Diagnostic capability of artificial intelligence tools for detecting and classifying odontogenic cysts and tumors: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the diagnostic capability of artificial intelligence (AI) for detecting and classifying odontogenic cysts and tumors, with special emphasis on odontogenic keratocyst (OKC) and ameloblastoma. STUDY DESIGN: Nine electronic databases and the gray literature were examined. Human-based studies using AI algorithms to detect or classify odontogenic cysts and tumors by using panoramic radiographs or CBCT were included. Diagnostic tests were evaluated, and a meta-analysis was performed for classifying OKCs and ameloblastomas. Heterogeneity, risk of bias, and certainty of evidence were evaluated. RESULTS: Twelve studies concluded that AI is a promising tool for the detection and/or classification of lesions, producing high diagnostic test values. Three articles assessed the sensitivity of convolutional neural networks in classifying similar lesions using panoramic radiographs, specifically OKC and ameloblastoma. The accuracy was 0.893 (95% CI 0.832-0.954). AI applied to cone beam computed tomography produced superior accuracy based on only 4 studies. The results revealed heterogeneity in the models used, variations in imaging examinations, and discrepancies in the presentation of metrics. CONCLUSION: AI tools exhibited a relatively high level of accuracy in detecting and classifying OKC and ameloblastoma. Panoramic radiography appears to be an accurate method for AI-based classification of these lesions, albeit with a low level of certainty. The accuracy of CBCT model data appears to be high and promising, although with limited available data.

Tumor odontogénico epitelial calcificante en la rama mandibular. Informe de un caso clínico basado en una actualización bibliográfica / Calcifying epithelial odontogenic tumor in the mandibular ramus. A case report based on a literature update

Objetivo: Presentar un caso clínico de un tumor odon- togénico epitelial calcificante (TOEC), así como una revisión de la literatura disponible sobre esta neoplasia para contribuir al análisis del mejor método de tratamiento de la patología. Caso clínico: Se presenta el caso de una paciente mujer de 35 años con un tumor odontogénico epitelial calcifican- te que recibió tratamiento de enucleación quirúrgica con una evolución favorable y seguimiento de 5 años por medio de evaluación clínica y radiológica. La elección terapéutica se basó en el resultado de un análisis exhaustivo de la literatura para determinar el mejor abordaje de la neoplasia (AU)

Aim: To present a clinical case of a calcifying epithelial odontogenic tumor (CEOT), as well as a review of the availa- ble literature on this neoplasia to contribute to the analysis of the best treatment method for the pathology. Clinical case: The case of a 35-year-old patient with a calcifying epithelial odontogenic tumor who received surgical enucleation treatment with a favorable evolution and 5-year follow-up through clinical and radiological evaluation is pre- sented. The therapeutic choice was based on the result of an exhaustive analysis of the literature to determine the best ap- proach to the neoplasia (AU))

Fibroma ameloblástico mandibular: caso clínico / Fibroblastic fibroma mandibular: a clinical case

El fibroma ameloblástico (FA) se describe como una neoplasia benigna de origen odontogénico mixto que suele presentarse entre la primera y segunda década de vida, frecuentemente en los molares permanentes inferiores. Por lo general es asintomático, pero las lesiones de gran tamaño suelen acompañarse con dolor e inflamación. Su tratamiento por lo regular es conservador. Se describe el caso de un fibroma ameloblástico en un paciente de 13 años de edad, que involucraba cuerpo y ángulo mandibular izquierdo, tratado de manera conservadora, se realiza extirpación del tumor, regeneración ósea guiada y rehabilitación con implante dental (AU)

Ameloblastic fibroma (AF) is described as a benign neoplasm of mixed odontogenic origin that usually presents between the first and second decade of life, frequently in lower permanent molars. It is usually asymptomatic, but large lesions are usually accompanied by pain and inflammation. His treatment is generally conservative. The clinical case of an ameloblastic fibroma in a 13-year-old patient is described, involving the left mandibular body and angle, treated conservatively, tumor removal, guided bone regeneration and rehabilitation with dental implants are performed (AU)

Ameloblastoma uniquístico con patrón plexiforme: revisión de la literatura a propósito de un caso clínico / Unicystic ameloblastoma with a plexiform pattern: literature review regarding a clinical case

