Nasopalatine Duct Cyst Research Articles

Automatic detection and classification of nasopalatine duct cyst and periapical cyst on panoramic radiographs using deep convolutional neural networks

The aim of this study was to evaluate a deep convolutional neural network (DCNN) method for the detection and classification of nasopalatine duct cysts (NPDC) and periapical cysts (PAC) on panoramic radiographs. A total of 1,209 panoramic radiographs with 606 NPDC and 603 PAC were labeled with a bounding box and divided into training, validation, and test sets with an 8:1:1 ratio. The networks used were EfficientDet-D3, Faster R-CNN, YOLO v5, RetinaNet, and SSD. Mean average precision (mAP) was used to assess performance. Sixty images with no lesion in the anterior maxilla were added to the previous test set and were tested on 2 dentists with no training in radiology (GP) and on EfficientDet-D3. The performances were comparatively examined. The mAP for each DCNN was EfficientDet-D3 93.8%, Faster R-CNN 90.8%, YOLO v5 89.5%, RetinaNet 79.4%, and SSD 60.9%. The classification performance of EfficientDet-D3 was higher than that of the GPs' with accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 94.4%, 94.4%, 97.2%, 94.6%, and 97.2%, respectively. The proposed method achieved high performance for the detection and classification of NPDC and PAC compared with the GPs and presented promising prospects for clinical application.

A giant nasopalatine duct cyst – A case report

The Nasopalatine duct cysts (NPDCs) are the most common developmental, epithelial and non-odontogenic cysts of the maxilla. They are generally asymptomatic and are diagnosed on routine clinical or radiographic examination. They should however be distinguished from large incisive fossae. On attaining a large size, they may cause symptoms like pain and itching, and may cause root resorption, teeth displacement or bone perforation. We report a case of a giant Nasopalatine duct cyst (NPDC) in a 65 year old female patient with surgical management.

Nasopalatine Duct Cyst in a 31 Year-Old Male: Imaging Findings in Computed Tomography

Nasopalatine Duct Cyst in a 31 Year-Old Male: Imaging Findings in Computed Tomography

Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study

IntroductionRadiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be low, they often mimic periapical pathoses, and consequently, histopathologic examinations after surgical revisions are nurtured. MethodsBiopsies submitted to the College of Dentistry between 2003 and 2021 were reviewed. Clinicopathologic characteristics were collected, including age, sex, medical history, location, sensibility tests, and clinic impressions from each specimen. Histopathologic diagnosis and gross description were also part of our database. ResultsA total of 72,055 pathology reports were reviewed, of which 10,031 lesions (13.9%) met the criterion of being intraosseous lesions at the periradicular area. Among those 10,031 lesions, 7.94% (n = 796) were of non-endodontic origin, 7153 were documented as non-vital, and 2.36% (n = 169) of these non-vital teeth were diagnosed with a non-endodontic origin. A total of 5707 lesions were obtained from surgeries within the periapical tissues, primarily performed by endodontists (94.02%). Non-endodontic lesions were reported in 1.09% of the cases. Odontogenic keratocyst was the most common non-endodontic diagnosis, followed by nasopalatine duct cyst and benign fibro-osseous lesion, respectively. ConclusionsPathologic findings of the periradicular tissues are not always from endodontic origin. The probability of encountering non-endodontic lesions is almost 8%. Even in clinically reported teeth with pulp necrosis, 1%–3% of biopsies were confirmed as non-endodontic lesions.

Interdisciplinary Management of Large Nasopalatine Duct Cyst in a Pediatric Patient: A Rare Diagnosis

Interdisciplinary Management of Large Nasopalatine Duct Cyst in a Pediatric Patient: A Rare Diagnosis

Huge Nasopalatine Duct Cyst Treated by Transnasal Endoscopic Marsupialization: A Case Report and Literature Review.

Nasopalatine duct cyst (NPDC) is the most common nonodontogenic cyst originating from the epithelial remnants of the incisive canal in the maxilla. NPDC is treated with complete enucleation via a sublabial or transpalatal approach, and recently tranasnasal endoscopic marsupialization has been gradually used. However, in large and extensive cases, it is difficult to remove the cyst completely, and there is a high risk of postoperative complications, including oronasal fistula. Therefore, tranasnasal endoscopic marsupialization is recommended as an effective treatment modality. Herein, we report a case of a 49-year-old man with a very large NPDC with a maximum diameter of 58 mm. NPDC was successfully managed by transnasal endoscopic marsupialization under general anesthesia without any major problems. No postoperative complications or recurrence occurred until 12 months postoperatively. Transnasal endoscopic marsupialization for large NPDC is minimally invasive and useful.

