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Odontogenic cysts are commonly seen in clinical practice. Surgical enucleation of these cysts becomes challenging when they form adjacent to anatomically important structures. Recently, computer-assisted surgery using computer-aided preoperative simulation and augmented reality (AR) has been applied in oral and maxillofacial surgery. The authors have introduced a new AR system that eliminates the need for markers and uses image recognition of the teeth to overlay the surgical field with preoperative surgical simulation images. This report describes two cases of cystectomy performed using an AR-assisted system, one for recurrent odontogenic keratocyst and the other for a dentigerous cyst. The teeth were scanned using a 3D intraoral scanner, while the face was scanned using a computed tomography scanner. A 3D reconstructed image of the mandible was generated, and a dentofacial skeleton model was designed using the intraoral and CT scan data. A camera was used to capture the clinical image and validate the AR. Two cystectomy cases performed using the AR-assisted system and preoperative planning are reported. This new AR system, which eliminates the need for markers and uses image recognition of the teeth to overlay the surgical field with preoperative surgical simulation images, has the potential to provide more accurate and efficient guidance during surgery. [ABSTRACT FROM AUTHOR]

Ameloblastoma, odontogenic keratocyst (OKC), and dentigerous cyst (DC) can have similar radiographic and histological appearances. The purpose of this study was to determine the utility of BRAF immunohistochemistry in discerning mandibular ameloblastomas from OKCs and DCs. This retrospective cohort study included patients treated between 1998 and 2018. Inclusion criteria include incisional biopsy-proven mandibular ameloblastoma, OKC, or DC, and sufficient tissue for immunohistochemistry. The primary predictor variable was the type of lesion. The primary outcome variable was the presence/absence of BRAF V600E immunoreactivity. The cohort consisted of 43 patients (19 female, 24 male; mean age 48 ± 17 years). There were 22 ameloblastomas, 11 OKCs, and 10 DCs. Among ameloblastomas, 68.2% (15/22) stained positive for BRAF V600E; no OKC or DC was positive (P < 0.001). By subtype, the majority of the follicular (83.3%), unicystic (83.3%), desmoplastic (66.7%), and acanthomatous (100%) subtypes were positive, but only 33.3% of the plexiform subtype were positive. BRAF immunohistochemistry may be a useful adjunct in the differentiation of ameloblastoma from OKCs and DCs on incisional biopsies. It may be particularly useful for small samples with a prominent cystic component or equivocal histopathology. Mandibular lesions that are BRAF immunohistochemistry positive are unlikely to be DCs or OKCs. [ABSTRACT FROM AUTHOR]

Oral and maxillofacial surgeons commonly encounter dentigerous cysts (DCs) in clinical practice. If the DC is large and involves vital structures, such as the inferior alveolar nerve, marsupialization can be a useful treatment option to reduce the cyst size, ensuring safer enucleation later. However, the process of postoperative cyst shrinkage remains largely unknown. We used three-dimensional (3D) computed tomography (CT) to analyze volumetric changes occurring in DCs after marsupialization. In addition, we evaluated several parameters that might influence the efficiency of volume reduction. This retrospective cohort study included 21 patients with mandibular DCs in the third molar region. Using 3D CT data obtained before and after marsupialization, we measured cyst volumes at approximately 6 and 12 months after marsupialization. All lesions gradually shrank after marsupialization. The relative velocity of volume reduction differed significantly between 6 and 12 months after marsupialization. Age was significantly related to the efficiency of cyst shrinkage at 12 months after marsupialization. The efficiency of cyst shrinkage was not correlated with sex, smoking status, tooth extraction, or CT values around the lesion. Marsupialization was effective in reducing cyst size in all patients. The efficiency of volume reduction caused by marsupialization was associated with marsupialization duration and patient age. These factors should be considered during marsupialization and subsequent follow-ups. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify nonendodontic periapical lesions (NPLs) mimicking endodontic pathosis, which are most frequently encountered by clinicians. A retrospective study was conducted on biopsies obtained from 2015–2020 at Texas A&M College of Dentistry's oral pathology laboratory. The online database was screened for cases submitted as suspected endodontic pathology using specific key words. Histologic diagnoses were collected to determine the prevalence of NPLs that were originally thought to be of endodontic origin. The frequency and percentage of endodontic pathology and NPLs were documented. Among 6704 biopsies clinically diagnosed as endodontic lesions, 190 (2.8%) were histopathologically diagnosed as NPLs. The most frequent NPLs were odontogenic keratocytes' (n = 70, 36.8%), cemento-osseous dysplasia (n = 27, 14.2%), and dentigerous cysts (n = 22, 11.6%). Of all NPLs, 3.7% were malignant neoplasms, with the most common diagnosis being squamous cell carcinoma. Of 6514 endodontic histologic diagnoses, the prevalence of periapical granulomas and cysts was 60.2% (n = 3924) and 39.1% (n = 2549), respectively. Although most endodontic submissions are likely to be histologically diagnosed as periapical granulomas or cysts, the clinician should be aware that a small portion of these lesions may be nonendodontic in origin and possibly neoplastic in nature. Histopathologic evaluation of biopsied specimens is critical to achieve a proper diagnosis to ensure the appropriate management of patients. [ABSTRACT FROM AUTHOR]

Erythropoietic protoporphyria is a rare disease and is potentially fatal because of the accumulation of porphyrin metabolites and associated liver dysfunction resulting from surgical invasion, acute photosensitivity, and administration of certain drugs. Therefore, intraoperative and perioperative stress, light stimulation, and the drugs used in oral surgical treatments must be carefully considered. Herein, we present the case of a 52-year-old man who underwent liver transplantation due to EPP exacerbation and in whom a left mandibular dentigerous cyst was found during postoperative observation. To reduce any stimulus during oral surgery, we performed a preoperative examination and used shading films for the excision of the dentigerous cyst without causing perioperative acute porphyric attack. [ABSTRACT FROM AUTHOR]

Matrix metalloproteinases (MMPs) are involved in remodeling the extracellular matrix, but also participate in the development of physiopathologic processes. As they are overexpressed in different types of epithelial cancers, it has been suggested that their level expression could explain the different biological behavior between odontogenic cysts and tumors. Here, we compared the expression level and proteolytic activities of MMP-2 and MMP-9 in dental follicles, dentigerous cysts, odontogenic keratocysts and unicystic ameloblastomas. We found similar expression of MMP-2 in all tissues, but a higher activity in cystic and tumor lesions than follicles. On the other hand, MMP-9 expression and activity was greater in cysts and ameloblastoma than in follicles. However, no differences were found in expression or activity of both MMPs between cystic and tumor injuries, suggesting that they could participate in the growth of these lesions, but they cannot define their different biological behavior. [Display omitted] • MMP-2 expression is similar in all tissues analyzed. • Expression of MMP-9 is higher in odontogenic cysts and tumor than in dental follicle. • Proteolytic activities of MMP-2 and MMP-9 are higher in odontogenic cysts and tumor than in dental follicle. [ABSTRACT FROM AUTHOR]

