Odontogenic Cysts Research Articles

Identification of Molecular Mechanisms of Ameloblastoma and Drug Repositioning by Integration of Bioinformatics Analysis and Molecular Docking Simulation.

Ameloblastoma (AM) is a benign tumor locally originated from odontogenic epithelium that is commonly found in the jaw. This tumor makes aggressive invasions and has a high recurrence rate. This study aimed to investigate the differentially expressed genes (DEGs), biological function alterations, disease targets, and existing drugs for AM using bioinformatics analysis. The data set of AM was retrieved from the GEO database (GSE132474) and identified the DEGs using bioinformatics analysis. The biological alteration analysis was applied to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Protein-protein interaction (PPI) network analysis and hub gene identification were screened through NetworkAnalyst. The transcription factor-protein network was constructed via OmicsNet. We also identified candidate compounds from L1000CDS2 database. The target of AM and candidate compounds were verified using docking simulation. Totally, 611 DEGs were identified. The biological function enrichment analysis revealed glycosaminoglycan and GABA (γ-aminobutyric acid) signaling were most significantly up-regulated and down-regulated in AM, respectively. Subsequently, hub genes and transcription factors were screened via the network and showed FOS protein was found in both networks. Furthermore, we evaluated FOS protein to be a therapeutic target in AMs. Candidate compounds were screened and verified using docking simulation. Tanespimycin showed the greatest affinity binding value to bind FOS protein. This study presented the underlying molecular mechanisms of disease pathogenesis, biological alteration, and important pathways of AMs and provided a candidate compound, Tanespimycin, targeting FOS protein for the treatment of AMs.

Odontogenıc Keratocyst: A Case Report

Odontogenic keratocyst was first mentioned in the literature by Mikulicz in 1876, and described by Philipsen in 1956. These cysts are developmental odontogenic cysts arising from dental laminate remnants. Generally, these cysts can be seen in the second or third decade of life, in both mandibular and maxillary jaws; but most often they are localized in the mandibular jaw. A 23-year-old male patient who came to our clinic complaining of swelling in the lower jaw and did not have a systemic disease had a radiolucent lesion measuring about 4 * 2 cm in the mandible and lateral tooth area in the maxilla. Enucleation of radiolucent lesions which are localized in maxillary and mandibular jaws was performed. Both lesions were sent to the pathology laboratory for detailed examination. Extraction of the impacted right mandibular canine was made. According to the pathology report, a diagnosis of odontogenic keratocyst was made to both lesions. In this case keratocysts were seen as multiocular, and it was suspected that there could be Gorlin Goltz syndrome. According to the medical genetic report of the patient, who does not have any systemic diseases, Multilocular Odontogenic Keratocysts could not be associated with Gorlin Goltz syndrome.

Treatment of supra-infected mandibular cysts using a decompression device. A case report

The golden standard treatment for odontogenic cysts of the jaws is the method of enucleation or cystectomy. Although this method is commonly used, it has some disadvantages: it is traumatic, there is a high risk of damage to adjacent anatomical structures (mandibular canal, maxillary sinus, nasal cavity) or to the vascular-nervous bundle of the teeth adjacent to the formation, and it is limited to patients with concomitant decompensated chronic pathologies. Therefore, in the case of large-sized cysts (over 3 cm), minimally invasive methods (decompression with aspiration or marsupialization) are more frequently used. Therefore, in this article, the authors described the treatment of a clinical case of a giant infected odontogenic cyst of the mandible, using for the first time a special decompression and aspiration device, individually made of acrylate. As a result, the cystic cavity decreased in volume, and the process of bone apposition contributed to the removal of the formation from the mandibular canal content, which allowed the removal of the remaining cystic membrane without damaging it, avoiding the risk of subsequent paresthesia.

A Rare Case of Dentigerous Cyst in a 1-day-old Neonate

Dentigerous cysts are the second-most common odontogenic cysts which are of developmental pathology. These cysts have a very rare occurrence during the first decade of life with a predilection for males compared to females. We report the earliest occurrence to date of a large dentigerous cyst of maxillary origin in a 1-day-old male baby. We were able to successfully manage the baby with a conservative surgical approach.

