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The objective of this study is to present an uncommon case of adenomatoid odontogenic tumor (AOT) with an impacted maxillary canine, initially mimicking a follicular cyst. AOT is a rare odontogenic tumor, accounting for approximately 1% to 9% of all odontogenic tumors. It primarily occurs in the maxilla and is often associated with an unerupted permanent tooth. Follicular cysts, also known as dentigerous cysts, are benign odontogenic cysts that encase the crown of an unerupted or impacted tooth. We describe a case of AOT occurring in a 14-year-old male. Both the follicular cyst and adenomatoid odontogenic tumor (AOT) can exhibit similar clinical and radiographic presentations. It is crucial to accurately differentiate between the two to ensure appropriate treatment and prognosis. [ABSTRACT FROM AUTHOR]

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

Background: Secreted protein acidic and rich in cysteine (SPARC) has been shown to modulate aggressive behavior in several benign and malignant tumors. Little is known about SPARC expression in odontogenic keratocyst (OKC), an odontogenic cyst with an aggressive nature. To the best of our knowledge, only one study has been investigated the expression of this protein in OKCs. This study aimed to characterize SPARC expression in OKCs. Additionally, to determine whether SPARC is associated with aggressive behavior in OKCs, SPARC expression in OKCs was compared with radicular cysts (RCs), dentigerous cysts (DCs) and calcifying odontogenic cysts (COCs). These odontogenic cysts showed no or less aggressive behavior. Methods: SPARC expression was evaluated in 38 OKCs, 39 RCs, 35 DCs and 14 COCs using immunohistochemistry. The percentages of positive cells and the intensities of immunostaining in the epithelial lining and the cystic wall were evaluated and scored. Results: Generally, OKCs showed similar staining patterns to RCs, DCs and COCs. In the epithelial lining, SPARC was not detected, except for ghost cells in all COCs. In the cystic wall, the majority of positive cells were fibroblasts. Compared between 4 groups of odontogenic cysts, SPARC expression in OKCs was significantly higher than those of RCs (P < 0.001), DCs (P < 0.001) and COCs (P = 0.001). Conclusions: A significant increase of SPARC expression in OKCs compared with RCs, DCs and COCs suggests that SPARC may play a role in the aggressive behavior of OKCs. [ABSTRACT FROM AUTHOR]

Background: The purpose of this systematic review (SR) is to gather evidence on the use of machine learning (ML) models in the diagnosis of intraosseous lesions in gnathic bones and to analyze the reliability, impact, and usefulness of such models. This SR was performed in accordance with the PRISMA 2022 guidelines and was registered in the PROSPERO database (CRD42022379298). Methods: The acronym PICOS was used to structure the inquiry‐focused review question "Is Artificial Intelligence reliable for the diagnosis of intraosseous lesions in gnathic bones?" The literature search was conducted in various electronic databases, including PubMed, Embase, Scopus, Cochrane Library, Web of Science, Lilacs, IEEE Xplore, and Gray Literature (Google Scholar and ProQuest). Risk of bias assessment was performed using PROBAST, and the results were synthesized by considering the task and sampling strategy of the dataset. Results: Twenty‐six studies were included (21 146 radiographic images). Ameloblastomas, odontogenic keratocysts, dentigerous cysts, and periapical cysts were the most frequently investigated lesions. According to TRIPOD, most studies were classified as type 2 (randomly divided). The F1 score was presented in only 13 studies, which provided the metrics for 20 trials, with a mean of 0.71 (±0.25). Conclusion: There is no conclusive evidence to support the usefulness of ML‐based models in the detection, segmentation, and classification of intraosseous lesions in gnathic bones for routine clinical application. The lack of detail about data sampling, the lack of a comprehensive set of metrics for training and validation, and the absence of external testing limit experiments and hinder proper evaluation of model performance. [ABSTRACT FROM AUTHOR]

Calcifying odontogenic cyst (COC) is a relatively uncommon cyst of odontogenic origin, occurring in the second decade of life, with no jaw predilection. Radiographically, it typically appears as a well‐defined unilocular radiolucency containing irregular calcifications of varying size and opacity. Treatment consists of conservative surgical excisions with low recurrence rates. The purpose of this paper is to report a rare case of late COC recurrence and review the pertinent literature. A 42‐year‐old female patient presented for evaluation of a painless swelling in the palate, which had been present for 5 years with a gradual, slow increase in dimensions. Twenty years before, a lesion at the same site was surgically excised with a diagnosis of COC. Clinical examination revealed a hard‐in‐consistency swelling in the anterior segment of the hard palate. Radiographically, a radiopaque lesion with an irregular outline was noticed in the left palate adjacent to the left maxillary canine and first premolar, along with a well‐defined radiolucent lesion between the maxillary central incisors. Both lesions were surgically excised, and histopathological examination revealed that the main lesion in the left palate was consistent with recurrent COC, while the lesion between the central incisors was compatible with a nasopalatine duct cyst. Even though the recurrence rate of COC is low, estimated at 3.4% based on our review of the relevant English‐language literature, the current case highlights the possibility of a late recurrence, even several years after the initial diagnosis and treatment, and therefore the need for long‐term follow‐up. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of studies evaluating the preservation and recovery vitality of teeth associated with cystic lesions in the jaws. The purpose of the present study was to evaluate whether the use of the marsupialization treatment method in the large cystic lesions of the jaws associated within involved teeth would save the pulp vitality. Materials and methods: It was a cohort study of patients treated at the Department of Oral and Maxillofacial Surgery from April 2019 to April 2023. Patients with primary cystic lesions associated teeth, with a cyst diameter of >3.4 cm, along with dental root resorption of less than half the root length, and treated by marsupialization were included. Patient age, gender, location, associated teeth, size, management, dental pulp vitality before and after marsupialization, and the duration of treatment were evaluated. Pulp vitality of involved teeth was assessed with electrical pulp tester. Predictor Variable: It was the treatment method. Main Outcome Variable(s): The primary outcome variable was the recovery or preservation of pulp vitality. Covariates: The study variables were demographic, clinical features of the cysts, clinical features of associated teeth, and treatment method. Analyses: Categorical data were presented in mean with standard deviation, and set the level of statistical significance at p < 0.05. Results: The sample included 73 patients with large cystic lesions; 47 (64.4%) were male and 26 (35.6%) were female. The age range was 9 to 68 years (mean ± standard deviation, 22.4 ± 4). The 73 patients had 305 teeth associated with large cystic lesions. Of these dentitions, 85.9% of teeth had normal pulp vitality and 14.1% were negative before marsupialization. Following marsupialization, preservation of pulp vitality was noted in 61.3% and 18.0% of teeth lost their vitality. Of those without normal dental pulp vitality, 70.9% of teeth recovered their vitality of which 46.5% had recovered their vitality 9 to 12 months following marsupialization. Conclusion: Marsupialization followed by second surgery maybe a treatment option for preserving and recovering the pulp vitality of teeth associated with large cystic jaw lesions. [ABSTRACT FROM AUTHOR]

