Inflammatory Cysts Research Articles

Paradental Cyst: An Underdiagnosed Entity

A paradental cyst (PC) is one of the inflammatory odontogenic cysts, which occurs on partially erupted or impacted mandibular third molar found on their mesial and distal or buccal aspects. It is one of the rarity included in the year 1992 by the WHO as one of the histological typing of odontogenic tumors. It has been hypothesized that reduced enamel epithelium is one of its sources of origin or expansion of the dental follicle unilaterally which could be secondary to the destruction of periodontium. This entity holds a lower prevalence rate of 3%–5% of all odontogenic cysts. It is likely that many cases of PC are diagnosed as inflamed dentigerous cyst. The present case report focuses on a case of PC affecting the permanent mandibular third molar.

Study of the cell proliferation index (Ki67) in inflammatory odontogenic cysts

IntroductionInflammatory odontogenic cysts are lesions that develop from the cellular remains of odontogenesis. They are lesions that may recur after incomplete surgical enucleation with a variable clinical appearance depending on the clinical form. These clinical variations could be explained by the biological behaviour of the lesion cells which can be explored by the study of the cell proliferation index (Ki67). This justifies the initiation of this work whose objective was to study the level of expression of Ki67 and to measure the index of proliferation in odontogenic inflammatory cysts. Material and methodThis was a cross-sectional study with an analytical aim on surgical parts of odontogenic inflammatory cysts over a period of 31 months in the odontostomatology department of the Hôpital Général Idrissa Pouye. The Ki67 immunohistochemistry study was performed on 3μ thick histological sections of paraffin-fixed tissue. The inclusion criteria were any surgical specimen of odontogenic inflammatory cyst that we could collect. The variables studied were sociodemographic, clinical and histopathological. ResultsRadiculo-dental cysts represented 80.5% of the surgical specimens collected and residual cysts 12.2%. The percentage of Ki67-labelled cells was greater than 15% in 80.5% of the odontogenic inflammatory cysts and less than 7% in 19.5% of the cases. In addition, intense labelling was noted in radiculo-dental cysts and weak labelling in the other clinical forms of inflammatory odontogenic cysts obtained. An association was noted between the percentage of Ki67 labelled cells and histological types (p-value <0.001); but also between the intensity of Ki67 labelling and histological types (p-value <0.001). ConclusionThe cell proliferation index (Ki67) could be used as a prognostic biomarker in odontogenic inflammatory cysts.

SURGICAL MANAGEMENT OF GIANT RADICULAR CYST OF MAXILLARY CENTRAL AND LATERAL INCISOR FOLLOWED BY APICOECTOMY- A CASE REPORT

Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst, ameloblastoma, odontogenic keratocyst, periapical cementoma and Pindborgtumour. Majority of these lesions engross the whole apex and appear as precise radiolucencies. The cystic lesion lined with the epithelium, which filled with fluid therefore, they are generally referred to as a true cyst. Based on clinical, radiographical and histopathological findings, the present case was diagnosed as an infected radicular cyst. The clinical characteristics of this cyst could be considered as an interesting and unusual due to its giant nature. The lesion was surgically enucleated without any postoperative complications and satisfactory healing, was achieved. Various mode of treatment available for radicular cyst management including surgical and non-surgical procedures, the present case report discuss the surgical management of radicular cyst of maxillary central and lateral incisors.

Periapical Pocket Cyst of Anterior Maxilla: A Case Report

Periapical cyst is an inflammatory odontogenic cyst of endodontic origin. It presents either as an epithelium lined closed pathological cavity (then it is called periapical true cyst) or the epithelium lined cavity is continuous with the root canal of the affected tooth (periapical pocket cyst). The treatment of choice for the majority of the periapical cysts is conventional root canal treatment. However large, true cysts respond less favorably to non-surgical treatment. We present a case of a 20 years old female patient who had a swelling in the upper lip region. A provisional diagnosis of periapical cyst was arrived at considering the clinical and radiographic features. Intra-operatively, the cyst was continuous with the root canal. Histopathological examination was done.

MANAGEMENT OF AN INFECTED RADICULAR CYST OF THE MANDIBLE: A CASE REPORT

Among all odontogenic cysts, Radicular cyst is the most common inflammatory odontogenic cyst. They develop from epithelial rests of malassez in the PDL, as a result of inflammation. It is a true cyst that occurs in association with the root of the non-vital tooth. An inflammatory response occurs in the periapical tissue, leading to resorption of bone and formation of granulation tissue which are infiltrated by inflammatory cells. Though treatment of choice for smaller cystic lesions involves endodontic therapy, massive cystic lesions don't heal completely with non-surgical endodontic treatment. Massive cystic lesions need Endodontic treatment followed by surgical decompression treatment. In this case report, we present the diagnosis and surgical management of an infected radicular cyst of the mandible.