En 1827 el médico James William Cusack describió una lesión tumoral expansiva con características clínicas similares al ameloblastoma. Para el 2017 la Organización Mundial de la Salud lo clasificó como un tumor odontogénico benigno de origen epitelial. En la actualidad hemos aceptado la teoría de su etiología asociada con una mutación en el biomarcador BRAF-V600E, donde se presentan claras heterogeneidades extra/intratumorales en el metabolismo de la tumorogénesis; la mutación en BRAF genera cambios en la regulación de la odontogénesis, en conjunto con el gen CDC73 presente en el cromosoma 1 q25-q32, lo que produce un cambio en la proteína parafibromina que inhibe la proliferación celular durante el crecimiento y la división celular, esto afecta en conjunto al gen p53 y su homólogo p63 presentes en el cromosoma 17, por lo que se tiene como resultado la expresión de quistes y tumores dentales como el ameloblastoma. La presente obra muestra el caso clínico de un paciente femenino de 11 años de edad con aumento de volumen en la región submandibular izquierda de 7 × 4 cm, con seis años de evolución; de tal manera que fue diagnosticado con ameloblastoma uniquístico y tratado de forma conservadora mediante enucleación, posteriormente fue valorada anualmente hasta que la paciente cumplió los 18 años de edad (AU)

In 1827, physician James William Cusack described an expansive tumor lesion with clinical characteristics similar to ameloblastoma. For 2017, the World Health Organization classified it as a benign odontogenic tumor of epithelial origin. Currently, we have accepted the theory of its etiology associated with a mutation in the BRAF-V600E biomarker, where there are clear extra/intratumoral heterogeneities in the metabolism of tumorigenesis; the BRAF mutation generates changes in the regulation of odontogenesis, together with the CDC73 gene present on chromosome 1 q25-q32, producing a change in the parafibromin protein that inhibits cell proliferation during cell growth and division, which together it affects the p53 gene and its p63 homolog is present on chromosome 17, resulting in the expression of dental cysts and tumors such as ameloblastoma. This work provides the clinical case of an 11-year-old patient with an increase in volume in the left submandibular region of 7 × 4 cm of 6 years of evolution. Being diagnosed as a unicistic ameloblastoma and treated conservatively by enucleation, it is subsequently evaluated annually until the patient reaches 18 years of age (AU)

Odontoma mandibular inusual y su resolución: reporte de un caso / Unusual mandibular odontoma and its resolution: report of a case

Objetivo: El odontoma es una lesión hamartomatosa benigna formada por tejido dentario (cemento, esmalte, pul­ pa). Según su grado de diferenciación podrá ser clasificado en sus dos variantes: compuesto y complejo en una relación 2:1. El objetivo de este artículo es presentar un odontoma mixto de gran tamaño de localización mandibular y su resolución quirúrgica. Caso clínico: Se describe el caso de un paciente mascu­ lino de 16 años de edad, portador de ortodoncia, que presenta un odontoma mixto de gran tamaño de localización mandibular y su resolución quirúrgica utilizando planificación 3D y confección de placa de titanio customizada (AU)

Aim: Odontoma is a benign hamartomatous lesion formed by dental tissue (cementum, enamel, pulp). According to its degree of differentiation, it can be classified in its two variants: compound and complex in a 2:1 ratio. The objective of this article is to present a large mixed odontoma of mandi­ bular location and its surgical resolution. Clinical case: A 16-year-old male patient with ortho­ dontics, who presents a large mixed odontoma with mandibu­ lar location and its surgical resolution using 3D planning and customized titanium plate fabrication (AU)

Odontomas: un reto para el tratamiento interdisciplinario del paciente de ortodoncia / Odontomas: a challenge for the interdisciplinary treatment of the orthodontic patient

El objetivo del presente trabajo es describir las técnicas para el diagnóstico y tratamiento de 3 casos clínicos de odontoma en pacientes ortodóncicos. En el caso 1, se trató a un paciente masculino de 17 años, que acudió para interconsulta con el servicio de ortodoncia, ya que no había erupcionado el canino superior izquierdo y el primer premolar superior izquierdo. El estudio anatomopatológico reveló odontoma complejo con áreas pindborgoides y acumulación de células fantasma. En al caso 2 se trató a un paciente femenino de 15 años. El estudio anatomopatológico reveló odontoma complejo. En el caso 3, se trató a un paciente masculino de 28 años que acudió a rehabilitación integral de su boca, y fue derivado a la cátedra de ortodoncia. En la radiografía panorámica se observó una imagen compatible con odontoma. Se remitió una muestra a anatomía patológica que confirmó el diagnóstico de odontoma. Conclusión: el conocimiento adecuado de las características clínicas, radiológicas y patológicas es necesario para un correcto diagnóstico y tratamiento. Es importante el trabajo interdisciplinario ortodoncista - cirujano para tratar estos casos (AU)