Background: Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. Material and method: 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. Result: Odontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. Conclusions: Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts. [ABSTRACT FROM AUTHOR]

Ectopic teeth are an eruption disorder in which teeth are located in anatomical structures where, physiologically, they should not occur. An ectopic tooth is a very rare phenomenon, affecting approximately 0.5% of the canine population, and few descriptions of the treatment of such teeth in dogs can be found in the available literature. This article describes the diagnostic and therapeutic handling of cavities following extraction of ectopic teeth in nine dogs. The cases are subdivided into uncomplicated (when the ectopic tooth was encapsulated in the surrounding connective tissue, without lysis of the bone around the tooth) and complicated (in which, in addition to the presence of the ectopic tooth, a dentigerous cyst had formed). Four cases of complicated ectopic teeth are described in more detail. In this study, special attention was paid not only to the technique of tooth extraction itself but also to the method of securing and healing large bone defects after the extraction using hydroxyapatite curdlan polymer. Owing to the plastic properties of the bone substitute preparation, it was possible to implant the material without enlarging the bone defect created during the tooth extraction. Control radiographs showed features of bone regeneration, and clinical examination at both the early and late stages revealed no postoperative complications. [ABSTRACT FROM AUTHOR]

A 7-month-old, male, Weimaraner dog was presented for maxillary swelling. Clinical evaluation including radiographs and computed tomography revealed a large cystic lesion, unerupted right maxillary canine tooth, and mass presumed to be a compound odontoma. The cyst and mass were expansile and occupied a large portion of the nasal cavity displacing anatomical structures of the maxilla. The mass was excised via curettage through an intraoral surgical approach and the unerupted tooth and cystic lining were removed. Histopathology supported dentigerous cyst and compound odontoma. This case confirms the first report of concurrent development of dentigerous cyst and compound odontoma in a dog with successful treatment and 18-month follow-up with no recurrence. [ABSTRACT FROM AUTHOR]

Background and Objectives: Dentigerous cysts are one of the most frequent pathologies associated with unerupted or impacted teeth. Such cysts show a male predilection and a preference for the mandibular region. Also, they commonly occur in the second and third decades of life, with only 9% occurring in the first decade. The aim of this work is to apply and study the therapeutic algorithms developed for dentigerous cysts and their outcomes, from the early diagnostic stage to the complete healing phase of pediatric patients diagnosed with this medical condition. Materials and Methods: The study included 19 pediatric patients diagnosed with dentigerous cysts who underwent the enucleation and extraction or conservative attitude of the associated tooth. The bony healing was also followed-up 9 months after the surgery. Results: A higher incidence in the posterior area of the mandible and maxilla was observed, as well as a higher incidence in boys. The 9 months postoperative radiographic assessment showed that the bony defects were completely healed. Conclusions: A thorough understanding of the nature of the lesion backed by a good clinical history and by state-of-the-art radiographic and radiologic examinations can go a long way in helping the surgeon to choose the correct therapeutic approach and to ameliorate the medical condition in the best long-term interest of the young patient. The considered dentigerous cyst cases demonstrated that an early diagnosis and treatment of this pathology is followed by a responsive treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. Material and method 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. Result Odontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. Conclusions Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts.