Adenomatoid Odontogenic Tumor (AOT) accounts for 3 % of all odontogenic tumors. It has been classified by WHO as an odontogenic tumor of purely epithelial origin. The current study attempts to establish the origin of the tumor along with detailed histopathological and clinicoradiographic analysis of 43 cases of AOT. Forty-three cases were reviewed from the departmental archives for demographic data, radiographic features and histological features. Further, histopathological slides were stained with Picrosirius Red (PSR) and observed under polarised light. A majority of the cases were seen in the anterior jaws (76.7 %), and were less than 3 cms (76.7 %) in greatest dimension. Equal number of cases were of follicular and extra-follicular location while one was peripheral. Predominantly solid histological pattern was noted in 53.5 %. Varied sub-patterns were observed with most cases exhibiting solid nodules and strands of tumor cells. Few cases showed melanin pigmentation. Over a third of cases (37.2 %) showed dentigerous cyst like areas and one case each showed features of ossifying fibroma and focal cemento-osseous dysplasia. Tumor droplets, hyaline rings within duct-like structures, dentinoid material and osteodentin showed reddish yellow birefringence when observed under polarised microscopy post PSR staining. This study highlights the diverse histopathological variation of AOT with evidence to reclassify it as a mixed odontogenic tumor based on the polarising microscopic findings with PSR staining. • Picrosirius red staining along with polarised microscopy has been used to highlight the mesenchymal component within AOT. • The study challenges conventional understanding of AOT by proposing a mixed odontogenic origin. • A detailed clinical, radiographic and pathologic analysis has been done, aiding in better understanding of the topic. [ABSTRACT FROM AUTHOR]

The precise mechanism of root resorption in human primary teeth is unclear. However, research has suggested that the enamel organ and dental follicle of the successive (permanent) teeth are important for this process. This review focuses on the mechanism of root resorption. Impaction of the maxillary permanent canines is occasionally seen. Computer tomography studies have shown that these canines cause root resorption in 12.5% of the neighboring central and lateral incisors. In such cases, enlargement of the radiolucent areas around the canine crowns is frequently seen. These radiolucent areas include dental follicles and reduced enamel epithelium, which are composed of degraded ameloblasts and cells of the papillary layer. Root resorbing factors, expressed from the reduced enamel epithelium, are likely to induce the odontoclastic root resorption. Physiological root resorption of the primary teeth is generally milder than this pathological root resorption, but involvement of the reduced enamel epithelium of the permanent tooth can be also proposed. This review highlights the role of the reduced enamel epithelium in root resorption under both pathological and physiological conditions. [ABSTRACT FROM AUTHOR]

Maxillary canines play a crucial role in dental and facial aspect, arch expansion, and efficient occlusion. When surgical exposure measures cannot be executed or the patient does not agree to take the treatment, autotransplantation should be considered. The aim of this case report was to describe a novel surgical technique using virtually planned three-dimensional (3D)-printed templates for guided apicoectomy and guided drilling of the recipient site for autotransplantation of an impacted maxillary canine with a curved apex. A 42-year-old man complaining of pain and increased mobility in the maxillary left primary canine came to the clinic. Autotransplantation of the impacted canine was completed using altered methods from guided implant surgery to manufacture 3D-printed templates. After a full-thickness mucoperiosteal flap elevation, the surgical template for the guided osteotomy and apicoectomy was inserted. This 3D-printed guide allowed the clinician to perform a quick and precise removal of the curved apex, providing an atraumatic extraction of the impacted canine throughout the cyst. Three further 3D surgical guides for implant burs and a 3D replica tooth were printed to modify the recipient socket. After the final position, the tooth was semi-rigid splinted to the adjacent teeth. Follow-up at 2 years showed complete regeneration of the palatal defect and remodeling of the bone surrounding the maxillary canine. Digitally planned procedures can facilitate the complex execution of an autotransplantation, reducing the treatment chair time and the morbidity for the patient as well as increasing the predictability of the result. [ABSTRACT FROM AUTHOR]

"Kissing molars (KMs)" is a rare phenomenon defined as impacted molars contacting the occlusal surface in a single follicular space and their roots pointing in opposite directions. Only 8 cases of bilateral KMs are reported in the literature. This article describes a case of mandibular bilateral KMs with a unilateral dentigerous cyst and the management of this condition. Furthermore, we provide a literature review of true-KMs reported in the English and Japanese literature. A 33-year-old woman presented to our department with chief complaints of swelling and pain in the right side of the mandible. Surgical removal of the right-side impacted molars was performed under general anesthesia. Histopathological analysis confirmed the diagnosis of a dentigerous cyst. After the surgical procedure, there were no signs of infection or paresthesia in the inferior alveolar nerve. In our review, the most frequent classification of true-KMs is unilateral Class Ⅱ, accounting for approximately half of all true-KMs. It is possible for asymptomatic true-KMs to cause cystic changes and subjective symptoms. Approximately half of all true-KMs cases had subjective symptoms. Most true-KMs had been removed, and the orthodontic treatment case for true-KMs has not yet been reported. The management of KMs should be planned according to patient age, classification of KMs, symptoms, cystic changes and depth of the embedded teeth. [ABSTRACT FROM AUTHOR]

The earliest reported case of the occurrence of a dentigerous cyst is described; the cyst surrounded an unerupted permanent tooth bud in a 6-month-old infant. Most commonly these lesions present between the second and third decades of life. They rarely occur before 10 years of age and have not been documented prior to 1 year of age. In the case reported here, the treatment instituted was extraction of the adjacent deciduous tooth and enucleation of the cyst along with the permanent molar tooth bud. Clinicians should be aware of the potential for this lesion to occur across a wide range of ages and the importance of prompt diagnosis and treatment to prevent complications and reduce morbidity. [ABSTRACT FROM AUTHOR]

The odontogenic keratocyst (OKC) is a potentially aggressive odontogenic lesion and there is an ongoing debate regarding its biological behavior and classification. The present systematic review aims to assess the expression of the p53 protein in the odontogenic keratocyst in comparison to the dentigerous cyst and ameloblastoma. We searched MEDLINE, Web of Science and Scopus for immunohistochemical studies reporting OKC's, dentigerous cysts and solid/multicystic ameloblastomas. The Risk Difference between the lesions expressing the p53 was the effect measure and a P value < 0.05 was considered to provide evidence to the effect estimates. Results: The first hit retrieved 126 records. After duplicates removal, there were 84 articles, of which eighteen were assessed for eligibility. Thirteen articles were included in the meta-analysis, showing that OKC's have an estimated difference of 23% (P < 0.003) in the probability to express the p53 over dentigerous cysts, and an estimated difference of 4% (P = 0.28) in the probability to express the p53 over ameloblastomas. OKCs seem to behave more similarly to a tumor rather than an odontogenic cyst regarding its p53 expression and the classification of this lesion into Keratocystic Odontogenic Tumor should be carefully revaluated. [ABSTRACT FROM AUTHOR]