INFECTED RADICULAR CYST- CASE REPORT

An inflammatory odontogenic cyst that occurs in the jaw of all tooth-bearing areas is radicular (1). It is a chronic condition that arises from the epithelial rests of malassez present in the periodontium of the affected tooth (2). This article aims to present the clinical features and treatment of the radicular cyst in a 38-year-old male patient complaining of discontinued root canal treatment of the mandibular anterior patient.

Characteristics of dental cysts

Introduction: lesions of odontogenic origin such as cysts with benign characteristics can cause great facial destruction and deformities. Cysts" become a type of benign affectation, forming either lumps or a pathological cavity with liquid or semi-liquid content and covered by epithelium on the inside and by connective tissue on the outside. Objective: to describe the characteristics and how dental cysts manifest themselves. Methods: a literature review was performed, through an electronic search in the main databases (PubMed, Taylor &amp; Francis, Scopus and ScienceDirect). Articles published between 2016 and 2022 were included. Results: The characteristics of cysts were identified that present asymptomatically and slow growth can cause dental migration and alteration of adjacent roots. There are different types, but the most common were odontogenic and dentigerous cysts. Conclusions: It is concluded that there are different characteristics of dental cysts due to the increase in volume and location of the cyst, these present themselves asymptomatically and cause facial inflammation with asymmetry, depending on their manifestations, clinic, radiography. Different types of odontogenic cysts can be found (radicular cyst and collateral inflammatory cyst) and non-odontogenic (nasopalatine duct cyst)

Impact of CD34-dependent Micro Vessel Density on Periapical Odontogenic Cysts.

Odontogenic cysts belong to a type of lesions with endodontic origin that in some cases mimic even aggressive odontogenic tumors sharing with them similar radiographic features. Periapical cysts (PCs) belong to the inflammatory odontogenic cysts sub-category and rarely squamous cell carcinoma arises from their hyperplastic/ dysplastic epithelia. This study aimed to explore the impact of cluster differentiation 34 (CD34) protein expression combined with micro vessel density (MVD) on PCs. Forty-eight (n=48) archival, formalin-fixed, and paraffin-embedded PC tissue specimens were included in the study. Immunohistochemistry (IHC) was performed in the corresponding tissue sections using an anti- CD34 antibody. CD34 expression levels and also MVD in the examined cases were measured by implementing a digital image analysis protocol. CD34 over-expression (moderate to high staining intensity levels) were detected in 29/48 (60.4%) cases, whereas the rest of them (19/48-39.6%) were characterized by low levels of expression. Extended MVD was identified in 26/48 (50.1%) cases correlated with CD34 over-expression, epithelial hyperplasia (p-value=0.001), and marginally with inflammatory infiltration level in the examined lesions (p-value=0.056). CD34 over-expression combined with increased MVD is associated with a neoplastic-like (hyperplastic) phenotype in PCs as a result of increased neo-angiogenic activity. These histopathological characteristics rarely form an eligible substrate for squamous cell carcinoma onset in untended cases.

Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study

This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.

Surgical treatment of jaw inflammatory odontogenic cysts in primary teeth: a retrospective analysis

Relevance. Odontogenic cysts in children are the most common bone pathology. The study aimed to conduct a retrospective descriptive analysis of inflammatory odontogenic cysts cases associated with primary teeth in children.Material and methods. The study analysed the medical records of children diagnosed with "radicular cyst associated with a primary tooth" from 2015-2020. We studied the following characteristics, namely, sex, age, location of the process, condition of the teeth in question, surgical treatment techniques and outcome. The data obtained were processed by methods of variational statistics. The Student t-test assessed the significance of differences.Results. The study analysed 60 cases of inflammatory odontogenic cysts in children aged 6 to 13 years. Cysts were more often associated with the primary lower second molars previously treated with the resorcinol-formaldehyde resin therapy. The period from the tooth treatment to the cyst diagnosis was 3 to 5 years. The treatment of cysts applied methods of a gentle and traditional cystotomy. Fifty-one children (85.0%) had follow-up examinations. All children showed bone tissue restoration during the period of 4 to 12 months and spontaneous eruption of permanent teeth in 3-8 months. Only 4 cases (7.8%) required orthodontic correction of permanent teeth position.Conclusion. Primary lower molars, previously treated with resorcinol-formaldehyde resin, are the most common cause of jaw inflammatory odontogenic cysts in children. Low-traumatic surgical methods preserving the follicles of permanent teeth are highly effective (88.2%).

