Evaluation of CT and MRI Imaging Results of Radicular Cysts, Odontogenic Keratocysts, and Dentigerous Cysts and their Contribution to the Differential Diagnosis.

AIM: This study aimed to evaluate the contribution of the MRI and CT results to the differential diagnosis of histopathologically different odontogenic cysts. BACKGROUND: Odontogenic cysts are commonly seen in the jaw bone and their surgical operations have an important place in the practice of maxillofacial surgery; treatment options for these cysts differ according to their histopathology. Differential results that can be obtained from the radiological evaluations of different cyst groups will allow the surgeon to plan a more accurate approach at the beginning of the operation. In this study, computed tomography (CT) and magnetic resonance imaging (MRI) results of different cyst groups were interpreted together with their histopathological diagnosis. METHODS: CT and MRI results of 17 patients aged between 19-61 were evaluated, whose histopathological diagnosis consisted of 3 radicular cysts (RC), a total of 9 odontogenic keratocysts (OKC) of which 4 were inflamed, and a total of 5 dentigerous cysts (DC) of which one of them was inflammatory. RESULTS: In the CT scan, all cysts showed lytic, a sclerotic surrounding, and showed MRI peripheral enhancement, whereas solid nodular enhancement was only observed in OKCs. Edema and/or air in the surrounding bone medulla was observed in the infected lesions. OKC was heterogeneous, whereas RC and DC were more homogeneous. Diffusion restriction was observed to be frequent in OKCs. The OKCs were ellipsoidal in appearance and were located parallel to the long axis of the bone, and their dimensions were observed to be larger than the other cysts. OKCs may be accompanied by unerupted teeth. Radicular cysts were located perpendicular to the long axis of the bone and were globular in appearance, and their dimensions were smaller and more homogeneous compared to the OKCs. Dentigerous cysts are also accompanied by an unerupted tooth, and their peripheral enhancement is minimal and homogeneous. However, dentigerous cysts can be dense in content and smaller in size, and ellipsoidal localization is more common than OKCs. CONCLUSION: In addition to classic panoramic radiography in the evaluation and differential diagnosis of maxillary and mandibular lesions, CT and MRI evaluations can provide helpful information to the surgeon and pathologist in making the diagnosis and may further help plan the operation.

Erratum: Evaluation of OnabotulinumtoxinA Treatment in Patients with Concomitant Chronic Migraine and Temporomandibular Disorders.

[This corrects the article on p. 330 in vol. 55, PMID: 30622389.].

Oral surgical procedures under local anaesthesia in day surgery.

BACKGROUND: The objective of this study was to analyze gender-stratified data of patients who underwent day surgery in a hospital based on the type of treatment, type of local anaesthesia, and local anaesthesia complications. By learning all these parameters, it is our main goal to find answers to questions such as what we can do in hospital conditions, what we can win, and what operations we can treat. METHODS: A retrospective review was performed to assess hospital records of 10,750 dental patients who received oral surgery under local anaesthesia at the Istanbul University Department of Oral and Maxillofacial Surgery from August 2013 through June 2016. RESULTS: Patients mostly received surgery for wisdom teeth, dental implants, or odontogenic cysts or tumours. Men aged 31-40 years (23.66%) and women aged 21-30 years (30.73%) were the largest groups undergoing operations. Surgery for an impacted tooth was the most common ambulatory procedure, accounting for 54.2% of operations. The second most common ambulatory procedure was dental implant surgery (10.2%), followed by root (7.4%), odontogenic cyst (7.2%), and impacted canine surgeries (6.4%). The most common age group receiving surgery was 21-30 years old (3304 patients, 60.75%). Twice as many women as men underwent surgery. CONCLUSIONS: Day case surgery is an expanding area of health care and a valuable method of treating patients in many aspects of oral surgical practice. Different medical and dental specialties can benefit from this ambulatory approach to treatment, which also reduces treatment costs.

Evaluation of OnabotulinumtoxinA Treatment in Patients with Concomitant Chronic Migraine and Temporomandibular Disorders.

