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Objectives Cysts of the mandible are common and are often found clinically in oral surgery. Marsupialization for relatively large cystic lesions may be performed to reduce the size of the lesion and to obtain a histopathological diagnosis. For cystic lesions of the mandible, the effect of marsupialization has many advantages, such as a reduction in lesion size, the avoidance of mental nerve palsy, and preservation of the teeth. It is still unclear whether there is a difference in the reduction rate based on patient age and pathology (dentigerous cyst, odontogenic keratocyst, radicular cyst, ameloblastoma (unicystic type)) and initial size of the lesion. Methods The subjects included 55 patients with cystic lesions with a major axis of 3 cm or greater (16 dentigerous cysts, 20 odontogenic keratocysts, 7 radicular cysts, and 12 ameloblastoma) who underwent treatment at our department. Using simulation software (ProPlanCMF®), the volume of the lesion was extracted from the CT data before and after the marsupialization, and the three-dimensional reduction rate before and after marsupialization was calculated. Results No significant difference was observed between the subgroups in terms of histopathological diagnosis, patient age or size of lesion. Although the effect of marsupialization on cystic lesions with a major axis of 3 cm or more showed a significant difference between 3.0 months and 4.5 months, the difference was not significant between 4.5 months and 6.0 months. Conclusions An indication for the enucleation timing after marsupialization is 4.5 months when the rate of decrease after fenestration slows down.

To evaluate the histopathologic outcomes of pericoronal radiolucencies and identify factors predictive of diagnosis.A retrospective cohort study of 258 patients with 280 radiolucent pericoronal lesions undergoing treatment at our institution between 2005 and 2019. The primary predictor variable was lesion size (≥2 cm and2 cm). The primary outcome variable was histopathologic diagnosis (dentigerous cyst vs other pathologic entity). Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between clinical and radiographic variables and histopathologic diagnosis.The study sample was composed of 258 patients with 280 histopathologic specimens. There were 218 dentigerous cysts (77.9%) and 62 other pathologic entities (22.1%). Lesions ≥2 cm were 3.20 times more likely to be diagnosed as a nondentigerous cyst pathologic entity (P ≤ .001). After adjusting for jaw (maxilla vs mandible), pain, history of infection, cortical perforation, expansion, and multiple lesions, younger age (P ≤ .001, odds ratio [OR] = 0.950, 95% confidence interval [CI] = 0.929-0.972) and lesion size as a continuous variable (P = .007, OR = 1.06, 95% CI = 1.02-1.11) were independent predictors of other pathologic entities.The majority of pericoronal radiolucent lesions were dentigerous cysts. Younger age and larger lesions were independent predictors of other pathologic entities.

“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.

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

The Aberdeen Royal Infirmary oral and maxillofacial surgery department is involved in the joint planning of cases with the orthodontic and restorative departments of the Aberdeen Dental Hospital to agree an optimal treatment plan for patients, with input from all three specialties. A 7-year-old girl was referred to the orthodontic department by her GDP due to non-eruption of the upper left central incisor. This was related to an associated dentigerous cyst. This presentation illustrates the phases of treatment involving marsupialization of the dentigerous cyst; surgical extraction and orthodontic treatment in order to provide the patient with the optimal outcome for her dentition. A retrospective assessment of the case is presented through photographs and radiological imaging outlining the chronology of the treatment and the outcome of marsupialization of the dentigerous cyst. It highlights this more conservative surgical approach as giving the best chances of preserving unerupted teeth in a younger patient. Marsupialization of a dentigerous cyst associated with UL1 and conservative management of cystic pathology led to preservation and natural mesial eruption of UL3 into the position of UL1. The unerupted UL1 associated with cystic pathology was extracted due to its ectopic position and root dilaceration. Seven years after diagnosis of the dentigerous cyst associated with the unerupted UL1, surgical and orthodontic management has facilitated the for patients tooth to erupt into the UL1 position. Restorative treatment is being planned following orthodontic treatment to restore for patients tooth to simulate the missing UL1. CPD/Clinical Relevance: This case encourages the appropriate referral of young patients with dentigerous cysts to achieve a satisfactory outcome.

