Lateral Periodontal Cyst Research Articles

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.

Odontogenic Keratocyst Imitating Lateral Periodontal Cyst: A Case Report

Collateral Odontogenic Keratocyst (OKC), a rare variant of OKC, is usually present in the mandibular premolar area and is often confused with lateral periodontal cysts due to common features. A 58-year-old male patient presented with a painless swelling in the mandibular left premolar area. The clinical and radiographical features were suggestive of a lateral periodontal cyst. Surgical enucleation followed by peripheral ostectomy was performed and the sample was sent for histopathological examination. The histopathological study demonstrated typical features of OKC. Owing to the high recurrence rate, the patient is kept on regular follow-up. During follow-ups, there were no clinical and radiographical signs of recurrences.

USE OF CONE BEAM COMPUTED TOMOGRAPHY GRAY SCALE VALUES FOR DIAGNOSING TUMORS AND CYSTS

The retrospective study was conducted in the Department of Radiology of the hospital from January 2022 to January 2023 to assess the ability of CBCT gray scale value to diagnose tumors and cysts and evaluate differences in bony changes of both. A total of 50 patients were included in the study. CBCT scanner with 68-1073μSv radiation dose was used for obtaining 3D images. Gray scale values were obtained on the tangential section. Radiological diagnosis was made after calculating mean gray values for benign lesions or cysts. Myxoma, odontogenic ghost cell tumor, and the adenomatoid odontogenic tumor had lower grayscale values, and multiple myeloma, cementoblastoma, acanthomatous ameloblastoma, residual cyst, and lateral periodontal cyst had higher values. The mean grayscale value for the tumor was 1468 ± 70.5, and for the cyst was 1292.1 ± 6.5. There was a significant correlation between both (P<0.001). The bone density of normal and pathological maxillofacial regions was compared. The radiolucent area (e.g., axillary sinus) had the lowest, and the radiopaque region (e.g., enamel) had the highest gray scale value. CBCT gray value is a powerful diagnostic tool for tumors, cysts, and other orofacial lesions and has better outcomes than conventional 2-D imaging.

Management of Lateral Periodontal Cyst with Platelet Concentrate

Abstract 
 A periodontal cyst (LPC) is considered a rare developmental odontogenic cyst, originates from epithelial rests in the periodontal ligament, and is a non-inflammatory cyst on the lateral surface of the root of a vital tooth. This case report features a 22-year-old female who complained of a painful hyperplastic lesion that had been present for two months between the distobuccal site of her maxillary right lateral incisor (#12) and the mesiobuccal site of her maxillary canine (#13). Radiographically, an interproximal periodontal cyst appears on the side of the root and extends to the apex of an involved tooth as a radiolucent area with a well-defined bordered by a radiopaque line that cannot be differentiated from that of a periodontal abscess. This case report discusses the management of LPC using surgical enucleation with adjunctive use of regenerative platelet concentrate.

Recurrent peripheral odontogenic keratocyst: Review of the literature and presentation of a novel case initially masquerading as an atypical infected lateral periodontal cyst

AimTo review published cases and case series of the peripheral odontogenic keratocyst (POKC) of the gingiva, report an unusual presentation, and discuss lesional recurrence. Materials and methodsA search of the English language literature for gingival OKCs was conducted. The inclusion of new case yielded a database containing 29 affected patients. Clinical, surgical, radiographic, and histopathologic findings have been summarized. ResultsWith available patient demographics, 62.5% were female and 37.5% were male, with an overall mean age at diagnosis of 53.8 years. There was near-equal lesional affinity for the jaws, of which 44.0% occurred in the posterior region, 32.0% anteriorly, and 24.0% overlapped these areas. Twenty-five percent of lesions had a normal color, 30.0% appeared yellow, 20.0% were white, and 10.0% were blue. The majority of lesions were < 1 cm and nearly 42% manifested exudation or fluctuance. Lesional pain was infrequent. Pressure resorption was recorded in 45.8% of cases. Most lesions were managed with conservative surgical modalities. Follow-up information was available in 16 primary cases, of which 5 recurred, signifying a 31.3% recurrence rate, including the featured case, which recurred twice. ConclusionTo reduce recurrence of a gingival OKC, supraperiosteal dissection is advocated. Further, it is advised to follow POKCs for 5–7 years postoperatively, remaining vigilant for subtle clinical manifestations of recurrence. Timely discovery and excision of a POKC of the gingiva may decrease the incidence of a mucogingival defect.

