Odontogenic Lesions Research Articles

Expression of ALKBH5 in Odontogenic Lesions.

N6-methyladenosine (m6A) is the most abundant epigenetic RNA modification in eukaryotes and plays a role in various cancers in humans. This m6A modification is regulated by m6A writers, erasers, and readers. One of the m6A erasers is α-ketoglutarate-dependent dioxygenase homolog 5 (ALKBH5). Previous studies have suggested that ALKBH5 is involved in the pathogenesis of head and neck squamous cell carcinoma. However, the role of ALKBH5 in odontogenic lesions has never been investigated. This study aimed to examine ALKBH5 expression in dental follicles (DFs), dentigerous cysts (DCs), odontogenic keratocyst (OKC), and ameloblastoma (AM) using immunohistochemistry. Six cases of DF, 20 cases of DC and OKC, respectively, and 30 cases of AM were included. The expression patterns, percentage of ALKBH5-positive cells, staining intensities, and immunoreactive scores were examined. ALKBH5 was mainly expressed in the nuclei of the epithelial cells in odontogenic lesions. The percentage of ALKBH5-positive cells was significantly higher in OKC and AM samples compared with DF samples (P < 0.01). The percentage of ALKBH5-positive cells was also higher in OKC and AM samples than in DC samples; however, these results did not show statistical significance (P > 0.05). ALKBH5 cell staining intensities and immunoreactive scores were significantly greater in OKC and AM samples than in DF and DC samples (P < 0.01). Our results suggested that ALKBH5 might play a role in the pathogenesis of odontogenic lesions. Further investigation is needed to elucidate the precise molecular mechanism of the role of ALKBH5 in these diseases.

Histone H3K9 Methylation Is Differentially Modified in Odontogenic Cyst and Tumors.

Histone modification in odontogenic lesions is mostly unexplored. Trimethylation of histone H3 at lysine residue 9 (H3K9Me3) has been studied in various pathologic conditions and showed biological significance promising for future therapeutic application. This study aimed to investigate the level and clinical relevance of the H3K9Me3 histone modification in odontogenic cysts and tumors. A total of 105 cases of odontogenic lesions, comprising 30 odontogenic keratocysts (OKCs), 30 adenomatoid odontogenic tumors (AOTs), 30 ameloblastomas, and 15 dental follicles, were included in the study. The paraffin-embedded tissues were immunohistochemically stained for H3K9Me3. Both the intensity and the distribution of staining were evaluated and calculated as H-score. The correlation between the H3K9Me3 expression and the clinical characteristics of each lesion was evaluated. The Kruskal-Wallis test followed by Bonferroni's correction was performed to assess the differences in H-score among groups. In addition, Pearson's chi-squared test or Mann-Whitney U test was used to analyze potential factors that could affect protein expression. The reduced enamel epithelium of the dental follicle showed uniformly strong H3K9Me3 expression. All odontogenic cysts and tumors examined demonstrated a significantly reduced H3K9Me3 level compared with dental follicles. The AOT showed the lowest H3K9Me3 level, followed by OKC and ameloblastoma. Its immunoreactivity was mainly localized in the basal and parabasal cells of OKC and the whorled/duct-like structures of AOT. Ameloblastoma exhibited marked variation in the H3K9Me3 level among cases. Notably, the upregulated H3K9Me3 was related to multilocularity of OKC and ameloblastoma. Histone H3K9 methylation is differentially expressed in odontogenic cysts and tumors. This epigenetic modification may contribute to the pathogenesis and aggressive behavior of odontogenic lesions.