The separation of the follicle from around the crown of an unerupted tooth causes formation of dentigerous cyst. It may undergo metaplasia in several cases. In this case a 30 year old female patient reported with a history of dentigerous cyst with respect to impacted 48. The swelling started growing gradually causing facial asymmetry. On intraoral examination the swelling seem to extend from 48 to 46 region and cortical plates were expanded. The histopathological examination revealed the sample to be cystic ameloblastoma (mural variety). This paper sends a message that the potential of a cyst should never be understated, instead it must be kept in an observation or understanding the biological behavior over a course of time.

A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molar. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla when the cyst expands into the sinus, usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old female with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.

Aims: The main goal of the following case report was to shed the light on the importance of thorough clinical, radiological and histological examinations in order to elaborate a final diagnosis of asymptomatic dentigerous cysts detected in unusual locations. Presentation of Case: A case of dentigerous cyst was identified accidentally in the maxillary left premolar region of an asymptomatic 14-year-old female post an orthodontic consultation. Histological examination of the tissue specimens following enucleation confirmed the diagnosis of a dentigerous cyst. Discussion: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They involve impacted, un-erupted, permanent, supernumerary, odontomas and rarely deciduous teeth. Dentigerous cysts are usually painless but may cause facial swelling and delayed tooth eruption. Extensive maxillary involvement and childhood presentation are rare. Radio-graphic and histological examinations should be done to confirm the diagnosis of a dentigerous cyst. Conclusion: In our case, we showed the presence of a maxillary premolar dentigerous cyst that was removed by enucleation. The presence of dentigerous cyst is not always associated with a syndrome and its removal is very important to avoid future complications.

BACKGROUND Although pathology in the maxillary and mandibular bones is rare in young patients, the differential diagnosis is broad. The World Health Organization (WHO) updated its classification of maxillofacial bone pathology in 2017. Using these updated guidelines, a systematic review of common maxillofacial bone lesions in the pediatric population was performed. METHODS A PubMed search was conducted capturing English language articles from inception to July 2020. Thirty-one articles were identified that described the frequency of maxillofacial bone pathology. Data were extracted and organized using the WHO 2017 classification of odontogenic and maxillofacial bone tumors. Prevalence data were analyzed among diagnostic categories and geographical regions. The SAS version 9.4 was used to complete statistical analyses. RESULTS The articles included patients from birth to a maximum age of 14 to 19 years. The most common odontogenic cysts included radicular cyst (42.7%) and dentigerous cyst (39.0%) followed by odontogenic keratocyst (15.0%). Among odontogenic bone tumors, odontoma (49.3%) was most common followed by ameloblastoma (29.1%). The most common nonodontogenic bone tumor was fibrous dysplasia (42.4%), and the most common malignant bone tumor was osteosarcoma (75.0%). Significant variations were found by geographic region, with dentigerous cyst more common than radicular cyst, and ameloblastoma more common than odontoma in African and Asian countries (P

Dentigerous cysts are the most common developmental odontogenic jaw cysts, associated with crowns of an Unerupted tooth. Usually, they occur in the second and third decade of life with a male predilection. They are frequently asymptomatic and mostly discovered incidentally on routine dental radiographic examination. Its growth is slow, and can reach a considerable size causing bone expansion and displacement of teeth. Mandibular lower third molars are the most frequently effected teeth; dentigerous cysts involving impacted mandibular canines are rarely reported. Surgical enucleation with extraction of the associated tooth is the standard treatment for dentigerous cyst, marsupialization is recommended for large lesions. We report a rare case of a large dentigerous cyst in a 62-year-old male patient, associated with impacted left mandibular canine, extending from the retro-molar area of left side crossing the midline to the 2nd premolar in the other side, that was successfully treated by marsupialization followed by enucleation and removal of the impacted tooth.

Adenomatoid odontogenic tumor (AOT) is a rare odontogenic origin tumor that manifests as a slow-growing cystic neoplasm in the anterior maxilla, often in conjunction with an impacted tooth. AOTs are divided into three kinds based on their histology: follicular, extrafollicular, and peripheral. Because the source of the AOT is unknown, it's impossible to say whether the lining of an associated cyst reflects the cause i.e. a real dentigerous cyst, a cystic alteration within an AOT, or a separate entity. The diagnosis and treatment should be determined following a thorough clinical, radiographic, and histological investigation. The presented case is a rare occurrence of its sort due to the favorable patient's age and the AOT's site in the lower jaw. The current study reports on a case with follicular AOT in the anterior mandibular region (a rare location), with unusual histomorphology (snow flake and calcified areas) associated with impacted 43 and retained 83.

