Endoscopic modified medial maxillectomy for odontogenic cysts and tumours.

BACKGROUND: Odontogenic maxillary cysts and tumours originate from the tooth root and have traditionally been treated through an intraoral approach. Here, we report the efficacy and utility of endoscopic modified medial maxillectomy (EMMM) for the treatment of odontogenic maxillary cysts and a tumour. METHODOLOGY: We undertook EMMM under general anaesthesia in six patients: four had radicular cysts, one had a dentigerous cyst, and one had a keratocystic odontogenic tumour. RESULTS: The cysts and tumours were completely excised and the inferior turbinate and nasolacrimal duct were preserved in all patients. There were no peri- or postoperative complications, and no incidences of recurrence. CONCLUSION: Endoscopic modified medial maxillectomy appears to be an effective and safe technique for treating odontogenic cysts and tumours.

An unusual dentigerous cyst in a young child.

A dentigerous cyst is an odontogenic developmental cyst associated with the crown of an unerupted tooth. This article describes the case of a 7-year-old girl with painful swelling in the left facial region, prolonged retention of tooth No. 9d, and a displaced tooth No. 9 in eruption. Radiographic examination revealed an extensive radiolucent lesion of approximately 28 mm and displacement of teeth No. 10 and 11. Marsupialization was performed, teeth No. 8d and 9d were removed, and the swelling reduced immediately. At a 2-year follow-up, radiographs revealed that teeth No. 10 and 11 had erupted but were displaced. Routine radiographic examinations are important for children during the eruption phase to prevent and detect any alterations that could damage the permanent dentition and occlusion.

Eruption prediction of mandibular premolars associated with dentigerous cysts.

OBJECTIVE: A tooth with a dentigerous cyst (DC) does not always erupt by marsupialization. The eruption duration and conditions of DC-associated premolars were examined to predict such eruption following marsupialization. STUDY DESIGN: The eruption and conditions including depth, root formation, inclination, and eruption space were examined retrospectively in 21 DC-associated mandibular premolars using dental and panoramic radiograms. RESULTS: Fifteen of 21 premolars erupted half within 3 months and all 15 erupted completely within 10 months after marsupialization, without orthodontic traction. The age of the patients, tooth depth, and inclination were significantly different between the erupted and non-erupted groups, whereas there was no significant difference in the root formation or the eruption space between the 2 groups. CONCLUSIONS: The successful eruption of a DC-associated premolar can be predicted within 3 months after marsupialization. Furthermore, the eruption may be affected by the patient's age, tooth depth, and tooth inclination.

Spontaneous regression of bilateral dentigerous cysts: a case report.

UNLABELLED: A dentigerous cyst is the most common developmental odontogenic cyst and believed to be slowly progressive in nature. This case report describes an incidental finding of spontaneous regression of bilateral dentigerous cysts associated with lower impacted third molars in a 30-year-old, fully dentate female. Together with three other similar reports, a few possible explanations are postulated and the understanding of natural history of dentigerous cysts is questioned. CLINICAL RELEVANCE: The discovery of a dentigerous cyst in a patient always warrants special attention. This article highlights the fact that surgical treatment is not the only solution for a dentigerous cyst and, in rare cases, conservative management can save the patient from having unnecessary surgery.

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

Estudo epidemiológico e avaliação histomorfológica de 108 casos de cisto dentígero / Epidemiological study and histomorphological analysis of 108 cases diagnosed as dentigerous cyst

O cisto dentígero constitui o cisto odontogênico não-inflamatório de ocorrência mais comum. Este estudo teve como objetivo realizar um estudo epidemiológico seguido de uma avaliação histomorfológica de 108 casos de cisto dentígero na Disciplina de Patologia oral da UFRN. Observou-se que esta lesão acometeu preferencialmente as três primeiras décadas de vida, sendo o gênero masculino e os pacientes leucodermas os mais afetados. A região anterior da maxila e posterior da mandíbula foram as mais acometidas e o padrão de crescimento lento foi o mais comumente observado. As lesões apresentaram-se assintomática em sua maioria, sendo o aspecto radiolúcido unilocular o padrão radiográfico mais, freqüentemente identificado. Histologicamente as lesões exibiram na maioria dos casos um limitante epitelial delgado e contínuo, com uma cápsula de tecido conjuntivo fibroso ricamente vascularizado e colagenizado exibindo reação inflamatória crônica

A radiologic analysis of dentigerous cysts and odontogenic keratocysts associated with a mandibular third molar.