Histopathological spectrum of primordial odontogenic tumor with co-existing dentigerous cyst: 1st reported case of the world with a proposed ‘updated diagnostic criteria’

BackgroundPOT is a relatively newly described benign odontogenic tumor with very few cases registered to date. We present the 1st case of Primordial odontogenic tumor (POT) from Sub-Saharan Africa with unique clinicopathological features; also, this is the first case to report POT’s existence as a Hybrid Odontogenic lesion (HOL), with a pertinent review of the literature.Case presentationThis was a 17-year-old patient who presented with slow-growing, painless posterior mandibular swelling. The imaging revealed a well-defined, unilocular, expansile, lytic lesion with internal calcific foci surrounding an impacted #36, indicating a calcifying odontogenic cyst. The incisional biopsy revealed the presence of POT. The tumor was excised along with the involved tooth.ConclusionPOT is predominantly a non-aggressive and mostly affects the pediatric population. Hence, clinicians must be updated on all the aspects of this tumor to diagnose it appropriately and avoid any undue over—or under-treatment.

Maxillary Giant Radicular Cyst: A Case Presentation and Management

Objectives: Radicular cysts are the most frequent odontogenic cystic lesions, they are inflammatory cysts that involve the apex of affected tooth and appear as well-defined radiolucencies. Most radicular cysts are small, but they can grow quite large due to their capacity for significant expansion, invasion of adjacent tissues, and rapid growth. They also have a high recurrence rate. We present here a rare case of a giant maxillary radicular cyst in a 60-year-old patient, aiming to highlight the clinical and radiological aspects, as well as the importance of enucleation with extraction of the offending tooth/teeth in the surgical management of these cysts. Methods: a 60-year-old male patient presented with an extensive involving the left anterior area of the maxilla. The cone-beam computed tomography (CBCT) image suggested the presence of an odontogenic cyst at the size of 50 mm × 30 mm in the affected side. For treatment, an enucleation of the cyst, along with the extraction of the association tooth, was performed. Results: The diagnosis of radicular cyst was established on the resected specimen. There were no signs of recurrence two years following the surgery. Conclusions: Imaging plays a crucial role in accurately diagnosing and assessing the extent of the cyst. Surgical treatment primarily relies on enucleation with extraction of the offending tooth which is essential for effective management and to minimize recurrence.

Immunohistochemical Evaluation of p300, H2AacK5 and H3AcK27 in Odontogenic Cysts and Tumors.

The acetylation of histones H2A on lysine 5 (H2AacK5) and H3 on lysine 27 (H3AcK27) modulate several cellular mechanisms through the p300 enzyme in pathological lesions; however, their role in odontogenic lesions has not been addressed. This study aims to evaluate the immunoexpression of p300, H2AacK5, and H3AcK27 in samples of ameloblastoma (AMB) (n = 30), odontogenic keratocyst (OK) (n = 15), adenomatoid odontogenic tumor (AOT) (n = 10), odontogenic fibroma (OF) (n = 8), calcifying odontogenic cyst (COC) (n = 8), odontogenic myxoma (MIX) (n = 10), and ameloblastic fibroma (AF) (n = 06). The percentage of p300-positive cells was higher in AOT and decreased in COC, OK, AMB, AF, OF, and MIX. H2AacK5-positive cells were higher in AF and decreased in AOT, COC, OK, OF, AMB, and MIX, whereas H3acK27-positive cells were higher in AOT and decreased in COC, OK, AF, OF, AMB, and MIX. The expression of these proteins was higher in nonaggressive lesions in comparison to aggressive lesions. There was a positive correlation between p300 and H2AacK5, and H3acK27 in AMB, MIX, and OF, whereas there was a positive correlation between p300 and H2AacK5 in AOT and COC. The histone acetylation may be involved in the biological behavior of these lesions, which could be used to improve their diagnosis and treatment.

The Effect of Decompression on Histologic Diagnoses of Cystic Jaw Lesions.