Glandular Odontogenic Cyst Mimicking a Dentigerous Cyst: Case Report

The glandular odontogenic cyst (GOC) is a locally invasive development cyst. It clinically affects patients aged 40-70 years, with the most common occurrence being in the anterior region of the jaw. Radiographically, GOCs are typically unilocular or multilocular, and radiolucent, with well-defined margins, often mimicking dentigerous cysts, lateral periodontal cysts, and globulomaxillary cysts. Histologically, GOCs are characterized by the presence of epithelial tissue with columnar cells that sometimes appear as ciliated, mucous cells, with the formation of microcysts and ductiform structures. The present case report describes a rare case of GOC in an unusual location, presenting clinical features and radiographs similar to a dentigerous cyst involving tooth 48. The glandular odontogenic cyst (GOC) is a locally invasive development cyst. It clinically affects patients aged 40-70 years, with the most common occurrence being in the anterior region of the jaw. Radiographically, GOCs are typically unilocular or multilocular, and radiolucent, with well-defined margins, often mimicking dentigerous cysts, lateral periodontal cysts, and globulomaxillary cysts. Histologically, GOCs are characterized by the presence of epithelial tissue with columnar cells that sometimes appear as ciliated, mucous cells, with the formation of microcysts and ductiform structures. The present case report describes a rare case of GOC in an unusual location, presenting clinical features and radiographs similar to a dentigerous cyst involving tooth 48.

GLANDULAR ODONTOGENIC CYST, A RARE ENIGMA – A CASE REPORT &amp; LITERATURE REVIEW

The glandular odontogenic cyst (GOC) is a rare cyst that was rst described in 1988 as a distinct entity. This lesion can occur in either jaw and is a rare developmental odontogenic cyst that resembles several other odontogenic lesions. However, GOCs have non-specic clinical and radiographic ndings, and diagnosing them can be very difcult given their rarity. Furthermore, GOCs may be difcult to diagnose because they have overlapping histologic features with other intraosseous lesions, such as the lateral periodontal cyst and its botryoid variant, and the dentigerous cyst with metaplastic changes. In this study, we report a new case of GOC in a 42-year-old female patient and review previous cases reported in the literature. We discuss the different kinds of features which will help a clinician distinguish GOC from other lesions.

Conservative Management of a Case of Lateral Periodontal Cyst Mimicking a Periodontal Abscess

Abstract Lateral periodontal cyst (LPC) is a relatively uncommon, usually asymptomatic developmental odontogenic cyst occurring on the lateral aspect of a vital tooth. The present case reports one such lesion. The patient had pain in gums along lower front teeth with occasional pus discharge since two month. Lingually, the tooth 41 had a periodontal pocket of 6 mm. It was vital and grade II mobile. The distinct radiographic picture changed the management plan. The radiograph showed a distinct well defined radiolucency on the middle third portion of the root. A provisional diagnosis of LPC was made. Conservative surgical curettage and enucleation of the cyst was performed under local anesthesia. Autogenous bone graft was harvested from the parasymphyseal region and placed in the defect. Lower anterior teeth were splinted and periodontal dressing was placed. Histopathological report was suggestive of a developmental odontogenic cyst. The patient is regularly followed up with no recurrence yet and an improving bone-fill of the defect. The case could have been easily misdiagnosed and managed as an abscess draining through the periodontal pocket. A seemingly routine case was managed conservatively after proper diagnosis by thorough clinical, radiographic, and histopathological examination improving the prognosis of the involved tooth.

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.

