Nasopalatine Duct Cyst Research Articles

Use of Cone-beam Computed Tomography as a Critical Component in the Diagnosis of an Infected Nasopalatine Duct Cyst Mimicking Chronic Apical Abscess: A Case Report

Nasopalatine duct cysts (NPDCs) and other nonodontogenic lesions of the oral cavity may mimic odontogenic pathoses. We present a case of a 22-year-old man with a history of dental trauma and a lesion displaying the typical clinical and radiographic signs of a chronic apical abscess— a buccal sinus tract that was traced to a radiolucent area in the periapex of a maxillary central incisor. A comprehensive diagnostic process that included a cone-beam computed tomographic scan and a histopathologic examination of the lesion after complete enucleation led to the final diagnosis of an infected NPDC. The adjacent tooth was vital at the 1-year posttreatment follow-up, and a radiograph demonstrated complete healing of the periradicular structures. This case demonstrates the ability of NPDCs to present clinical and radiographic signs similar to apical inflammatory lesions and the need for a meticulous diagnostic process in order to avoid unnecessary endodontic intervention. The article also discusses the differential diagnoses of nonodontogenic lesions in the premaxillary area.

Nasopalatine Duct Cyst: A Common Lesion with Uncommon Presentation in a Young Girl

Nasopalatine Duct Cyst: A Common Lesion with Uncommon Presentation in a Young Girl

Clinicopathologic features of nasopalatine duct cysts: A retrospective study in two Brazilian oral and maxillofacial pathology referral centers.

Background Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast.Material and Methods A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected.Results Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells.Conclusions The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopathological features with the clinical and radiographic findings to establish a correct diagnosis. Key words:Oral cavity, oral pathology, nonodontogenic cysts, diagnosis.

Bilateral Nasopalatine Duct Cyst: A Diagnostic Quandary Solved

The Nasopalatine Duct Cyst (NPDC) also commonly referred to as the anterior midline palatine cyst is a developmental cyst derived from the proliferation of embryonic epithelial remnants of nasopalatine duct. It is unique for the reason that it develops in only one location, which is the midline of anterior maxilla in close relationship to the nasopalatine canal. Radiographically, it presents as a well-demarcated ovoid or heart shaped cystic structure which is seen in close proximity to the apex of maxillary central incisors. Due to its anatomical location, it can be sometimes misdiagnosed as central giant cell granuloma, periapical cyst or follicular cyst. Chronic, large periapical lesions following traumatic injuries are challenging to diagnose and treat. The present case report described the successful management of a rare case of bilateral NPDC in a 30-year-old male patient, who gave a presentation closely mimicking that of an infected periapical cyst. The case was treated by both conventional endodontic therapy and surgical intervention. The NPDC tends to show a predilection in giving rise to squamous cell carcinomas which commonly occur in the anterior part of the maxilla. Therefore, cystic lesions seen in the premaxillary region require a thorough analysis so as to successfully treat the lesion and to avoid further complications that may arise due to a missed diagnosis.

Epidemiological evaluation of jaw cysts according to the new WHO classification: a 30-year retrospective analysis.

The aim of the present study was to analyze the epidemiology of maxillofacial odontogenic and non-odontogenic cysts diagnosed for 30 years in a Brazilian population. A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1989 and 2019. Data regarding age, gender, anatomical location, and histopathological diagnosis were collected and categorized. Further, a literature search for similar studies was performed. A total of 6.994 biopsy records were evaluated, but only 367 (5.24%) cases were classified as odontogenic cysts (OC) or non-odontogenic cysts (NOC). Among all cystic lesions, 341 cases (92.9%) were OC and 26 cases (7.1%) were NOC. These lesions were more common in females (n = 208 / 56.67%) and located mostly in the mandible (n = 195 / 53.1%). In patients with OC, the radicular cyst was the most frequent (n = 134 / 36.5%), followed by the dentigerous cyst (n = 101 / 27.5%) and the odontogenic keratocyst (n = 52 / 14.2%). Patients with NOC had a higher frequency of epidermoid cyst (n = 12 / 3.3%), oral lymphoepithelial cyst (n = 7 / 1.9%), and nasopalatine duct cyst (n = 4 / 1.1%). The OCs were more prevalent than NOCs, and inflammatory cysts were the most common among all the OCs.