The aim of this study is to investigate if and how decompression alters histopathologic diagnoses of cystic jaw lesions. A retrospective study was conducted on patients with a histologic diagnosis of an odontogenic cystic lesion that was surgically treated with decompression followed by a definitive surgery. The correlation between variables including age, gender, location of the lesion, decompression time and the change in histopathologic diagnosis following decompression was analyzed. Thirty-nine patients were included in the study. The mean decompression time was 7.87 ± 3.43 months. Post-decompression histologic examination at time of definitive surgery was consistent with the initial biopsy diagnosis in 83.33% (5 of 6) of odontogenic keratocysts (OKCs), 94.11% (16 of 17) of radicular cysts, 100% of dentigerous cysts, and 100% of residual cysts. The change in histopathologic diagnosis of the cystic lesions was not found to be statistically correlated with the study variables. Histopathologic diagnoses of odontogenic cystic lesions predominantly remain unchanged after decompression. A treatment protocol based on the initial diagnosis may be appropriate for odontogenic cystic lesions that are considered for decompression before definitive surgery.

BRCA1/2 Immunohistochemical Analysis in Unicystic Ameloblastoma, Multicystic Ameloblastoma, and Ameloblastic Carcinoma

Background: Lesions arising from odontogenic tissues cover a wide spectrum, from simple cysts to benign tumors and even carcinomas. Unicystic ameloblastoma (UA), multicystic ameloblastoma (MA), and ameloblastic carcinoma (AC) are relatively common among these odontogenic lesions. Nevertheless, the exact origin of these lesions remains unclear. It is noteworthy that BRCA1/2 mutations have been identified as potential contributing factors to the onset of various cancers. The aim of the current study was to scrutinize the BRCA1/2 expression profiles in UA, MA, and AC samples. Methods: Biopsy specimens were collected from 60 patients, with 20 samples representing each lesion, sourced from the pathology department archive of a teaching hospital from 2000 to 2019. Immunohistochemical staining was conducted on all biopsy samples. Statistical analyses were performed using the Kruskal-Wallis H test. The differences in the data were compared with Mann- Whitney U test, and P&lt;0.05 was considered to be significant. Results: The Kruskal-Wallis test results revealed significant differences between the examined samples in terms of the cytoplasmic expression level of the BRCA1 basal cells (P&lt;0.001). Regarding the cytoplasmic expression of BRCA1 stellate reticulum-like cells, there was a statistically significant difference between the examined groups (P&lt;0.001). Furthermore, the results of the Kruskal-Wallis test demonstrated a significant difference concerning the cytoplasmic expression levels of BRCA2 basal cells between the studied groups (P&lt;0.003). Based on the Kruskal-Wallis results, significant differences were found in terms of the cytoplasmic expression level of BRCA2 stellate reticulum-like cells between the investigated samples (P&lt;0.001). The Mann-Whitney U test compared differences between the two examined groups. Conclusion: The findings mainly revealed the expression of BRCA1/2 at the invasive front, which is composed of the most aggressive cells. Molecular interactions in this area may affect tumor progression. BRCA1/2 mutations can be a promising future treatment option for ameloblastoma and related lesions.

Registration of thermal images of dead teeth to identify odontogenic infection foci

Infrared thermal imaging (IRT) remotely and contactless maps the temperature on the examined surface, recording the distribution of infrared radiation emitted by each body whose temperature is higher than absolute zero. The aim of the study was to evaluate the usefulness of thermography in the assessment of asymptomatic infection foci in patients with high systemic infection. The 150 cases diagnosed based on roentgenograms, divided into 6 groups of diagnosed odontogenic lesions, along with a control group. Thermal imaging was performed with a FLIR Systems T1020 thermal camera. Thermal image analysis was performed using ThermaCAM Researcher Pro 2.10, MS Office Excel 2022 and Statistica 10. The periapical areas of selected dead teeth were selected as areas of interest. The Mann Whitney’s U test showed statistically significant (p < 0.001) differences in average temperature between each patient’s and healthy group. Depper’s analysis showed statistical significance also between the ZM and BZ groups (p = 0.004). Moreover, obtained results may also suggest that thermal imaging can be useful in identify odontogenic infection foci. The thermal asymmetry of periapical tissues of teeth differentiates dead from living teeth, as well as individual pathologies related to the process of gangrenous pulp decay. Thermographic mapping is a promising diagnostic technique that can detect asymptomatic inflammations that carry the risk of infection of the entire body.

