Jaw Cysts Research Articles

Diagnosis of odontogenic keratocysts and non-keratocysts using edge attention convolution neural network.

The study's objective was to develop an automated method for a histopathology recognition model for odontogenic keratocysts (OKC) and non-keratocyst (Non-KC) in jaw cyst sections stained with hematoxylin (H) and eosin (E) on a tiny bit of incisional biopsy prior to surgery. This hastens the speed and precision of diagnosis to patients. Also, navigates the clinicians with the therapeutic doctrine. To build such a system and to increase the accuracy of the existing models, the edge attention CNN model with Keras functional API was implemented which efficiently analyzes the texture information of the images. Approximately 2861 microscopic images at a 40X magnification were taken from 54 OKC, 23 Dentigerous cysts (DC), and 20 Radicular cysts. The model was trained using both RGB and canny edge-detected images. The model gave a good accuracy of 96.8%, which is suitable for real-time. Histopathological images are better analyzed through textural features. The proposed edge attention CNN highlights the edges, making texture analysis more precise. The suggested method will work for OKC and Non-KC diagnosis automation systems. The use of a whole slide imaging scanner has the potential to increase accuracy and remove human bias.

DAAM-Net: A dual-encoder U-Net network with adjacent auxiliary module for pituitary tumor and jaw cyst segmentation

In the diagnosis of various diseases, accurate segmentation of lesions in medical images is crucial. However, when faced with the challenges of blurred edges, noise, and low contrast in images of pituitary tumors and jaw cysts, existing methods do not perform well in solving these problems. To overcome these problems, we present a new approach based on U-Net architecture. Firstly, a more comprehensive semantic information capture is realized by superimposing two U-Net network structures. Following that, the method incorporates atrous spatial pyramid pooling (ASSP) technology to enable adjustable multi-scale feature extraction. Thirdly, an adjacent auxiliary module (AAM) is designed to smoothly fuse features from different levels, effectively suppressing noise interference and reducing feature ambiguity. By testing on the dataset provided by Quzhou People’s Hospital, the IoU, Dice, Specificity, and Mcc of the method were 77.46%, 87.18%, 99.64% and 86.97% on the pituitary tumor dataset, and 81.32%, 89.53%, 99.91% and 89.55% on the jaw cyst dataset, respectively. Compared with existing algorithms, our method exhibits superior segmentation performance and is expected to become a more reliable auxiliary tool in the diagnosis of medical diseases.

An attempt to generate panoramic radiographs including jaw cysts using StyleGAN3.

The purpose of this study was to generate radiographs including dentigerous cysts by applying the latest generative adversarial network (GAN; StyleGAN3) to panoramic radiography. A total of 459 cystic lesions were selected, and 409 images were randomly assigned as training data and 50 images as test data. StyleGAN3 training was performed for 500 000 images. Fifty generated images were objectively evaluated by comparing them with 50 real images according to four metrics: Fréchet inception distance (FID), kernel inception distance (KID), precision and recall, and inception score (IS). A subjective evaluation of the generated images was performed by three specialists who compared them with the real images in a visual Turing test. The results of the metrics were as follows: FID, 199.28; KID, 0.14; precision, 0.0047; recall, 0.00; and IS, 2.48. The overall results of the visual Turing test were 82.3%. No significant difference was found in the human scoring of root resorption. The images generated by StyleGAN3 were of such high quality that specialists could not distinguish them from the real images.

MARes-Net: multi-scale attention residual network for jaw cyst image segmentation.

Jaw cyst is a fluid-containing cystic lesion that can occur in any part of the jaw and cause facial swelling, dental lesions, jaw fractures, and other associated issues. Due to the diversity and complexity of jaw images, existing deep-learning methods still have challenges in segmentation. To this end, we propose MARes-Net, an innovative multi-scale attentional residual network architecture. Firstly, the residual connection is used to optimize the encoder-decoder process, which effectively solves the gradient disappearance problem and improves the training efficiency and optimization ability. Secondly, the scale-aware feature extraction module (SFEM) significantly enhances the network's perceptual abilities by extending its receptive field across various scales, spaces, and channel dimensions. Thirdly, the multi-scale compression excitation module (MCEM) compresses and excites the feature map, and combines it with contextual information to obtain better model performance capabilities. Furthermore, the introduction of the attention gate module marks a significant advancement in refining the feature map output. Finally, rigorous experimentation conducted on the original jaw cyst dataset provided by Quzhou People's Hospital to verify the validity of MARes-Net architecture. The experimental data showed that precision, recall, IoU and F1-score of MARes-Net reached 93.84%, 93.70%, 86.17%, and 93.21%, respectively. Compared with existing models, our MARes-Net shows its unparalleled capabilities in accurately delineating and localizing anatomical structures in the jaw cyst image segmentation.