Types, Complications, and Prognosis of Inflammatory and Developmental Odontogenic Cyst

In general, odontogenic cysts might have an inflammatory or developmental origin. The review study aims to increase understanding of the various categories of odontogenic cysts by describing their primary characteristics, consequences, treatments, and prognoses of lesions. Different types of developmental odontogenic cysts are the dentigerous cyst, eruption cyst, odontogenic keratocyst (OKC), orthokeratinized odontogenic cyst (OOC), gingival cyst (adult and new-born), lateral periodontal cyst (LPC), glandular odontogenic cyst, and calcifying odontogenic cyst (COC). Periapical or lateral radicular cysts, residual cysts, and paradental cysts are forms of inflammatory odontogenic cysts. The mandible and maxilla are affected by these inflammatory lesions. The most prevalent developmental odontogenic cysts were dentigerous cysts and OKC. Most developmental cysts reported rare recurrence and excellent prognosis except for glandular odontogenic cysts (30 to 55% recurrence) and OKC (30%). Glandular odontogenic cysts, OKC, and COC have the propensity to behave aggressively and recur frequently compared to others. Although most inflammatory cysts are asymptomatic and benign, because of their continuous growth, these lesions have the potential to become destructive because they damage and infect the nearby bone. Malignant transformation has been reported in periapical and residual inflammatory cysts. As a result, they should be properly diagnosed and treated. All inflammatory cysts have a favorable prognosis.

Contribution of endoscopy in high sinus inclusions, a case report

Introduction: This paper will discuss the management of iatrogenic displacement of the third molar (3M) into the maxillary sinus through a specific case that we have encountered. Observation: This case reports the atypical clinical history of an ectopic intra sinusal 3M of iatrogenic origin, associated with an inflammatory cyst. A 52-year-old man presented with chronic sinusitis and an oral-sinus communication 30 yr after the displacement of his 3M into the maxillary sinus. A minimally invasive multidisciplinary management using endoscopy was proposed to the patient as well as an 18-month follow-up reporting a normalization of his initial sinus symptoms. Discussion: An analysis of the literature concerning intra sinusal teeth was carried out, whatever their etiology, in order to situate our case and to be able to propose the least invasive procedure for these patients. The different surgical approaches are analyzed as well as the effectiveness of a multidisciplinary management. Conclusion: In this case, the simultaneous oral and nasal approach enabled a minimally invasive procedure. The endoscope is now part of the surgeon's therapeutic arsenal, and the training of practitioners in its use could greatly facilitate procedures.

Prevalence of odontogenic cysts in oral and maxillofacial surgery department of hasan sadikin general hospital: 2 years retrospective study

Background: Odontogenic cysts are cysts arising from the odontogenic epithelium. According to the World Health Organization in 2017, classification of odontogenic cysts are classified into cysts originating from inflammatory and developmental processes. Most cystic lesions of the oral and maxillofacial cavity are of odontogenic origin and have higher incidence than other body parts. This study to explain about prevalence of odontogenic cyst in RSUP Hasan Sadikin in 2019-2020 .Method: This study was a retrospective study that included 30 patients diagnosed with odontogenic cysts during 2019-2020. The data taken in each patient were age, gender, location of predilection, investigations, diagnosis, management, and recurrence of cases of odontogenic cysts.Result: A total of 15 patients had developmental odontogenic cysts and 15 had inflammatory odontogenic cysts. Most developmental cysts were 12 patients with dentigerous cysts, Odontogenci Keratocyst in 2 patients, and calcifying odontogenic cyst in 1 case. Inflammatory cysts were dominated by 15 patients with radicular cysts.Conclusion: Prevalence of odontogenic cyst was found more in female, with radicular cyst and location in the maxilla

Inflammatory dentigerous cyst management in paediatric patient followed by management of impacted maxillary canine with 1 year follow up: A rare case report

Cysts of jaw present as swellings of jaws and midface. Of different varieties, dentigerous cyst is most common type of noninflammatory odontogenic cyst. Dentigerous cysts are generally associated with crowns of impacted or unerupted permanent teeth. Here we present a case of dentigerous cyst in 13‑year‑old female child, which was successfully treated with conservative therapy. Patient also reported after one and half year with protruding teeth and retained deciduous right upper canine &amp; impacted permanent canine. This case report also presents orthodontic management of retained deciduous canine and impacted permanent canine.

Pankreaszysten – Indikationen, Zeitpunkt und Rationale für eine Surveillance

BackgroundCystic pancreatic lesions are detected incidentally at an increasing rate. Often, the patients present asymptomatically. Hence, the resulting clinical consequences remain challenging and unsettling for both physicians and patients.ObjectivesStatus of current recommendations in handling cystic pancreatic lesions.Materials and methodsSelective literature search of PubMed while taking current guidelines into account.ResultsCorrect diagnostic classification of the cystic lesion is crucial since further action depends on the type of cystic lesion. Resection is generally recommended for mucinous cystic neoplasms (MCN), solid pseudopapillary neoplasms (SPN), and intraductal papillary mucinous neoplasms (IPMN) with relevant risk criteria such as prominent main-duct dilation. Surveillance is recommended for IPMN without risk criteria, as long as comorbidities and life expectancy of the patient will allow preventive resection over the years. SCNs are benign and only symptomatic SCNs require resection. Inflammatory pancreatic cysts should only be treated under certain circumstances.