Introduction: Migraine and temporomandibular disorders (TMD) are both common diseases and TMD are reported as a risk factor in migraine progression. OnabotulinumtoxinA is used in the treatment of chronic migraine (CM), and also has a potential role in TMD treatment. In this study, it is aimed to compare the efficacy of onabotulinumtoxinA treatment in CM patients with and without TMD. Methods: In this retrospective study, 30 CM patients (age range: 18-65 years), satisfying the inclusion and follow-up criteria in their medical records were investigated. The PREEMPT injection protocol was taken as reference and onabotulinumtoxinA 155-195 U with fixed-dose has been administered into 31 specific sites within the head/neck muscles in included subjects. Two cycles of treatment were assessed in all patients at the baseline and 12 weeks later. The headache diaries, which were completed routinely one month before, and during 6 months follow-up after the treatment, were assessed. The effect of onabotulinumtoxinA treatment was compared between CM patients with and without TMD/bruxism. Results: Of 30 female patients, 17 had concomitant TMD. In week 24, there were significant improvement in the groups with and without TMD regarding to the mean change of frequencies in the days with migraine compared to the initial findings (p<0.001). However, there was no significant difference between the two groups. Conclusions: OnabotulinumtoxinA is an effective and safe treatment for CM. Its efficacy appears to be similar in CM patients with and without TM, speculating that the comorbidity of TMD did not play a role for the treatment response.

The effects of etodolac, nimesulid and naproxen sodium on the frequency of sister chromatid exchange after enclused third molars surgery.

PURPOSE: Non-steroidal anti-inflammatory drugs (NSAID) are frequently used in oral surgical procedures in dentistry. The evaluation of the frequency of sister chromatid exchange (SCE) is accepted as a reliable cytogenetic method to assess the genotoxic effects of environmental factors. MATERIALS AND METHODS: In this study, the genotoxic effects of various NSAIDs were assessed in 30 patients to who they were administered following encluosed third molar surgery using SCE analysis before and after the operation. The frequency of SCE was evaluated before the operation and after 3 days of etodolac, nimesulid and naproxen use. RESULTS: There was no statistically significant difference in the frequency of SCE between the preoperative and postoperative states in patients given etodolac, nimesulid or naproxen sodium. CONCLUSION: Short term use of selective and non-selective NSAIDs was not associated with a significant genotoxic effect that could be detected using the SCE method in peripheric lymphocytes.

Anesthesia following overfilling of a root canal sealer into the mandibular canal: a case report.

The surgical treatment of a case of anesthesia that occurred with the extrusion of Endomethasone root canal sealer into the mandibular canal is presented. Endomethasone is a neurotoxic root canal sealer containing paraformaldehyde and eugenol. The literature indicates immediate surgical decompression on the extrusion of Endomethasone into the mandibular canal. In our case, the decompression surgery was done 3 weeks after the endodontic mishap. The nearly complete resolution of anesthesia 4 months following the decompression surgery suggests that the neurotoxic effects of Endomethasone are still reversible after 3 weeks.

Odontogenic cysts: a clinical study of 90 cases.

The maxillofacial region is affected by a greater number of cysts than any other part of the body. In this study, 90 odontogenic cysts were collected from 90 patients over a five-year period. Patients with radicular cysts, dentigerous cysts and odontogenic keratocysts were further analyzed with regard to age, sex and anatomical distribution. Using the histological classification of the World Health Organization, 53 cases (59%) were classified as radicular cysts, 24 (27%) as keratocysts and 13 (14%) as dentigerous cysts. Radicular cysts occurred most frequently in the anterior region of the maxilla, odontogenic keratocysts in the ramus and angular region of the mandible, and dentigerous cysts in the mandible. No recurrences were observed during the limited follow-up period.

Adenomatoid odontogenic tumor: a report of an unusual maxillary lesion.

Adenomatoid odontogenic tumor is an odontogenic tumor that appears in the anterior portion of the jaws and more frequently, in the anterior maxilla usually in association with the crowns of inclused teeth. A case report of adenomatoid odontogenic tumor with an associated impacted right maxillary first premolar is presented. Under general anesthesia the lesion and the impacted tooth were removed. There was no recurrence at the 1 -year follow-up.