Non-endodontic periapical lesions clinically diagnosed as endodontic periapical lesions: A retrospective study over 15 years.

BackgroundThis study aimed to provide the frequency and demographic data of non-endodontic periapical lesions clinically misdiagnosed as endodontic periapical lesions from a Southeast Asian population over a 15-year period. Material and MethodsA retrospective study was conducted from departmental archives between 2005 and 2019. Cases clinically diagnosed as endodontic periapical lesions were retrieved. Then, cases with a histopathological diagnosis of non-endodontic periapical lesion were selected. Demographic data of non-endodontic periapical lesions were recorded. Radiographic features of cases with available radiographs were analyzed. ResultsOf 1,566 cases clinically diagnosed as endodontic periapical lesion, 157 cases received a histopathological diagnosis of non-endodontic origin. Eighteen different histopathological diagnoses were identified. The most frequent lesion was dentigerous cyst (n= 51, 32.48%) followed by odontogenic keratocyst (n=31, 19.75%), nasopalatine duct cyst (n=18, 11.46%) and ameloblastoma (n=15, 9.56%). Three cases of malignant tumors, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and metastatic papillary thyroid carcinoma were observed. ConclusionsNon-endodontic periapical lesions constituted 10.03% of cases clinically diagnosed as endodontic periapical lesions. Histopathological examinations of non-endodontic periapical lesions revealed a variety of lesions ranging from foreign body reaction, cysts, fibro-osseous lesions, benign tumors and primary or metastatic malignant tumors. Of clinical significance is that some non-endodontic periapical lesions had different treatment modalities and prognoses compared with endodontic lesions. Therefore, dentists must be aware that periapical radiolucent lesions are not always a consequence of pulpal necrosis. Key words:Ameloblastoma, dentigerous cyst, endodontic periapical lesions, non-endodontic periapical lesions, odontogenic keratocyst.

Nonendodontic periapical lesions: a retrospective descriptive study in a Brazilian population.

Background Several nonendodontic diseases can occur in the periapical region, resembling endodontic inflammatory conditions. Therefore, the aim of the present study was to determine the frequency of nonendodontic periapical lesions diagnosed in a Brazilian population. Material and Methods The files of two Oral Pathology laboratories were reviewed and all cases including at least one clinical diagnosis of endodontic periapical lesions were selected for the study. After initial selection, demographic and clinical data, clinical diagnosis and final diagnosis were reviewed and tabulated. Final diagnosis included endodontic periapical lesions, and benign and malignant nonendodontic periapical lesions. Data were descriptively and comparatively analyzed among the three groups, with a significance level of 5% (p<0.05). Results Nonendodontic periapical lesions were identified in 208 (19%) out of the 1.125 registries included in the final sample. Benign nonendodontic periapical lesions (200 cases, 18%) were mostly odontogenic keratocysts, ameloblastomas, nasopalatine cysts, dentigerous cysts, glandular odontogenic cysts, and benign fibroosseous lesions. Malignant nonendodontic periapical lesions (8 cases, 1%) included carcinomas, adenocarcinomas, and melanoma. In general, nonendodontic periapical lesions were more common in males and in the posterior mandible (p>0.05). Conclusions The frequency of nonendodontic periapical lesions was high and, although the general distribution was similar to the results from other populations, some features were probably associated with the profile of the studied populations and to the methods applied in the present study. Knowledge on differential diagnosis of endodontic and nonendodontic periapical lesions is essential to avoid unnecessary treatments and diagnostic delay in routine dental practice. Key words:Differential diagnosis, nonendodontic, periapical lesion, pulp necrosis.