Background The vascularized fibula free flap is a workhorse flap in pediatric mandibular reconstruction. This study aimed to address functional outcomes, complications, and morbidity associated with the fibula resection in a consecutive series of mandibular reconstruction using this technique in skeletally immature patients. Methods Functional outcomes in terms of maximal mouth opening capacity, patient-reported eating ability, occlusion, and gait were retrospectively reviewed in 34 consecutive pediatric patients (18 males, 16 females) who underwent mandibular reconstruction using the vascularized free fibula flap. Data regarding donor and recipient site complications were also retrieved. Results The mean follow-up period was 50.6 months (range, 12-108 months). The average age was 10.3 years (range, 2-15 years). Underlying pathologies included ossifying fibroma, ameloblastoma, mandibular arteriovenous malformation, fibrous dysplasia, Goldenhar syndrome, dentigerous cyst, mandibular lymphoma, odontogenic fibroma, adenomatoid odontogenic tumor, aneurysmal bone cyst, neurogenic sarcoma, and central giant cell granuloma. Defect length ranged from 8 to 17 cm. Mean return to normal ambulation was achieved 12 days postoperatively. All patients reported ability to eat solids and liquids, with 29 of 34 achieving normal mouth opening. Normal or minimally disturbed occlusion was maintained postoperatively in most patients. Temporomandibular joint ankylosis and condylar displacement were each developed in one patient. Two patients reported gait disturbances that receded after physical therapy. No other major donor site complications, including flexion contracture of the great toe, were identified. Conclusions The vascularized fibula free flap is reaffirmed to be the criterion standard for mandible reconstruction in pediatric patients, providing satisfactory functional results and adequate adaptation to the growing facial skeleton with minimal sequelae. Complications regarding hallux function may be prevented by assessing the vascularity of the flexor hallucis longus intraoperatively and ensuring tension-free closure of the donor site.

OBJECTIVES: The current study was conducted to analyze immunohistochemical appearance of P53 protein in odontogenic cysts. METHODOLOGY: Thirty paraffin blocks of confirmed case were prepared to investigate the immunohistochemical appearance of P53 protein. RESULTS: Sixteen out of thirty odontogenic cysts (53.3%) showed P53, four out of ten dentigerous cyst (40%) had P53, twelve out of fifteen odontogenic keratocysts (80%) expressed P53 while none of the five radicular cysts (0%) showed P53 protein. CONCLUSION: Reclassification of OKC as keratocystic odontogenic tumor was supported by the present study and its findings.

Background: The dentigerous cyst is the second most common developmental cysts of the jaws. Despite being asymptomatic in many cases, untreated lesions can reach significant sizes and result in extensive bone resorption. Associated complications may include facial asymmetry, teeth mobility, nerve compression, and pain. Large extensive dentigerous cyst are more difficult to manage. Aim of the study: This study was conducted to evaluate the management of extensive dentigerous cysts in adults as well as the associated potential risks and complications. Patients and methods: Fourteen (8 males and 6 females) patients with age range of 20-55 years (mean age of 33.9 years) who had large dentigerous cysts were included in this study. Enucleation of the cystic lesions along with the associated teeth was performed. Patients were clinically and radiographically evaluated for one year postoperatively. Results: Nine mandibular (64.3%) and 5 maxillary dentigerous cystic lesions (35.7%) were operated. No surgical postoperative complications were encountered. Radiographic evaluation showed adequate new bone formation in the surgical defects within 6-12 months. Conclusion: Untreated dentigerous cysts can reach a significant size. Extensive dentigerous cysts can be adequately treated with careful enucleation. Extensive dentigerous cysts may be associated with an increased risk for transformation into more aggressive lesions.