The objective of this work is to describe the techniques for the diagnosis and treatment of 3 clinical cases of odontoma in orthodontic patients. In case 1, a 17-year-old male patient was treated who came for consultation with the orthodontic service, since the upper left canine and the upper left first premolar had not erupted. Pathological study revealed complex odontoma with pindborgoid areas and accumulation of ghost cells. In case 2, a 15-year-old female patient was treated. The anatomopathological study revealed a complex odontoma. In case 3, a 28-year-old male patient was treated who attended comprehensive rehabilitation of his mouth and was referred to the orthodontic department. In the panoramic radiography, an image compatible with odontoma was observed. A sample was sent to pathological anatomy, which confirmed the diagnosis of odontoma. Conclusion: Adequate knowledge of the clinical, radiological and pathological characteristics is necessary for a correct diagnosis and treatment. Interdisciplinary orthodontist-surgeon work is important to treat these cases (AU)

New WHO odontogenic tumor classification: impact on prevalence in a population.

OBJECTIVES: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). METHODOLOGY: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. RESULTS: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). CONCLUSIONS: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.

New WHO odontogenic tumor classification: impact on prevalence in a population

Abstract Objectives: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). Methodology: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. Results: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). Conclusions: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.

Los odontomas y sus implicancias / Odontomas and their implications

La Organización Mundial de la Salud clasifica los odontomas como tumores odontogénicos benignos compuestos de epitelio odontogénico y ectomesénquima odontogénico con formación de tejido duro dental. Los odontomas, por definición, son lesiones habitualmente hamartomatosas que suelen encontrarse sobre dientes no erupcionados, compuestas de esmalte, dentina, pulpa y cemento en formas reconocibles de dientes (odontoma compuesto) o bien como una masa nudosa sólida (odontoma complejo). Algunos tumores constituyen una combinación de ambos tipos (es decir, no solo contienen estructuras múltiples de aspecto similar a un diente, sino también masas calcificadas de tejido dental dispuestas al azar). Estas lesiones se denominan odontomas complejos-compuestos. Otro tipo, el fibroodontoma ameloblástico, es un tumor infrecuente que contiene los componentes tisulares blandos del fibroma ameloblástico y los componentes de tejido duro del odontoma complejo (AU)

The World Health Organization classifies odontomas as a benign odontogenic tumor composed of odontogenic epithelium and odontogenic ectomesenchyma with dental hard tissue formation. Odontomas, by definition, are usually hamartomatous lesions, frequently found on unerupted teeth, composed of enamel, dentin, pulp and cement in recognizable forms of teeth (compound) or a solid knotty mass (complex). Some tumors constitute a combination of both types (i.e., they not only contain multiple structures similar in appearance to a tooth, but also calcified masses of dental tissue arranged at random). These lesions are called complex-compound odontomas. Another type, the ameloblastic fibro-odontoma, is an infrequent tumor that contains the soft tissue components of the ameloblastic fibroma and the hard tissue components of the complex odontoma (AU)

A Thirteen-year Retrospective Analysis of 179 Odontogenic Tumours in a Nigerian Tertiary Healthcare Facility / Análisis retrospectivo de trece años de 179 tumores odontogénicos en un centro de salud terciaria nigeriana

ABSTRACT Background: Tumours of odontogenic origin (OTs) resulting from epithelial and mesenchymal elements that are part of the tooth-forming apparatus must be considered as a differential diagnosis when analysing jaw lesions. They may be cystic, myxomatous or sometimes have a mixture of cystic and solid areas. Objective: To analyse the OTs seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, between 2001 and 2013 based on the World Health Organization 's 2005 classification of OTs. Methods: A retrospective search and analysis was conducted of the medical records of all patients with a histopathologic diagnosis of orofacial tumours and tumour-like lesions seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, from 2001 to 2013. Results: Odontogenic tumours constituted 179 (15.3%) cases out of a total of 1170 orofacial tumours and tumour-like lesions seen within the study period. The 179 OTs were found in 101 (56.4%) males and 78 (43.6%) females, giving a male to female ratio of 1.3:1. The ages of the patients ranged from 12 to 88 years (mean, standard deviation: 33.31, 14.07 years). The lesions were predominantly benign (n = 176; 98.3%), with only three (1.7%) being malignant OTs. Conclusion: The distribution of OTs in this study compared well with that in previous reports from Nigeria.