Nasopalatine cyst excision and bone regeneration

Introduction: The nasopalatine cyst is a non-odontogenic cyst, located within the nasopalatine duct of the maxilla, its diagnosis in most cases is by routine radiological finding and in other cases by the presence of symptomatology; coming to generate pain, paresthesia and visible signs such as facial deformities. Case description: The objective of this article is to make a literature review and presentation of the case of a 38-year-old male patient, who comes to the consultation for presenting an increase in volume in the anterior maxilla, of two years of evolution that presented favorable results after excision and placement of bone graft. Final considerations: Nasopalatine cyst represents less than 5% of the cysts at maxillary level and its recurrence is low. When it is a large cyst with destruction of the surrounding bone tissue, the best option is the use of a bone graft depending on biocompatibility, the affected site and costs. Demineralized bone matrix (DBX) is considered the gold standard due to its capacity for osteoinduction, osteoconduction and osteogenesis.

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 & 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)

Deep learning system for distinguishing between nasopalatine duct cysts and radicular cysts arising in the midline region of the anterior maxilla on panoramic radiographs.

The aims of this study were to create a deep learning model to distinguish between nasopalatine duct cysts (NDCs), radicular cysts, and no-lesions (normal) in the midline region of the anterior maxilla on panoramic radiographs and to compare its performance with that of dental residents. One hundred patients with a confirmed diagnosis of NDC (53 men, 47 women; average age, 44.6±16.5 years), 100 with radicular cysts (49 men, 51 women; average age, 47.5±16.4 years), and 100 with normal groups (56 men, 44 women; average age, 34.4±14.6 years) were enrolled in this study. Cases were randomly assigned to the training datasets (80%) and the test dataset (20%). Then, 20% of the training data were randomly assigned as validation data. A learning model was created using a customized DetectNet built in Digits version 5.0 (NVIDIA, Santa Clara, USA). The performance of the deep learning system was assessed and compared with that of two dental residents. The performance of the deep learning system was superior to that of the dental residents except for the recall of radicular cysts. The areas under the curve (AUCs) for NDCs and radicular cysts in the deep learning system were significantly higher than those of the dental residents. The results for the dental residents revealed a significant difference in AUC between NDCs and normal groups. This study showed superior performance in detecting NDCs and radicular cysts and in distinguishing between these lesions and normal groups.

Unusually Large Nasopalatine Duct Cyst- A Case Report

Palatal swellings can at times be a challenging task for clinicians to diagnose, as they may result from various aetiological factors and can derive from the structures within palate or beyond it, either be congenital or acquired in origin. Nasopalatine duct cysts are the most common developmental non-odontogenic cysts account for 10% of maxillary cysts in oral cavity. Though exact aetiology is unknown, these cysts commonly arise from epithelial remnants of nasopalatine duct and usually present as asymptomatic swelling in anterior part of hard palate posterior to the palatal papilla. A unique case report of 28-year-old male patient manifested with a large palatal swelling in the middle of the hard palate with associated symptoms of burning sensation in nose, difficulty while swallowing and change in voice resonance. Radiographic findings revealed well-defined radiolucency in anterior maxilla causing disruption in nasal cavity with histopathological evidence of nasopalatine duct cyst is presented.

Aggressive Nasopalatine Cyst with Nasal Involvement in an Edentulous Patient

The purpose of this study was to report a rare case of an aggressive nasopalatine cyst with nasal involvement in an edentulous patient. A 61-year-old edentulous Caucasian male presented with an anterior maxillary lesion that prevented him from wearing his complete upper denture. Clinical examination showed vestibular and palatal swelling around the edentulous sites of teeth #11, 12 and 13. Radiological examination revealed a well-limited cyst of the anterior maxilla that was aggressive in nature because of its size, erosion of the palatal and buccal cortical bone, and extension to the nasal floor. The provisional diagnosis was an aggressive nasopalatine duct cyst, but because the patient had been edentulous for years, the differential diagnosis also included a residual cyst. To remove the lesion, we used a slightly modified surgical procedure compared with the conventional approach: a flap was raised on the palatal side and another on the vestibular side instead of the classical palatal approach. The diagnosis of a nasopalatine duct cyst was confirmed after a histopathological examination. Large destructive nasopalatine duct cysts involving the nasal cavity are rare. In an edentulous patient, this lesion may be misdiagnosed as a residual cyst. In this case, the surgical risk was the inadvertent creation of a naso-antral communication. The lesion was completely enucleated without complications and healing was uneventful.