Dentigerous cysts (DC) are the most common odontogenic cystic lesions of inflammatory origin occurring in children. These lesions can be treated by enucleation with or without related impacted teeth or marsupialization/decompression. The latter procedures have been used successfully for many years, but decompression is increasingly recommended in children because of its good outcomes and the preservation of the developing tooth. This conservative surgical technic allows simultaneously the normal eruption of the involved permanent teeth and the ossification of the bony defect. The present report describes an 8-year-old female patient with an inflammatory DC associated with an endodontically treated primary molar accidentally discovered on panoramic radiograph. Decompression of the cyst was performed, by means of a removable space maintainer acting as an acrylic obturator after removal of teeth 83 and 84. Ten months after the decompression procedure, a complete resolution and regression of the cystic lesion with full spontaneous eruption of the premolar were observed.

The glandular odontogenic cyst (GOC) is an uncommon jawbone cyst with a challenging diagnosis because of the presence of several clinical and histopathologic overlaps with other odontogenic lesions and central mucoepidermoid carcinoma. To date, less than 200 cases of GOC have been published in the literature with reliable clinical and histopathologic information. Furthermore, the lack of a well-documented GOC case series impairs a more detailed understanding about the biological behavior and appropriate management of the lesion. Therefore, in this study, we report 3 well-documented cases of GOC in the literature. In one of the cases, the incisional biopsy was misdiagnosed as a dentigerous cyst, and the lesion recurred. Therefore, we also discuss key points regarding the diagnosis and treatment of GOC.

Background: The process of odontogenesis is complex involving epithelial–mesenchymal interactions, along with the molecular signaling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. Cytokeratins are the intermediate filament proteins which maintain cell integrity and alter their properties in cysts and tumors. In the following study, cytokeratin 19 expression patterns are assessed quantitatively in reduced enamel epithelium, dentigerous cyst and unicystic ameloblastoma. Aim: The aim of present study is to assess expression of CK 19, a stem cell marker in reduced enamel epithelium, dentigerous cyst and unicystic ameloblastoma, quantitatively. Materials and Methods: The present study is carried out with 15 samples in each group. Reduced enamel epithelium is derived from the patients undergoing treatment for impacted teeth. Histopathologically diagnosed cases of dentigerous cyst and unicystic ameloblastoma were considered for the study. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 45 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data were analyzed using SPSS software version 23. Descriptive for scale data, One way anova with post hoc Tukey's test for intergroup comparison. Results: The results showed significant P value

Introduction: Dentigerous cyst is a pathological epithelial cavity that surrounds an unerupted tooth crown. Dentigerous cysts are usually associated with impacted teeth, mandibular third molars, first and second premolars and canines. Dentigerous cysts can occur at any age, but most cases of these cysts occur at the age of approximately 20 years. Men are affected more often than women. Purpose.To find out how the mechanism of dentigerous cysts. The cyst cavity is lined with epithelial cells derived from the epithelial enamel that is reduced from the tooth-forming organs. According to its pathogenesis, the pressure exerted by an erupted tooth on the follicle can block venous flow leading to accumulation of exudate between the reduced enamel epithelium and the crown of the tooth. These cysts are mostly due to fluid accumulation either between the reduced enamel epithelium and the enamel or between the layers of the enamel organ. This fluid accumulation occurs as a result of the pressure exerted by the erupting tooth on the affected follicle, which blocks venous flow, thus inducing rapid transudation of serum in the capillary walls. Discussion: The expansion of the dentigerous cyst causes the release of bone resorbing factor and an increase in the osmolarity of the cyst fluid as a result of the discharge of inflammatory cells, the discharge of residual epithelial enamel and tooth enamel, and desquamation of epithelial cells into the lumen of the cyst. In theory, the fluid will cause cystic proliferation. because the hyperosmolar content produced by cellular breakdown and cell products causes an osmotic gradient to pump fluid into the lumen of the cyst or it can also be said that an increase in the osmolarity of cyst fluid is the result of a shortcut to inflammatory cells and desquamation of epithelial cells into the lumen of the cyst resulting in a dentigerous cyst. Conclusion: The dentigerous cysts that surround the unerupted dental crowns are caused by the accumulation of fluid either between the reduced enamel epithelium or between the layers of the enamel organs. Dentigerous cysts can cause infection, pain, swelling, root dislocation, and resorption of adjacent tooth roots.

