Three-dimensional cone-beam computed tomography for diagnosis of keratocystic odontogenic tumours; evaluation of four cases.

The keratocystic odontogenic tumour (KCOT), formerly known as the odontogenic keratocyst (OKC) is a benign intraosseous lesion that derives from remnants of the dental lamina. Due to its characteristics, clinical and histopathological features and various treatment approaches, this pathology is different comparing with other odontogenic cysts. Radiographically the KCOT appears as well-defined unilocular or multilocular radiolucency with thin radiopaque borders. In most cases, conventional radiographic imaging, such as panoramic views and intraoral periapical films, are adequate to determine the location and estimate the size of an KCOT. However, the clinical use for cone-beam computed tomography (CBCT) in oral and maxillofacial surgery increases and provides additional information about the contents and borders of the large lesions. In the present cases, the diagnostic performances of CBCT versus panoramic radiograph for four KCOTs were evaluated. It was concluded that appearance of lesions in the maxillofacial region could be better documented in the correct dimensions by CBCT versus panoramic radiograph.

Pathological changes and immunoexpression of p63 gene in dental follicles of asymptomatic impacted lower third molars: an immunohistochemical study.

OBJECTIVE: The aim of this study was to examine the pathologic changes and immunoexpressivity of p63 gene in dental follicles (DFs) of asymptomatic partially and completely impacted lower third molars. STUDY DESIGN: Clinical and radiologic examinations included 50 DFs with no signs of abnormal radiolucency (follicular space <2.5 mm), taken from 50 patients. RESULTS: Histopathologic examinations of the specimens revealed 47 normal dental follicular tissues, 1 ameloblastoma, and 2 dentigerous cysts. p63 Immunoexpressivity was stronger in the DFs of the group with completely impacted teeth (64%),than it was in the case of DFs of the group with partially impacted teeth (40%). CONCLUSIONS: Stronger p63 gene immunoexpression in the group with completely impacted teeth might be a consequence of bigger number of stem cells than it is in the case of the group with partially impacted teeth. This study also supports prophylactic removal of impacted teeth because of the development of pathologies associated with them.

Angiofibrolipoma of the buccal mucosa: a case report.

Angiofibrolipoma is a rare histopathological variant of lipoma, characterized by mature adipocytes, blood vessels and dense collagenous tissue. It is seldom seen in the oral and maxillofacial region. Clinically, as it shares macroscopic similarity with lipoma and fibroma, the diagnosis of angiofibrolipoma is only possible based on its histopathological features. The aim of this report is to present an unusual case of a 59-year-old female patient, who reported a pathological soft mass in the buccal mucosa of the left cheek which was present for 20 years. After excisional biopsy and histopathological evaluation of the sample, the diagnosis of angiofibrolipoma was made.

Desmoplastic ameloblastoma.

Ameloblastoma is a rare benign odontogenic epithelial tumor characterized by abnormal cell growth, which easily infiltrates and destroys surrounding bony tissues. Clinically, it is mostly seen in the ascending ramus area, in men in their fourth and fifth decades more frequently than in women. One of the 3 clinical variants of ameloblastoma is desmoplastic type, with involvement of the maxillary arch more often than the mandible. Its histopathologic variant characterized by extensive squamous metaplasia, islands of tumor cells, and sometimes keratin formation is known as desmoplastic acanthomatous ameloblastoma.The aim of this report was to present an unusual case of symphysis located desmoplastic acanthomatous ameloblastoma in a 56-year-old female patient, who was experiencing laryngeal carcinoma 2 years ago.

Surgical approach to iatrogenic complications of endodontic therapy: a report of 2 cases.

Iatrogenic complications in endodontics are not irrelevant. One of the most seen is overfilling of the root canal, which has a negative effect on prognosis for endodontically treated teeth. Although more than a half of the overfilled teeth heal satisfactorily after proper endodontic therapy, in some cases, such as injury of the inferior alveolar nerve or presence of filling material in soft tissues or sinus spaces, surgical procedure is more suitable and effective. The purpose of this article is to present 2 clinical cases of iatrogenic complications of endodontically treated teeth and the approach to them by surgical procedure. In the first case, extruded endodontic filling material was present in the periapical region of lower second premolar tooth causing anesthesia of the mental nerve; in the second case, extruded material was found to have perforated the cortical bone of maxilla and passed through the mucoperiosteum to the muscle fibers.