Intraosseous myofibroma mimicking an odontogenic lesion: case report, literature review, and differential diagnosis

BackgroundIntraosseous myofibroma of the jaw is a rare neoplasm of mesenchymal origin with limited comprehensive understanding. It typically affects patients in the first two decades of life with a male predilection.Case presentationThis study presents a rare case of myofibroma mimicking an odontogenic lesion in a 2-year-old boy. The patient presented with an incidental finding of a painless swelling of the right mandibular ramus of unknown etiology. Imaging analysis revealed a solid, expansile lesion adjacent to the germinal zone of the right mandibular first molar. Histopathologic analysis and immunohistochemistry after incisional biopsy suggested a possible central odontogenic fibroma, and the patient underwent total enucleation, leading to the final diagnosis of intraosseous myofibroma. Follow-up examinations showed no evidence of recurrence.ConclusionsThis report contributes to the understanding of myofibroma in pediatric patients and underscores the critical role of meticulous histopathologic examination for effective surgical planning and optimal patient outcomes.

Podoplanin immunoexpression in odontogenic lesions: a systematic review, meta-analysis, and integrated bioinformatic analysis

BackgroundPodoplanin (PDPN) is a transmembrane glycoprotein implicated in the pathogenesis of odontogenic lesions (OL). It is localized at the membrane and cytoplasmic level, and its interaction with other proteins could trigger cell proliferation, invasion and migration. The main objective of this systematic review is to explore the immunoexpression pattern of podoplanin in OL. In addition, as secondary objectives, we aimed to compare the immunostaining intensity of PDPN in OL, to analyze its interaction networks by bioinformatic analysis and to highlight its importance as a potential diagnostic marker useful in the pathogenesis of OL.MethodsThe protocol was developed following PRISMA and Cochrane guidelines. The digital search was performed in the databases: PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science and Google Schoolar from August 15, 2010 to June 15, 2023. We included cross-sectional and cohort studies that will analyze the pattern of PDPN immunoexpression in OL. Two investigators independently searched for eligible articles, selected titles and abstracts, analyzed full text, conducted data collection, and performed assessment of study quality and risk of bias. In addition, part of the results were summarized through a random-effects meta-analysis. STRING database was used for protein-protein interaction analysis.ResultsTwenty-nine relevant studies were included. The ages of the subjects ranged from 2 to 89 years, with a mean age of 33.41 years. Twenty-two point two percent were female, 21.4% were male, and in 56.4% the gender of the participants was not specified. A total of 1,337 OL samples were analyzed for PDPN immunoexpression pattern. Ninety-four (7.03%) were dental follicles and germs, 715 (53.47%) were odontogenic cysts, and 528 (39.49%) were odontogenic tumors. Meta-analysis indicated that the immunostaining intensity was significantly stronger in odontogenic keratocysts compared to dentigerous cysts (SMD=3.3(CI=1.85-4.82, p=0.000*). Furthermore, bioinformatic analysis revealed that PECAM-1, TNFRF10B, MSN, EZR and RDX interact directly with PDPN and their expression in OL was demonstrated.ConclusionsThe results of the present systematic review support the unique immunoexpression of PDPN as a potential useful diagnostic marker in the pathogenesis of OL.

Immunohistochemical Analysis of CD117 in the Mast Cells of Odontogenic Keratocysts.