We demonstrate a reliable and minimally invasive treatment with endoscopically-assisted surgery for enucleation of a posterior mandibular dentigerous cyst with an intraoral approach. A 28-year-old Japanese man had a bilateral mandibular dentigerous cyst that was contiguous with the third molars. Surgical enucleation of the cyst was performed with an endoscope-assisted field of view. The alveolar nerve was identified endoscopically, and continuity of the nerve was carefully preserved. In addition, it was clearly confirmed in the endoscopic visual field that the root apex of the mandibular second molar was not completely exposed. The use of an endoscope made it possible to clarify the operative field and to preserve the surrounding tissues. Surgery in the mandible was safer and less invasive with endoscopic assistance than it would have been without such assistance.

A 14-year-old American Paint Horse mare was referred for further evaluation of a firm mass with an associated draining tract at the base of the left ear suspected to be a dentigerous cyst. Approximately three months prior, the draining tract had been excised under the presumed diagnosis of an abscess with no improvement. Physical examination revealed a firm mass palpable at the base of the left ear with a draining tract that did not elicit any pain response on palpation. Digital radiographs revealed a 6x11cm mineral mass in the left temporal region. Medially, there were two projections that extended into the left temporal bone. Cone beam computed tomography (CT) showed mild thinning of the temporal bone separating the mass and the brain at the conical extension of the caudal aspect of the mass. Both structures were isolated and elevated using a combination of osteotomes, mallet, and bone rongeurs under general inhalant anesthesia with radiographs to determine complete removal. Although histopathology was declined, gross examination of both structures resembled adult molar teeth. At eight months postoperative, the owners reported that the surgical site was healed and no discharge was present. Dentigerous cysts should remain a differential for a mass with an associated draining tract at the base of the ear in horses. Practitioners should strongly consider CT when feasible for additional diagnostics in similar cases. Although benign and removal poses risk, dentigerous cysts can be surgically excised with a positive outcome.

This study evaluated the presence of radiolucid lesions in digital panoramic radiographs from the archives of the State University of Paraiba (UEPB) Diagnostic Imaging Clinic, performed in 2017. After surveying the radiographs performed by the service in that year, those with radiolucent lesions were selected, being excluded those with poor quality and with patient positioning errors. By means of a structured form, the characteristics observed in the radiographs were recorded by a single trained and calibrated observer. The analysis took place through descriptive statistics and all ethical aspects were respected. There was a low prevalence (14.2%) of radiographs with radiolucent lesions, which mainly affected young female patients. These lesions were small in size, located predominantly in the posterior periapical region of the mandible, with a unilocular aspect, being associated with a posterior tooth, mainly premolar. Inflammatory lesions were the most prevalent, with a presumptive diagnosis highlighting the predominance of abscesses followed by cysts/granulomas. The dentigerous cyst was the third most prevalent odontogenic lesion, occurring in its entirety in females. Odontogenic keratocysts and Stafne's bone cavity were also detected.

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 1.9cm. 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.

Dentigerous cyst is the most prevalent lesion of odontogenic origin, commonly radiographically diagnosed, between the second and fourth decades of life, with a predilection for the male sex. The treatment of choice is enucleation; however, decompression is indicated for cysts that reach large proportions. The most frequent complications are expansion and resorption of the bone cortex, facial asymmetry, root resorption of adjacent teeth, migration or delay of dental eruption and compression of the lower alveolar nerve canal. Objective: To report a clinical case of a dentigerous cyst adjacent to an impacted mandibular third molar, treated with decompression and enucleation. Case report: A 39-year-old male, attended the Stomatology service with a history of a radiographic finding in the mandible. At the radiopraghic evaluation, it was possible to observe a radiolucent unilocular cystic tumor lesion, well delimited by a radiopaque, asymptomatic, intraosseous image in the region of the mandible right angle, extending from the left first pre molar to the left third molar, with the later included in a mesioangular position. The patient underwent a previous cystic decompression process, followed up regularly for 6 months, and referred for endodontic treatment of the left first and second molars to prepare for surgical enucleation and removal of the third molar. After removal, the material was sent to anatomopathological analysis, and the results confirmed the diagnosis of dentigerous cyst. The patient is being followed up without postoperative comorbidities. Conclusion: The chosen treatment allowed the maintenance of the teeth involved in the lesion, and mainly, the minimization of the enucleation procedure by previous decompression.

