Cisto dentígero: modalidades de tratamento

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lateral periodontal cyst: a case report and literature review

The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts. A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp. A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was lateral periodontal cyst of developmental origin. There was no recurrence or complications for 24 months follow-up. The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.

Impacted permanent incisors associated with compound odontoma

Odontomas are the most common odontogenic tumours of the maxillary bones, characterised by a slow growth and benign behaviour. They are usually small, asymptomatic and diagnosed after routine radiographic examination. The aim of this study was to report a case of a compound odontoma in the anterior maxilla of a 7-year-old girl, which was causing the impaction of the maxillary right central and lateral incisors, as well as the prolonged retention of the corresponding primary teeth. We also aimed to review the literature about these tumours, since they are not part of the dentist's day-to-day clinical practice. The clinical and radiographic features, the diagnosis and treatment of the case were discussed in this work.

Tumor odontogênico queratocístico e considerações diagnósticas

Keratocystic odontogenic tumor (KCOT is benign, featuring controversies in diagnosis and treatment. It occurs mainly in the region of the mandibular angle, which may or may not be related to a tooth and whose importance is due to its aggressive behavior and high recurrence rate. The causes of high rates of relapse observed in this lesion are dependent on factors such as age, location and size of lesion, gender, type of treatment and histological variant. The thin capsule and friable connective tissue of KCOT may favor the retention of epithelial debris responsible for the high proliferative capacity of this clinical entity. Due to the aggressiveness with its recurrence this paper aims to conduct a literature review addressing clinical and imaging aspects, composes the histopathological diagnosis of KCOT.

Quarto molar retido: a importância do diagnóstico precoce

Introductions: A supernumerary tooth is one that is additional to the normal series and can be found in almost any region of the dental arch. Its etiology is not fully understood. With regard to its prevalence, it occurs more commonly in permanent dentition and twice as often in men than in women. Supernumerary teeth are classified according to their morphology and location. Their presence can cause problems such as failure of eruption, displacement of teeth, crowding and odontogenic cysts and tumors. The diagnosis is usually by routine radiographs, for the majority of such teeth are impacted and asymptomatic. Objective and Case report: The purpose of this study was to make a brief review of the relevant literature and report one clinical case of the female patient, 23 years, melanoderma, featuring three quarters molars. Final considerations: The early diagnosis proved to be important for the resolution of the case in order to minimize or even prevent the development of complications and thus establish a proper plan of treatment.

Estudo radiográfico de terceiros molares inferiores retidos e parcialmente irrompidos e revisão de literatuda

Introduction: Pathology associated with retained or partially erupted teeth are common in the general population. Objective: the aim was to evaluate the measurement of pericoronal space of retained third molars and partially erupted teeth in panoramic radiographs. Method: a retrospective study was carried on on the frequency of tooth retention and the problems it can cause in 107 radiographs of patients where the width was measured to verify the presence or absence of diseases associated with the involved teeth. Results: in the 107 panoramic radiographs analyzed the most frequent measurement was of 1.0 mm with 32.71% of cases followed by 2.0 mm with 29.91% of cases. Conclusion: The measurement of the pericoronal sapce of retained third molars and partially retained through its greatest width is in a practical and effective technique for application in routine clinical practice, which suggests the presence or absence of eraly odontogenic pathology

Odontoma em pacientes odontopediátrico: diagnóstico e tratamento. Relato de caso clínico.

Odontoma is a term that refers to a benign tumor of odontogenic and mixed nature, composed of epithelial and mesenchymal components. Histologically, they are compounds of different configurations including dental enamel, dentin, cementum and in some cases the pulp tissue. A slow growing asymptomatic tumor, odontoma is usually discovered through routine radiographic examination. A 3-year old male patient sought care at the School of Dentistry’s Baby Clinic (UNESP-Araçatuba), complaining of “small ball close to the teeth.” During the interview, the mother reported that the lesion was observed soon after a trauma, and evolved in less than one month. An ulcerated lesion with a 0.8 cm diameter was found during intraoral clinical examination. It was located in the inferior and anterior region of the mouth, between teeth 81 and 82, and there was also crown distalization. A radiographic examination showed a radiolucent area and root distance. In the absence of clinical and radiographic characteristics suggesting a case of odontoma, the differential diagnosis was peripheral giant cell lesion and pyogenic granuloma. So the area was punctured. Nonetheless, due to the absence of liquid, the surgical removal of the lesion was performed, followed by histological examination, which showed the definite diagnosis of a suggestive case of emerging odontoma.

