypic pattern.Cases presentationCase 1: A 10-year-old male was evaluated radiographically, revealing four impacted canines, each accompanied by unilocular pericoronal radiolucency. Case 2: A 16-year-old male was planning orthodontic treatment; following his radiological evaluation all third molars were found to be accompanied with pericoronal radiolucencies. Enucleation, and third molar removal along with the pericoronal tissue were the respective treatments. Microscopically, in both cases, the specimens shown odontogenic epithelium, and type I and II calcifications in the hyperplastic follicles, all these characteristics were consistent with MCHDF.ConclusionAlthough MCHDF are a rare entity, they must be considered in the differential diagnosis of multiple pericoronal lesions. Under the light of the current evidence, the histological findings may be relatively heterogeneous, but their integration with both the clinical data, which are apparently particular, and with the radiographic characteristics, can lead to a definitive diagnosis.

UNUSUAL DENTAL FOLLICULAR HAMARTOMA ASSOCIATED WITH A DENTIGEROUS CYST WITH FOCAL PARAKERATOSIS: A CASE REPORT AND REVIEW OF THE LITERATURE

Introduction Dental follicular hamartoma with central odontogenic fibroma-like features is a rare condition that has been reported primarily in black African teenagers and young adults and is characterized by involvement of multiple teeth that either show amelogenesis imperfecta or enamel dysplasia, hypodontia, open-bite malocclusion, and gingival overgrowth. Case Report We report a case of an unusual dental follicular hamartoma associated with a dentigerous cyst in the left mandible of a 23-year-old male who was otherwise healthy. The patient presented to his oral surgeon with pain in the left mandible. Clinical examination revealed soft tissue swelling and suppuration associated with the distal aspect of tooth #18. A panoramic radiograph revealed a 3.3 cm x 2.3 cm unilocular radiolucency associated with impacted tooth #17 that extended from the superior aspect of the crown to the mandibular notch. This lesion had been present at least four years prior when it measured 2.6 cm x 2.0 cm. Tooth #17 was extracted and the bulk of the lesion was curetted. The biopsy revealed a cellular proliferation of spindled fibroblast-like cells in a delicately and densely collagenous matrix. Scattered throughout were clustered basophilic spherical calcifications associated with condensations of spindled cells, rarely associated with odontogenic rests. A dentigerous cyst was also present. Following this, the residual lesion was curetted and revealed only an inflamed dentigerous cyst. The differential diagnoses for this condition include regional odontodysplasia or unusual hyperplastic dental follicle with dystrophic calcifications. Conclusion We review the past and current literature on dental follicular hamartoma. To the best of our knowledge, our case report represents only the 9th documented case of dental follicular hamartoma and the first not to be associated with any dental-related dysplasia and other dental abnormalities.

Hyperplastic dental follicle: case report

ABSTRACT The dental follicle is characterized as a radiolucent area around an impacted tooth. It is believed that these follicles can originate cysts and tumors. The aim of this study was to report a clinical case of a 15-year-old female, normosystemic patient, with an increased dental follicle involving the crown of the tooth 48, which was removed and referred for histopathological examination. The diagnosis hypothesis was dentigerous cyst, but the histopathological report describes a definitive diagnosis of dental follicle. After six months of postoperative follow-up the patient presented no signs of relapse or complaints in the region.

Retracted: A Rare Pathological Entity of Multiple Calcified Hyperplastic Dental Follicles

[This retracts the article DOI: 10.1155/2016/4190827.].

Loss of taste due to clopidogrel; early recognition is rewarding

Hyperplastic dental follicles are very commonly seen associated with an impacted tooth. Multiple calcifying hyperplastic dental follicles (MCHDF), a term used for multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles is a rare entity. Varied pattern of calcifications have been observed in such follicles. We report one such case with four patterns of calcifications and odontogenic epithelium associated with bilaterally impacted canines.

Multiple calcifying hyperplastic dental follicles

Hyperplastic dental follicles are very commonly seen associated with an impacted tooth. Multiple calcifying hyperplastic dental follicles (MCHDF), a term used for multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles is a rare entity. Varied pattern of calcifications have been observed in such follicles. We report one such case with four patterns of calcifications and odontogenic epithelium associated with bilaterally impacted canines.