NAZOPALATİN KANAL KİSTLERİ - 3 OLGU SUNUMU VE LİTERATÜR DERLEMESİ

Nazopalatin kanal kisti ya da diğer adıyla insiziv kanal kisti, nazopalatin kanalın embriyolojik kalıntılarından meydana gelir. Gelişimsel, epitelyal ve non-odontojenik bir kisttir. Palatinal ön bölgede orta hatta lokalize olup genellikle rutin radyografik muayene sırasında tespit edilir. Bu yazıda kliniğimizde opere edilen üç adet nazopalatin kanal kisti olgusu bildirilmiş ve bu kist tipinin tanı, tedavi ve özellikleriyle ilgili literatür derlemesine yer verilmiştir.

Nasopalatin duct cysts: Report of ten cases and review of literature

Nasopalatine duct cyst is the most common non-odontogenic cyst. It develops in the midline of the anterior maxilla. It is usually asymptomatic and sometimes it can be overlooked or misdiagnosed. We present 10 patients who applied to Istanbul University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery.

Nasopalatine Duct Cyst: A Case Report and Review of Literature

Nasopalatine duct cyst is the most common developmental non-odontogenic cysts seen in the midline region of anterior maxilla. An epithelial remnant of the nasopalatine ducts remain in the incisive canal is the most common etiology. Nasopalatine duct cysts are generally asymptomatic and infrequently produce a swelling and associated pain in the anterior palate if secondarily infected. On radiograph it presents with a welldefined round, oval or heart shaped radiolucency. Histopathologically it shows non-keratinized epithelium typically with neurovascular bundles in the connective tissue capsule. Surgical enucleation is the treatment of choice. In the present case report clinical features, diagnosis and management of nasopalatine duct cyst in a 23-year-old male in the anterior maxillary palatal region is discussed.

CT Texture解析を用いた鼻口蓋管の定量性評価：正常鼻口蓋管と鼻口蓋管嚢胞との比較検討

CT Texture解析を用いた鼻口蓋管の定量性評価：正常鼻口蓋管と鼻口蓋管嚢胞との比較検討

EXTENSIVE NASOPALATINE DUCT CYST: A CASE REPORT

Nasopalatine duct cyst (NDC) is a development originating from epithelial remnants of the nasopalatine duct. NDC has a slow growth and is usually asymptomatic. The aim of this study is to describe a case of NDC in a 26-year-old male who presented with swelling in the anterior palate measuring approximately 2.5 cm on its longest diameter. Tomographic examination showed a unilocular, well-defined radiolucency with sclerotic border located between the maxillary central incisors roots. The microscopic examination revealed fragments of cystic capsule lined by a thin stratified squamous epithelium in combination with simple columnar and pseudostratified ciliated columnar epithelium. The diagnosis of NDC was made. The lesion was surgically removed by enucleation. The patient remains under follow-up. Nasopalatine duct cyst (NDC) is a development originating from epithelial remnants of the nasopalatine duct. NDC has a slow growth and is usually asymptomatic. The aim of this study is to describe a case of NDC in a 26-year-old male who presented with swelling in the anterior palate measuring approximately 2.5 cm on its longest diameter. Tomographic examination showed a unilocular, well-defined radiolucency with sclerotic border located between the maxillary central incisors roots. The microscopic examination revealed fragments of cystic capsule lined by a thin stratified squamous epithelium in combination with simple columnar and pseudostratified ciliated columnar epithelium. The diagnosis of NDC was made. The lesion was surgically removed by enucleation. The patient remains under follow-up.