Prevalence and Pattern of Oral and Maxillofacial Pathology in Al‐Qassim Region, Saudi Arabia

Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al‐Qassim region, Saudi Arabia.Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients’ data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel.Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological‐mediated lesion category (13%). The sub‐diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively.Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al‐Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region.

Interdisciplinary Management of Orthokeratinized Odontogenic Cyst

Wright in 1981 identified orthokeratinized variant of the odontogenic keratocyst and named it as orthokeratinized odontogenic cyst (OOC). Due to its different histopathology and reduced likelihood to recur, he held it to be distinct from the parakeratotic type. It usually occurs in the mandible and after surgical removal, it showed rare recurrence. Numerous studies have shown that OOC has typical characteristic clinicopathologic features when compared to other developmental odontogenic lesions such as keratocystic odontogenic tumors and dentigerous cysts. This case report is a typical example of an odontogenic lesion diagnosed histopathologically as OOC in the maxilla having clinic-radiographic features similar to dentigerous cyst. Interdisciplinary management of OCC helps in proper diagnosis, plan treatment, and provide the best quality of care to the patient.

Immunohistochemical evaluation of yes-associated protein molecule in the odontogenic epithelium of different histopathological variants of ameloblastoma and unicystic ameloblastoma.

Ameloblastoma is one of the major odontogenic neoplasms with an invasive and recurrence potential. Its tumourigenesis and proliferative capacity can be attributed to the activation or inactivation of certain molecular signalling pathways. Hippo signalling pathway is known to regulate diverse physiological processes related to mitosis and organ growth and is an emerging tumour suppressor pathway, the dysfunction of which is implicated in various diseases including cancers. Yes-associated protein1 (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) are the downstream effectors in the Hippo cascade, which on nuclear activation leads to cellular proliferation in various tumours. The current study was undertaken to evaluate the expression of YAP in various histopathological variants of ameloblastoma and unicystic ameloblastoma. Fifty formalin-fixed paraffin-embedded tissue samples of histopathologically diagnosed cases of ameloblastoma, and 10 histopathologically diagnosed cases of unicystic ameloblastoma were obtained from the departmental archives to evaluate the immunohistochemical expression of YAP both manually and by software analysis. More than 90% of cases of conventional ameloblastoma and unicystic ameloblastoma elicited positive expression of YAP. No statistical difference was found among different histopathological variants of conventional ameloblastoma. Significant difference between the means of all four quantitative score groups was observed. In view of the modulating effect of YAP in tumourigenesis and its higher expression in ameloblastoma, further exploration of this molecule appears to be a promising area of research.

A large radiolucent lesion with impacted teeth: was it an ameloblastoma or a dentigerous cyst? a case report

Objectives: This case report aims to describe a large radiolucent lesion associated with an impacted tooth from CBCT radiographs. Case Report: A 19-year-old woman was referred to have a CBCT examination in the dentomaxillofacial radiology unit in Dental Hospital Universitas Padjadjaran with swelling on the palatal side of the face and a lump on the gum at the upper right unerupted canine and premolar. The CBCT examination results showed impacted teeth 13 and 14 with a large radiolucent lesion with a well-defined and corticated border surrounding teeth 13 and 14, expanding into the maxillary sinus and nasal cavity. Oral hygiene was in good condition. The facial profile looked asymmetrical. Conclusion: Based on the CBCT result in terms of location and radiographic feature, this extensive radiolucent lesion led to a suspect radiodiagnosis of the ameloblastoma. Histology examinations are required to establish a definitive diagnosis. A cyst wall lined with odontogenic squamous epithelium was confirmed in the histology result examination.

Intraosseous Dentinogenic Ghost Cell Tumor – A Case Report and Review of Literature

Dentinogenic ghost cell tumor is an extremely rare odontogenic neoplasm that was initially considered to be a solid variant of Calcifying Odontogenic Cyst with locally aggressive nature. The main characteristic features of DGCT are ameloblastoma like odontogenic epithelial proliferation, an aberrant keratinization in the form of ghost cells and dysplastic dentin. DGCT occur as two forms intraosseous and extra osseous of which more aggressive intraosseous variety requires careful monitoring and aggressive local resection to prevent recurrence. Here we are reporting a case of intraosseous Dentinogenic ghost cell tumor in a 65 years old male patient with a clinical presentation of bony hard swelling in the right mandibular posterior region. This lesion was diagnosed with clinical, radiological, and histopathological investigations which revealed it to be rare entity. Key words: Calcifying odontogenic cyst, Dentinogenic ghost cell tumor

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.

Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.

Orthokeratinized odontogenic cyst: a case report

Orthokeratinized odontogenic cysts (OOC) are rare developmental odontogenic cysts characterized by an ortho-keratinized stratified squamous epithelial lining. They were originally believed to be part of the spectrum of Odontogenic Keratocyst but are now considered a distinct entity.They comprise approximately 1% of all odontogenic cysts and about 10% of cases previously coded as odontogenic keratocysts. They usually occur as a single radiolucent lesion.In this paper, we present a case of OOC and compare them to previous case reports and a literature review.

Orthodontic management of a developing dentigerous cyst related to lower second molar: a case report

The dentigerous cyst is a developmental odontogenic asymptomatic cyst, that is associated with the crown of an unerupted or impacted tooth. Early diagnosis is important to avoid any future complications and choose the best treatment option. The purpose of this case report is to describe the management of a dentigerous cyst related to lower second molar in a young female patient using orthodontic traction as a conservative treatment approach. This procedure helps to spare the patient an unnecessary surgical excision procedure and the associated excessive bone removal for a safety margin, stimulates bone healing and promotes the eruption of the cyst-associated tooth.

Evaluation of biological behavior of odontogenic cysts through epithelial and stromal characterization: A histochemical study

Objectives: Odontogenic lesions include a broad range of pathologies that depend upon an inductive process toward odontogenesis before hamartomatous/neoplastic growth. The epithelium and stroma have an imperative role in pathogenesis and biological behavior. Hence, the study aims to evaluate the biology of the epithelium and stroma in odontogenic cysts (OCs). Material and Methods: Histochemical analysis was done (Hematoxylin and Eosin stain, Papanicolaou stain, toluidine blue, and picrosirius red) to determine the presence of keratin, epithelial thickness, mast cells (MCs), and the nature of collagen in OCs. Results: Keratin was absent in highly inflamed cases. MCs play a crucial role in cyst pathogenesis. In addition, polarizing microscopy helps in depicting the pattern of collagen fibers. Conclusion: The epithelium and the nature of stroma have an imperative role in the biological behavior of OCs.

Immunohistochemical Comparison of Ki-67 and MCM-3 in Odontogenic Cysts: An Observational Study.

Odontogenic cysts are a diverse group of pathologic entities with different proliferation potential, leading to variations in their biological behavior. One of the most cited proliferation markers used in diagnostic histopathology is Ki-67. Another group of proteins recently investigated is minichromosome maintenance (MCM-3) and its expression has been evaluated in several odontogenic lesions but the results were controversial. Thus, the present study endeavored to compare the expression of MCM-3 and Ki-67 in odontogenic cysts. Furthermore, a pioneer attempt was made to evaluate the sensitivity of these markers to inflammation. A total of 101 cases (37 dentigerous cysts, 37 odontogenic keratocysts, and 27 radicular cysts) were included. Immunohistochemical expression of Ki-67 and MCM-3 were investigated using a labeling index (LI). In addition, they were scored for inflammation, followed by correlation with both markers. The data obtained were subjected to statistical analysis ( P <0.05). Overall, a higher LI of MCM-3 than Ki-67 was obtained in all study groups along with a positive correlation of Ki-67 LI with inflammation. Thus, MCM-3 proteins proved to be a more accurate means to determine the proliferation potential and were not sensitive to external stimuli like inflammation than conventional markers, such as Ki-67.