Background: Impacted teeth are commonly asymptomatic and not associated with any pathologic lesions for years. Any change in the size of the follicle associated with impacted teeth may result in odontogenic cysts or tumors. CBCT plays an important role in determining the radiographic features of a lesion and therefore, is very helpful for accurate diagnosis and treatment planning. Objective: This study aims to evaluate radiolucent lesions associated with impacted teeth in terms of age and sex distribution, localization, and comparison with the pathological diagnosis. Methods: In this retrospective study, out of 6758 CBCT images, 400 images revealing radiolucent lesions were detected. The study included only 190 cases (regarding 180 patients) which had a matching histopathological evaluation. Data related to the age and sex of the patients, localization of the lesions, and their comparison with the pathological diagnosis were recorded and analyzed. Results: The most encountered lesions were dentigerous cysts (60%) and odontogenic keratocysts (26.3%). Males were the most affected (63.3%). Most of the lesions were found in the left and right posterior mandible and mostly (66.8 %) associated with third molars. Out of 123 radiological diagnoses of dentigerous cyst cases, histopathological diagnoses confirmed 108 cases. Regarding odontogenic keratocyst, histopathological diagnosis confirmed 40 cases out of 48. Conclusion: Radiological diagnoses of the lesions mostly match with their pathological diagnosis unless their characteristics are changed due to infection. CBCT, as a technique enabling detailed imaging of the involved dental structures, is a helpful instrument for differential diagnosis.

This study aimed to investigate the presence of BRAF V600E mutation in mandibular ameloblastoma by comparing the results of molecular detection and immunohistochemical analysis. A 128 cases of mandibular ameloblastoma and 30 cases of dentigerous cyst (control group) were selected for analysis. Detection of BRAF V600E mutation was performed with immunohistochemistry (IHC) and polymerase chain reaction techniques. Clinico-pathologic data were collected in order to investigate possible associations with the mutation. Of the 128 cases submitted to IHC, 81.2% (108 cases) showed positivity for anti-BRAF V600E antibody, whereas 24 were negative (18.8%). Molecular analysis of the BRAF V600E mutation by polymerase chain reaction was possible in 116 cases due to DNA quality. Of these cases, 96 were positive (82.8%) and 20 negative (17.2%). All cases of dentigerous cyst were negative for BRAF V600E mutation in both techniques. Considering the sequencing as a gold standard method, the receiver operating characteristics curve analysis showed sensitivity of 0.99 and specificity of 1 (area under the curve=0.995, standard error=0.006; P

BACKGROUND: Follicular cysts are osteolytic lesions characterized by greater growth, differentiation, and degeneration potentials, compared to inflammatory root cysts. Those connected to upper third molars can disrupt the neighboring teeth and extend to maxillary sinus and adjacent anatomical structures. CASE PRESENTATION: In this study, we present a case of a large dimension follicular cyst associated with the upper third molar, extended to maxillary antrum and pterygomaxillary space, uncommon for dimensions, involving meso- and sovra-structure describing the clinical diagnostic procedures, and the surgical strategies adopted. The cone-beam computed tomography allowed a very accurate analysis of the lesion. Surgical excision was performed through Caldwell-Luc technique, approaching to the pterygomaxillary space. A 1-year follow-up shows good clinical, anatomical, and functional conditions. Histological examination confirmed the diagnosis of follicular cyst. CONCLUSION: Giant follicular cysts require an accurate pre-operative study due to the delicate structures that may be involved.

Objectives: To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. Method: The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2–3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. Results: On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. Conclusion: In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.