Tratamento cirúrgico de ameloblastoma mandibular

Ameloblastomas are benign, invasive locally and highly recurrent. It is an odontogenic tumor, characterized by the proliferation of epithelial ameloblastic in a fibrous stroma. This paper reports a case of mandibular ameloblastoma, in patients 27 years of age without pain with developments around 4 years, with about 20 mm at its greatest extent, sessile base and surface coatings full. The treatment of choice was the surgical conservative

Lymphoepithelial cyst in jugal mucosa

Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

Infecções odontogenicas: relato de caso clínico e implicações terapêuticas

Acute infections maxillo-facial are of great importance, both for its high population, as the risk of complications. The aim of this study was to present a clinical case of extensive odontogenic abscess in a patient of 31 years of age attended the Service of Surgery and Maxillo-Facial, Faculty of Dentistry of Araçatuba - UNESP in Araçatuba, SP. Complications of infections odontogências although infrequent can lead the patient to death.

Cisto ósseo simples: relatos de casos

Usually diagnosed in routine radiographs, the simple bone cyst occurs infrequently. Etiology is unknown and differential diagnosis has to be made with dentigerous cyst, keratocystic odontogenic tumor, adenomatoid odontogenic tumor, ameloblastoma and central giant cell granuloma. Treatment is surgical, by perforating the cortical bone. In most cases an empty cavity, without any capsule or epithelial covering, is encountered, but it may have a liquid content. Perforation of the mandibular cortical bone elicits a response that results in bone repair of the empty cavity. This article reviews the subject and presents two cases of this entity and discusses the possible factors that could interfere in healing course.

Tumor odontogênico de células granulares

Introduction: the granular cell odontogenic tumors are an uncommon neoplasm with benign clinical behavior. The lesion occurs over a wide age range with a typically predilection for the mandibular canine and molar regions. Aim: present a granular cell odontogenic tumor literature review. Conclusions: the tumor don’t present an aggressive biological behavior although recurrences can occur. The lesion is treated by conservative surgery with curettage and enucleation as election procedures.

Ameloblastoma demographic, clinical and treatment study - analysis of 40 cases

Dental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. Objective: To describe the cases of ameloblastoma in a reference department. Methods: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. Results: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in.the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. Conclusion: Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.

Immunohistochemical Analysis of Human Homologue of Drosophila Patched (PTCH) in Dental Follicles of Impacted Third Molars

This study investigated the immunodetection of PTCH in epithelial components of dental follicles associated with impacted third molars without radiographic signs of pathosis. One hundred and five specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferation was determined by using immunohistochemical labeling. Statistical analysis was performed using Fisher exact test and a level of significance of 5%. Of the 105 dental follicles collected, 3 were PTCH-positive. The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PTCH, as well as those with active remnants of odontogenic epithelium. This study suggests that the odontogenic cells of the dental follicle might be proliferating during the rhizogenesis, while the squamous metaplasia and hyperplasia of the epithelial lining and proliferative odontogenic epithelial rests show the differentiation potential of dental follicles.

Immunohistochemical expression of Rho GTPases in ameloblastomas

Rho GTPases are proteins that regulate cell cycle, shape, polarization, invasion, migration, and apoptosis, which are important characteristics of normal and neoplastic cells. Rho GTPases expression has been reported in normal tooth germ and several pathologies; however, it has not been evaluated in ameloblastomas. The aim of this study was to analyze the expression and distribution of RhoA, RhoB, Rac1, and Cdc42 Rho GTPases in solid and unicystic ameloblastomas. Three-micrometer sections from paraffin- embedded specimens were evaluated by using an avidin- biotin immunohistochemical method with antibodies against the proteins mentioned above. RhoA and RhoB staining was observed in a high number of cells (P < 0.05) and greater intensity in non-polarized ones. Rac1 was not observed, andCdc42 didnot showany statistical differences between the number of non-polarized and basal positive cells (P > 0.05). Upon comparing the studied ameloblastomas, a higher number of positive cells in the unicystic variant was observed than that in the solid one (P < 0,05). The results obtained suggest that theseGTPases could play a role in the ameloblastoma neoplastic epithelial cell phenotype determination (polarized or non-polarized), as well as in variant (solid or unicystic) and subtype (follicular or plexiform) determination. Furthermore, they could participate in solid ameloblastoma invasion mechanisms. J Oral Pathol Med (2012) 41: 400-407