The Relationship Between Odontogenic Cyst and P53 Codon 72 And P53 Codon 175 Variants in Turkish Patients

Objective: Odontogenic cysts that cause bone destruction can exhibit various types of metaplasia. Inherited genetic variants in codons 72 and 175, the hotspot codons of p53, known as the guardian of the genome, can cause a wide variety of cancers. We aimed to investigate the effects of the p53 codon 72 and p53 codon 175 variants on odontogenic cyst formation. Methods: This research encompassed 71 individuals with odontogenic cysts and 90 without any conditions as a control group. After DNA was extracting, the p53 codon 72 was detected using PCR techniques, while p53 codon 175 was identified through allele-specific amplification-PCR. Results: The presence of the p53 codon 72 GG genotype and its G allele was less frequent in the group with odontogenic cysts compared to the healthy participants. Conversely, the C allele was found more often in the cyst-afflicted group. For the p53 codon 175, the AA genotype and A allele were more common in the affected group, while the G allele was more predominant in the control group. Conclusion: The p53 codon 175 AA genotype and A allele, p53 codon 72 C allele, and p53 codon 72/codon 175 CCAA combined genotype may be associated with odontagenic cyst formation. Individuals with this allele and genotype can be considered at risk for odontagenic cyst formation.

The Incidence of Devitalization of Vital Teeth Associated with Pathologies of the Jaws Following Surgical Intervention: A Mixed-case Study.

The purpose of this mixed-case study is to explore the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws. The records of 341 biopsies submitted to the institute's histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up. There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia. Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection. Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.

Current Perspectives on Paradental Cyst: A Literature Review.

Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.

23. 3D printed decompression stent for the treatment of extensive odontogenic cysts

23. 3D printed decompression stent for the treatment of extensive odontogenic cysts

P102 Glandular odontogenic cyst – report of a case and a review of the literature

P102 Glandular odontogenic cyst – report of a case and a review of the literature

Adenoid Ameloblastoma- A very rare, odontogenic tumor variant with less than 20 reported cases in the literature: Report of two cases and literature review

Abstract Introduction/Objective We describe two cases of Adenoid Ameloblastoma (AA), a very rare, hybrid variant, of two of the most common odontogenic neoplasms (Ameloblastoma and adenomatoid odontogenic tumors). AA is a benign epithelial odontogenic tumor characterized microscopically by epithelium resembling conventional ameloblastoma, with additional duct-like structures, epithelial whorls, and cribriform architecture. Dentinoid deposits, clusters of clear cells, and ghost-cell keratinization may also be present. These tumors do not harbor BRAF or KRAS mutations and their molecular basis appears distinct from conventional ameloblastoma but remains unknown. The lesion tends to recur, and sometimes, only correctly diagnosed after recurrence. Methods/Case Report Adenoid Ameloblastomas were identified after a review of the Temple University, Department of Pathology archive from 2012-2022. A total of four specimens (two patients) were identified. Results (if a Case Study enter NA) Case# 1 22-years-old female Biopsy Location/ size: Mandible, left, 2.1 cm. Microscopic: Neoplastic proliferation composed of odontogenic epithelium in a plexiform pattern with the formation of pseudo glandular structures of variably sized cystic spaces, the peripheral epithelial cells are palisaded with reversed polarity. The central cells have clear cytoplasm and resemble stellate reticulum with occasional tight whorls of cells noted. Hemorrhage and giant cells are present in granulation tissue. The lesion was incompletely excised. Diagnosis: Benign odontogenic tumor. Case#2 (1st occurrence): -49-years-old male -Biopsy -Location and size of lesion: Maxilla-left anterior, 0.9 cm. -Microscopic: Cyst lined by loosely arranged epithelial cells with a basal cell layer having hyperchromatic and palisaded nuclei. Knots of squamous cells are present within the cyst lining. The luminal layer is flattened to cuboidal and nonkeratinized. Duct-like openings are present within the epithelium and contain myxoid stromal tissue. Focally the epithelium extends into the connective tissue as thin anastomosing strands surround the myxoid tissue. -Diagnosis: Benign odontogenic tumor. Case#2 (2nd occurrence): -Biopsy -Diagnosis: Benign odontogenic tumor Case#2 (3rd occurrence): -Excisional biopsy -Diagnosis: AA Conclusion AA is a rare, aggressive odontogenic tumor variant with morphologic overlap with other odontogenic lesions; therefore, oral pathologists and clinicians should be familiar with this entity to achieve an accurate diagnosis and prompt management.