NONENDODONTIC PERIAPICAL LESIONS: A RETROSPECTIVE STUDY OF A CASE SERIES

Objective: To evaluate the prevalence of nonendodontic periapical lesions (NEPLs) initially diagnosed, based on clinicoradiographic criteria, as inflammatory periapical diseases (IPDs). Study Design: Between 2000 and 2017, all cases with clinicoradiographic diagnosis of IPD sent to histopathological analysis in an oral pathology laboratory were analyzed. Among these lesions, all cases that were microscopically diagnosed as NEPL were selected for the study. The clinical and demographic data were recorded from the clinical charts. A histologic slides review was performed to confirm the diagnosis in all cases. The data were tabulated and the variables were distributed; this was done by descriptive analysis. Results: From 225 lesions with clinicoradiographic diagnosis of IPD, 13 (5.8%) were NEPL. Seven cases were in the maxilla and 6 were in the mandible. Eight cases (61.5%) occurred in women and 5 (38.5%) in men, with a mean age of 31.2 years (range, 19-53 years). Six cases (46.1%) represented odontogenic tumors (mainly ameloblastoma), 2 (15.4%) were odontogenic keratocysts, 2 (15.4%) nasopalatine duct cysts, 2 (15.4%) fibroosseous lesions, and 1 (7.7%) was a sinonasal mucosal melanoma. Conclusion: A high percentage of NEPL mimicking IPD was found. Thus, the dental practitioners should keep in mind that detailed clinical and radiographic examinations are essential for correct approach and diagnosis.

A Case of Nasopalatine Duct Cyst with Cholesterol Granuloma in Maxillary Sinus

Nasopalatine duct cysts are the most common non-odontogenic cysts that occur in the maxilla. Cholesterol granulomas, on the other hand, are commonly found in patients with chronic middle ear disease, but rarely occur in the paranasal sinuses. We report a rare case of a 30-year-old woman who was treated for a nasopalatine duct cyst and cholesterol granuloma at the same time. The patient complained of sudden nasolabial pressure and right nasal obstruction from three weeks ago. A 3 cm sized cystic mass, diagnosed as a nasopalatine duct cyst, was observed in the maxilla and haziness of the right maxillary sinus suspected of chronic rhinosinusitis was detected by computerized tomography. Marsupialization of the nasopalatine duct cyst was performed through the endoscopic transnasal approach. Solid mass in the maxillary sinus, diagnosed with cholesterol granuloma by pathology after surgery, was completely removed by endoscopic sinus surgery. The patient was followed up for 18 months without any recurrence or complications.

Recurred Nasopalatine Duct Cyst with Intraluminal Calcifications

Recurred Nasopalatine Duct Cyst with Intraluminal Calcifications

An Unusual Case of a Large Periapical Cyst Mimicking a Nasopalatine Duct Cyst

This article reports on the management of a large median symmetrical lesion of the anterior palate, which was clinically and radiographically diagnosed as an infected nasopalatine duct cyst. However, histopathology demonstrated it to be a radicular cyst of endodontic origin.

Nasopalatine Cyst or Apical Pathology? A Diagnostic Dilemma and How to Manage It

Nasopalatine cysts (NPCs) present as maxillary midline radiolucencies and are the most common radiolucency of non-odontogenic origin. The proximity of these radiolucencies to the apical region of the maxillary anterior teeth may complicate diagnosis. We are presenting two cases of maxillary midline radiolucencies with a similar presentation but different diagnoses. Reaching a definitive diagnosis may be complicated, even when a detailed clinical examination has been carried out. The use of CBCT has been a valuable addition to the diagnostic armamentarium which can help clinicians reach more accurate diagnoses in such cases. A definitive diagnosis may be established following histopathological analysis, which is indicated in symptomatic cases. CPD/Clinical Relevance: This article highlights the importance of careful assessment of apical radiolucencies associated with the maxillary midline, leading to the correct diagnoses and appropriate treatment planning.

