Dentigerous cysts suspected the other odontogenic lesions on panoramic radiography and CT.

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.

Kissing molars class III detected at a young age.

BACKGROUND: Kissing molars (KMs) is defined as a state in which the apex of two impacted molars face opposite directions and the occlusal surfaces touch each other and the crown is in one follicle. Class III KMs have been reported previously; however, reports on class III KMs in young people (< 18 years of age) are limited. CASE PRESENTATION: Here, we present the case of KMs class III confirmed at an early age, supported by a review of the literature. The patient was a 16-year-old female and experienced discomfort in the left molar of the lower jaw and visited in our department. We diagnosed KMs based on an impacted teeth on the buccal side, near the lower jaw wisdom teeth, and a cyst-like low-density area observed around the crown of both teeth, as revealed by computed tomography. We decide to extract the tooth and enucleate the cyst under local anesthesia as the patient experienced discomfort due to occlusion. Furthermore, the cyst-like structure removal and tooth extraction including tooth root were necessary as the patient had KM class III, possibly inducing complicated malocclusion. Although no previous reports recommended timing for KMs tooth extraction, we propose that extraction at an early stage is important regardless of age especially in class III cases. CONCLUSIONS: We report a case of KM class III detected at an early age.

Clinical investigation of patients with jaw deformity with comorbidities.

BACKGROUND: With improvements in the safety and stability of surgeries, the number of orthognathic surgeries is increasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeries for patients with comorbidities is also increasing. We report a survey and clinical investigation of patients with comorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathic surgery. RESULTS: The participants included 296 men and 712 women, with a mean age of 28 years (13-19 years, n=144; 20-29 years, n=483; 30-39 years, n=236; 40-49 years, n=102; 50-59 years, n=39; ≥60 years, n=4). In total, 347 patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwent SSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent other surgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases (n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologic diseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrine diseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases (n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses (hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder), and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia was managed with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetes mellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventful course. CONCLUSIONS: The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacial surgeons should adequately manage cases requiring cautious perioperative control and highlight the importance of preoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oral surgeons should adopt appropriate additional preventive measures for patients with comorbidities.

Aging-related metabolic changes in the extensor digitorum longus muscle of senescence-accelerated mouse-prone 8.

AIM: Sarcopenia - aging-related loss of muscle mass and muscle strength - is a key feature of the frailty model. In the present study, we aimed to elucidate the molecular biological changes associated with aging in the extensor digitorum longus muscle of senescence-accelerated mouse prone 8 mouse model by capillary electrophoresis-mass spectrometry. METHODS: Three groups of senescence-accelerated mouse prone 8 mice were used, namely, 12-week-old (young; n = 5), 40-week-old (elderly; n = 5) and 55-week-old mice (late elderly; n = 5). The extensor digitorum longus muscle was collected. After preliminary analyses, metabolome analysis was carried out by capillary electrophoresis-mass spectrometry. Additionally, we examined whether the activity of enzymes in the metabolic pathway fluctuated with aging, by real-time polymerase chain reaction. RESULTS: Among the 116 water-soluble metabolites associated with the central energy metabolism pathway, changes were observed in 19 metabolites between 12- and 40 -weeks-old, in 40 metabolites between 40- and 55-weeks-old, and in 57 metabolites between 12- and 55-weeks-old. The fluctuated metabolites that were common among the groups were Val, putrescine and His. The levels of putrescine, associated with cell proliferation, protein synthesis and nucleic acid synthesis, and ß-Ala and His, a component of carnosine that is characterized by its anti-oxidant and anti-fatigue effects, decreased with age. CONCLUSIONS: We confirmed that there were two aging-related metabolic changes in the extensor digitorum longus muscle of senescence-accelerated mouse prone 8 mice. Based on the changes in metabolites, cell senescence and fatigue in the extensor digitorum longus muscle might increase in old mice compared with those in young mice, showing molecular biological changes with aging. Geriatr Gerontol Int 2022; 22: 160-167.