OBJECTIVE: The purpose of this study was to discriminate radiographically between dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with a mandibular third molar. STUDY DESIGN: The material consisted of panoramic radiographs of dentigerous cysts (44 patients, 45 cysts) and odontogenic keratocysts (15 patients, 16 cysts), all of which were related to a mandibular third molar. The radiographic images were analyzed with reference to the patients' ages and symptoms. RESULTS: The mean age of patients in the OKC group was less than that of patients in the DC group. The mean area of the cysts in the OKC group was larger than that of those in the DC group. The mean distance from the second to the third molar in the DC group was greater than that in the OKC group. Although there was a significant correlation between the area and distance in the DC and OKC groups, the patients' ages did not significantly correlate to the area and distance of either cyst. CONCLUSIONS: The OKCs had a tendency toward rapid growth in the patient's youth but short movement of a third molar compared with the DCs. The DCs and OKCs do not appear to develop gradually from the period when follicles or dental lamina were formed but arise at various periods randomly.

Quiste dentígero: nuevos conceptos sobre su etiopatogenia / Dentigerous cyst new concepts about its etiopathogenesis

Aunque el quiste dentígero es el segundo quiste odontogénico más común, se desconoce su verdadera histogénesis. Se ha sugerido que existen dos tipos clínico-histopatológicos de quistes dentígeros: con un origen de desarrollo e inflamatorio. El propósito de este artículo fue presentar dos casos de grandes quistes dentígeros. Estos casos fueron usados para explicar la patogenia y el comportamiento de los dos tipos de quistes dentígeros, basados principalmente en los avances de la biología molecular disponible en la literatura

Quiste dentígero: nuevos conceptos sobre su etiopatogenia / Dentigerous cyst new concepts about its etiopathogenesis

Aunque el quiste dentígero es el segundo quiste odontogénico más común, se desconoce su verdadera histogénesis. Se ha sugerido que existen dos tipos clínico-histopatológicos de quistes dentígeros: con un origen de desarrollo e inflamatorio. El propósito de este artículo fue presentar dos casos de grandes quistes dentígeros. Estos casos fueron usados para explicar la patogenia y el comportamiento de los dos tipos de quistes dentígeros, basados principalmente en los avances de la biología molecular disponible en la literatura (AU)

Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases.

PURPOSE: This study evaluated the spontaneous bone healing after enucleation of large mandibular cysts subjectively and with a computed analysis of postoperative panoramic radiographs. PATIENTS AND METHODS: Twenty-nine patients had large mandibular cysts treated by surgical enucleation. Postoperative clinical and radiographic examinations were performed at 6, 12, and 24 months in 27 patients. Bone regeneration and reduction of the residual cavities and bone density were evaluated with a computed analysis of preoperative and postoperative panoramic radiographs. A subjective and clinical radiographic evaluation of the healing process also was performed. RESULTS: Uneventful healing and spontaneous filling of the residual cavities was obtained in all cases. The computed analysis of the postoperative radiographs showed mean values of reduction in size of the residual cavity of 12.34% after 6 months, 43.46% after 12 months, and 81.30% after 24 months. The increase in bone density was 37% after 6 months, 48.27% after 12 months, and 91.01% after 24 months. CONCLUSION: Spontaneous bone regeneration can occur in large mandibular cysts without the aid of any filling materials. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications.

Odontogenic cysts related to pulpotomized deciduous molars: clinical features and treatment outcome.

OBJECTIVE: The purpose of this study was to assess the morbidity and outcomes associated with large cysts that developed in conjunction with pulpotomized deciduous molars. STUDY DESIGN: This retrospective study was based on the files of 18 patients who were referred to 2 oral surgery departments during a 10-year period (1986-1996). The inclusion criteria were large cyst lesions (>1 cm in diameter) and complete documentation. Data regarding symptoms at presentation, histologic and radiologic features, treatment modalities, morbidity, and outcomes were analyzed. RESULTS: An equal gender distribution of patients was found, as were a later development in males (12+/-2 years in boys, 9+/-2 years in girls) and a 5:1 ratio favoring the mandible over the maxilla. Treatment included enucleation (12 patients) and marsupialization (6 patients). The morbidity was high and included loss of permanent teeth (3 patients), extensive loss of alveolar bone (3 patients), use of flaps (2 patients), and adjuvant orthodontic treatment (9 patients). CONCLUSION: Failure of early detection and treatment of cysts that develop in conjunction with pulpotomized deciduous molars can cause considerable morbidity. Therefore, periodic clinical and radiologic follow-up until the eruption of succedaneous teeth is recommended.