RESUMEN Antecedentes: Los tumores de origen odontogénico (TO) como resultado de los elementos epiteliales y mesenquimales que son parte del aparato de formación de los dientes, se deben considerar como diagnosis diferencial a la hora de analizar lesiones maxilares. Pueden ser quísticos, mixomatosos, o constituidas a veces por una mezcla de áreas quísticas y sólidas. Objetivo: Analizar los TO vistos en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello de Zaria, Nigeria, de 2001 a 2013, a partir de la clasificación de TO de la Organización Mundial de la Salud de 2005. Métodos: Se realizó una búsqueda y análisis retrospectivo de las historias clínicas de todos los pacientes con diagnóstico histopatológico de tumores orofaciales y lesiones tumorales observadas en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello en Zaria, Nigeria, de 2001 a 2013. Resultados: Los tumores odontogénicos constituyeron 179 casos (15.3%) de un total de 1170 tumores orofaciales y lesiones tumorales vistas en el período de estudio. Los 179 TO fueron encontrados en 101 (56.4%) varones y 78 (43.6%) hembras, para un ratio varón-hembra de 1.3:1. Las edades de los pacientes variaron de 12 a 88 años (media, desviación estándar: 33.31, 14.07 años). Las lesiones fueron predominante benignas (n = 176; 98.3%), hallándose solamente tres TO malignos (1.7%). Conclusión: La distribución de TO en este estudio es comparable con la de los reportes anteriores en Nigeria.

Nova classificação da OMS para tumores odontogênicos: o que mudou? / Updated WHO classification for odontogenic tumors: what has changed?

Objetivo: apresentar e discutir as mais relevantes modificaçõesna quarta classificação de tumores de cabeçae pescoço da Organização Mundial de Saúde (OMS),no ano de 2017, especialmente para os tumores odontogênicos.Revisão de literatura: o trabalho baseia-seem uma revisão da literatura relacionada ao tema, emespecial no artigo publicado pelos professores John M.Wright e Marilena Vered no Head & Neck PathologyJournal, no ano de 2017, o qual apresenta as principaisatualizações desde as reuniões de 1992 e 2005. O quefoi excluído da terceira edição, o que foi retomado dasegunda edição, as novas descobertas e o porquê detais mudanças serão alguns pontos abordados. Consideraçõesfinais: observa-se que as atualizações foramorientadas pelos princípios de simplicidade, relevânciaclínica, validade científica e utilidade, no intuito defornecer uma classificação contemporânea e menoscomplexa, servindo como base para o clínico e o patologistaem termos de diagnóstico e condução dos casos. (AU)

Objective: this study aimed to present and discuss the most relevant updates in the 4th classification of head and neck tumors by the World Health Organization (WHO) in 2017, especially for odontogenic tumors. Literature review: the study is based on a literature review related to the topic, particularly on the article published by Professors John M. Wright and Marilena Vered in the Head & Neck Pathology Journal in 2017, which presents the main updates since the meetings of 1992 and 2005. What was excluded from the third edition and resumed from the second one, the new findings and the reason for such changes will be some of the points addressed. Final considerations: it is observed that the updates were guided by the principles of simplicity, clinical significance, and scientific validity and utility, in order to provide a contemporary and simpler classification that works as a basis for practitioners and pathologists in terms of diagnosis and management of cases. (AU)

Reclassification and treatment of odontogenic keratocysts: A cohort study.