In this study, we aimed to systematically review and critically appraise the available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines were followed and the study protocol was registered at the 'International Prospective Register of Systematic Reviews' (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science. Searches were complemented with three grey literature sources: Google Scholar, ProQuest, and Open Grey. Any reduction measures, compared with preoperative status or other procedures, were considered. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thirty-one studies were included, of which five were judged with low, 24 with moderate, and two with high risk of bias. Considering surgical approach, 20 studies assessed the decompression and 11 the marsupialisation technique. Most studies considered these techniques as preliminary treatments, followed by enucleation. From 1088 lesions found, most were odontogenic keratocysts (33.8%), followed by unicystic ameloblastomas (21.0%), dentigerous cysts (20.6%), and radicular cysts (8.4%). Large lesions and younger individuals frequently presented more favourable responses to treatment and anatomical location was not associated with lesion reduction overall. The intervention duration generally ranged between one to two years. In conclusion, marsupialisation and decompression were mostly considered as preliminary treatments, followed by enucleation. Lesion reduction was generally considered insufficient for these techniques to be used as definitive therapies, although benefits concerning the diminished invasiveness of the secondary surgery were often proposed. [ABSTRACT FROM AUTHOR]

Ameloblastoma is an odontogenic neoplasm of the mandible and maxilla with various histological types and subtypes. It has been reported that some ameloblastomas could arise from dentigerous cyst walls; thus, the development of ameloblastoma from dentigerous cysts may be due to differential protein expression. Our aim was to identify a membrane protein that is differentially expressed in ameloblastomas with respect to dentigerous cysts. We analyzed the SDS-PAGE profiles of membrane proteins from ameloblastomas and dentigerous cysts. The protein in a band present in the ameloblastoma sample, but apparently absent in the dentigerous cyst sample was identified via mass spectrometry as the chaperonin Hsp60. We used western blotting and immunohistochemistry to analyze its overexpression and localization in ameloblastoma. We found a differential band of 95 kDa in the membrane proteins of ameloblastoma. In this band, the chaperonin Hsp60 was identified, and its overexpression was corroborated using western blotting and immunohistochemistry. Hsp60 was localized in the plasma membrane of all ameloblastoma samples studied; in addition, it was found in the cell nucleus of the plexiform subtype of conventional ameloblastoma. Our results suggest that Hsp60 may be involved in ameloblastoma development, and could therefore be a potential therapeutic target for ameloblastoma treatment. [Display omitted] • Hsp60 is overexpressed in ameloblastoma respect to dentigerous cyst. • Hsp60 is detected in plasma membrane of ameloblastoma. • Hsp60 is located in nucleus of conventional amleloblastoma subtype plexiform. [ABSTRACT FROM AUTHOR]

• Mitochondrial dysfunction is considered as a key marker of odontogenic lesions. • Apoptosis was increased, while necroptosis was suppressed in ameloblastoma. • These markers are potentially used to predict the severity of odontogenic lesions. We aimed to compare mitochondrial function, mitochondrial dynamics, apoptosis, and necroptosis between odontogenic cysts/tumors, including radicular cysts, dentigerous cysts, ameloblastoma, vs. dental follicles as control. We demonstrated that mitochondrial dysregulation and imbalanced mitochondrial dynamics were observed in ameloblastoma. Apoptosis was increased in dentigerous cysts, and ameloblastoma, while necroptosis was suppressed in ameloblastoma. Necroptosis in radicular cysts was higher than that of control, suggesting that the inflammation-associated cell death occurred in radicular cysts. Our findings suggest ameloblastoma exhibited mitochondrial dysfunction, decreased mitochondrial fusion, and potential apoptosis. Therefore, alleviating mitochondrial dysregulation and apoptosis may be novel-targeted therapy for odontogenic cysts and tumors. [ABSTRACT FROM AUTHOR]

The association between Dentigerous cysts (DCs) and Gorlin-Goltz syndrome (GGS) was claimed theoretically in a very few reports, with very few clinical foundations. The aim of this report was to present a unique case of multiple DCs in the mandible in a patient showing features of GGS. A 63-year-old male patient presented with multiple cyst-like lesions in the mandible associated with some clinical and radiological features of GGS, and that raised the suspension of odontogenic keratocyst (OKC). The patient underwent marsupialization and enucleation of these cysts, and the histopathological examination confirmed the diagnosis of DCs. In this report, the patient presented with symptoms related to multiple unilocular radiolucent lesions found in the mandible and the clinical and radiological features were highly suggestive of OKCs associated with GGS. However, the perioperative findings raised the suspicion of DCs, which was confirmed by histopathology. Interestingly, GGS is an inherited autosomal dominant disorder arising from mutations in the patched tumor suppressor gene (PTCH). Previous studies showed this gene alteration in DCs; this can possibly be implicated in the pathogenesis of the association found in this report. This report presented a case of bilateral DC in the mandible in a patient showing features of GGS. Therefore, this report verified the very rare association between DC and GGS. This may help dentists and physicians in reaching an accurate and early diagnosis of GGS. • Multiple jaw cysts can raise the suspicion of Gorlin-Goltz syndrome. • Dentigerous cysts are considered as minor criteria for diagnosis of Gorlin-Goltz syndrome. • PTCH gene mutation may be implicated in the association between Gorlin-Goltz syndrome and dentigerous cysts. [ABSTRACT FROM AUTHOR]

Non-neoplastic jaw cyst (NJC) is one of the most common lesions in oral cavity, but there are only few detailed and extended epidemiological data based on the 2017 WHO classification. The aim of this study was to perform an epidemiological analysis of all NJCs treated from 1990 to 2019 at the Marche Polytechnic University, and to compare these data with those published in the literature. This retrospective study considered 2060 patients treated from 1990 to 2019. The NJCs were classified according to the 2017 WHO classification, and the main clinicopathological variables were analysed (sex, age, diagnosis, site of onset, size, and recurrences). Of 2150 total lesions, there were 2095 primary cysts and 55 recurrences; men are more frequently affected than women (M/F ratio of 1.73:1). The mean age of occurrence was 46.6 years, with a peak of frequency in the fifth decade. The mandible was more frequently involved than the maxilla, with a mean size of 1.9 cm. Radicular cyst was the most frequently diagnosed cyst (56.6%), followed by dentigerous cyst (23.4%) and odontogenic keratocyst (12.9%). This is the first epidemiological study on NJCs in the Italian population according to 2017 WHO classification. [ABSTRACT FROM AUTHOR]