[Dentigerous cysts. Developmental aspects. Apropos of 3 cases]. / Les kystes dentigères. Aspect évolutif. A propos de trois observations.

Dentigerous cysts, also called follicularor corono-dental cysts, are malformative odontogenic cysts in the WHO classification of odontogenic tumors. We review the general characteristics of these frequent odontogenic tumors which always occur in associated with an included tooth. Diagnosis is based on clinical features, X-ray findings and pathology results. We report the evolutive aspect in three patients of different ages.

Bilateral mucous cell containing dentigerous cyst of madibular third molars: report of an unusual case

A 38-year-old Caucasian male with bilateral dentigerous cysts of the mandibular third molars is reported as follows. The cyst cavities were lined with a nonkeratinized squamous epithelium. Mucous cells were seen in some areas of the cyst walls

Dentigerous cyst--an attempt to ascertain the normal eruption of involved tooth in child patient.

Dentigerous Cyst, in a young patient, located in the right palatal region, extending from 61 to 55, limited to the right side of mid-palatine suture and treated by marsupialization with post operative follow-up of 6 months has been reported. The involved permanent tooth (21) entrapped in the cyst was not extracted and found to erupt in normal direction.

In vitro growth characteristics of human odontogenic keratocysts and dentigerous cysts.

Using an in vitro system, the growth characteristics and enzyme histochemical properties of 3 odontogenic keratocysts and 3 dentigerous cysts were studied. It was found that the epithelial cells of the keratocysts but not of the dentigerous cysts grew in vitro. Furthermore, the epithelial-like cells of the keratocysts showed the same activities of acid phosphatase and NADH-diaphorase in vitro as earlier described in vivo. These enzymatic activities were increased in epithelial-like cells close to proliferating fibroblast-like cells, indicating a close relationship between these two cell types. The results are discussed in the light of the known clinical behaviour of the keratocyst and certain conclusions are also drawn concerning the suggested neoplastic potential of the keratocyst.

Epithelial jaw cysts: 10 years of the WHO classification.

Numerous papers on epithelial jaw cysts have appeared in the decade since the publication in 1971 of the WHO histological classification of odontogenic tumours, jaw cysts, and allied lesions. Despite clarification of certain cyst varieties no major revisions are necessary. The following minor modifications are proposed. In the developmental odontogenic group, the terms keratocyst and follicular are preferred to primordial and dentigerous. The alveolar cyst of infants is categorised separately from the gingival cyst of adults. The developmental lateral periodontal cyst is included as a distinctive new type. In the non-odontogenic group the globulomaxillary is deleted as a unique entity, whereas the midpalatal cyst of infants is a new inclusion. To the inflammatory category are added the inflammatory follicular and inflammatory lateral periodontal varieties.

Clinical perspectives on premature tooth eruption and cyst formation in neonates.

Premature eruption of teeth occurs in 1 of every 2,000 births. The reported association between natal teeth and serious, rare, inherited syndromes suggests that particular caution should be exercised in examination of newborns having prematurely erupted teeth. The ectomesenchyma, from which the orofacial structures develop, undergoes a complex, coordinated series of steps of proliferation and differentiation during the first two months in utero. At approximately seven weeks the presumptive mandibular and maxillary arches show a bandlike ectodermal thickening called the dental lamina. Odontogenesis (tooth development) begins with budding of the dental lamina and continues into the second week of life. Remnants of odontogenic epithelium or of epithelium covering the embryonic facial processes may develop into cystic structures, causing intraoral swellings on the alveolar ridges or palate (i.e., Bohn's nodules and Epstein's pearls). Prematurely erupted natal and neonatal teeth are generally normal deciduous incisors. Hypermobility of these teeth, resulting from poorly formed roots, may stabilize within a short period of time. Extraction of natal and neonatal teeth should not be done precipitously.