Dentigerous Cyst Associated with an Impacted Maxillary Supernumerary Tooth

Dentigerous cysts are common cysts of the oral cavity and are said to arise, due to an accumulation of fluid between the reduced enamel epithelium of the dental follicle and the crown of the unerupted tooth. Their indolent behaviour warrants only surgical enucleation which is curative. The occurrence of dentigerous cysts in association with impacted supernumerary teeth accounts for 5% of the total cases, making it a rare phenomenon and raising considerable concerns due to the possible metaplastic and neoplastic transformations reported to arise from dentigerous cysts. Here we report a case of a 38-year-old male patient with a slow growing swelling in the anterior maxilla which was a radiographically seen as a unilocular radiolucency with no associated calcifications and hence prompted suspicions of a nasopalatine duct cyst which was contradicted on surgical enucleation which produced two small teeth like structures.

CLINICAL AND HISTOPATHOLOGICAL FEATURES OF NASOPALATINE DUCT CYST: A 20-YEAR RETROSPECTIVE STUDY

<h3>Objectives</h3> To analyze the clinicopathologic features of nasopalatine duct cysts (NDCs) diagnosed in 2 Brazilian oral and maxillofacial pathology referral centers. <h3>Study Design</h3> A retrospective clinicopathologic study of NDCs diagnosed between 2000 and 2020 was performed. All cases were revised, and clinicopathologic data were collected. <h3>Results</h3> Among 18,121 diagnoses in the oral pathology services, 45 were NDCs (0.2%), with a slightly high prevalence of males (53.3%) and mean age of 43.2 years old. Most lesions were asymptomatic (60%), with a mean size of 2.1 cm. Microscopically, nonkeratinized stratified squamous epithelium was the most common (66.7%). However, epithelial lining varied in 88.9% of cases. There was no significant association between the type of epithelium and cyst size (<i>P</i> = .389). In the histopathological exam, nerves, blood vessels, hemorrhage and chronic inflammatory infiltrate were commonly observed. There was low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells. <h3>Conclusions</h3> Our clinical, radiographic, and microscopic findings are similar to those reported in the literature. Due to the morphological diversity of NDC, it is necessary to correlate its histopathologic features with clinical and radiographic findings to establish a correct diagnosis.

NASOPALATINE DUCT CYST AS A SWELLING IN A 22-YEAR-OLD MALE PATIENT: A CASE REPORT

The nasopalatine duct cyst is the most common nonodontogenic cyst of the oral cavity, diagnosed especially between the fourth and sixth decades of life and generally detected by routine radiographs. A 22-year-old man presented a painless swelling in the anterior region of the maxilla, with a history of a previous lesion 8 years before but without previous histological examination. Computed tomography revealed a well-delimitated hypodense area, and an excisional biopsy was performed with the hypothesis of a dentigerous cyst. Microscopic examination revealed a pathologic cavity covered by both ciliated pseudostratified columnar epithelium and a stratified squamous epithelium. The capsule was characterized by an extensive area of fibrous connective tissue, with a proliferation of vascular vessels, fibroblasts, and collagen fibers. Additionally, hyaline cartilage and nerve bundles were found. Combining clinical and histologic findings, the diagnosis of nasopalatine duct cyst was established. The patient was lost to follow-up during the pandemic.

Nonmalignant nonendodontic lesions mimicking periapical lesions of endodontic origin: A systematic review.

The objective of the study is to describe the clinical and radiographic features of nonmalignant nonendodontic periapical lesions (NMNPLs) mimicking lesions of endodontic cause. Five electronic databases, PubMed, Web of Science, Scopus, Embase, and ProQuest, were searched (till July 2021) for case reports, case series, and cross-sectional studies, in English language, reporting NMNPLs, which were clinically and/or radiographically simulating periapical pathosis of endodontic origin. Data extraction was done followed by quality assessment of the included articles using the Joanna Briggs Institute tool for case reports and case series. Seventy-three articles comprising 176 cases were included. Sixty-one articles were case reports, nine articles were case series, and three articles were retrospective studies. Male:female ratio was 1.5:1, with a higher prevalence of lesions occurring in the fourth and second decades of life. The majority of the lesions were located in the anterior maxilla. Radiographically, most of the lesions were well defined, radiolucent, and unilocular. Histologically, 29 different types of NMNPLs were reported, with the most common ones being odontogenic keratocyst (25.56%), dentigerous cyst (17.61%), ameloblastoma (11.36%), nasopalatine duct cyst (10.79%), and adenomatoid odontogenic tumor (5.68%). As all the included studies were observational, the quality of available evidence is considered low. Various features such as loss of tooth vitality, history of trauma, and presence of periapical radiolucency may lead to misdiagnosis of NMNPLs and must be considered during diagnosis of the lesion. Additional imaging modalities and histopathology can aid in right diagnosis.