• Primary intraosseous carcinoma arising in a dentigerous cyst is a rare observation. • There are no clinical or radiological pathognomonic characteristics and the diagnosis is often made fortuitously. • A surgical excision with clear margin is the cornerstone of treatment. • A systematic and careful microscopic analysis of any cyst, even if look like benign, should be undertaken. Carcinomas arising in odontogenic cysts are uncommon. Malignant transformation of a dentigerous cyst is a rare observation. A primary intraosseous carcinoma from a dentigerous cyst in a 69 years old female is presented in this case report. The patient initially consulted for pain in the mandibular left molar region. Primary investigations firstly showed a probably benign lesion but immunochemistry analysis finally revealed a squamous cell carcinoma arising in a dentigerous cyst. An extension assessment was performed and no evidence of lymph node extension or distant metastasis were found. A non-interrupting mandibular bone resection without neck dissection was realized. The patient made a good recovery after surgery without postoperative complication. No clinical symptoms or sign of local recurrence or metastasis was detected after 17 months follow-up. PIOC arising in a dentigerous cyst is a rare observation. PIOC from odontogenic cysts have an incident rate of 0,3 to 2% and only 16%–51% of them are PIOC from dentigerous cyst. There are no clinical or radiological pathognomonic characteristics. They often look like benign lesion and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. Clinical and radiological follow-up of the patient is recommended. This case underlines the importance of a systematic and careful microscopic analysis of any lesion, even benign at first sight. Surgeons and pathologists should be aware of the malignant potential of odontogenic cysts. This can modify the surgical management and the follow-up of the patient. [ABSTRACT FROM AUTHOR]

Intrabony migration of tooth is a rare phenomenon observed in permanent dentition when the normal eruption of the tooth is disturbed. This unusual pattern of tooth movement, which is away from the usual developmental location, is termed as ectopia. Its occurrence is commonly noted in the mandibular lateral incisors, canine and second premolars. This kind of pre-eruptive tooth movement usually occurs due to associated pathologies like cysts, tumors, or odontomes. Intrabony migration of mandibular molars is a rare occurrence, and bilateral presentation of such migration is even rarer. Here, we report such a unique entity of simultaneous bilateral migration of mandibular second molar in a 22-year old healthy male. [ABSTRACT FROM AUTHOR]

To describe our strategy for the management of odontogenic cysts involving the maxillary sinus, and to define the role of transnasal endoscopic sinus surgery in the treatment algorithm. A retrospective study was conducted. Included were all consecutive patients with odontogenic cysts involving the maxillary sinus who were treated in a single medical center between 2011 and 2019. Their medical records were reviewed for demographic data, preoperative presentation, surgical approach, final pathology, and postoperative course. Odontogenic cysts were classified as small or large according to maxillary sinus extension within or beyond the alveolar recess, respectively. A total of 30 patients with odontogenic cysts involving the maxillary sinus were treated by a team of maxillofacial and endoscopic sinus surgeons during the study period. There were 11 cases of dentigerous cysts, 11 radicular cysts, seven odontogenic keratocysts (OKCs), and one glandular cyst. Sixteen cases were managed by transnasal endoscopic sinus surgery alone and 14 were managed by a combined intraoral and endoscopic sinus surgery approach. A total of 22 patients had large cysts and total resection was achieved in 20 of them. There was one case of OKC recurrence during an average follow-up of 31 months. No major complications were recorded. The endoscopic approach can serve as an alternative to the transalveolar or lateral window approach. The endoscopic approach is associated with low morbidity and low recurrence rates. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the results of dentigerous cysts enucleation with preservation of cyst-associated teeth as a single procedure in a group of children and preadolescents. A retrospective case series of seven patients with 15 unerupted developing teeth associated with or adjacent to dentigerous cysts was conducted. Patients were treated using the uniform surgical protocol (cystectomy, preservation of cyst-associated teeth, without use of orthodontic traction, primary wound closure). The metric analysis of the cysts and unerupted teeth on CBCT and an evaluation of the state of involved teeth after the treatment was performed. The mean age of patients was 9.0 ± 2.1 years (range 5–12 years, median = 9 years). All teeth erupted spontaneously. No serious postoperative complications or recurrences of lesions were detected. The mean follow-up was 53.1 ± 15.7 months (range 25–71 months, median = 52 months). The cystectomy of dentigerous cysts with preservation of associated teeth may be considered an alternative to marsupialization in children and preadolescents. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the incidence of the histopathological status of suspected pathologic pericoronal tissues of asymptomatic embedded teeth. A total number of 298 specimens from 274 patients without any significant symptomatic signs and symptoms were collected. Radiological and histopathological examinations were done for the participants and the results were recorded. Sizes of the dental follicles in the radiograph were reassessed and grouped as less than 2.5 mm and 2.5 mm and above. The widest region of dental follicular space was measured by tracing the tooth contours and pericoronal space on tracing paper with caliper scale. Findings of histological diagnosis were analyzed for associations with sex, age and size of the dental follicle. Biopsy results of follicular tissues showed pathological lesions such as dentigerous cyst, odontogenic keratocyst, chronic nonspecific inflammatory tissue and ameloblastoma. 48 % showed histologic changes suggestive of normal follicle and 52 % were suggestive of pathological entities. Most pathologies were encountered in the third decade and there was an increase incidence of pathological entities as the age of the patient increased at a statistical significance level of 0.01 (P =.001). There was the male predominance of incidence of pathological changes but there was no statistical significance between the follicle size group and the histologic results of the dental follicles. This study showed that the incidence of the histopathological status of suspected pathologic pericoronal tissues of asymptomatic embedded teeth increased following the increase age. Therefore, the suggestion of asymptomatic embedded tooth should be removal consideration. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the features of lesions obtained from biopsies at the periapical area of teeth with a radiographic or clinical initial diagnosis of apical periodontitis. A retrospective study was conducted on biopsies obtained from 1953–2018 at 3 Brazilian oral and maxillofacial pathology centers. Cases of endodontic and nonendodontic periapical lesions (NPLs) with a clinical diagnosis of endodontic pathoses were retrieved. Data regarding patient age, sex, and anatomic location were obtained from patients' records. The frequency and percentage of cases with clinical diagnoses of a periapical cyst, periapical granuloma, or dentoalveolar abscess were recorded, and the final histopathologic diagnosis was documented. Among 66,179 oral biopsies, 7246 (10.94%) were clinically diagnosed as periapical disease, 306 (4.22%) of which were histopathologically diagnosed as NPLs. The most frequent NPLs were odontogenic keratocysts (n = 107, 34.96%) followed by dentigerous cysts (n = 48, 15.68%). The mean age at diagnosis was 39.68 years with a range of 6–80 years. A total of 159 (51.96%) cases occurred in females and 147 (48.03%) in males (female to male ratio = 1.08:1). Most lesions (137, 44.77%) were located in the posterior mandible. A wide variety of histopathologic diagnoses, including benign odontogenic and nonodontogenic cystic and tumorous lesions, infectious diseases, and malignant neoplasms, was reported in the present survey. The features presented in this study were consistent with previous findings reported in the literature. [ABSTRACT FROM AUTHOR]