Gorlin-Goltz Syndrome with Multiple OKC in a 10-Year-Old Child: A Case Report

Gorlin-Goltz syndrome is rare multi-system disease, which is, characterized by neoplasms and other developmental abnormalities. 1 It is a hereditary condition inherited as an autosomal dominant trait and caused by abnormalities in the PTCH1 (Patched1) gene which is traced to the long arm of chromosome 9q22.3-q31. It is characterized by the triad of multiple baso-cellular epitheliomas, odontogenic keratocysts (OKC) in the jaws and skeletal anomalies. Early diagnosis and treatment are important for long-term prognosis of the syndrome by reducing the severity of cutaneous carcinomas and deformities due to jaw cyst. Current case discusses a 10-year-old child suffering from Gorlin-Goltz syndrome, this case report emphasizes on early diagnosis and prompt treatment of such case. Keywords OKC, Gorlin-Goltz syndrome, Multi nodular radiolucency

THE STUDY OF THE USE OF AN ERBIUM LASER FOR SURGICAL TREATMENT OF ROOT CYSTS OF THE JAWS

The problem of surgical treatment of patients with odontogenic root cysts (periodontal ligament) remains relevant to this day. This is due to the high frequency of this disease. Periodontal root cysts account for about 86% of all odontogenic cysts and 7-15% of all diseases of the maxillofacial region. In addition, the urgency of the problem of treating patients with odontogenic jaw cysts is due to the possible development of complications of surgical treatment (cystectomy or cystotomy) using cutting or rotating tools: damage to neighboring anatomical structures, infection, suture divergence and disease recurrence - all this leads to long-term treatment [1-6 ]. Despite the extensive arsenal of surgical methods and medications used to treat patients with this disease, this problem is not considered to be completely solved.

CBCT-3D radiographic analysis of an infected radicular cyst of the upper jaw: a case report

Objectives: The purpose of this case report is to find out the function of CBCT that can analyze in detail a radicular cyst case where CBCT has the ability to determine the density of a lesion. An overview of the density pattern of a radicular cyst can help determine the lesion and its margins. Case Report: : A 40-year-old patient complained of swelling in the palate that had been felt for about a year with a history of trauma due to an accident fifteen years ago. The patient underwent CBCT examination with the results of a hypodense area compared to the surrounding bone in the maxillary anterior area involving teeth 11,21,22 to 23 accompanied by a discontinuity of the cortical plate of the palatal bone and extending to involve the base of the nasal cavity. Part of the lesion is clearly demarcated, while the other side is diffuse. The suspected radiodiagnosis of the case was a moderately aggressive radicular cyst with a differential diagnosis of an odontogenic tumor. Conclusion: The final diagnosis of this case was a radicular cyst with chronic granulomatous inflammation, based on a combination of radiographic findings, clinical findings, and histopathological examination.

Decompression-first or direct enucleation: The choice of treatment for medium-sized odontogenic jaw cysts

BackgroundThe treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts. MethodsOdontogenic cysts with lesion sizes ranging 2–4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups. ResultsOut of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon's preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05). ConclusionsThere is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression.

Orofacial Cysts: A Single Institution Experience of 85 Cases in Enugu, Nigeria.