The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

Tumor odontogénico adenomatoideo: reporte de un caso / Adenomatoid odontogenic tumor: report of a case

El tumor odontogénico adenomatoide (TOA) es una lesión benigna,infrecuente, clasificada por la OMS dentro de los tumores odontogénicoscon participación del ectomesénquima que muestra una morfología histológica muy peculiar. Esta entidad patológica es de baja prevalencia, representa 0.1% de los tumores y quistes de losmaxilares con raras recidivas. Su frecuencia de aparición es más comúnen pacientes jóvenes, generalmente mujeres, de mayor aparición en maxilar superior, asintomático, asociado a dientes sin erupcionar(principalmente caninos) que plantea diagnósticos diferenciales entre otras lesiones de mayor agresividad como el quiste dentígero y el ameloblastoma. Se presenta el caso de una paciente de nueve años de edad con lesión tumoral en el sector del maxilar superior izquierdo de 40 días de evolución. Clínicamente hay ausencia del órgano dentario número 23. Se indica la realización de una radiografía panorámica, en la cual se observa la presencia del órgano dental 23 en el piso de órbita del maxilar superior izquierdo. Se procede a la remoción quirúrgica con diagnóstico presuntivo de quiste dentígero, se biopsia el total de la lesión, con diagnóstico definitivo por histopatología de TOA, con buena evolución clínica odontológica.

The adenomatoid odontogenic tumor (TOA) is a rare, uncommon,WHO-classified lesion in odontogenic tumors with ectomesenchyma,which shows a very peculiar histological morphology. This pathologicalentity is of low prevalence representing 0.1% of the tumors and cystsof the jaws with rare recurrences. Its frequency of appearance is morecommon in young patients, generally females, of greater presentationin the upper jaw, asymptomatic, associated with unruptured teeth(mainly canines) that presents diff erential diagnoses among other moreaggressive lesions such as dentigerous cyst and ameloblastoma. Wepresent the case of a nine-year-old patient with tumor lesion in the leftupper jaw of 40 days of evolution. Clinically there is absence of the tooth23. A panoramic radiograph is indicated, in which the presence of thetooth 23 is observed in the orbital fl oor of the upper left jaw. Surgicalremoval is performed with a presumptive diagnosis of dentigerouscyst; the total of the lesion was biopsied, with defi nitive diagnosis byhistopathology of TOA with good odontological clinical evolution.

Prevalence profile of odontogenic cysts and tumors on Brazilian sample after the reclassification of odontogenic keratocyst.

PURPOSE: The aim of this study was to evaluate the impact of the reclassification of odontogenic keratocyst (OKC) as a tumor on the prevalence profile of odontogenic cysts (OCs) and odontogenic tumors (OTs). STUDY DESIGN: Two referral Oral and Maxillofacial Pathology services in Brazil were evaluated. All cases diagnosed as OCs or OTs were selected and classified according to the 1992 WHO-classification (cases before 2005 WHO classification of tumors excluding OKC) and the 2005 WHO classification of tumors, going forward including cases of odontogenic keratocyst tumor (KCOT). The frequency and prevalence of OCs and OTs were compared before and after the reclassification. RESULTS: Among 27,854 oral biopsies, 4920 (17.66%) were OCs and 992 (3.56%) were OTs. The prevalence of OTs before 2005 WHO classification of tumors was 2.04%, while the prevalence after 2005 WHO classification was 11.51% (p < 0.0001). Before 2006, the most frequent tumor diagnosed was odontoma with 194 cases (39.67%), and after 2005 WHO classification of tumors the KCOT was the most frequent with 207 cases (41.07%). CONCLUSIONS: The increase in the prevalence of OTs after 2005 WHO is related to the improvement of pathology services and to the inclusion of KCOT in the OTs group.

Reclassification and treatment of odontogenic keratocysts: A cohort study

Abstract: The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

Odontoma compuesto: revisión de la literatura y reporte de un caso con 40 dentículos / Compound odontoma: a review of the literature and report of a case involving 40 denticles

El odontoma compuesto es un tumor benigno odontogénico conformadopor varios dentículos o dientes rudimentarios los cuales se encuentran conformados de tejido dental organizado. Su etiología no está biendefi nida pero se atribuye a traumatismos durante la primera dentición, así como a procesos infl amatorios o infecciosos, anomalías hereditarias o alteraciones en el gen de control del desarrollo dentario. Su presencia se encuentra entre los tres tumores odontogénicos más frecuentes, en diferente orden según el autor que se consulte. Está relacionado por logeneral con una alteración en la erupción o malposición dental. Tiene predilección en hueso maxilar, frecuentemente asintomáticos, se caracterizan por un crecimiento lento, diagnosticándose de forma casualmediante exámenes radiográfi cos de rutina entre la segunda y terceradécada de la vida. En este estudio se presenta el caso de un pacientefemenino de 14 años de edad, con presencia de un odontoma compuestode 40 dentículos, en la región parasinfi siaria izquierda, tratado medianteenucleación, y colocación de injerto óseo.