Odontogenic lesions contain mast cells (MCs), particularly those with a cystic appearance. Because of their high recurrence rates and aggressive clinical behaviour, odontogenic keratocysts (OKCs) require special treatment. A particular kind of protein called cluster of differentiation (CD) 117/ receptor tyrosine kinase (c-KIT) is present on the surface of many cells. Most hematopoietic cells lose their expression of KIT during the differentiation process, with the exception of MCs, which continue to express KIT throughout their lifetime. Using the CD117 immunomarker, this immunohistochemical investigation sought to assess the presence and location of MCs in OKCs and examine the relationship between MC numbers in sporadic, syndromic, and recurrent OKCs. The study comprised 30 paraffin-embedded tissue specimens, and a histopathological diagnosis was made from hematoxylin and eosin-stained sections with a thickness of 4-5 µ. Out of 30 specimens, 21 were sporadic, six were recurrent OKCs, and three were syndrome-associated OKCs. CD-117/c-kit rabbit polyclonal primary antibody was used to stain the sections for observing MCs, which were then viewed under a light microscope with a digital camera and a desktop computer with MICAPS software for viewing images. To compare the number of MCs among OKCs, a one-way ANOVA test was used. Our study revealed that a statistically significant increase in MCs has been observed in the subepithelial and deep connective tissue of recurrent OKC (p < 0.05). However, a comparison of the mean MC value among three OKC subtypes did not reveal any statistically significant differences. An increased mast count was observed in the deep connective tissue layer of syndromic OKC under multiple comparisons. Our study concluded that MCs were present in increased numbers both in the superficial and deep connective tissue of recurrent OKCs, indicative of their aggressive clinical behaviour. Increased mean MC counts observed in some of the sporadic cases may be an indicator of their chances of recurrence in the future.

Odontogenic Maxillary Sinusitis: A clinical case report

underdiagnosed due to its nonspecific clinical presentation, which overlaps with other types of rhinosinusitis. The etiopathogenesis involves a complex interplay of factors including iatrogenic causes, periodontal infections, and traumatic events, leading to a persistent inflammatory response in the maxillary sinus. This report details a clinical case involving a 19-year-old male patient presenting with exacerbated sinusitis symptoms linked to a carious upper right first molar. Clinical manifestations included blurred vision, facial pain, and nasal regurgitation of liquids. Radiographic analysis revealed a radiolucent area indicative of sinus involvement, confirming the diagnosis of OMS.Surgical intervention comprised the extraction of the infected molar and the debridement of the maxillary sinus, followed by the application of Bichat’s fat pad to repair the resulting oroantral communication. This technique demonstrated effective closure of the defect, promoting tissue healing and reducing postoperative complications. The postoperative regimen included antibiotics, anti-inflammatories, and antihistamines, which facilitated recovery. This case underscores the necessity of a multidisciplinary approach in the diagnosis and management of OMS, integrating dental and surgical expertise to optimize patient outcomes. Imaging plays a crucial role in the diagnostic process, enabling precise identification of odontogenic lesions and their extent. The successful use of Bichat’s fat pad highlights its utility in oral-maxillofacial surgery for managing oroantral fistulas. This report contributes to the growing body of evidence supporting the importance of tailored surgical and medical strategies in managing complex cases of odontogenic maxillary sinusitis.

Magnetic Resonance Imaging Signal Intensity in the Characterization of Odontogenic Lesions: A Systematic Review

Magnetic Resonance Imaging Signal Intensity in the Characterization of Odontogenic Lesions: A Systematic Review

Gingival Cyst of the Adult: A Case Description with a Relevant Literature Analysis

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic tumors. The aim of this paper is to report a new case occurring in an adult, analyzing the clinical, radiographic, and histopathological features as guidelines for a differential diagnosis. We report a 49-year-old patient complaining of a small, pigmented lesion localized on the attached gingiva with no history of trauma, which was surgically excised and histologically diagnosed as a gingival cyst. A differential diagnosis may be challenging for clinicians it includes a wide spectrum of inflammatory and non-inflammatory lesions, so a correct diagnostical–therapeutical approach is needed to avoid possible overtreatment and minimize the recurrence rate.