Diversity of an Odontogenic cyst of Jaws – A case report with literature review

A dental lesion called a lateral periodontal cyst (LPC) can appear on a tooth's lateral radicular surface. Standish and Shafer described LPC for the first time in 1958. The mandibular premolars are where this cyst is most frequently found, however it has also been noted in other places too. The average age of incidence is 52 years, and there is no preference for any race or gender. It is frequently found during routine radiography examinations. The remnants of dental lamina in the alveolar bone are most likely the histogenetic source of LPC. The lateral periodontal cyst is surgically removed, and there is no risk of recurrence. The present article aims to present a case of Lateral periodontal cyst in anterior mandible in a young female patient with added literature review.

LATERAL PERIODONTAL CYST: A CASE REPORT

Lateral periodontal cyst (LPC) is an uncommon developmental cyst. The lesion often presents as a unilocular mandibular radiolucency adjacent to a vital tooth. About one-third of LPCs can be associated with tooth displacement. A 16-year-old male patient was referred to the clinic presenting an asymptomatic intraosseous lesion in the edentulous left premolar region. Periapical radiography revealed a radiolucent area delimited by a radiopaque halo in the alveolar bone. The clinical diagnosis was residual cyst, and it was treated by enucleation. Histological examination showed a cystic capsule lined by thin, nonkeratinized stratified epithelium with thickening areas containing clear cells. Those findings are compatible with LPC. After the final diagnosis, the patient did not return. Unilocular LPCs have a good prognosis, with recurrence rates of approximately 2%. Lateral periodontal cyst (LPC) is an uncommon developmental cyst. The lesion often presents as a unilocular mandibular radiolucency adjacent to a vital tooth. About one-third of LPCs can be associated with tooth displacement. A 16-year-old male patient was referred to the clinic presenting an asymptomatic intraosseous lesion in the edentulous left premolar region. Periapical radiography revealed a radiolucent area delimited by a radiopaque halo in the alveolar bone. The clinical diagnosis was residual cyst, and it was treated by enucleation. Histological examination showed a cystic capsule lined by thin, nonkeratinized stratified epithelium with thickening areas containing clear cells. Those findings are compatible with LPC. After the final diagnosis, the patient did not return. Unilocular LPCs have a good prognosis, with recurrence rates of approximately 2%.

IMMUNOEXPRESSION OF STEM CELL MARKERS IN DEVELOPMENTAL ODONTOGENIC CYSTS

<h3>Objectives</h3> Developmental odontogenic cysts (DOCs) originate from remnants of the odontogenesis, rich in multipotent stem cells (SC). The aim was to evaluate the immunoexpression of multipotent SC markers in DOCs and to compare aggressive and indolent cysts. <h3>Study Design</h3> Immunohistochemistry using the immunoperoxidase technique was performed on 42 DOCs using monoclonal antibodies for CD44 and CD90. The sample consisted of 20 odontogenic keratocysts (OKs), 7 dentigerous cysts (DCs), 7 glandular odontogenic cysts (GOCs), 4 calcifying odontogenic cysts (COC), 2 adult gingival cysts, 1 lateral periodontal cyst, 1 botryoid odontogenic cyst, and 1 orthokeratinized odontogenic cyst. <h3>Results</h3> DOCs revealed immunopositivity in epithelium and capsule for CD44 and CD90. CD44 immunoexpression in epithelium and capsule was superior in OK, followed by DC and GOC (<i>P</i> = .000). For CD90, only the capsule showed greater expression in OK, followed by calcifying odontogenic cyst and DC (<i>P</i> = .000). Aggressive cysts (OK and GOC), when compared to indolent cysts, showed superior positivity for CD44 in the epithelium (<i>P</i> = .007) and for CD90 in the capsule (<i>P</i> = .006). <h3>Conclusions</h3> Multipotent SC can participate in the histogenesis and pathogenesis of DOCs. This study also suggests that multipotent SC can be associated with the distinct biological behaviors of these lesions.

SPINDLE CELL TUMOR INVOLVING THE JAW OF A YOUNG PATIENT

An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor. An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor.