Dental cysts can be of inflammatory (radicular cysts) or noninflammatory (dentigerous cysts) origin. Apical periodontitis is a necrosis of the pulp and infection of the root canal causing the development of apical granulomas or radicular cysts. The immunology of granuloma and cyst formation is important because modern root filling materials are immunologically active and can contribute to the resolution of apical granulomas. In contrast, radicular cysts often require apicectomy. A better understanding of the pathophysiology of inflammation and bone resorption in apical periodontitis could be the basis for developing new root filling materials with superior immunomodulatory properties. Forty-one apical granulomas, 23 radicular cysts, and 23 dentigerous cysts were analyzed in this study. A tissue microarray of the 87 consecutive specimens was created, and human leukocyte antigen–DR isotype (HLA-DR)-, CD83-, receptor activator of nuclear factor kappa B ligand–, macrophage colony-stimulating factor (MCSF)-, galectin-3 (Gal3)-, CD4-, and CD8-positive cells were detected by immunohistochemistry. Tissue microarrays were digitized, and the expression of markers was quantitatively assessed. HLA-DR, CD83, MCSF, and Gal3 expression was significantly (P <.05) higher in radicular cysts compared with apical granulomas. HLA-DR, CD83, MCSF, receptor activator of nuclear factor kappa B ligand, and Gal3 expression in dentigerous cysts was significantly (P <.05) lower than in both periapical lesions (apical granulomas and radicular cysts). CD4 and CD8 infiltration was not statistically different between apical granulomas and radicular cysts. Dentigerous cysts showed a significantly (P <.05) lower T-cell infiltration than apical periodontitis. The CD4/CD8 ratio was not significantly different between the analyzed groups. The development of radicular cysts in apical periodontitis is associated with an increased expression of myeloid inflammatory markers and bone resorption parameters. Antigen-presenting cells and myeloid cells might be more relevant for the pathogenesis of apical periodontitis than T cells. Increased inflammation might promote the formation of radicular cysts and more pronounced bone resorption. [ABSTRACT FROM AUTHOR]

This epidemiological study was designed to find out the incidence and factors associated with the occurrence of intraosseous lesions diagnosed at a Reference Centre in Brazil. We included all patients diagnosed with intraosseous lesions (cyst, tumour, bone-associated lesion, and periapical disease) during the period 2006–2017, and analysed the association between some sociodemographic and clinical variables and the types of lesion. There was a total of 290 intraosseous lesions, the most common being odontogenic cysts. There was a significant association between age and odontogenic tumours (p = 0.001). In relation to the histopathological diagnosis, root cysts were the most common (n = 57), followed by dentigerous cysts (n = 26). The lesions studied were seen most often in women between the second and fourth decades of life, odontogenic cysts being the most common type found. We know of few publications of similar epidemiological work, either in Brazil or in the rest of the world, so we suggest that more such studies are made. [ABSTRACT FROM AUTHOR]

• Bilateral ectopic eruptions of maxillary third molars in Antrum of Highmore (Maxillary sinus) are rarely seen and scantly documented in the literature. • Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature & discussed. • An unusual case of bilateral ectopic third molars in maxillary sinus associated with dentigerous cyst, and impacted mandibular third molars. • Ectopic teeth are commonly observed in the second or third decade of life. The age range varies from 4 to 57 with a mean age of 28.06 years. Ectopic eruptions of a tooth in a non-dentate region is a rare entity and such cases have been reported to occur in the nasal cavity, orbital floor, maxillary sinus, mandibular condyle, chin, palate and coronoid process. We report a case of bilateral ectopic eruption of maxillary third molars associated dentigerous cyst. A 27 years old female patient reported to us with chief complaint of purulent discharge form nose and recurrent facial swelling for last 2 years. Complete removal of cystic lining and extraction of ectopic maxillary third molars along with mandibular third molars was carried out. Post-operative healing was uneventful. Bilateral ectopic eruptions of maxillary third molars in Antrum of Highmore (Maxillary sinus) are rarely seen and scantly documented in the literature. Dental ectopia may occur in antrum and present with local sino-nasal symptoms attributed to chronic sinusitis. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature & discussed. [ABSTRACT FROM AUTHOR]

This systematic review aimed to investigate the prevalence of odontogenic cysts and tumors associated with impacted third molars (ITM). Only studies that performed histopathological diagnosis of lesions were eligible for inclusion. Five main electronic and three grey literature databases were searched. Risk of bias (RoB) of included articles was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. From 1,300 studies identified, 16 met the inclusion criteria. Seven studies were classified as high, seven as moderate, and two as low RoB. The prevalence of odontogenic cysts and tumors associated with ITM was 5.3% (95%CI: 3.1%–8.1%) of ITM. Odontogenic cysts in particular were found in 4.4% (95%CI: 2.5–6.8%) of the extracted ITM, whilst odontogenic tumors in 0.5% (95%CI: 0.2–0.9%). The dentigerous cyst was mentioned in eleven studies with a pooled prevalence of 2.1% (95%CI: 1.4–3.1%). The odontogenic keratocyst was cited by nine studies and had a prevalence of 0.5% (95%CI: 0.2–0.7%). The radicular cyst was mentioned only in three articles and the pooled prevalence was 4.7% (95%CI: 0.0–19.4%) Odontogenic cysts and tumors were found in 5.3% of ITM extracted. The most common lesions were the radicular cyst, dentigerous cyst, and odontogenic keratocyst. [ABSTRACT FROM AUTHOR]

Highlights • Dentigerous cysts are commonly single lesions. Bilateral and multiple dentigerous cysts are very rare. • Ectopic tooth eruption outside the oral cavity is a rare entity. • The endonasal endoscopic approach has the advantages of avoiding external mucosal incision, oroantral fistula formation and recurrent sinusitis. Abstract Introduction Dentigerous cysts are the second most common form of benign odontogenic cysts. These cysts are commonly single lesions. Bilateral and multiple dentigerous cysts are very rare. Case presentation This article presents a rare case report of bilateral dentigerous cysts associated with two ectopic teeth located atypically in the maxillary sinuses in a 19-year-old male manifesting as bilateral upper jaw pain, post-nasal discharge and recurrent sinusitis which was managed via the endonasal endoscopic approach by enucleation of the cysts and teeth removal. Conclusion This paper presented our experience in the management of a rare case of bilateral dentigerous cysts associated with ectopic teeth in the maxillary sinuses. Ct scan of the paranasal sinuses confirmed the diagnosis and the endonasal endoscopic approach is superior to the external approaches in preserving physiological function in managing these patients. [ABSTRACT FROM AUTHOR]