Regarding "Multiple calcifying hyperplastic dental follicle (MCHDF): a case report".

Multiple calcifying hyperplastic dental follicles (MCHDF) are disorders characterized by multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles. 1 Recently, I encountered a case of MCHDF and while reviewing the scientific literature, I came across a similar case report published by Jamshidi et al, 2 published in the Journal of Dental Research, Dental Clinics, Dental Prospects. 2 The authors erroneously declared their case report as the 11th case of MCHDF based on their wrong interpretation of the total number of cases reported till then. The two cases reported by Lukinmaa et al 3 were limited in the same quadrant of the jaw, and hence, were declared by Cho et al 4 as single hyperplastic dental follicles (SCHDF) and not MCHDF. Thus, the case report by Jamshidi et al 2 should be suitably considered as the 9th case of MCHDF in the literature and not 11th in number. The detailed summary of all the nine cases, including the case reported by Jamshidi et al 2 is given in the Table below. Table Summary of multiple calcifying hyperplastic dental follicles cases until the report of Jamshidi et al 2 No Authors (Year) Age/Sex Impacted teeth (Total No.) Type of Calcification 1 Sandler et al 5 (1988) 15/M 2, 13-15, 18, 20, 21, 28, 29, 31 (9) Type I 2 Gardner et al 6 (1995) 40/M 2, 11, 15, 27, 29, 31 (6) Type II > Type I 3 Gomezet al 1 (1998) 15/M 2, 5-7, 11, 12, 15, 18-22, 27-31 (17) Type I and Type II 4 Cho et al 4 (2010) 11/M 2, 6, 11,15, 18, 19,31 (7) Type I and Type II 5 Cho et al 4 (2010) 14/M 2, 6, 11, 15, 18, 31 (6) Type I and Type II 6 Cho et al 4 (2010) 11/M 2, 15, 18, 31 (4) Type I 7 Cho et al 4 (2010) 15/M 2, 4, 13, 15, 18, 20, 31 (7) Type I with Liesgang ring 8 Cho et al 4 (2010) 17/M 2, 15, 19 (3) Type I and Type II 9 Jamshidi et al 2 (2013) 19/M 1, 2, 15-18, 22, 27, 31, 32, right and left maxillary distomolars – one each (12) Type A and Type B Editor’s note The concern raised in this letter was shared with a reviewer of the paper of Jamshidi et al. 2 The reviewer stated that the statement by Jamshidi et al—“to date, 10 cases of MCHDF have been published worldwide”—was mainly based on the paper of Cho et al, 4 in which the authors report five cases of MCHDF. Cho et al 4 claim, in the beginning of the discussion section, that there were only five published cases of MCHDF before their paper, but continue to discuss, later in the text, that the two cases reported by Lukinmaa et al 3 should be regarded as single calcifying hyperplastic dental follicle. Our reviewer stated that if the two cases of Lukinmaa et al 3 are considered as single, not multiple, then the claim raised in this letter is reasonable. Competing interests The author declares no competing interest with regards to authorship and/or publication of this article. Table. Summary of multiple calcifying hyperplastic dental follicles cases until the report of Jamshidi et al 2

Gubernacular Cord and Canal

The gubernacular cord, located within the gubernacular canal, links the tooth follicle to the overlying gingiva and can be identified in the alveolar region of the lingual/palatal surface of deciduous teeth. Some authors believe that the gubernacular canal and cord play a role in the guiding the course of tooth eruption, whereas others claim that these structures can influence the development of an adenomatoid odontogenic tumor (AOT). Here, we present the case of an 11-year-old female who, on a routine panoramic radiograph, presented a well-defined radiolucency around the crown of an impacted tooth associated with a canal in the apical direction, which was diagnosed as hyperplastic dental follicle associated with gubernacular cord. It is likely that most cases presenting gubernaculum dentis are undiagnosed or misdiagnosed. Current data show that there is a histogenetic relationship between the gubernaculum dentis and AOT; hence its importance.