Treatment of a Secondarily Infected Nasopalatine Duct Cyst: A Case Report

Nasopalatine duct cyst (NPDC) is an intraosseous, developmental, epithelial, non-neoplastic cyst and is considered the most common non-odontogenic cyst of the midline anterior palate. This cyst develops mainly from epithelial remnants in the nasopalatine duct. Following the non-vital pulp, lesions may develop in the periapical area around the apex of the anterior teeth due to the spread of infection and the formation of NPDC. Radiographically, the NPDC is well-defined round or roughly heart-shaped. Enucleation is the preferred treatment plan for removing NPDC. The presented report deals with the diagnosis and treatment of NPDC in a 30-year-old male patient with no complaints or symptoms.

Nasopalatine duct cyst occurring after secondary alveolar bone grafting: A case report

AbstractBackgroundWe describe an exceedingly rare case of a nasopalatine duct cyst that developed after bone grafting into an alveolar cleft.Case presentationA 10‐year‐old male patient with a unilateral lip and alveolar cleft underwent alveolar bone grafting. Computed tomography at the 1‐year follow‐up revealed a well‐defined, round radiolucency including the grafted bone and the incisive canal. Cystectomy and bone grafting were performed, and the resected specimen was histopathologically diagnosed as a nasopalatine duct cyst. The postoperative course was good and bone bridging was achieved, including at the alveolar cleft.ConclusionBased on our observations and the findings of previous reports, surgical stimulation due to alveolar bone grafting was suggested to have caused the NDC.

Nasopalatine duct cyst: A jigsaw puzzle

For the success of endodontic treatment outcome, diagnosis plays a very important role. Endodontic diagnosis is similar to a jigsaw puzzle which cannot be made from a single isolated piece of information. Radiography plays a vital role in diagnosing dental diseases. Overcoming the major disadvantage of two dimensional imaging of superimposing the dento-alveolar structures, 3 dimensional images by Cone Beam Computed Tomography is of great help. It is very common that when radiographs show a superimposition of the incisive foramen over the apex of maxillary central incisors, mimicking apical periodontitis, unnecessary endodontic treatment or retreatment may be prescribed. Diseases of non endodontic origin that affect the tooth apex, such as Nasopalatine duct cyst, should be included in the differential diagnosis. In the present case report the role of CBCT in diagnosis is being discussed.

Nasopalatine duct cyst with sebaceous differentiation: a rare case report with literature review

BackgroundThe aim of this study was to report a rare case of nasopalatine duct cyst with sebaceous differentiation. Further, a systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation.Case presentationA 55-year-old Korean man was referred to our hospital because of a cystic lesion of the anterior maxilla. Radiologic examination revealed a well-circumscribed radiolucent lesion in the anterior maxilla. Histology showed a respiratory columnar and cuboidal epithelium-lined cyst. Transition from the ciliated columnar epithelium to stratified squamous epithelium with sebaceous differentiation was observed. Based on these findings, the final diagnosis was nasopalatine duct cyst with sebaceous differentiation. A systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation. There were 24 cases of sebaceous differentiation in the epithelium of the cysts including 2 odontogenic keratocysts, 8 orthokeratinized odontogenic cysts, 8 dentigerous cysts, 1 radicular cyst, and 2 glandular odontogenic cysts. However, no case reports describing the occurrence of nasopalatine duct cysts with sebaceous differentiation have been reported.ConclusionThis first case report of nasopalatine duct cysts with sebaceous differentiation could provide insight into the diagnostic process of cystic lesions with sebaceous differentiation.

Peripheral Ossifying Fibroma Veiling a Nasopalatine Duct Cyst: An Unusual Concurrence.

We hereby report an unusual case which presented as a routinely encountered reactive lesion on the palate, whilst the radiological examination revealed a radiolucent cystic lesion underneath. After the investigations from radiography to histopathology, it was finally diagnosed as a peripheral ossifying fibroma coexisting with a nasopalatine duct cyst.