The compound odontoma is a benign odontogenic tumor composed ofseveral denticles or rudimentary teeth made up of organized dentaltissue. Its etiology is not well defi ned but is attributed to trauma duringthe fi rst dentition, as well as to infl ammatory or infectious processes, inherited abnormalities, odontoblastic hyperactivity or alterations in the gene that controls tooth development. It is among the 3 mostcommon odontogenic tumors, though its ranking among these varies depending on the author consulted. It is usually associated with analteration in the eruption or malposition of teeth. It has a predilection for the maxillary bone, and is often slow-growing and asymptomatic. Odontomas are diagnosed incidentally during routine X-ray examinations of patients between the second and third decades of life. In this study, we present the case of a 14-year-old female patient with the presence of a compound odontoma comprised of 40 denticles inthe left parasymphyseal region, which is treated by enucleation andbone graft placement.

Fibroma odontogénico central: reporte de dos casos / Central odontogenic fibroma: report of two cases

El fibroma odontogénico central es una lesión poco común dentro de los tumores odontogénicos. La variante central incrementa esta rara incidencia, representando solamente 1.5 por ciento de éstos. En el presente artículo se reportan dos casos de fibroma odontogénico central en la región maxilar, así como el tratamiento empleado para la resección del mismo y la reconstrucción de la región, mediante técnica de injerto óseo, malla de titanio y osteosíntesis...

Tumor odontogénico adenomatoide en la mandíbula de una niña de 11 años de edad / Adenomatoid odontogenic tumor in the jaw of an 11-year-old girl

Presentar un caso de tumor odontogénico adenomatoide y realizar consideraciones relativas a su diagnóstico y prevención. Caso clínico: una paciente de 11 años de edad presentaba intenso dolor y deformación facial a nivel mandibular. El diagnóstico anatomopatológico de certeza fue tumor odontogénico adenomatoide. Conclusiones: el tumor odontogénico adenomatoide es un tumor benigno de los maxilares, frecuentemente asociado a una pieza dentaria retenida. Sus dimensiones pueden ser importantes, lo cual compromete las estructuras vecinas y su funcionalidad. Se enfatiza la importancia del diagnóstico oportuno de parte del médico pediatra, del odontólogo pediatra y del cirujano bucomaxilofacial...

Tumor odontogénico adenomatoide: presentación característica de un tumor infrecuente; revisión bibliográfica y presentación de un caso clínico / Adenomatoid odontogenic tumor: characteristic presentation of an unusual tumor; review of the literature and report of a case

El tumor odontogénico adenomatoide (TOA) es una neoplasia benigna epitelial de origen odontogénico que se manifiesta con mayor predisposición en el sextante anterior del maxilar superior, aunque puede presentarse en otras localizaciones. Su nombre refleja el rasgo histológico característico de estructuras parecidas a conductos entremezclados con todo el componente epitelial, dando a la lesión un aspecto glandular o adenomatoso. Sigue patrones clínicos y radiográficos característicos. Dado que la lesión no es agresiva biológicamente y requiere de tratamiento conservador, es de extrema importancia su identificación y diferenciación de otras lesiones, especialmente del ameloblastoma...

Differential expression of glypican-1 in ameloblastoma variants.

Although benign, ameloblastomas are locally invasive and destructive tumors of the jawbones. The glypicans comprise a family of glycosylphosphatidylinositol-anchored proteoglycans that, by virtue of their cell-surface localization and heparin sulfate chain composition, might regulate the response of cells to numerous heparin-binding growth factors, cell adhesion molecules, and extracellular matrix components. The expression of glypican-1 is differentially altered among different types of malignancies, suggesting a possible role in the tumorigenesis and biological behavior of these neoplasms. The aim of this study was to determine the expression of glypican-1 and then hypothesize the possible role that this protein may play in the biological behavior of ameloblastomas. We assessed the presence of glypican-1 by immunohistochemical staining analyses in a series of 80 cases of different types of ameloblastomas. Desmoplastic ameloblastomas exhibited the highest expression of glypican-1 (100%), followed by the peripheral (66%), solid/multicystic (51.2%), and unicystic (47.2%) types, showing statistically significant differences among them (P<0.001). Differences detected in glypican-1 expression among different subtypes of ameloblastomas, could be suggesting a possible association with their different biological behavior.