Purpose The aim of this study was to examine the long-term results of mandibular dentigerous cysts treated with decompression using a custom-made appliance. Patients and Methods This retrospective study included 34 patients with dentigerous cysts who were treated as outpatients at the Faculty of Dentistry, Marmara University. Medical history, complaints, intraoral and extraoral clinical findings, treatment time, and complications of these patients were collected. Results The average age of the patients was 7.94 years. Three tooth buds (canine, first permanent premolar [P1], and second permanent premolar) in 2 cases, two tooth buds in 7 cases (P1 and second permanent premolar in 6 cases and P1 and canine in 1 case), and one tooth bud in 25 cases were related to the cyst. The mean decompression time was 5.97 months (range, 3 to 9 months). No major complications occurred during or after decompression. No evidence of infection, breakdown and/or dehiscence of the soft tissue, or inferior alveolar nerve paresthesia was observed. The complications and complaints were minor and straightforward to resolve. Conclusions Decompression is a very effective and successful method for the treatment of mandibular dentigerous cysts.

Odontogenic keratocyst (OKC), previously known as keratocystic odontogenic tumor, are benign cystic lesions involving the mandible or maxilla and are believed to arise from dental lamina. What makes this cyst special is its aggressive behavior and high recurrence rate. This cyst is predominantly seen in younger patients (2nd–3rd decade) and may be seen in either the body or ramus of the mandible or maxilla. The distribution between sexes varies from equality to a male-to-female ratio of 1.6:1, except in children. There may be male predilection. Radiographically, it appears as unilocular or multilocular lesions with scalloped contour. This cyst is commonly detected incidentally. When symptomatic, jaw swelling and pain are common symptoms associated with this tumor. Less commonly, trismus and paresthesia may occur. Here, we present a case of OKC in a young male patient associated with an impacted right mandibular third molar.

Eruption cyst is an odontogenic cyst which is regarded as the soft tissue variant of dentigerous cyst. They are usually seen in first decade of life and appears as raised dome shaped swelling on the mucosa of alveolar ridge. This paper presents a case of an eruption cyst in a 7 year old male and its successful management.

Dentigerous cyst is the most common developmental maxillary cyst, often being associated with impacted third molars. The occurrence of bilateral or multiple lesions is usually associated with syndromes. The present report describes a case of multiple dentigerous cyst affecting both maxilla and mandible in association with impacted third molars in a non-syndromic patient. The complementary use of cone beam computed tomography (CBCT) could provide accurate knowledge for pre-operative radiologic assessment to delineate the extension of the lesion as well as its relationship with adjacent structures. The typical imaging characteristics can be useful for an adequate diagnosis. This type of lesion requires comprehensive pre-operative evaluation and logical operational approach.

Radicular cysts are the most common cystic lesions in the oral cavity. Radicular cysts have a rare occurrence in the primary dentition. Radicular cysts arising from deciduous teeth are reported to occur in the age range of 3–19 years with a male predominance. The etiological factor is long-standing dental caries and dental trauma. The present case report describes the inflammatory radicular cyst involving the deciduous mandibular second molar. Surgical management includes enucleation of the cyst along with mandibular second premolar in a 5-year-old female patient. The surgical cavity was closed by an obturator appliance to maintain the patency. Eventful healing was seen after 3 months of follow-up. How to cite this article: Kajjari S, Gowtham A, Meharwade P, et al. Infected Radicular Cyst of Deciduous Second Molar Mimicking Dentigerous Cyst of Second Premolar in a Young Child: A Rare Entity. Int J Clin Pediatr Dent 2021;14(3):434–437.

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

Aims and Objectives: The present study aims at evaluation of age, sex and site of occurrence related prevalence of Radicular cyst, Dentigerous cyst, Odontogenic keratocyst (OKC), Lateral Periodontal cyst, Residual cyst, Adult Gingival cyst, Calcifying odontogenic cysts. Materials and Methods: During 8 year period (From 2010 to 2017), 1000 patients with cystic lesions of the jaws were analysed. All patients underwent clinical examination and plain film radiography (panoramic, periapical, and occlusal views). Some of them were referred for CBCT or computed tomography (CT) with a multiplanar reconstruction program (MPR). Age, sex, type of cyst and location were recorded in designed performa. The treatment modalities used for the management of cysts are marsupialization, enucleation, enucleation with bone grafting or resection under local or general anaesthesia depending on the case. Results: Radicular cyst(45.2%) is most common cyst followed by dentigerous cyst(23.2%),Odontogenic keratocyst (13.4%), lateral periodontal cyst(8.9%), residual cyst(4.5%),Calcifying odontogenic cyst (4.4%) followed by the least common occurring adult gingival cyst (1.1%). The mandibular posterior region (41.3%) is most predilected site of occurrence of cysts in orofacial region however maxillary anterior region (17.7%) is least predilected site of occurrence. Conclusion: The radicular cyst is most common cyst of oral cavity while adult gingival cyst is least common cyst. Keywords: Cyst, Jaw bone, Prevalence, Odontogenic, Nonodontogenic.