Intraosseous arteriovenous malformations (AVM) are uncommon high-flow vascular malformation that can affect the maxilla or mandible. AVM may present with aspecific and misleading signs and symptoms. The diagnosis is often accidental and bleeding may represent the first symptom. Radiographically, there are few characteristic features and misdiagnosis is easy. Here we report the case of a young male affected by arteriovenous fistula on the right side of the mandible initially misdiagnosed as a cystic lesion. The patient underwent transarterial embolization of the vascular malformation and subsequently the lesion was surgically removed. 1-year follow-up showed complete healing of the mandibular bone and absence of recurrence. Intraosseous arteriovenous malformations are rare entities. However, due to their harmfulness, both clinicians and radiologists must be aware of this type of lesion and should always consider them in the differential diagnosis of osteolytic lesions. [ABSTRACT FROM AUTHOR]

Statment of the Problem: Podoplanin can indicate the lymphangiogenesis. On the other hand, lymphangiogenesis affects the biological behavior of lesions. The clinical behavior of odontogenic keratocysts (OKC) and dentigerous cysts (DC) is different.Purpose: This study aimed to evaluate the immunohistochemical expression of podoplanin and to investigate lymphangiogenesis in OKCs as compared to DCs.Materials and Method: In this experimental laboratory study, sixty paraffined blocks, including 30 OKC and 30 DC samples, were examined in this study, all of which were histopathologically non-inflamed. To evaluate lymphangiogenesis, the immunohistochemi­cal reaction of D2-40 was evaluated via cytoplasmic and membrane staining of lymphatic endothelial cells. The expression of podoplanin in the epithelial cells of two cyst groups was also examined. To analyze the collected data and compare the results between the two groups of cysts, independent samples t-test, Mann-Whitney U test, and Chi-square test were performed in SPSS version 22. The significance level was set at 0.05.Results: The mean lymph node count and podoplanin expression were significantly higher in the OKC epithelium as compared to DC (P

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

Introduction: Although numerous syndromic and non-syndromic odontogenic lesions of the jaws have been documented in the literature, there are very few cases of simultaneous benign and malignant jaw lesions. Patient Concerns: We present a case of right maxillary squamous cell carcinoma along with several benign odontogenic cystic lesions of the jaws and skeletal abnormalities that meet the criteria for Gorlin-Goltz syndrome. Take-Away Lessons: With a review of the literature, the specifics of management and follow-up are discussed.

Objective: This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars. Materials and Methods: A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and Web of Science, from the inception of the databases to March 2024. Keywords and Medical Subject Heading (MeSH) terms such as "dentigerous cysts", "odontogenic keratocysts", "immunohistochemistry", "Ki-67", and "p53" were used. The PRISMA 2020 guidelines were followed to ensure methodological rigor. Inclusion criteria encompassed studies on humans and animals providing definitive diagnoses or specific signs and symptoms related to DCs and OKCs, with results on protein expression derived from immunohistochemistry, immune antibody, proteomics, or protein expression methods. Results: Of the 159 studies initially identified, 138 met the inclusion criteria. Our analysis highlighted significantly higher expressions of Ki-67 (22.1% ± 4.7 vs. 10.5% ± 3.2, p < 0.001), p53 (15.3% ± 3.6 vs. 5.2% ± 1.9, p < 0.001), and Bcl-2 (18.4% ± 3.2 vs. 8.7% ± 2.4, p < 0.001) in OKCs compared to DCs, indicating a higher proliferative index, increased cellular stress, and enhanced anti-apoptotic mechanisms in OKCs. Additionally, PCNA levels were higher in OKCs (25.6% ± 4.5 vs. 12.3% ± 3.1, p < 0.001). Genetic mutations, particularly in the PTCH1 gene, were frequently observed in OKCs, underscoring their aggressive behavior and potential malignancy. Conclusions: The findings emphasize the significant role of immunohistochemical markers in distinguishing between DCs and OKCs, with elevated levels of Ki-67, p53, Bcl-2, and PCNA in OKCs suggesting a higher potential for growth and recurrence. Genetic insights, including PTCH1 mutations, further support the need for personalized treatment approaches. These markers enhance diagnostic accuracy and inform targeted therapeutic strategies, potentially transforming patient management in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Intravascular papillary endothelial hyperplasia (IPEH) represents an uncommon reactive endothelial hyperplastic proliferation. A 46-year-old man experienced increased volume in the right maxilla, elevation of the nasal ala, and swelling of the hard palate with a reddish hue for 3 months. Computed tomography revealed an expansive hypodense region and cortical bone destruction associated with an impacted supernumerary tooth and an endodontically treated tooth. Under the differential diagnoses of a radicular cyst, dentigerous cyst, and ameloblastoma, an exploratory aspiration and incisional biopsy were performed. This revealed the formation of blood vessels of various diameters lined by endothelium, forming intravascular papillae positive for CD-34. The definitive diagnosis was IPEH, and the patient was treated by embolization and surgery. Histological analysis confirmed the presence of IPEH associated with an odontogenic cyst. After 12 months of follow-up, no recurrence was observed. Also, we reviewed case reports of IPEH affecting the maxilla and mandible. Fourteen intraosseous cases were reported in the maxilla and mandible, with a preference for males and affecting a wide age range. Complete surgical excision was the treatment of choice, and recurrences were not reported. The pathogenesis of IPEH is controversial and may originate from trauma or inflammatory processes. To the best of our knowledge, this is the first report of an association of IPEH with an odontogenic cyst. The importance of IPEH in the differential diagnosis of intraosseous lesions in the jaws is emphasized, and preoperative semiotic maneuvers are needed to prevent surgical complications. [ABSTRACT FROM AUTHOR]

Unerupted teeth in dogs are fairly common and may develop an odontogenic cyst that causes destruction of the surrounding bone and affect adjacent teeth. We analyzed histological reports of cysts associated with unerupted teeth in a large population of dogs. Medical records and histopathological results of cysts associated with unerupted teeth were evaluated from all dogs treated at a private referral veterinary dental clinic over a 10-year period (2012-2022). A total of 192 dogs with 279 cysts associated with one or more unerupted teeth were included in the study. Brachycephalic breeds were overrepresented. The most affected were Tibetan Spaniels with 58 dogs (30%) and Boxers with 48 dogs (25%). The most common affected tooth was the mandibular first premolar tooth with 238 (84%) cysts. Of the total of 279 cysts, 208 (75%) were histopathologically examined. None of the cysts examined contained malignant changes. Based on these 208 cysts, the probability of finding a cyst with malignant changes in a population of dogs is 0-1.4% (confidence interval 95%). [ABSTRACT FROM AUTHOR]

Aim: To evaluate the indication of the endodontic treatment for vital intact teeth with the root apex involved in large radicular cystic lesions of endodontic origin. Methodology: This prospective cohort study enrolled healthy participants with radicular cysts of endodontic origin and with the root apex of vital intact teeth involved in the bone defect, as determined by cone beam computed tomography (CBCT). Thirty‐two sound vital teeth were analysed by thermal (TPT) and electric pulp tests (EPT) before surgery (T0) and 1 week (T1), 2 weeks (T2), 3 months (T3) and 6 months (T4) post‐surgery. Student's t‐test (p <.05) was used to compare the EPT values at baseline and T4. anova (p <.05) was used to analyse the EPT variations for all maxillary and mandibular teeth. McNemar test (p <.05) was used to compare the results according to variation in EPT values gathering by variation, no variation and no response. Results: At T1, 75 and 65.7% of teeth responded positively whilst 25 and 34.3% did not respond to EPT and TPT, respectively. The variation of the EPT values between T0 and T1 was observed for 50.0% of teeth, whilst no variation was noticed in 25.0% of teeth. At T4, 90.6 and 87.5% of teeth responded positively whilst 9.4 and 12.5% did not respond to EPT and TPT, respectively. At T4, variation of the EPT values between T0 and T4 was observed for 28.1%, whilst no variation was noticed in 62.5% of teeth. There were no statistical differences in EPT results between T0 and T4 (p >.05), but significant differences were observed for EPT values between T1 and T4 (p <.05), and between mandibular and maxillary teeth. The pulp sensibility of maxillary teeth worsened after surgery, before reverting progressively to T0 values, whilst no statistically significant differences were observed for mandibular teeth at the different time points. Conclusions: These data support the inconsistence of the prophylactic endodontic treatment in healthy vital teeth with apex involvement in large cystic lesions of endodontic origin. Post‐surgery follow‐up with TPT and EPT is recommended to assess pulp status. [ABSTRACT FROM AUTHOR]

Nasopalatine duct cyst, which is also known as incisive canal cyst, is the most common developmental cyst of the maxilla. It arises from the proliferation of the remnants of the nasopalatine duct stimulated by trauma or infection. In this article, the authors report a rare case of an extensive nasopalatine duct cyst in a 57-year-old Male associated with non-vital tooth. Clinical examination revealed facial asymmetry associated with swelling that is painful and tender. Correlating clinical and radiological findings, a diagnosis of nasopalatine duct cyst was formed, and the histopathological examination confirmed the diagnosis of nasopalatine duct cyst. This case highlights the importance of knowing that nasopalatine duct cyst can be associated with non-vital teeth, challenging the assumption that they are exclusively associated with vital teeth. [ABSTRACT FROM AUTHOR]

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

Statment of the Problem: Podoplanin can indicate the lymphangiogenesis. On the other hand, lymphangiogenesis affects the biological behavior of lesions. The clinical behavior of odontogenic keratocysts (OKC) and dentigerous cysts (DC) is different. Purpose: This study aimed to evaluate the immunohistochemical expression of podoplanin and to investigate lymphangiogenesis in OKCs as compared to DCs. Materials and Method: In this experimental laboratory study, sixty paraffined blocks, including 30 OKC and 30 DC samples, were examined in this study, all of which were histopathologically non-inflamed. To evaluate lymphangiogenesis, the immunohistochemical reaction of D2-40 was evaluated via cytoplasmic and membrane staining of lymphatic endothelial cells. The expression of podoplanin in the epithelial cells of two cyst groups was also examined. To analyze the collected data and compare the results between the two groups of cysts, independent samples t-test, Mann-Whitney U test, and Chi-square test were performed in SPSS version 22. The significance level was set at 0.05. Results: The mean lymph node count and podoplanin expression were significantly higher in the OKC epithelium as compared to DC (p< 0.001). Based on the results, 90% of OKC samples and 43.3% of DC samples showed grade 3 staining. Conclusion: The rate of lymphangiogenesis and podoplanin expression in the epithelium were higher in OKCs compared to DCs. According to the results, the expression of podoplanin may be a useful marker for determining the invasiveness and proliferation of OKC. [ABSTRACT FROM AUTHOR]

Introduction: Nasopalatine duct cyst (NDC) is the most prevalent non-odontogenic cyst emerging from the epithelial remnants in the maxillary incisive canal. A sublabial or transpalatal approach is performed to enucleate NDC completely. More recently, transnasal endoscopic marsupialization has been used gradually. Case Presentation: A 24-year-old male patient with a large nasopalatine duct cyst with a diameter of 51 mm was managed by transnasal endoscopic marsupialization under general anesthesia. The presentation involves painless swelling around the left side of the anterior maxilla and bulging of the hard palate. No postoperative complications were observed after a 3-month follow-up. Transnasal endoscopic marsupialization is a minimally invasive surgery for large NDC. Clinical discussion: Approximately 1% of the population has a nasopalatine duct cyst. Surgical treatment was carried out under general anesthesia; the cyst was dissected and removed using a typically transnasal endoscopic marsupialization technique. Conclusion: The cause of the NDC is unclear. Simple surgical resection and clinical and radiological control are recommended to ensure the case is resolved correctly. [ABSTRACT FROM AUTHOR]

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]

Introduction: A former study on orthopantomograms from young children with abnormal dental development (not canine ectopia) demonstrated that the tooth bud of the mandibular canine, compared to a stable longitudinal canine axis, could be located normally, anteriorly or posteriorly, with close relation to the first premolar. Aim: The aim of the present study is to analyse on orthopantomograms if the canine axis can demonstrate where the ectopic mandibular canine started tooth formation. Materials: The material consists of orthopantomograms with ectopic mandibular canines and presence of primary mandibular canines from 47 cases (29 cases 9–21 years old and 18 cases with unknown ages). The primary canines demonstrated from minor apical resorption to more severe apical resorption. Methods: Based on canine maturity, location of the canine axes and the interrelationships between the roots of the permanent canine and first premolar, the location from where the canine started tooth formation was determined. Canine maturity. Maturity stage below half root length and maturity stage above half root length revealed that 11 ectopic canines had less than half root length and 36 cases more than half root length. Canine axes. The canine axis, through the length of the primary canines Ax, is inserted on drawings of the orthopantomograms using the tracing programme Inkscape®. Interrelationship between roots. By visual inspection, the distance between the canine and first premolar was designated close distance, normal distance and extended distance. Results: The results are divided into 3 groups. Group 1: The initial site of the permanent ectopic canine is located within the canine axis (6 cases). Group 2: The initial site of the permanent ectopic canine is located posterior to the canine axis (36 cases). Group 3: The initial site of the permanent ectopic canine is located anterior to the canine axis (5 cases). Conclusion: The study explained that the canine axis could divide cases of ectopic canines into three groups according to the location from where tooth formation starts. For getting closer to the pattern of the ectopic canine eruption, it is necessary to analyse series of orthopantomograms taken from the same individual over several years. [ABSTRACT FROM AUTHOR]

To detect predictive factors for the occurrence of complications associated with unerupted maxillary canines (C). A total of 83 cone beam computed tomograms (CBCT), made from November 1, 2021 to October 31, 2022, have met the inclusion criteria, whereby 110 unerupted C were detected. Independent variables were: gender, age, and C position. Outcome variables were detected complications: external root resorption (ERR) and dilaceration of adjacent tooth, ERR and dilaceration of C, dentigerous cyst, canine ankylosis, and adjacent teeth malposition. Chi-square test and logistic regression analysis were used to examine the relationship between income variables and detected complications. Vertical position of unerupted C showed as predictor for adjacent tooth dilacerations and malposition. Chance for dilaceration increases 5.5-fold with C position at the middle third of lateral incisor (LI) root, while chance of malposition increases 23.4-fold with its supra-apical position to the LI root, in comparison to the C position occlusal to the LI cemento-enamel junction. Age is a predictive factor for dentigerous cysts, with decreasing the chance of their occurrence 1.5-fold with each additional year of age. Early evaluation of the vertical position and timely treatment of C are decisive steps in preventing complications. [ABSTRACT FROM AUTHOR]

The most common kind of developing odontogenic cysts are dentigerous cysts. They frequently push impacted teeth into ectopic locations by encircling the crown of the tooth. The mandibular third molar, maxillary canine, mandibular premolar, and maxillary third molar are the teeth that are most commonly afflicted, in decreasing order. Although these cysts are more prevalent in men, they can also occur in children and teenagers, especially in the second and third decades of life. Dentigerous cyst-related teeth in the maxilla frequently cause root dilatation in the mandibular area, permanent tooth bud displacement close to the sinus, and cortical bone enlargement, sometimes, even up to the level of the orbit or floor of the nose. Clinically, these cysts do not cause any symptoms and are frequently found by chance during radiographs done to look into cases of primary teeth that are retained, teeth that are missing, teeth that erupt slowly, or orthodontic issues. Cone-beam computed tomography's advent has just made it possible to shed fresh, extensively documented light on diagnostic and treatment approaches. Protocol for management: Surgery is typically used to treat dentigerous cysts. In this instance, the affected tooth underwent endodontic therapy, after which the cyst was curettaged, a further apicoectomy was performed, and canine impaction was completed. In the end, a bone graft and platelet-rich fibrin were implanted for rehabilitation. [ABSTRACT FROM AUTHOR]

Dentigerous cysts are known as the second most common type of cyst in the jaws. The cyst is one of the lesions occurred frequently in the posterior body of the mandible and is often related to the unerupted third molar and forms around the crown of the unerupted tooth attaching at the cementoenamel junction. Such characteristic appearances are the diagnostic points differentiating from ameloblastoma or odontogenic keratocyst. However, it would be hard for us to diagnose it as a dentigerous cyst if the lesion does not show its typical appearance. We experienced two cases of dentigerous cysts which did not form around the crown of the unerupted tooth on radiologically. Both cysts were relatively large and resorbed adjacent teeth roots. Therefore, an ameloblastoma or an odontogenic keratocyst was suspected rather than a dentigerous cyst as the imaging diagnosis. The biopsy revealed that the lesion was a "dentigerous cyst" in one of the cases and "developmental cyst with inflammation" in another case. After the excision, the histopathological diagnosis was a dentigerous cyst with inflammation in both cases. This report shows the two cases of dentigerous cysts focusing on panoramic radiography and CT images. Also, we discuss the differential diagnosis by reconsidering those diagnostic points. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this retrospective study is to compare dentigerous cysts and odontogenic keratocysts for cytoplasmic activation/proliferation - associated protein-1 antibodies via immunohistochemical staining to obtain a new perspective about the specific behavioural characteristics of odontogenic keratocysts at the molecular level. Material and Methods: Forty dentigerous cysts (DC) and forty odontogenic keratocysts (OKC) tissue samples were examined using immunohistochemical staining to detect cytoplasmic activation/proliferation - associated protein-1 (CAPRIN-1) antibodies. Nuclear and/or cytoplasmic staining was evaluated as "positive". Cell staining rate (%) and cell staining intensity were determined, and a staining intensity distribution (SID) score was calculated for each sample. Cases were considered "negative" if they showed no staining for CAPRIN-1 antibodies, thus were given a SID score of zero. According to the SID scores, the expression levels were rated as negative, mild, moderate, or high. Results: Of 80 samples, 16 that could adversely affect immunohistochemical evaluation were excluded. Ten negative, 21 positive and three negative, 30 positive CAPRIN-1 expressions were observed in DC and OKC groups, respectively. The difference between the negative and positive cases within groups was significant only in the OKC group (P = 0.000). The SID score range and mean were 0 to 160 and 31.1 (SD 35.7) for DC and 0 to 160 and 57.3 (SD 42.3) for OKC groups. CAPRIN-1 expression was significantly higher in the OKC group (P = 0.043). Conclusions: The molecular basis for increased mitotic activity, high recurrence rates or presence of satellite cysts in odontogenic keratocysts may be attributed to the expression of cytoplasmic activation/proliferation - associated protein-1. [ABSTRACT FROM AUTHOR]

Squamous odontogenic tumour-like proliferations (SOTLPs) in the wall of odontogenic cysts are rare occurrences. Due to the histopathological similarity of these proliferations to neoplasms, such as squamous odontogenic tumour, intraosseous well-differentiated squamous cell carcinoma, and acanthomatous ameloblastoma, their correct elucidation is of paramount importance to avoid unnecessary and unwanted treatment. SOTLPs are uncommon in dentigerous cysts and rare in those that occur in the maxilla particularly the anterior region. This paper presents a case of maxillary dentigerous cyst involving 33 and a mesiodens in a 32 year old male which on histopathological examination showed SOTLPs in a dentigerous cyst. [ABSTRACT FROM AUTHOR]

Background: It is a well-recognized fact that abnormal cell proliferation plays a crucial role in the development of odontogenic lesions. p53 is a tumour-suppressor gene which assists in cell cycle regulation and p63 is a homolog of p53 responsible for ectodermal differentiation and maintenance of stratified epithelial progenitor-cell. Analysing the tissue expression of p53 and p63 in odontogenic lesions may provide us with an insight into their potential role in the development of these lesions. Objective: The objective is to study the expression of p53 and p63 in selected odontogenic lesions using immunohistochemistry. Materials and Methods: Formalin-fixed paraffin-embedded tissues of 15 ameloblastomas, 10 adenomatoid odontogenic tumours (AOT), 15 odontogenic keratocysts (OKCs), 10 dentigerous cysts (DCs) along with 10 cases of normal mucosa were retrieved from the departmental archives. These specimens were then subjected to immunohistochemical staining using p53 and p63 oncoproteins. Results: p53 and p63 immune-expression showed mainly intranuclear localization. The mean positivity of p53 in ameloblastoma (59.45%) and OKC (26.38%) was significantly higher than AOT (6.77%) and DC (4%). In contrast, there was no significant difference in the positivity of p63 in between ameloblastoma (77.55%), AOT (69.50%), OKC (76.47%), and DC (50.69%). Conclusion: p53 expression can be correlated with the clinical behaviour of the odontogenic lesions and it can be used as a prognostic marker in odontogenic cysts and tumours. In contrast, p63 expression does not corelate with the biological behaviour of odontogenic lesions. [ABSTRACT FROM AUTHOR]

Background: Odontogenic cysts are characterized by their sluggish growth and ability to enlarge, primarily affecting the oral and maxillofacial tissues. Timely diagnosis and treatment are crucial to prevent potentially serious consequences. The present study aimed to evaluate and compare the immunohistochemical expression of cytokeratin 19 in the epithelium of odontogenic keratocyst, dentigerous, and radicular cysts. Methods: This study analyzed forty-five formalin-fixed, paraffin-embedded tissue blocks containing odontogenic cysts. The sample consisted of fifteen odontogenic keratocysts, fifteen dentigerous cysts, and fifteen radicular cysts. Immunohistochemical analysis was performed to assess the expression of the cytokeratin 19 epithelial marker in these samples. Statistical analyses were conducted using Statistical Package for Social Sciences version 26, employing the Chi-square test for comparative analysis of cytokeratin 19 expression among the odontogenic keratocyst, dentigerous cyst, and radicular cyst. Results: This study showed that 80% of basal layer tissue samples in the odontogenic keratocyst group had negative cytokeratin 19 biomarker scores. In contrast, 60% of dentigerous cyst tissue blocks and 53.3% of radicular cyst tissue blocks were +1. This difference was statistically significant (P = 0.034). In comparison, between groups, there was no significant difference (P = 0.103) in CK19 expression in the surface and spinous layers. Conclusion: The level of epithelial differentiation is correlated with cytokeratin 19 expression. The cysts with well-differentiated epithelium (radicular cyst and dentigerous cyst) express cytokeratin 19, whereas those with less well-differentiated epithelium (odontogenic keratocyst) exhibit low positives. Thus, it serves as a diagnostic tool for distinguishing these three lesions. [ABSTRACT FROM AUTHOR]

Introduction: Odontogenic cysts are cysts that originate from the odontogenic epithelium and are found in the areas of the jaw that bear teeth. Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental radiographs and/or as asymptomatic swellings. Treatment usually involves cyst enucleation or tooth extraction, although decompression may be used for larger lesions. Case report: We report the case of an 8-year-old patient referred by his ENT physician following the swelling of the left maxilla for whom the clinical, radiological examination associated with biopsy suggested a dentigerous cyst. Conclusion: management consisted of decompression of the lesion after eight months which allowed the disappearance of the cystic. The patient continues to be followed clinically and radiologically.

A 23-year-old female symptomatic with unilateral proptosis with superior globe displacement and hypertropia was found to have a multiloculated cystic lesion with bony lining arising from the inferomedial orbit. The adjacent maxillary sinus was markedly smaller on the affected side, with no defect of the wall on radiographic or intraoperative examination. Surgical excision and histological analysis of the lesion demonstrated an orbital respiratory epithelial cyst. A literature review of congenital orbital respiratory epithelial cysts is presented. To our knowledge, this is the first published case of choristomatous orbital respiratory epithelial cyst associated with ossification, and a primary or secondary anomaly of the adjacent sinus without bony defect. [ABSTRACT FROM AUTHOR]

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

Objectives: To assess the prevalence and characterize the dentigerous cyst in a Portuguese population with bone pathology and to study the concordance rate between clinical and histological diagnoses of all cases. Methods: Clinical records of patients attending Oral Surgery and Oral Pathology consultations in a Portuguese university clinic between 2000 and 2023 were consulted. Bone pathology cases were selected along with information about sex, age, and anatomic location. The concordance rate between clinical and histological diagnoses was also calculated, dividing the cases into totally concordant, partially concordant, and discordant. Statistical analysis was conducted using chi-square tests. Results: The dentigerous cyst prevalence within bone pathology cases was 10.50%. It was more prevalent in males (68%), with no statistical significance (p>0.05). The average age of patients was 36.9 ± 13.5 years old. About half of the cases (56%) were associated with unerupted teeth, and third molars were the most affected teeth (33.33%). Most cases (57%) were in the mandible, with no statistical significance, more prevalent in the fourth quadrant (38.89%). The clinical diagnosis of 44.80% of the cases analyzed agreed with the histological diagnosis, 17.65% agreed partially, and 37.55% disagreed. Conclusions: The prevalence of dentigerous cysts in the referred population was 10.50%. They were more prevalent in males and mostly located in the mandible, with a higher incidence between 19 and 50 years of age. The concordance rate between clinical and histological diagnoses was 62.45%, a value that can and should be improved.

Adenomatoid Odontogenic Tumour (AOT) constitutes about 5% of all odontogenic tumours and is most commonly seen in young females, in association with impacted maxillary canines in a Dentigerous Cyst (DC) like relationship. Extrafollicular AOT is an uncommon variant seen unassociated with impacted teeth. Rare cystic presentation is reported with most cases seen arising from or in association with DC. Here, the authors present a case of extrafollicular AOT in a 29-year-old Dravidian male, who reported with a chief complaint of swelling of lower anterior jaw region. Radiographically, a well-defined radiolucent lesion was noted extending from mesial aspect of the roots of right mandibular second molar, crossing the midline to involve the body of mandible till mesial aspect of lower left canine. There was evidence of cortical perforation. The lesion was excised and sent for histopathological evaluation. Histopathologically, the lesion was diagnosed as cystic AOT-extrafollicular variant. There was adequate healing and no signs of recurrence or residual disease were noted 18 months after the surgery. The present case is a unique presentation of cystic extrafollicular AOT with pictorial demonstration and detailed explanation of its pathogenesis.

Abstract Background Secreted protein acidic and rich in cysteine (SPARC) has been shown to modulate aggressive behavior in several benign and malignant tumors. Little is known about SPARC expression in odontogenic keratocyst (OKC), an odontogenic cyst with an aggressive nature. To the best of our knowledge, only one study has been investigated the expression of this protein in OKCs. This study aimed to characterize SPARC expression in OKCs. Additionally, to determine whether SPARC is associated with aggressive behavior in OKCs, SPARC expression in OKCs was compared with radicular cysts (RCs), dentigerous cysts (DCs) and calcifying odontogenic cysts (COCs). These odontogenic cysts showed no or less aggressive behavior. Methods SPARC expression was evaluated in 38 OKCs, 39 RCs, 35 DCs and 14 COCs using immunohistochemistry. The percentages of positive cells and the intensities of immunostaining in the epithelial lining and the cystic wall were evaluated and scored. Results Generally, OKCs showed similar staining patterns to RCs, DCs and COCs. In the epithelial lining, SPARC was not detected, except for ghost cells in all COCs. In the cystic wall, the majority of positive cells were fibroblasts. Compared between 4 groups of odontogenic cysts, SPARC expression in OKCs was significantly higher than those of RCs (P