Usage of Guided Bone Regeneration in the Case of Lateral Periodontal Cyst in the Maxilla with Buccal Cortical Expansion

A lateral periodontal cyst (LPC) is a rare finding. Patients diagnosed with LPC younger than 40 years of age are not that common. Mostly asymptomatic LPCs can be discovered on routine radiographs as an oval radiolucency between two mandibular premolar teeth roots and can vary in shape and size. Most cases are treated with enucleation, bone curettage, or a combination of both, greatly depending on the surgeon’s preference. Because most LPCs are quite small, lesions do not require any regenerative procedures. In the presented case, because of cortical expansion of the lesion and loss of vital bone bridge surrounding two adjacent maxillary teeth, a guided bone regenerative procedure (GBR) with xenograft bone substitute was used. Despite that small lesions can heal on their own, nowadays the approach of full-mouth therapy (FMT), including direct soft or hard tissue reconstruction in the oral cavity, seems to be a wise treatment. The presented paper presents and describes an unusual LPC case with cortical bone expansion in a very rare maxillary canine–premolar region.

The spectrum and frequency of histopathological diagnosis of oral diseases in Oslo: Implications to oral pathology syllabus.

To assure knowledge and skills in diagnostic work of oral diseases a continuously updated curriculum is essential. The first aim of the present study was to evaluate the spectrum and frequency of oral histopathological diagnoses signed out by oral pathologists at the Department of Pathology, Oslo University Hospital (OUS), Norway during a two-year period. The second aim was to compare the spectrum of histopathological diagnoses with the content of the current syllabus in oral pathology at the Faculty of Dentistry, University of Oslo (UiO). In this retrospective cross-sectional study, all histological diagnosis signed out during 2015 and 2016 were included. All histopathological reports were analysed with regard to clinical information and histopathological diagnosis. The spectrum of histopathological diagnoses was compared to the diagnoses presented in lectures and courses for dental and dental hygienist students at UiO. Three thousand four hundred and two histopathological reports (47% males and 53% females) were included. The diagnoses were categorised into eight disease groups and the three most frequent disease groups were cysts, benign tumours/reactive lesions, and white, red, ulcerative and vesiculobullous lesions. The lateral periodontal cyst was more frequent than expected. We conclude that a minor revision of the syllabus is needed, although the most frequent oral conditions presented in this study are well covered in the oral pathology teaching in Oslo. A more clinical related teaching approach should be considered by categorising oral diseases according to, for example location and age groups.

Case series of Adenomatoid Odontogenic Tumors: Clinical, Radiographic, and Histologic Features

<h3>Objective</h3> We present a case series of adenomatoid odontogenic tumor (AOT), a benign odontogenic tumor from a large biopsy service. AOT has a limited growth potential and is often seen in children and young adults, between the ages of 10-19 years. AOT has uncertain pathogenesis and studies suggest enamel organ, reduced enamel epithelium, and rests of Malassez as potential sources. Clinically, AOT's are asymptomatic and identified upon routine radio- graphic examination. <h3>Methods</h3> Information was collected from the University of Florida Oral Pathology Biopsy Service archives (1994-2019). The clinical and demographic data along with any accompanying radiographic images and original slides were evaluated. <h3>Results</h3> A total of 26 cases of AOT were identified, with a mean age of 22.3 years (range: 12-67). A slight female predilection was noted (57.7%, n=15). Most cases presented in the anterior region of the jaw (73%, n=19) and a slight maxillary predilection was observed (61.5%, 16 cases). Most patients were aged under 20 (69.2%, n=18). Clinical impression included dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst (57.7%, n=15). Radiographs were available for six cases and all presented as a unilocular radiolucency. The histologic diagnosis was consistent with AOT in 24 cases and peripheral AOT in two cases.One case had a fo- cal area of CEOT that tested positive with a Congo Red stain. <h3>Conclusion</h3> In almost all cases within the study the clinical impression of AOT was not rendered. This implied that AOT is rarely considered in the differential of such lesions. In addition, while most patients were children or young adults, there were a few outliers above thirty (19.2%, n=5). This may suggest that AOT is diagnosed late in some cases due to its benign nature. Clinicians should be sentient of this lesion as the treatment and prognosis differs from other odontogenic cysts and tumors.