Multiple Calcifying Hyperplastic Dental Follicles: A Case Report

ntroduction: Pathologic changes may occur in dental follicle of impacted teeth, which makes the microscopic evaluation of enlarged follicle an important issue. One of the exceedingly rare conditions seen in dental follicles is multiple calcifying hyperplastic dental follicles, which has microscopical appearance similar to central odontogenic fibroma (WHO type). Case Presentation: A 13-year-old boy, in the case presented in this article, had 15 unerupted teeth, each associated with hyperplastic pericoronal tissue. Conclusions: The purpose of this article is to report an example of this entity and describe the histopathologic characteristics that helps diagnose and treat such condition in the most appropriate manner.

Multiple Calcifying Hyperplastic Dental Follicles: A Case Report

Introduction: Pathologic changes may occur in dental follicle of impacted teeth, which makes the microscopic evaluation of enlarged follicle an important issue. One of the exceedingly rare conditions seen in dental follicles is multiple calcifying hyperplastic dental follicles, which has microscopical appearance similar to central odontogenic fibroma (WHO type). Case Presentation: A 13-year-old boy, in the case presented in this article, had 15 unerupted teeth, each associated with hyperplastic pericoronal tissue. Conclusions: The purpose of this article is to report an example of this entity and describe the histopathologic characteristics that helps diagnose and treat such condition in the most appropriate manner.

Hyperplastic dental follicle: a case report and literature review.

Hyperplastic dental follicle is an odontogenic hamartomatous lesion associated with delayed or tooth eruption failure in young patients. The occurrence of this pericoronal dental lesion may be single or multiple and it seems to be more frequent than literature has reported. We present a literature review focusing on the etiopathogenesis and clinicopathological features of this hamartomatous lesion in young patients. In addition, we reported a case of hyperplastic dental follicle causing delayed tooth eruption of 14-year-old male patient. Microscopic analyses based on routine staining and immunohistochemistry were used to discuss the cells found in pericoronal follicle. This paper reinforces the importance of association between clinical history and radiographic features with microscopic pericoronal follicle examination for diagnosis of this hamartomatous lesion.

Pathognomonic oral profile of Enamel Renal Syndrome (ERS) caused by recessive FAM20A mutations.

Amelogenesis imperfecta (AI) is a genetically and clinically heterogeneous group of inherited dental enamel defects. Commonly described as an isolated trait, it may be observed concomitantly with other orodental and/or systemic features such as nephrocalcinosis in Enamel Renal Syndrome (ERS, MIM#204690), or gingival hyperplasia in Amelogenesis Imperfecta and Gingival Fibromatosis Syndrome (AIGFS, MIM#614253). Patients affected by ERS/AIGFS present a distinctive orodental phenotype consisting of generalized hypoplastic AI affecting both the primary and permanent dentition, delayed tooth eruption, pulp stones, hyperplastic dental follicles, and gingival hyperplasia with variable severity and calcified nodules. Renal exam reveals a nephrocalcinosis which is asymptomatic in children affected by ERS. FAM20A recessive mutations are responsible for both syndromes. We suggest that AIGFS and ERS are in fact descriptions of the same syndrome, but that the kidney phenotype has not always been investigated fully in AIGFS. The aim of this review is to highlight the distinctive and specific orodental features of patients with recessive mutations in FAM20A. We propose ERS to be the preferred term for all the phenotypes arising from recessive FAM20A mutations. A differential diagnosis has to be made with other forms of AI, isolated or syndromic, where only a subset of the clinical signs may be shared. When ERS is suspected, the patient should be assessed by a dentist, nephrologist and clinical geneticist. Confirmed cases require long-term follow-up. Management of the orodental aspects can be extremely challenging and requires the input of multi-disciplinary specialized dental team, especially when there are multiple unerupted teeth.

Multiple Calcifying Hyperplastic Dental Follicle (MCHDF): A Case Report.

Evaluation of enlarged follicles with unerupted teeth is always important because some changes may occur. One of the ex-tremely rare conditions seen in dental follicles is multiple calcifying hyperplastic dental follicle. We report a case of multi-ple calcifying hyperplastic dental follicle. Radiographs showed that mandibular third molars had a pericoronal radiolucent zone delineated by a well-defined and sclerotic border. Microscopic examination revealed a combination of fibrous connec-tive and small calcifications. Multiple calcifying hyperplastic dental follicle is a rare condition and its correct diagnosis is necessary to apply appropriate treatment.

Multiple calcifying hyperplastic dental follicles: A case report

This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made.