Orofacial cysts are pathologic cavities that could be symptomatic and may cause facial disfigurement. The only epidemiologic report of such lesions in Southeast Nigeria studied jaw cysts from 1987 to 1996. New studies reflecting recent research findings and classifications on the subject in Southeast Nigeria are lacking. To determine the prevalence and distribution of orofacial cysts in a tertiary hospital in Enugu, Southeast Nigeria. A 10-year retrospective study of patients with orofacial cysts diagnosed by histology was carried out. Orofacial cysts constitute 9.5% (85) of 897 orofacial lesions identified. The male-to-female gender ratio was 1.2:1. The mean age (± standard deviation) at the onset of the cystic lesion was 28.58 (±16.98) years. Developmental odontogenic cysts 52.9% (45) and salivary cysts 18.8% (16) were the most common group of orofacial cysts. The most prevalent orofacial cysts were odontogenic keratocysts at 25.9% (22), mucoceles 16.5% (14), and dentigerous cysts 14.1% (12). Straw-colored aspirates 34.8% (16) and dark brown aspirates 28.3% (13) were the predominant cystic contents. The mandible 45.9% (39) and maxilla 27.1% (23) were the commonest sites for orofacial cysts, while the lip 9.4% (8) was the most frequent soft tissue site. A significant association exists between anatomical site and cyst type at a 95% confidence interval with P = 0.000, X2 = 247.17. Unilocular radiolucency 62.5% (20) and multilocular radiolucency 34.4% (11) were the most common radiographic features. Developmental odontogenic cysts particularly odontogenic keratocysts were most prevalent while mucocele was the most common soft tissue cyst.

Epidemiological analysis of the clinicopathologic characteristics, treatment, and prognosis of 2648 jaw cysts in West China.

Epidemiological analysis of the clinicopathologic characteristics, treatment, and prognosis of 2648 jaw cysts in West China.

The Management of a Geriatric Patient Using Dabigatran Therapy on Dentigerous Cyst with Oral Bleeding.

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.

Digital pathology-based artificial intelligence models for differential diagnosis and prognosis of sporadic odontogenic keratocysts

Odontogenic keratocyst (OKC) is a common jaw cyst with a high recurrence rate. OKC combined with basal cell carcinoma as well as skeletal and other developmental abnormalities is thought to be associated with Gorlin syndrome. Moreover, OKC needs to be differentiated from orthokeratinized odontogenic cyst and other jaw cysts. Because of the different prognosis, differential diagnosis of several cysts can contribute to clinical management. We collected 519 cases, comprising a total of 2 157 hematoxylin and eosin-stained images, to develop digital pathology-based artificial intelligence (AI) models for the diagnosis and prognosis of OKC. The Inception_v3 neural network was utilized to train and test models developed from patch-level images. Finally, whole slide image-level AI models were developed by integrating deep learning-generated pathology features with several machine learning algorithms. The AI models showed great performance in the diagnosis (AUC = 0.935, 95% CI: 0.898–0.973) and prognosis (AUC = 0.840, 95%CI: 0.751–0.930) of OKC. The advantages of multiple slides model for integrating of histopathological information are demonstrated through a comparison with the single slide model. Furthermore, the study investigates the correlation between AI features generated by deep learning and pathological findings, highlighting the interpretative potential of AI models in the pathology. Here, we have developed the robust diagnostic and prognostic models for OKC. The AI model that is based on digital pathology shows promise potential for applications in odontogenic diseases of the jaw.

Application of concentrated growth factor and immediate auto transplantation on the treatment of mandibular cyst: A case report

Jaw cyst often results in varying degrees of jaw bone defects as a common disease. The presented case is a pioneering attempt to reconstruct and repair mandibular bone defect with Concentrated Growth Factor (CGF) and immediate tooth transplantation

An Unusual Case Report of Unicystic Ameloblastoma of the Mandible

ABSTRACT There are plenty of benign lesions that can result in swelling of the mandible, and these can be classified as odontogenic and non-odontogenic lesions. Among the categories of odontogenic lesion, ameloblastoma is the most occurring lesion that takes origin from the epithelial cellular elements and dental tissues in their different stages of development. Ameloblastoma is the most serious odontogenic neoplasm due to its prevalence and clinical characteristics. Ameloblastoma is a broad class which encompasses 80% of solid multicystic type of ameloblastoma with unicystic ameloblastoma (UA) variant included as vital clinicopathological form claiming the rest 20% along with peripheral ameloblastoma variant. UA refers to cystic lesions that seem like jaw cysts clinically, radiographically, or grossly but are lined by typical ameloblastomatous epithelium, with or without luminal and/or mural tumor development, on histologic investigation. Around 5–15% of all ameloblastic lesions do not have a propensity to metastasis, and this is UA. Unicystic mural form, although slow growing overall, is very invasive locally and has a high recurrence rate. As UA tumors show very close features with dentigerous cyst, a very sharp differential diagnosis protocol need to be executed to exclude the other unicystic odontogenic lesions considering the clinical, radiological, and biological characteristics along with proper follow-up and seeing any recurrence of the lesion taking place. Here, we report the case of a twenty-one year male patient with UA of the mandible and review of the literature.