Abstract Background MCM3 is a marker of proliferation that has been used as a diagnostic or prognostic marker in many pathologic lesions. Purpose The purpose of this study is to investigate the proliferative activity of dentigerous cysts, odontogenic keratocyst and ameloblastoma using minichromosome maintenance 3 (MCM3) and compare it with Ki-67 proliferation marker. Methods In this cross-sectional study, 40 cases including 11 cases of dentigerous cyst, 14 odontogenic keratocyst, and 15 ameloblastoma were included. Immunohistochemical expression of MCM3 and Ki-67 were investigated and compared statistically using ANOVA, Chi-square, Tukey and Spearman's correlation tests. Results All subjects were positive for Ki-67 and MCM3. There was a significant difference in MCM3 and Ki-67 expression among all groups. Compared to Ki-67, MCM3 exhibited a higher level of expression. Ameloblastoma and odontogenic keratocyst revealed higher expression rate of both markers in comparison to dentigerous cysts. Conclusion The results showed MCM3 and Ki67 expression in the most common odontogenic cysts and tumors, especially more aggressive lesions. MCM3 might have a role in pathogenesis of these lesions and could be a reliable marker for assessing proliferation activity. [ABSTRACT FROM AUTHOR]

Dentigerous cysts in young adults may compromise the natural evolution of the dentition and can be treated surgically or non-surgically. We report the minimally-invasive treatment of dentigerous cysts in two young patients using a modified Hawley plate to avoid traumatic injury to anatomical structures, with up to four years' follow up. [ABSTRACT FROM AUTHOR]

Unicystic ameloblastoma is a less encountered variant of the ameloblastoma that usually presented as unicystic lesions of jaw occurring in 3rd and 4th decades of life. It shows a typical ameloblastomatous epithelium lining the cyst cavity, with or without variable tumor proliferations. The case presented here is of a 9 yr old boy who was referred to our center for the management of a large diffuse swelling on the right side of the face. Clinical and radiologic evaluation showed two interconnected cystic lesions in the right body and the symphyseal regions of the mandible associated with impacted canines bilaterally. The initial histopathology of both cystic spaces showed the lesion to be dentigerous cysts and the results were reconfirmed in two other centers. A complete surgical enucleation of this bilocular cyst was done sparing the impacted teeth. The histopathologic examination of the post-operative specimen showed features of Unicystic Ameloblastoma. The patient was followed up on a regular basis for more than 3 years. There is no signs of recurrence and his latest radiographic examinations shows good bone formation. The impacted teeth are erupting into position. This case reports the difficulty in clinical diagnosis and the peculiar bilocular presentation of unicystic ameloblastoma which was conservatively managed by surgical enucleation of the complete lesion, sparing the dentition. [ABSTRACT FROM AUTHOR]

Odontomas, the most common benign odontogenic tumors, are usually asymptomatic. Eruption of these lesions in the oral cavity can rarely be occurred, and accompanied by a wide range of clinical signs and symptoms. Among the developmental odontogenic cysts, the dentigerous cyst is the most common type. However, a dentigerous cyst associated with an erupted odontoma is an extremely rare finding. A case of a large erupted complex odontoma is presented in a 23-year-old man. Intraoral examination revealed an irregular, solid yellowish tumor-like mass measuring about 2 cm with calcified surface. Radiographic examination showed a dense well-defined radiopaque lesion located distal of the mandibular left second molar and above the crown of the impacted third molar. The mandibular molars and the attached hard and soft tissues were surgically removed. The histopathological diagnosis of complex odontoma combined with the eruption of the lesion in the oral cavity set the diagnosis of erupted complex odontoma. Histopathological examination revealed that the attached soft tissue associated with odontoma was an inflamed dentigerous cyst. In conclusion, the exposure within the oral microflora of a large in size erupted odontoma may contribute as predisposing factor for a local inflammation that needs surgical intervention. [ABSTRACT FROM AUTHOR]

Odontogenic lesions differ in their rate of recurrence and aggressiveness. This study aimed to evaluate the presence of myofibroblasts and mast cells in odontogenic lesions. Sample consisted of 20 cases each of dentigerous cysts, odontogenic keratocysts, and solid ameloblastomas. Histologic sections were submitted to immunohistochemistry using anti–α-smooth muscle actin and anti-tryptase antibodies. Myofibroblasts and mast cells were counted at ×400 magnification in 5 and 10 fields, respectively. Myofibroblasts were more frequent in ameloblastomas (24.41), followed by odontogenic keratocysts (16.21) and dentigerous cysts (11.85; P = .002). Granulated and degranulated mast cells were more frequent in dentigerous cysts (7.88 and 8.96, respectively), followed by odontogenic keratocysts (6.53 and 7.08) and ameloblastomas (5.21 and 1.88). The difference was only significant for degranulated mast cells ( P < .05). Analysis of the correlation between myofibroblasts and mast cells (granulated and degranulated) revealed a moderate positive correlation only in ameloblastomas ( R = 0.621, P = .003). Probably, myofibroblasts are related to the biological behavior of the odontogenic lesions studied, particularly their aggressiveness. On the other hand, mast cells seem to be associated with inflammatory processes, which are more frequent in cystic lesions than in benign neoplasms. In addition, mast cells may induce the differentiation of fibroblasts into myofibroblasts, thus increasing the number of the latter. [ABSTRACT FROM AUTHOR]

The keratocystic odontogenic tumor (KCOT) is capable of causing vast osseous destruction. Histopathological examination is pivotal for diagnosis. The diagnostic process can sometimes be hindered by tissue inflammation of KCOTs with loss of defining criteria, resulting in misdiagnosis as an odontogenic jaw cyst. We discuss the possible merits of volumetric analysis when facing this particular diagnostic dilemma and for pathophysiological characterization of KCOTs. We included 114 patients, of whom 27 were histopathologically diagnosed with a KCOT and 87 with dentigerous (n = 41) and periapical cyst (n = 46). Semiautomatic segmentation and radiological analysis of preoperative cone beam computed tomography (CBCT) image data was carried out using ITK-SNAP. The mean volumetric extent of KCOTs is significantly higher compared to non-neoplastic odontogenic jaw cysts (p = 0.001). The mean volume and standard deviation for KCOTs and non-neoplastic odontogenic jaw cysts was 10381 mm 3 ± 6410 and 5813 mm 3 ± 4425, respectively. Volumetric analysis reveals that KCOTs significantly exceed the mean size of non-neoplastic odontogenic jaw cysts, adding an argument in favor of the neoplastic nature of KCOTs. In the case of difficult histopathological examination, lesions with a size exceeding a value of about 3000 mm 3 could be considered for close clinico-radiologic follow-up. [ABSTRACT FROM AUTHOR]