Ameloblatoma: An aggressive odontogenic neoplasm with altered vickers and gorlin criteria

Plexiform ameloblastoma is a rare aggressive odontogenic neoplasm comprising about 1% of all odontogenic lesions of the jaw arising from cells of enamel organ that has failed to differentiate to form the hard tissues of tooth. Clinically, Ameloblastoma presents as painless swelling of jaw occurring in 3 and 4 decade in the posterior region of the mandible with equal sex distribution. It shows multiple patterns including solid, unicystic, extra osseous and desmoplastic type. Due to its varied presentation and relative risk of recurrence, it possesses a great challenge to physician for early diagnosis. Vickers and Gorlin (V and G) criteria is an integral part of diagnosis of histological types of Ameloblastoma. This article aims to highlight the variations observed in V and G criteria in the histopathological features of mixed variety of Ameloblastoma in a middle aged man.

Odontogenic cystic lesion segmentation on cone-beam CT using an auto-adapting multi-scaled UNet.

Precise segmentation of Odontogenic Cystic Lesions (OCLs) from dental Cone-Beam Computed Tomography (CBCT) is critical for effective dental diagnosis. Although supervised learning methods have shown practical diagnostic results in segmenting various diseases, their ability to segment OCLs covering different sub-class varieties has not been extensively investigated. In this study, we propose a new supervised learning method termed OCL-Net that combines a Multi-Scaled U-Net model, along with an Auto-Adapting mechanism trained with a combined supervised loss. Anonymous CBCT images were collected retrospectively from one hospital. To assess the ability of our model to improve the diagnostic efficiency of maxillofacial surgeons, we conducted a diagnostic assessment where 7 clinicians were included to perform the diagnostic process with and without the assistance of auto-segmentation masks. We collected 300 anonymous CBCT images which were manually annotated for segmentation masks. Extensive experiments demonstrate the effectiveness of our OCL-Net for CBCT OCLs segmentation, achieving an overall Dice score of 88.84%, an IoU score of 81.23%, and an AUC score of 92.37%. Through our diagnostic assessment, we found that when clinicians were assisted with segmentation labels from OCL-Net, their average diagnostic accuracy increased from 53.21% to 55.71%, while the average time spent significantly decreased from 101s to 47s (P<0.05). The findings demonstrate the potential of our approach as a robust auto-segmentation system on OCLs in CBCT images, while the segmented masks can be used to further improve OCLs dental diagnostic efficiency.

Neuroectodermal influence in odontogenic cyst and tumor: evidence through CD56 immunoexpression.

CD56, associated with neuroectodermal differentiation of the embryonal cells, is often considered a marker of neural lineage. Odontogenic keratocysts (OKCs) are of particular interest because of their characteristic histopathologic features, high recurrence rate, and aggressive behavior. CD56 immunoreactivity in these lesions has been reported with very high frequency. The present study analyzes the immunoexpression of CD56 in ameloblastoma (AM) and OKC to infer neuroectodermal influence in the pathogenesis of odontogenic lesions and its correlation with clinicopathologic parameters. Fifty histopathologically confirmed cases of OKC and AM, 25 from tooth-bearing (TB) and molar-ramus (MR) regions each, and 5 dental follicular tissues as control were collected from the department archives and immunohistochemical analysis with CD56 was carried out. CD56 immunopositivity was seen in 64% AM and 36% OKC cases. The majority of AM cases showed cytoplasmic expression in the peripheral cells of odontogenic islands; similarly, OKC cases showed continuous and uniform cytoplasmic expression in the basal and parabasal cells of the cystic lining. CD56 immunopositivity was found in more AM cases as compared to OKC cases in both the TB and MR regions. The assessment of CD56 immunoexpression in odontogenic cyst and tumor (AM) may aid in understanding the role of neuroectodermal influence in the etiopathogenetic pathways and a possible influence of CD56 on the clinical behavior and aggressiveness of the odontogenic lesions. A correlation of CD56 expression with the clinical outcome of the disease (site, perforation, root resorption, and tooth displacement) can help envisage possible prognostic assessment for these lesions.