Background Calretinin is a calcium-binding protein of 29-kilodalton (kDa), which is widely expressed in normal human tissues and tumorigenic tissues. Its expression in the odontogenic epithelium during odontogenesis and in neoplastic odontogenic tissues has been demonstrated. Unicystic ameloblastoma poses a diagnostic challenge, as its histologic presentation can be sometimes mistaken for cystic odontogenic lesions. In the present study, an attempt is made to overcome the confusion encountered in the diagnosis of dentigerous cyst and unicystic ameloblastoma, using the expression of calretinin in both lesions and to compare this expression with conventional ameloblastoma to accurately diagnose and differentiate these lesions. Materials and methods A total of eighty cases, in which twenty cases each of ameloblastoma, unicystic ameloblastoma, dentigerous cyst, and odontogenic keratocyst (OKC) were included in the study. Slides were made from the archival blocks of each case and were stained immunohistochemically with calretinin. Results Correlation between calretinin staining and histopathological diagnosis was done, and it was found that all twenty cases of ameloblastoma showed positivity for calretinin, whereas 17 of twenty cases of unicystic ameloblastoma showed positivity for calretinin staining. All the cases of OKC and dentigerous cyst were negative for calretinin. Conclusion Calretinin may serve as an important diagnostic adjunct in the differential diagnosis of ameloblastoma and cystic odontogenic lesions.

Purpose: The dentigerous cyst is the second most common odontogenic cyst in the jaws. These lesions are observed in routine examinations. The third molars and maxillary canines are the most affected teeth. Definition of marsupialization and enucleation techniques as well as consideration of important objective criteria for the treatment plan like cyst size, age, and proximity to anatomical structures, clinical importance of the tooth or teeth associated with the lesion and risk of bone fracture. This paper will present a case report treated by maneuver of decompression followed by enucleation and bone reconstruction. Case report: A 43-year-old female patient, Caucasian, attended the Oral-Maxillofacial Surgery consultation at Clitrofa - Centro Médico, Dentário e Cirúrgico, in Trofa - Portugal, to assess extraction of 3.8 and 4.8. On intraoral physical examination, a slight bulging of the cortical bone was noted in the region of the left external oblique line. Aspiration puncture was performed and a small amount of light-yellow liquid confirmed the cystic nature of the lesion. In a second stage, osteotomy through piezoelectric surgery was performed. The cystic capsule was excised together with the extraction of tooth 3.8 included and tooth 3.7. Bone regeneration was performed. The material obtained from the cystic cavity was sent for pathological examination, confirming the diagnosis of dentigerous cyst. During observation of the patient for twelve months, no hypoesthesia or any sign of recurrence of the lesion was observed. Conclusion: The technique preserved the neurosensory function and was effective for the enucleation and reconstruction of the lesion. Despite the clinical peculiarities of each case and the chosen treatment method, the prognosis of these lesions is favourable when appropriate therapy is used.

Nonmineralized cysts and cyst-like lesions that frequently occur in the mandible include ameloblastomas, odontogenic keratocysts, and dentigerous cysts. They have specific features of well-demarcated, unilocular, and radiolucent lesions that are often associated with tooth impaction. Although it rarely occurs, these cysts can become extremely large. Furthermore, cyst enlargement causes additional symptoms that can challenge the success of tooth recovery through orthodontic treatment. This clinical report presents the successful eruption of 2 impacted molars in a large dentigerous cyst treated with marsupialization and orthodontic traction using an orthodontic miniplate anchorage over a 4-year treatment period.

Background This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts. Material and Methods A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD 42020189349). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool. Results Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates. Conclusions The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible. Key words:Computer-assisted diagnosis, computer-assisted image analysis, computer-assisted image processing, odontogenic cysts, keratocysts, radicular cysts.