Background and aims The odontogenic keratocyst (OKC) remains the most challenging jaw cyst to treat because of its locally-aggressive behaviour and high recurrence potential. Emerging evidence suggests that osteopontin, its receptors CD44v6 and integrin α v , and podoplanin, have a role in the local invasiveness of this cyst. However the spatial distribution characteristics of these pro-invasive markers in the lining epithelium of OKC, and their association with the clinicopathologic parameters of OKC are largely unexplored. This study sought to address these issues in comparison with dentigerous cysts (DCs) and radicular cysts (RCs) and to evaluate their biological relevance. Methods A sample consisting of 20 OKC cases, 10 DCs and 10 RCs was subjected to immunohistochemical staining for osteopontin, CD44v6 and integrin α v , and podoplanin, and semiquantitative analysis was performed. Results All factors (except integrin α v ) were detected heterogeneously in the constitutive layers of the lining epithelium in all three cyst types. Key observations were significant upregulation of CD44v6 and podoplanin in OKC compared to DCs and RCs, suggesting that these protein molecules may play crucial roles in promoting local invasiveness in OKC ( P < 0.05). Osteopontin underexpression and distribution patterns were indistinctive among all three cysts indicating its limited role as pro-invasive factor. Clinical parameters showed no significant correlations with all protein factors investigated. Conclusions Present findings suggest that an osteopontin low CD44v6 high and podoplanin high immunoprofile most probably represent epithelial signatures of OKC and are markers of local invasiveness in this cyst. [ABSTRACT FROM AUTHOR]

Background/purpose Langerhans cells (LCs) are antigen-presenting cells. This study assessed the LC counts in 80 dentigerous cysts (DCs). Materials and methods The S100-positive LC numbers in the lining epithelia and subepithelial connective tissues were counted at 80 DC sites without inflammation, 33 DC sites with mild/moderate inflammation, and 9 DC sites with severe inflammation from 80 DC specimens. Results The mean S100-positive LC counts in the lining epithelia and subepithelial connective tissues increased significantly from no inflammation (0.6 ± 0.6 and 0.7 ± 0.6 cell/high-power field or HPF, respectively) through mild/moderate inflammation (8.1 ± 2.0 and 4.5 ± 2.3 cells/HPF, respectively) to severe inflammation DC sites (21.0 ± 7.0 and 11.1 ± 6.5 cells/HPF, respectively; P -value < 0.001). DC sites with inflammation had thicker lining epithelia than those without inflammation. Moreover, the mean LC counts in the lining epithelia and subepithelial connective tissues of DCs were significantly higher in the thicker lining epithelium (>50 μm) group (8.6 ± 7.1 and 4.8 ± 4.5 cells/HPF, respectively) than in the thinner lining epithelium (≦50 μm) group (0.6 ± 0.6 and 0.6 ± 0.6 cells/HPF, respectively; both P -values < 0.001). Conclusion A significant association of high-grade inflammation and thick lining epithelium with the increased LC number in DCs is found. Very few LCs in the lining epithelia of DCs without inflammation indicate the reduced immunosurveillance ability against DC lining epithelial cells in DC patients. It needs further studies to confirm the role of reduced immunosurveillance in the enlargement of the DC. [ABSTRACT FROM AUTHOR]

Background/purpose: Langerhans cells (LCs) are antigen-presenting cells. This study assessed the LC counts in 80 dentigerous cysts (DCs).Methods: The CD1a-positive LC numbers in the lining epithelia and subepithelial connective tissues were counted at 80 DC sites without inflammation, 33 DC sites with mild/moderate inflammation, and 9 DC sites with severe inflammation from 80 DC specimens.Results: The mean LC counts in the lining epithelia and subepithelial connective tissues increased significantly from no inflammation (0.5 ± 0.5 and 0.2 ± 0.3 cell/high-power field or HPF, respectively) through mild/moderate inflammation (6.8 ± 1.8 and 2.4 ± 2.0 cells/HPF, respectively) to severe inflammation DC sites (18.9 ± 7.0 and 6.7 ± 5.8 cells/HPF, respectively; all P-values < 0.001). DC sites with inflammation had thicker lining epithelia than those without inflammation. Moreover, the mean LC counts in the lining epithelia and subepithelial connective tissues of DCs were significantly higher in the thicker lining epithelium (>50 μm) group (7.4 ± 6.5 and 2.6 ± 3.4 cells/HPF, respectively) than in the thinner lining epithelium (≦ 50 μm) group (0.5 ± 0.5 and 0.2 ± 0.3 cells/HPF, respectively; both P-values < 0.001).Conclusion: A significant association of high-grade inflammation and thick lining epithelium with the increased LC number in DCs is found. The finding of few LCs in the lining epithelia of DCs without inflammation indicates the reduced immunosurveillance ability against DC lining epithelial cells in DC patients. It needs further studies to confirm the role of reduced immunosurveillance in the enlargement of the DC. [ABSTRACT FROM AUTHOR]

To perform an integrated analysis in identifying novel hub genes that could facilitate the diagnosis and targeted therapy of ameloblastoma. The expression profiling dataset, GSE38494, was obtained from the Gene Expression Omnibus database. Differentially expressed genes were identified through GEO2R online tool and characterised via Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The protein-protein interaction network and hub genes were screened using the STRING database and Cytoscape software. Subsequently, an upregulated gene was selected for further validation using the GSE132472 dataset. Further, immunohistochemistry was performed to assess the expression of the selected gene in ameloblastomas, odontogenic keratocysts, dentigerous cysts, and gingival tissues. The diagnostic and therapeutic utility of the selected hub genes were further verified by receiver operating characteristic analysis and the DGIdb database. We identified six hub genes in ameloblastoma, among which the upregulated gene PKD2 and its related gene PKD1 were further validated. GO functional annotation revealed that PKD2 is involved in cell-cell junction, extracellular exosome, cytoplasm, endoplasmic reticulum, and calcium ion transport. The immunohistochemical analysis showed that the expression of polycystin-1 and polycystin-2, encoded by the PKD1 and PKD2 genes, respectively, was upregulated in ameloblastoma. PKD1 and PKD2 had a high diagnostic utility for ameloblastoma, and allopurinol interacted with the PKD2 gene. Our research indicates that polycystins are highly expressed in ameloblastoma and might be involved in the oncogenesis of ameloblastoma, thus offering a new perspective on the molecular mechanisms and targeted therapies on ameloblastoma. • Polycystin-1 and polycystin-2 had higher expression in ameloblastoma. • PKD1 and PKD2 genes had a high diagnostic utility for ameloblastoma. • Allopurinol interacts with PKD2 gene and could be a potential drug candidate. • Polycystins offer a new perspective on the targeted therapies of ameloblastoma. [ABSTRACT FROM AUTHOR]