Coincidence of nasopalatine duct cyst and dentigerous cyst: a rare case report

&#x0D; &#x0D; &#x0D; Dentigerous cyst is one of the most common odontogenic cysts of the jaw that slowly grows around an unerupted tooth crown. Nasopalatine duct cyst is a non-odontogenic common jaw cyst. Co-oc- currence of nasopalatine duct cyst and dentigerous cyst in the same location of the same jaw is ex- tremely rare. Odontogenic and non-odontogenic cysts occurring simultaneously in non-syndromic patients is rare. The lesions must be fully extracted by surgery. We report the treatment procedure of a patient suffering from this rare phenomenon.&#x0D; &#x0D; &#x0D;

HIMS-Net: Horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images.

Jaw cysts are mainly caused by abnormal tooth development, chronic oral inflammation, or jaw damage, which may lead to facial swelling, deformity, tooth loss, and other symptoms. Due to the diversity and complexity of cyst images, deep-learning algorithms still face many difficulties and challenges. In response to these problems, we present a horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images. First, the horizontal-vertical interaction mechanism facilitates complex communication paths in the vertical and horizontal dimensions, and it has the ability to capture a wide range of context dependencies. Second, the feature-fused unit is introduced to adjust the network's receptive field, which enhances the ability of acquiring multi-scale context information. Third, the multiple side-outputs strategy intelligently combines feature maps to generate more accurate and detailed change maps. Finally, experiments were carried out on the self-established jaw cyst dataset and compared with different specialist physicians to evaluate its clinical usability. The research results indicate that the Matthews correlation coefficient (Mcc), Dice, and Jaccard of HIMS-Net were 93.61, 93.66 and 88.10% respectively, which may contribute to rapid and accurate diagnosis in clinical practice.

Glandular Odontogenic Cyst: An Arduous Diagnostic Entity

Glandular odontogenic cyst GOC is a rare cyst that is predominantly noticed in the anterior region of the mandible with a prevalence of 0.012- 1.3 of all jaw cysts more commonly in male population with a mean age of 49.5 years. Clinically in most cases it presents as an asymptomatic swelling and radiographically it may appear as unilocular or multilocular radiolucency which is non-specific. Histopathological diagnosis is of utmost importance and it is challenging as it can resemble other jaw cysts like botryoid odontogenic cyst lateral periodontal cyst and malignant neoplasms like mucoepidermoid carcinoma. In this article we present a series of six cases reported to our institution with swelling of the face of varying extent and different radiological presentations which were diagnosed as GOC.

MFI-Net: Multi-Level Feature Integration Network With SE-Res2Conv Encoder for Jaw Cyst Segmentation

MFI-Net: Multi-Level Feature Integration Network With SE-Res2Conv Encoder for Jaw Cyst Segmentation

Cysts of the jaws and how to make their diagnoses under a microscope: a need for a better communication between clinicians and pathologists

Introduction: Cysts of the jaws constitute an heterogenous group of lesions occurring in the maxillofacial region. Their diagnosis is challenging and necessitating a meticulous correlation of clinical, radiological, and pathological features. Pathologists often face numerous difficulties stemming from inadequate clinical and radiological information, along with limited samples. Nevertheless, clinicians are not always aware of the pathologist's concerns, making difficult to know exactly which pertinent clinical information they should deliver in their request form. The objective of this article is to illustrate the microscopic diagnostic pitfalls associated with cystic lesions of the jaws and enhance communication between oral surgeons and oral pathologist. Corpus: This section starts by examining the essential clinical and radiological data necessary for a precise pathological diagnosis. Subsequently, we discuss about the differential diagnosis of jaw cystic lesions, categorizing them into five distinct subsets based on their microscopic features, particularly their histological lining. For each subset, we engage in a detailed discussion concerning the primary diagnostic challenges and their implications for treatment decisions. Conclusion: Pathologist and clinicians are not irreconcilables: improved communication, rooted in a mutual understanding of each other's concerns, leads to optimizing the diagnosis and subsequently the treatment of jaw cysts.

Enucleation of jaw cyst combined with intentional replantation to retain cyst-involved teeth

BackgroundJaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal. Materials and MethodsFifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12–14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption. ResultsNo cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment. ConclusionsIR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst.