Residual cyst with semisolid content, a clinical case / Quiste residual con contenido semisólido, a propósito de un caso clínico

Abstract Objective: To present a clinical case of a residual cyst in the right maxillary region with semi-solid content. Main data of the case: 61-year-old patient who comes to consultation for the realization of upper jaw dentures, during the clinical examination a slight facial asymmetry of the right side is observed; radiographic and tomographic examination revealed a radiolucent lesion in the right premolar region. It is diagnosed as a residual cyst and an enucleation is decided; during the surgical procedure a viscous content of yellowish coloration and semi-solid content is observed. Main comments: It is very rare to find residual cysts with semi-solid content, since they generally have purulent or serosanguinous contents.

Resumen Objetivo: Presentar un caso clínico de un quiste residual en la región maxilar derecha, con contenido semisólido. Datos principales del caso: Paciente de 61 años, que acude a consulta para la realización de una prótesis en el maxilar superior, al examen clínico se observa leve asimetría facial del lado derecho; al examen radiográfico y tomográfico se observa lesión radiolúcida en región premolar derecha. Se diagnostica como quiste residual y se decide enucleación, en el procedimiento quirúrgico se observa un contenido viscoso de coloración amarillenta y contenido semisólido. Principales comentarios: Es muy poco común encontrar quistes residuales con contenido semisólido, generalmente son de contenido purulento o serosanguinoso.

Pain Control : Current Understanding And Multimodal Approach In Management Of Maxillary Midline Cyst

In 1968 Mc Caffery defined pain as “Whatever the experiencing person says it is whenever he/she says it does” Pain is the most common reason individuals seek health care. Pain control in Oral And Maxillofacial Surgery is an important factor for reducing the fear Department of Oral and Maxillofacial and anxiety associated with dental procedures. In dentistry, local Bharati Vidyapeth Dental College anaesthetics form the backbone for pain control. This case report highlights the implication of splash block technique in enucleation a maxillary midline Contact no: +91-8552887325 residual cyst which would otherwise be operated under general anesthesia owing to its proximity to nasal floor.

Malignant Transformation of Radicular Cyst/Residual Cyst: A Review of Literature.

Aim: The aim of this study is to review the literature concerning malignant transformation of radicular cyst. Material and Method: A literature search using MEDLINE, accessed via the National Library of Medicine PubMed interface (http://www.ncbi.nlm.nih.gov/pubmed), searching for articles relating to the malignant transformation of radicular/residual cyst written in English from 1960-2013. Results: Our search identified only fourteen studies available to date in English written literature. No randomized controlled trials to assess the possibility of malignant transformation of radicular/residual cyst were in the literature. Conclusion: The development of malignancy from radicular /residual cysts is rare, however, it should always be considered as a differential diagnosis. The numbers of studied cases in literature are few but small number of case series & case reports are available. Also it is recommended that further work involving large series of tumors arising from radicular /residual cyst to determine the malignancy potential.

Avaliação do metabolismo epitelial em cistos radiculares pela técnica de AgNORS / Epithelial metabolism evaluation in radicular cysts by the AGNOR technique

Introdução: A formação do Cisto Radicular (CR) está associada à proliferação dos restos epiteliais de Malassez por estímulos inflamatórios, provenientes da proliferação bacteriana do canal radicular de um dente não vital. Quando o dente é removido, esse cisto passa a ser denominado Cisto Residual (CRe). O tratamento de escolha para o CR é endodôntico, com o objetivo de eliminar a inflamação presente no periápice. No entanto, em alguns casos, o cisto pode continuar a crescer, necessitando de tratamento cirúrgico, o que ocorre na maioria dos casos de CRe. Objetivo: Avaliar o metabolismo do epitélio de revestimento de CR e CRe, utilizando a quantificação das AgNORs, e verificar a influência da presença de inflamação sobre o crescimento desses cistos. Material e método: Vinte casos de CR e dez de CRe foram submetidos à técnica de AgNOR. A análise quantitativa das NORs foi realizada utilizando-se o software 'Contando células'. O teste estatístico pós-hock de Newman-keuls foi realizado para a comparação do número médio de AgNORs entre CR e CRe, e entre áreas inflamadas e não inflamadas. Resultado: Diferença estatisticamente significante (p=0,0094) foi observada entre áreas inflamadas (1,86±0,26) e não inflamadas (1,65±0,20). Na comparação entre CR (1,81±0,28) e CRe (1,73±0,16), não houve diferença estatisticamente significante (p=0,37). Conclusão: A inflamação interfere no metabolismo epitelial de CR e CRe, o que reflete a ação de fatores de crescimento na proliferação do epitélio, contribuindo para o crescimento do cisto, independentemente da presença do fator etiológico associado com a origem da lesão. .

Introduction: Radicular Cyst (RC) development is associated with the activation and proliferation of epithelial rests of Malassez. This occurs due to inflammatory stimuli resulting from bacteria proliferation in the root canal of a non-vital tooth. When the tooth is removed, the cyst becomes known as Residual Cyst (ReC). The RC common treatment is the endodontic therapy, with the aim of eliminating the inflammation in the periapical region. Nonetheless, this treatment is not always effective and the cyst may continue to grow, what happens in most cases of ReC. Objective: To evaluate the metabolism of the RC and ReC epithelial lining through the technique of AgNOR quantification and of the influence of the presence of inflammation in the growth of these cysts. Material and method: 20 cases of RC and 10 of ReC, were processed by the AgNOR technique. The AgNOR quantitative analysis was performed using the "Counting cells" software. The statistical post-hock Newman-Keuls test was applied to compare the RC and ReC mean number of AgNORs in inflamed and non-inflamed areas. Result: Statistically significant difference (p=0.0094) was observed between inflamed (1.86±0.26) and non-inflamed (1.65±0.20) areas. No statistically significant difference (p=0.37) was observed in the comparison between RC (1.81±0.28) and ReC (1.73±0.16). Conclusion: Inflammation interferes in the epithelial metabolism of RC and ReC, reflectings the action of growth factors in epithelial proliferation and contributing to the growth of the cyst, regardless the presence of the etiologic factor associated with the injury origin. .

Quiste periodóntico apical de gran tamaño en el maxilar: reporte de un caso clínico / Apical periodontal cyst in the maxilla large: a case report

La lesión quística es una cavidad anormal revestida de epitelio que contiene material líquido o semisólido, la cual consta de tres estructuras fundamentales: una cavidad central (luz), un revestimiento epitelial y una pared externa. El quiste periodontico apical es la lesión quística más frecuente de la cavidad bucal, representando aproximadamente 50 a 75 % de todos los quistes verdaderos. Dicha entidad tiene su origen en la proliferación de pequeños residuos epiteliales odontogénicos (restos epiteliales de Malassez). Suele diagnosticarse al realizar exámenes radiográficos de rutina. No hay predilección por sexo y se presenta la mayor incidencia entre la 2da a 5ta década de vida, siendo el incisivo central superior el diente más afectado. Usualmente no hay dolor ni molestia asociado al quiste a menos que se infecte secundariamente. Clínicamente la patología presenta un comportamiento de crecimiento lento, pudiendo expandir las corticales óseas con deformación en el lugar de nacimiento del quiste, borrando los surcos de la cara o produciendo deformidad facial, desplazamiento dentario y dolor. Radiográficamente se observa una imagen radiolúcida que tiene forma redonda u ovoide y presenta un borde radiopaco delgado, contiguo a la lámina dura del diente. Su tratamiento se determina principalmente por el tamaño de la lesión, siendo considerada la enucleación quirúrgica y la marzupialización. A continuación se presenta un caso clínico de un paciente de sexo masculino, que presenta una lesión de grandes dimensiones, invadiendo el seno maxilar, se realizó eliminación quirúrgica y estudio histopatológico, dando como resultado quiste periodóntico apical

The cystic injury is an abnormal cavity redressed in epithelium that contains liquid or semisolid material, which consists of three fundamental structures: a central cavity (light), a coating epitelial and an external wall. The peri-apical cyst is the most frequent cystic lesion in oral cavity, representing approximately 50 to 75 % of all cysts. The above mentioned entity has it's origin in the proliferation of small odontogenic ephithelial rests (rests of Malassez). It's often diagnosed whith routine radiographic examination. There is no predilection for sex and it's frequently found between 2th and 5th decade of life, being the maxilar central incisor the most affected tooth. Usually there is neither pain nor inconvenience associated with the cyst until it becomes secondarily infected. Clinical the pathology presents a slow growth behavior, being able to expand the cortical bone with deformation in the place of birth of the cyst, erasing the facial lines or producing facial deformity, displacement of teeth and pain. Radiographically it shows an egg-shaped or round radiolucid image, and it presents a radiopaque thin halo, contiguous to the hard sheet of the tooth. The treatment is determined mainly by the size of the injury, being considered surgical enucleación and the marzupialization. In the present article, it is our aim to present a clinical case of male patient, who presents a large injury invading the maxillary sinus, surgical elimination and hystopathological study were carried out, giving as result peri-apical cyst

Queratocisto odontogênico em região anterior de maxila: relato de caso / Odontogenic Keratocyst inthe Anterior Maxillary Region: Case Report

O queratocisto odontogênico é uma lesão que apresenta comportamento clínico e aspectos microscópicos específicos. Tem maior predileção na 2a e 3a décadas de vida, sendo mais prevalente na região mandibular posterior e mais freqüente no gênero masculino. O tratamento pode ser constituído de descompressão, marsupialização e enucleação, sendo a crioterapia solução de Carnoy e escarificação procedimentos auxiliares algumas vezes adotados, já que esta lesão possui altas taxas de recidiva. O objetivo do trabalho é apresentar o caso clínico de um paciente leucoderma, 44 anos, gênero masculino, que foi encaminhado à Clínica Odontológica da Universidade Estadual de Maringá (UEM) com suspeita de lesão cística em maxila. Ao exame radiográfico, detectou-se umaárea radiolúcida unilocular na região anterior de maxila. Através dos achados clínicos e radiográficos, o diagnóstico presuntivo foi de cisto residual. O paciente foi submetido à enucleação da lesão em ambiente hospitalar e, após a análise microscópica da lesão, a compatibilidade foi de queratocisto odontogênico. O paciente encontrase em proservação e não apresenta sinais clínicos e radiográficos de recidiva

The odontogenic keratocyst is a lesion that presents both peculiar clinical behavior and microscopic aspects. Most cases are diagnosed in the 2nd and 3rd decades of life. It occurs most commonly in the posteriormandibular region and, more often, in males. Its treatment may include decompression, marsupialization and enucleation, sometimes followed by cryotherapy, Carnoy solution and scarification because of the high rates ofrecurrence. The aim of this study is to present a case of a 44-year-old patient, white, male, who was referred to the Maringá State University (UEM) oral clinic by his dentist because a maxillary cystic lesion was suspected. The radiographic exam showed a unilocular radiolucent area in the anterior maxillary region. Based on the clinical and radiographic findings, the presumptive diagnosis was residual cyst. The patient was submitted to enucleation of the lesion. The microscopic exam was compatible with odontogenic keratocyst. The patient is being followed-up and so far without any clinical or radiological evidences of recurrence