Calcifying Epithelial Odontogenic Tumor: A Case Series Spanning 25 years

The calcifying epithelial odontogenic tumor (CEOT), also known as the Pindborg tumor, is a rare benign neoplasm which makes up less than 1% of all odontogenic tumors. The purpose of this study is to describe a series of cases of CEOT spanning 25 years. METHODS: With IRB approval, all cases diagnosed as CEOT between 1994 and 2019 were retrieved from the archives of the UF Oral Pathology Biopsy Service. RESULTS: A total of 22 cases were included in the study. Patient age ranged from 8 years to 70 years with an average of 40 years. Females were affected slightly more often (55%, n=12) than males (45%, n=10). The mandible was a more common location (55%, n=12) than the maxilla (45%, n=10) by a small margin. A clinical impression was provided by the clinician in 17 cases, of which the most common (53%, n=9) was that of a cystic lesion (including dentigerous/follicular cyst, periapical/inflammatory cyst, lateral periodontal cyst and odontogenic keratocyst). Radiographs were available for 7 cases and the most common radiographic presentation was a unilocular mixed radiolucent/radiopaque lesion (43%, n=3). Lesion du- ration was provided in 9 cases and the range was from 3 months to 10 years. The histologic diagnosis of CEOT was made for all cases. One case was believed to represent a recurrent tumor. Also included were the variants "incip- ient CEOT" (8%, n=2) and "peripheral CEOT" (8%, n=2). One case exhibited features of adenomatoid odontogenic tumor in addition to CEOT. Congo red staining for amyloid was performed in 14 cases, all of which were positive. CONCLUSION: CEOT is an uncommon tumor with a variable presentation and affects patients across a wide age range. Although most cases are intraosseous, the peripheral counterpart is occasionally encountered.

Adenomatoid odontogenic tumor: a series of 28 cases from a biopsy service.

Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with an excellent prognosis, often seen in children and young adults. The aim was to examine the spectrum of clinical, radiographic, and histologic attributes of AOT and assess clinician recognition of this entity. In addition, diagnostic considerations and treatment modalities were explored. With Institutional Review Board approval, archival cases of AOT from the University of Florida Oral Pathology Biopsy Service (1994-2019) were examined. Clinical and demographic data along with accompanying radiographs and original slides were reviewed. A total of 28 cases of AOT were identified. These were all solitary in nature, with a mean age of 20.6 years (range 12-67 years). Most patients were under 20 (75.0%) with a definite female predilection (64.3%). Anterior jaws remained the most common location (85.2%), with a higher maxillary predilection (57.1%). Clinical impression included odontogenic lesions such as dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst. The spectrum of features of AOT is described. As clinicians were unfamiliar with AOT, highly characteristic features of AOT and more unique variants are discussed extensively to improve diagnostic aptitude. Clinicians must remain aware of this entity, as treatment is minimal compared to other odontogenic entities.

Atypical Lateral Periodontal Cyst- Case Report and Diagnosis

Lateral periodontal cyst is a rare developmental odontogenic type of cyst. It is being frequently diagnosed as an incidental radiographic finding, presenting as a well circumscribed round or tear shaped radiolucent area between the roots of vital teeth. It is often misdiagnosed as one of the lesion of endodontic origin. This case reports of a classical example of lateral periodontal cyst describing its clinical, radiological and histological features representing that the final diagnosis must be based on histopathological examination.

Ağız İçi Ultrasonografi ile Teşhis Edilmiş Bir Lateral Periodontal Kist

A lateral periodontal cyst (LPC) is a non-inflammatory odontogenic cyst that usually develops around the lateral root surfaces of premolars and canines. Patients usually visit clinics with complaints of painless swelling in a localized area of the mouth. Generally, the related teeth are vital, with no other symptoms. On radiographs, LPCs can be seen as regular and oval radiolucent lesions. Depending on their location and shape, the lesions may not be visible on panoramic radiographs in some cases, thereby necessitating the use of advanced imaging methods. Advanced imaging methods, such as ultrasonography (USG), can be used to diagnose these lesions. Intraoral USG is a rare application of USG, which has recently been introduced in the field of dental radiology. In dentistry, intraoral USG has been used for the examination of salivary glands and their ducts, the floor of the mouth, mucosal lesions, the tongue, periodontal tissues, and periapical lesions. In this case, a LPC case diagnosed by using intraoral USG and conventional imaging and treated surgically is presented.