Cytokeratin expression patterns for distinction of odontogenic keratocysts from dentigerous and radicular cysts.

BACKGROUND: The clinical outcome of treatment of odontogenic cysts differs depending on separate entities. Particular clinical relevance must be attached to the distinction between odontogenic keratocysts, which have an evident tendency to recur, and other odontogenic cysts. The aim of this study was to evaluate cytokeratin (CK) expression patterns as an additional tool for characterization of different cysts as the histomorphologic appearance often is not decisive. METHODS: Thirty cases of dentigerous and radicular cysts respectively as well as 15 cases of odontogenic keratocysts were considered. Expression of CK 5/6, 7, 10, 13, 17, 19 and 20 was determined in addition to Ki-67 immunohistochemically. RESULTS: Expression of CK 17 was discernible in 93.3% of the odontogenic keratocysts, but only in 35.0% of dentigerous and radicular cysts under study (P < 0.001). CK 19 could be detected in 48.3% of dentigerous and radicular cysts, whereas odontogenic keratocysts were completely negative (P < 0.002). CONCLUSION: Immunohistochemical detection of CK 17 and 19 seems to be a valuable additional parameter distinguishing between odontogenic keratocysts and other odontogenic--especially dentigerous--cysts which clinically are likely the most significant differential diagnoses in this context. J Oral Pathol Med (2005) 34: 558-64.

Quiste dentígero: presentación de un caso / Dentigerous cyst: report of a case

Se presenta el caso de una paciente femenina, la cual acude al servicio de cirugía estomatológica de la Facultad de Odontología de la U.C.V. por presentar un abultamiento en la región nasogeniana del lado izquierdo de aproximadamente 5 meses de evolución; intrabucalmente se presenta un adelgazamiento de la tabla vestibular. Radiográficamente se observa una imagen radiolúcida del lado izquierdo del maxilar que contiene el canino permanente. De igual manera ser realizó una revisión bibliográfica de esta patología, sus características clínicas, tratamiento y pronóstico

New developments in selected cysts of the jaws.

The number and variety of cysts that occur in the jaws are greater than those in any other part of the body. Consequently, dental practitioners must keep up with advances in this field, including the definition of new entities, such as the glandular odontogenic cyst; the deletion of the old incorrect concept of maxillofacial fissural cysts, including the globulo-maxillary cyst; and the advances in the molecular biology of established cysts, such as the dentigerous cyst and the odontogenic keratocyst.

Morphologic analysis of odontogenic cysts with computed tomography.

PURPOSE: The purpose of this study was to analyze the effects of lesion site and epithelial keratinization on the morphologic characteristics of odontogenic cysts and clarify determinate factors for cyst morphology. MATERIAL AND METHODS: Computed tomographic images of 92 odontogenic cysts were analyzed: 31 primordial, 31 dentigerous and 30 radicular. Thirty-four cysts were located in the maxilla (6 primordial, 10 dentigerous, and 18 radicular) and 58 in the mandible (25 primordial, 21 dentigerous, and 12 radicular). Histologically, 31 cysts showed epithelial keratinization (18 primordial and 13 dentigerous). No keratinization was seen in radicular cysts. The morphologic features of cysts were assessed by measuring long length parallel to dental arch and short length vertical to it and calculating the long/short ratio. In addition, the computed tomography pattern of the cyst was classified into unilocular, lobulated, and multilocular patterns. Appearance of the sclerotic rim and surrounding cortex were classified into three and four patterns respectively to evaluate the developmental features of the cyst. RESULTS: As a whole, the long length of the primordial cysts was statistically larger than the other two cyst groups and resulted in a larger long/short ratio. Statistical differences of CT pattern were also seen among cyst groups. There was no preference in any cyst group for the appearance of the sclerotic rim and cortex. There were statistical differences between maxilla and mandible in short axis and long/short ratio. The maxillary cysts generally showed round shapes irrespective of their histologic characteristics. A multilocular pattern was more frequent in the keratinized group of mandibular primordial cysts. In dentigerous cysts, a multilocular pattern was seen only in the keratinized group and the long/short ratio was statistically larger; cyst shape was elliptical along the long axis. CONCLUSION: Our results demonstrated morphologic differences of odontogenic cysts caused by lesion site and keratinization. The dentigerous cyst with predominant keratinization should be included in the primordial cyst (odontogenic keratocyst) group.

Dentigerous cysts in animals.

This article is a review of the literature on dentigerous cysts in animals. Three different lesions have been referred to in the veterinary literature as dentigerous cysts. The first of these cysts, similar to those that occur in human beings, is extremely rare. The second lesion, an odontogenic cyst located in the anterior mandibles of mature sheep, is quite common in New Zealand and parts of Britain. The third is actually a teratoma that contains teeth and is found in the temporal region of young horses; it is also rare.

[Histopathology of odontogenic cysts]. / L'histopathologie des kystes odontogènes.

Odontogenic cysts present problems of diagnosis, radiology and histopathology. This review of the literature considers the current system of classification and reveals a level of agreement with regard to the major categories of cysts. The term "developmental odontogenic cyst" embraces primordial cysts (or odontogenic keratocysts), gingival cysts (newborn and adult), lateral periodontal cysts, eruption and dentigerous cysts and odontogenic calcified cysts (Gorlin cysts). "Inflammatory odontogenic cyst" includes: the radicular cysts and its etiological variance, residual cysts, inflammatory collateral cysts, periodontal cysts and inflammatory follicular cysts. Clinical symptoms are not in themselves sufficient to differentiate between several of the different categories. A combination of clinical and histopathological evidence is essential if a definitive diagnosis is to be achieved and the risk of carcinoma eliminated. Developmental or inflammatory cysts arise from cells involved in the development of the dental organ.