The aim of the present study was to reveal the effects of hypoxia-associated signaling in odontogenic cysts. The expression levels of genes involved in the hypoxia-associated signaling pathway were determined by quantitative Polymerase Chain Reaction (PCR) method. As a result, it was found that phosphatase and tensin homolog (PTEN) expression was low (p = 0.037), and the expression levels of phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) (p = 0.0127), hypoxia inducible factor 1 alpha (HIF1A) (p < 0.001), and HIF1A antisense RNA 1 (HIF1A-AS1) (p = 0.0218) were higher in cyst tissue compared to normal tissue. HIF1A gene expression was found to be significantly altered according to the pathologic subtypes of odontogenic keratocyst, dentigerous cyst, and radicular cyst. Odontogenic cysts were found to have higher expression of HIF1A and HIF1A-AS1, which may be related to the increased hypoxia in these lesions. In addition, PI3K/Akt signaling may be stimulated by increased PIK3CA and decreased PTEN expression, which promote cell survival and support the mechanism of cyst formation. • Stimulation of hypoxia can promote the formation of odontogenic cysts. • HIF1A and HIF1A-AS1 gene expression is increased in odontogenic cysts. • Increased PIK3CA gene expression may stimulate cyst formation. • Low PTEN gene expression can stimulate cyst formation by activating PI3K/Akt signaling. [ABSTRACT FROM AUTHOR]

We prospectively investigated in adults the decompression of dentigerous cysts associated with impacted third molars at high risk of iatrogenic damage during extraction. The computerised calculated volumetric postoperative reductions measured by cone-beam computed tomography at four and eight months were correlated with the duration of treatment, initial volume, and patient’s age. We prospectively monitored 14 adult patients with 14 dentigerous cysts that were associated with impacted third molars, for eight months after decompression. The mean (SD) reduction in volume during the first eight months was 71 (14) % (51% after the first four months and 20% after the second four months), with a monthly reduction rate of 9%. Both the total decrease in volume (a) and the monthly rate of reduction (b) were significantly associated (p < 0.01) and linearly correlated with the duration of decompression [r (a) = −0.89, r (b) = −0.61] and initial volume [r (a) = r (b) = 0.92], but not with the patient’s age (p = 0.49) [r (a) = r (b) = 0.04]. The trend towards reduction in volume within a period of eight months of treatment allowed us to better understand the duration of decompression required. [ABSTRACT FROM AUTHOR]

Ameloblastoma is classified as a benign odontogenic tumor characterized by locally invasive behavior and high risk of recurrence. Here, we evaluate a potential role for glycosaminoglycan, a structural component of cell membranes and extracellular matrix, in ameloblstoma pathogenesis. We subjected formalin-fixed, paraffin-embedded tissue sections of 34 cases of ameloblastoma, 10 of odontogenic keratocyst, and 17 of dentigerous cyst to immunohistochemistry using monoclonal antibodies recognizing chondroitin sulfate A (CS-A), heparan sulfate (HS), and keratan sulfate (KS). Expression levels of CS-A in epithelial component and stroma of ameloblastoma were significantly higher than those in odontogenic keratocyst and dentigerous cyst. Moreover, CS-A in ameloblastoma was more strongly expressed in stellate reticulum-like cells than in amelobast-like cells with statistical significance. On the other hand, expression levels of HS and KS in epithelial component and stroma of ameloblastoma were lower compared with CS-A. These results overall reveal that among these odontogenic lesions, CS-A is preferentially expessed in ameloblastoma, suggesting potential pathogenetic role probably in cytodifferention of tumor cells to stellate reticulum-like cells. [ABSTRACT FROM AUTHOR]

The classification of odontogenic cysts has been widely debated and there has been much debate and controversy about the true nature of some of the lesions. Although cysts are common in the jaws, most are radicular cysts of inflammatory origin or simple dentigerous cysts. Others are less frequently encountered and may present diagnostic difficulties because of their varied features. The previous WHO classification, in 2005, redesignated a number of these lesions as true neoplasms, but this was controversial and was not based on sound evidence. For the latest WHO classification (2017), an international consensus group reappraised these lesions and agreed a terminology and new classification. This brief review presents this new classification, and explains the reasoning behind the agreed terminology. [ABSTRACT FROM AUTHOR]

Background Odontogenic Cysts & tumors originate through some aberration from the normal pattern of odontogenesis. Ameloblastoma is one of the most frequent intraosseous odontogenic tumors. However it is no longer appropriate to use the diagnosis of ameloblastoma without specifying the type. Varied-clinical entities of ameloblastoma differ in their biologic behaviour. Odontogenic cysts like dentigerous and radicular cysts are less aggressive in nature than odontogenic tumors. Recently, podoplanin commonly used as a lymphatic endothelial marker in cancers has recently been found to play a possible role in odontogenic tumorigenesis also. Therefore the purpose of this study was to immunohistochemically analyse the expression of podoplanin in ameloblastomas, KCOTs, dentigerous cysts, radicular cysts & dental follicles. Methods Paraffin-embedded tissue specimens of 15 Ameloblastomas (7 follicular, 6 unicystic, 2 desmoplastic),10KCOTs, 5 dentigerous cysts, 5 radicular cysts & 5 dental follicles were immunohistochemically examined using antibody against podoplanin. Results All ameloblastomas displayed podoplanin expression in ameloblast-like cells of the epithelial islands while the stellate-reticulum like cells exhibited no or weak immunostaining. Expression of podoplanin in KCOTs was strongly positive in the cells of the basal and suprabasal layers & odontogenic epithelial nests. Positive immunoreaction for podoplanin was observed in the inflammatory radicular cysts and inflamed dentigerous cyst only and negative or weak expression in the lining epithelium of uninflamed dentigerous cysts and dental follicles. Conclusion Our results suggest that podoplanin can be used as a potential proliferative marker to observe the aggressive behaviour of ameloblastomas and KCOTs. [ABSTRACT FROM AUTHOR]

the aim of this study was to analyze the prevalence of histopathological diagnoses in oral biopsied tissues obtained from a Brazilian pediatric population. an analytical, cross-sectional retrospective study was performed with biopsy files of patients ≤14 years of age from a Brazilian oral pathology laboratory over a 43-year period. Data included sex, age, location, and diagnoses. The prevalence was calculated by means of relative frequency. Associations between sex, age groups and diagnoses were verified with Pearson's chi-square test. from 19,456 oral biopsies, 1480 (7.6%) were obtained from patients aged ≤14 years. Most children were 10–14 years of age (60.1%) and females (55.1%), with an overall M:F of 1:1.2. Children aged 0–9 years and males had a higher frequency of lesions of the oral mucosa, whilst the 10–14 year age group showed a higher frequency of cysts, odontogenic tumors, and salivary gland lesions. The latter was also significantly higher in females. Samples consisted mostly of soft tissue lesions (53%) obtained from the lower lip (30.7%). Intraosseous lesions showed a slight predilection for the mandible (21.2%). Salivary gland lesions (28.8%) was the most common diagnostic category, followed by reactive lesions (18.8%), and cysts (16.1%). Mucocele (33.5%), dentigerous cyst (6.7%), and fibrous hyperplasia (5.9%) were the top three histopathological diagnoses. Malignant lesions affected only 0.9% of this population. our results were similar to other retrospective studies. Due to the low frequency of oral biopsies in children, data on the prevalence of oral pathology in this population might aid in the clinical and histopathologic diagnoses. [ABSTRACT FROM AUTHOR]