Large Radicular cyst disfiguring the midline face; a case report

A radicular cyst is an inflammatory odontogenic cyst of the jaw commonly found at the apices of the tooth of the anterior maxilla. It develops as a sequel of untreated dental caries with pulp necrosis and periapical infection. Different treatment includes surgical endodontic treatment, extraction of the involving tooth, marsupialization, and enucleation with primary closure followed by rehabilitation. We presented a case of a huge midline radicular cyst of a 52 years lady who presented with increasing size of swelling at the midline of the upper lip region which makes patients ugly for 25 years. It leads to the mass effect at the philtrum of the upper labium at midlines leads to elevation and ugly looking face making her socially embarrassing. Endoscope-assisted complete excision was performed via midline mini visor incision and with no evidence of recurrence found at three-month follow-up.

Treatment of Inflammatory Dentigerous Cyst Using a Surgical T Drain in a Child.

Dentigerous cysts are rarely reported in young children. They are usually asymptomatic and only identified when becoming significantly large. Treatment by enucleation may damage structures like the inferior alveolar nerve, maxillary sinus, or permanent teeth, thus reducing the child's quality of life. Therefore, conservative surgical treatment such as decompression is indicated. This case report describes the treatment and subsequent complete regression of an inflammatory dentigerous cyst based on the decompression method using a customized surgical tube in a 10-year-old girl. The innervation was preserved, and permanent teeth erupted.

Surgical treatment of inflammatory periapical cyst: a clinical case report

Among the odontogenic cysts, there are radicular cysts or also called periapical cysts, are the most common odontogenic cyst. They develop at the apex of a tooth with pulp necrosis, which may be the consequence of dental caries or trauma. they are asymptomatic, grow slowly, and are discovered on routine radiographs. With the proliferation of the ERM and its activation, there is an increase in osmotic pressure, causing the cyst to expand, normally this ERM is not activated, so only granulation tissue develops at the apex of the affected tooth. Granulation tissue is called periapical granuloma and, as such, histologically lacks an epithelial lining. In the present study, a case of a 65-year-old female patient with an inflammatory periapical cyst in the region of the lower incisors is reported.

A common cyst in an uncommon location

OKC is the rare and noteworthy developmental odontogenic cyst which arises from dental lamina. Around 7.8% of all cysts of the jaw are categorized in to this type and grow in an antero-posterior direction in the medullary cavity of the bone without causing bone expansion until &amp; unless when expansion is large. The frequent location is the mandibular posterior body. It is uncommon in the maxilla and only 13% occur in the anterior region. An interesting case of OKC in the maxillary central and lateral incisor region of a 36-year-old male patient is being presented. Such a case can be a diagnostic challenge for the clinician, as it can closely mimic the inflammatory cysts in the anterior region.

CONSERVATIVE TREATMENT OF INFLAMMATORY FOLLICULAR CYST: CASE SERIES

Inflammatory follicular cysts originate from the interactions between periapical inflammation of a deciduous tooth with its successor's follicle. We report 4 cases of patients diagnosed with this entity who were treated conservatively. The presence of a compromised primary tooth, combined with radiographic findings of an image compatible with a cyst involving the permanent adjacent tooth, was suggestive of an inflammatory follicular cyst. Extraction of the deciduous compromised tooth followed by decompression of the cystic lesion and preservation of the permanent tooth were performed in all cases. Removed material was sent for anatomopathologic examination and the result was compatible with inflammatory odontogenic cyst. Patients evolved without complications and with spontaneous eruption of the permanent tooth. Conservative management with the preservation and subsequent eruption of the permanent tooth is feasible for this condition and must be considered. Inflammatory follicular cysts originate from the interactions between periapical inflammation of a deciduous tooth with its successor's follicle. We report 4 cases of patients diagnosed with this entity who were treated conservatively. The presence of a compromised primary tooth, combined with radiographic findings of an image compatible with a cyst involving the permanent adjacent tooth, was suggestive of an inflammatory follicular cyst. Extraction of the deciduous compromised tooth followed by decompression of the cystic lesion and preservation of the permanent tooth were performed in all cases. Removed material was sent for anatomopathologic examination and the result was compatible with inflammatory odontogenic cyst. Patients evolved without complications and with spontaneous eruption of the permanent tooth. Conservative management with the preservation and subsequent eruption of the permanent tooth is feasible for this condition and must be considered.