Abstract Background Dentigerous cyst are most common odontogenic cyst and they frequently occur at the mandibular third molar. Their asymptomatic long medical history always resulted in severe bone resorption at the distal aspect of the adjacent second molar. BonMaker® ATB demonstrate an excellent autogenous bone graft candidacy. The aim of this study is to share a single team’s experience of dentigerous cyst osseous defect repairing by applying autogenous tooth sticky bone graft. Method In total, 18 patients with dentigerous cyst, which was arised from mandibular third molar unilaterally, were enrolled in this study. Enucleation of dentigerous cyst was performed extracting with involving teeth under general anesthesia. Autogenous tooth sticky bone graft was prepared using extracted tooth and autogenous fibrin glue. Subsequently, grafting was performed above covering with concentrate growth factors. Patients were followed up at sixth months. Results They were eleven male and seven female patients. Their ages ranged from 20 to 40 years, with a mean of 31 years. Primary wound healing of all sites was achieved in all the patients. Sixth months postoperative radiographic assessment show that dentigerous cysts osseous defects of seventeen patients were good bone filling and ossification. One patient occurred slight bone resorption at the distal aspect of the adjacent second molar. Conclusion Within the limitation of sample size and retrospective nature of the present study, autogenous tooth sticky bone graft demonstrates one of the best alternative alveolar bones repairing graft.

Abstract Background Dentigerous cysts are the second most common form of a developmental cyst. These cysts might be the cause of ectopic teeth. Dentigerous cysts associated with ectopic teeth in the maxillary sinus are seldom seen in clinical practice. Case presentation We reported a 23-year-old woman who presented with nasal obstruction and facial pain on the left side 4 months ago. Three courses of antibiotics and analgesia were prescribed for her without improving the presenting features. Furthermore, extraction of the left upper second premolar and second molar, but the condition persisted. An orthopantogram and computerized tomography scan revealed the ectopic position of the left third upper molar tooth, which was embedded in a cystic lesion occupying the whole maxillary sinus. Removal of the cystic lesion with the ectopic tooth was performed with a Caldwell-Luc procedure. The histopathological evaluation confirmed the diagnosis of a dentigerous cyst. The presenting symptoms were resolved following surgery with no intra- or postoperative complications. Conclusion We are reporting another case of a dentigerous cyst occupying the whole left maxillary sinus with an ectopic left third upper molar tooth. Reporting such a case will enrich the literature regarding this rare clinical entity.

Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up. [ABSTRACT FROM AUTHOR]

Adenomatoid Odontogenic Tumour (AOT) constitutes about 5% of all odontogenic tumours and is most commonly seen in young females, in association with impacted maxillary canines in a Dentigerous Cyst (DC) like relationship. Extrafollicular AOT is an uncommon variant seen unassociated with impacted teeth. Rare cystic presentation is reported with most cases seen arising from or in association with DC. Here, the authors present a case of extrafollicular AOT in a 29-year-old Dravidian male, who reported with a chief complaint of swelling of lower anterior jaw region. Radiographically, a well-defined radiolucent lesion was noted extending from mesial aspect of the roots of right mandibular second molar, crossing the midline to involve the body of mandible till mesial aspect of lower left canine. There was evidence of cortical perforation. The lesion was excised and sent for histopathological evaluation. Histopathologically, the lesion was diagnosed as cystic AOT-extrafollicular variant. There was adequate healing and no signs of recurrence or residual disease were noted 18 months after the surgery. The present case is a unique presentation of cystic extrafollicular AOT with pictorial demonstration and detailed explanation of its pathogenesis. [ABSTRACT FROM AUTHOR]

Glandular Odontogenic Cyst (GOC) is a rare odontogenic cyst that indicates the pluripotency of the oral epithelium due to the exhibition of glandular characteristics. It is more prevalent in the mandibular anterior region and shows a predilection in males. The cyst was first described by Padayachee and van Wyk in 1987. It has non distinct clinical and radiographic features but very characteristic histopathological features. Here, the authors report a rare case of GOC occurring in a 36-year-old male patient in the maxillary anterior region. An intraoral periapical radiograph revealed a large unilocular radiolucency from the apex of 11 to the mesial aspect of 15. The cyst was enucleated under local anaesthesia, and endodontic treatment was performed for the associated teeth. No recurrence was seen at the two-month follow-up. [ABSTRACT FROM AUTHOR]

This article presents a case report on the treatment of a labially impacted canine using orthodontic and surgical techniques. The authors describe the use of a closed-eruption or tunnel technique to expose the impacted tooth and guide its eruption into the center of the alveolus. The treatment involved the use of archwires, elastics, and various appliances to align the canine. After 30 months of treatment, the impacted canine was successfully brought into the arch, resulting in improved occlusion, alignment, and periodontal health. [Extracted from the article]

This case report of an 11-year-old subject shows the digital workflow for the management of an impacted mandibular canine using Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology along with Temporary Anchorage Devices (TADs). The miniscrew insertion site was planned using software, and a surgical guide was digitally designed and 3D printed. Orthodontic traction was performed using a 3D-designed and -printed device. In a single sitting, the miniscrew was inserted and the disimpaction device was also delivered. The primary objective of recovery and the repositioning of the impacted mandibular canine in the axis with its eruptive path was achieved. The space available and the subject's early stage of mixed dentition was considered favourable to a spontaneous eruption. This case report shows how CAD/CAM digital technology, combined with 3D printing, enables the creation of a surgical guide to position the miniscrew and the customized devices used for mandibular canine disimpaction. CAD/CAM surgical guides can help clinicians to position TADs with more accuracy and predictability, ensuring high quality bone support offering primary stability. Although orthodontic traction is the most complex therapeutic choice to implement, with the aid of CAD/CAM technology it is possible to proceed with accurate and minimally invasive orthodontic traction in order to recover a mandibular canine. [ABSTRACT FROM AUTHOR]