Clinical and radiographic diagnosis of Nasopalatine Duct cyst treated by total enucleation - Case report

The nasopalatine duct cyst presents as a cyst of non-odontogenic origin, whose etiology has not yet been defined. However is believed in the theory of the proliferation of embryonic remains of the nasopalatine duct that leads to its formation. It is often detected in routine radiological examinations, which shows characteristics of a radiolucent lesion, defined, with a radiopaque halo, with a heart format due to overlapping of the anterior nasal spine. Because of this, it can be easily confused with an inflammatory periapical cyst from the upper central incisors. Besides, clinically the patient may complain of pain and swelling in the anterior region of the hard palate. The pain, pus, and swelling are usually associated with secondary infection. The present study aims to report a successful clinical case, of the diagnosis of a nasopalatine duct cyst, where the pulp sensitivity test and computed tomography helped in the treatment, that consisted in palatal access and total enucleation of the lesion. The recurrence of this cyst is low and usually affects adults from the fourth to the sixth decade of life. Treatment consists of total enucleation for small cysts or marsupialization followed by enucleation for larger cysts. This way, the imaging exams, and the clinical exam assist in the correct diagnosis, enabling the correct treatment. In our case, the total enucleation of the lesion was satisfactory, since, it did not cause damage to the adjacent structures and was the definitive treatment in only one surgical time. The patient continues been followed up, not showing symptoms or recurrence.

"Radiographic demonstration of association of ubernaculum Dentis (Gubernaculum tract) in odontogenic cysts and tumors"-A CBCT finding.

Spectrum of lesions that occur in the jaws have a cyst-like radiographic appearance. These lesions may be odontogenic or non-odontogenic and are often difficult to differentiate them on the basis of their clinical, radiographic features alone. Among odontogenic lesions without mineralization, ameloblastomas, odontogenic keratocysts, and dentigerous cysts can all appear as well-defined, unilocular, well-corticated, lucent lesions that can mimic with non-odontogenic cysts and tumors like nasopalatine duct cyst, aneurysmal bone cyst, central giant cell granuloma, hemangioma and so on. So understanding the pathogenesis of these lesions become the most imperative criteria for determining the additional investigations and treatment protocol. We hereby discuss 8 diagnosed cases of odontogenic and non-odontogenic jaw lesions, which were retrospectively visualized in cone beam computed tomography (CBCT), and an association of gubernaculum tract (cord) with odontogenic origin lesions was demonstrated.

NASOPALATINE DUCT CYST: CLINICOPATHOLOGIC, RADIOGRAPHIC, AND THERAPEUTIC FEATURES

Nasopalatine duct cyst (NDC) is a nonodontogenic developmental cyst originating from the epithelial rests of the nasopalatine duct. We report the case of a 61-years-old male patient showing a swelling of softened consistency sensitive to palpation with texture and normal coloration in the anterior region of the maxilla close to the midline. The sensibility test revealed vitality of the adjacent teeth. Radiographically, we observed a well-circumscribed unilocular radiolucent defect. An excisional biopsy was performed, and the surgical specimen was sent for histopathologic analysis, which revealed the presence of a cystic lesion lined by pseudostratified columnar epithelium with few cell layers associated with a cyst wall of dense fibrous connective tissue. Thus, the diagnosis of nasopalatine duct cyst was established. After 2 years, the postoperative control did not reveal recurrence of the lesion. Nasopalatine duct cyst (NDC) is a nonodontogenic developmental cyst originating from the epithelial rests of the nasopalatine duct. We report the case of a 61-years-old male patient showing a swelling of softened consistency sensitive to palpation with texture and normal coloration in the anterior region of the maxilla close to the midline. The sensibility test revealed vitality of the adjacent teeth. Radiographically, we observed a well-circumscribed unilocular radiolucent defect. An excisional biopsy was performed, and the surgical specimen was sent for histopathologic analysis, which revealed the presence of a cystic lesion lined by pseudostratified columnar epithelium with few cell layers associated with a cyst wall of dense fibrous connective tissue. Thus, the diagnosis of nasopalatine duct cyst was established. After 2 years, the postoperative control did not reveal recurrence of the lesion.