Odontogenic Cutaneous Fistula: A Zombie Diagnosis.

Odontogenic cutaneous fistula (OCF) is a pathologic communication between the cutaneous surface of the face and oral cavity. Majority of oral cutaneous fistulas are reported to arise from chronic dental infection. Delay in treatment may result in chronic tissue injury as well as cosmetic deformities. Lesions are often misdiagnosed, leading to delayed management. Misdiagnosis may be the result of the variability of clinical morphological presentation and location of lesions compounded by the lack of knowledge that these lesions can have dental etiology. It is estimated that half of patients with OCF undergo multiple dermatologic surgical operations, antibiotic regimens, and other excisions and biopsies before a correct diagnosis is made. Herein, we present a systematic review to detail cases of odontogenic cutaneous lesions that had been previously misdiagnosed or managed inappropriately. In addition, we include a case report from our own institution. The aims are to demonstrate various presentations of OCF, increase awareness of plastic surgeons and oral maxillofacial surgeons to this pathological condition, and reinforce the importance of prompt diagnosis and treatment. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in PubMed, Web of Science, and Cochrane databases from January 1, 2013 to July 24, 2023. The following search terms were utilized: "odontogenic cutaneous fistula" OR "odontogenic cutaneous sinus." Twenty-three articles published between 2013 and 2023 were included in this review. In addition, we report a case from our own institution. A total of 28 cases were included in the review. Diagnosis of OCF is challenging for numerous reasons. Misdiagnosis can lead to multiple trials of antibiotics and surgical procedures as well as reoccurrence of the lesion. Cases summarized highlight the importance of communication between oral maxillofacial surgery, plastic surgery, other medical subspecialists, and dentists in the evaluation of patients with head and neck lesions. Physicians should consider dental etiology in the differential diagnosis of orofacial skin lesions, even if teeth appear normal on oral examination.

Evaluation of Paxillin Expression in Odontogenic Cysts and Tumors.

Paxillin (PXN) is one of the proteins involved in cell adhesion. PXN and integrins constitute a key site for the focal adhesion between the cell and extracellular matrix. Several studies have shown that PXN is a factor in tumor formation, progression, invasion, and metastasis. This study evaluated PXN expression in four types of odontogenic lesions with different aggressive behaviors. In this retrospective cross-sectional study, PXN expression was immunohistochemically assessed in 68 paraffin-embedded tissue samples from patients with the confirmed diagnosis of four types of odontogenic lesions, including 14 dentigerous cysts (DC), 20 odontogenic keratocyst (OKC), 16 unicystic ameloblastoma, and 18 solid ameloblastoma. The PXN expression in these samples were scored based on the percentage and intensity of immunoreactivity, and compared among the groups by Chi-square test. The PXN marker was detected in the cytoplasm of tumor cells (unicystic and solid ameloblastoma) and the epithelial layer of cysts (DC and OKC). The intensively stained marker of PXN was observed in 9 cases (64.3%) of the DC, 14 cases (70%) of OKC, 12 cases (75%) of unicystic ameloblastoma, and 13 cases (72.2%) of solid ameloblastoma. However, there was not statistical difference of PXN protein expression between DC and OKC (p Value = 0.51) and unicystic and solid ameloblastoma (p = 0.58), also the same was true for cysts and tumors (p = 0.37). The expression of PXN is not related to the biological behaviors of odontogenic lesions.

Ameloblastic Carcinoma of Anterior Mandible - A Case Report

Odontogenic malignancies are rare and have spectrum of clinical presentations, making diagnosis challenging. Ameloblastic carcinoma(AMCa) is a rare odontogenic malignant lesion with characteristic clinical and histopathological features. Histologically it resembles ameloblastomatous tumor cells with cellular atypia. In this presentation, we are going to discuss a case of ameloblastic carcinoma of the anterior mandible in a 75-year-old male patient with a typical aggressive clinical course which posed a diagnostic difficulty due to variable histopathological presentation.