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Aim: The glandular odontogenic cyst (GOC) is a rare odontogenic cyst with a potentially aggressive growth potential and high recurrence rate. An absence of pathognomonic clinical, radiographic and histopathological features means the glandular odontogenic cyst is rarely included in a differential diagnosis for a well‐defined radiolucent cyst or tumour of the jaw. There is an absence of clarity on the most effective method of treatment for GOCs to reduce recurrence risk. Materials and Methods: In this case series, we documented the treatment of three male patients who were referred for further investigation of well‐defined, corticated radiolucent lesions. Two lesions were located in the body of the mandible and one in the anterior maxilla. All three patients were in their fifth decade of life. Two patients reported mild discomfort, while one patient was asymptomatic upon presentation. Results: The included cases were treated conservatively with enucleation and curettage under general anaesthesia. Histological examination confirmed a diagnosis of GOC in all cases. No clinical or radiographic recurrence has been observed. Conclusion: The clinical, radiographic and histological appearance of the GOC mimics other cysts and tumours of the jaw, most significantly central mucoepidermoid carcinoma. Long‐term follow‐up is recommended due to the potential for recurrence, which is influenced by lesion size, locularity and cortical plate integrity. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of recurrence of OKC varied from 2.5 to 62%. Studies have linked recurrence to treatment methods and also clinical and pathological features. The aim of this study was to evaluate the 5-year recurrence and the factors associated with recurrence in odontogenic keratocysts of the jaws. Methods: A retrospective review of records was done from the Institute's Medical Records Directory from 2010 to 2021. The following data were obtained of the lesion; age at presentation, gender, site, subsite, radiographic presentation (locularity), radiographic borders, presence or absence of satellite cysts, inflammatory infiltrate, and treatment rendered presence or absence of cortical perforation and soft-tissue extension and presence or absence of recurrence. Kaplan Meir estimator was used to evaluate recurrence rate and log rank test was used to compare the survival amongst groups. Cox regression analysis was used to evaluate the odds ratio to find out the possible factors influencing risk of recurrence. A p value of < 0.05 was considered statistically significant at 95% confidence interval. Results: In our study cohort, 27.2% of patients had recurrence. Posterior maxillary lesions, multilocular lesions, lesions with scalloped borders, presence of soft-tissue extension and cortical perforation, presence of satellite cysts and inflammatory infiltrate and enucleation with peripheral ostectomy were significantly associated with recurrence. However, soft-tissue extension, cortical perforation, multilocular lesions and presence of satellite cysts were independent risk factors. Conclusion: There is still debate on the best treatment modality for the management of OKCs. More studies are required to quantify the results. [ABSTRACT FROM AUTHOR]

Abstract Background Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. Case Presentation A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. Discussion The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. Conclusion The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.

Background: Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. Case Presentation: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. Discussion: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. Conclusion: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the accuracy of formula-based volume measurements and the 3D volume analysis with different software packages in the calculation of preoperative cystic jaw lesions' volume. The secondary aim was to assess the reliability and the accuracy of 3 imaging software programs for measuring the cystic jaw lesions' volume in CBCT images. Materials and methods: This study consisted of two parts: an in vitro part using 2 dry human mandibles that were used to create simulated osteolytic lesions to assess the accuracy of the volumetric analysis and formula-based volume. As a gold standard, the volume of each bone defect was determined by taking an impression using rapid soft silicone (Vinylight) and then quantifying the volume of the replica. Afterward, each tooth socket was scanned using a high-resolution CBCT. A retrospective part using archived CBCT radiographs that were taken from the database of the outpatient clinic of the oral and maxillofacial radiology department, Faculty of Dentistry, Minia University to assess the reliability of the 3 software packages. The volumetric data set was exported for volume quantification using the 3 software packages (MIMICS-OnDemand and InVesalius software). Also, the three greatest orthogonal diameters of the lesions were calculated, and the volume was assessed using the ellipsoid formula. Dunn's test was used for pair-wise comparisons when Friedman's test was significant. The inter-examiner agreement was assessed using Cronbach's alpha reliability coefficient and intra-class correlation coefficient. Results: Regarding the results of the retrospective part, there was a statistically significant difference between volumetric measurements by equation and different software (P value < 0.001, Effect size = 0.513). The inter-observer reliability of the measurements of the cystic lesions using the different software packages was very good. The highest inter-examiner agreement for volume measurement was found with InVesalius (Cronbach's alpha = 0.992). On the other hand, there was a statistically significant difference between dry mandible volumetric measurements and Gold Standard. All software showed statistically significantly lower dry mandible volumetric measurements than the gold standard. Conclusion: Computer-aided assessment of cystic lesion volume using InVesalius, OnDemand, and MIMICS is a readily available, easy to use, non-invasive option. It confers an advantage over formula-based volume as it gives the exact morphology of the lesion so that potential problems can be detected before surgery. Volume analysis with InVesalius software was accurate in determining the volume of simulated periapical defects in a human cadaver mandible as compared to true volume. InVesalius software proved that open-source software can be robust yet user-friendly with the advantage of minimal cost to use. [ABSTRACT FROM AUTHOR]

Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Cysts of the jaws constitute an heterogenous group of lesions occurring in the maxillofacial region. Their diagnosis is challenging and necessitating a meticulous correlation of clinical, radiological, and pathological features. Pathologists often face numerous difficulties stemming from inadequate clinical and radiological information, along with limited samples. Nevertheless, clinicians are not always aware of the pathologist's concerns, making difficult to know exactly which pertinent clinical information they should deliver in their request form. The objective of this article is to illustrate the microscopic diagnostic pitfalls associated with cystic lesions of the jaws and enhance communication between oral surgeons and oral pathologist. Corpus: This section starts by examining the essential clinical and radiological data necessary for a precise pathological diagnosis. Subsequently, we discuss about the differential diagnosis of jaw cystic lesions, categorizing them into five distinct subsets based on their microscopic features, particularly their histological lining. For each subset, we engage in a detailed discussion concerning the primary diagnostic challenges and their implications for treatment decisions. Conclusion: Pathologist and clinicians are not irreconcilables: improved communication, rooted in a mutual understanding of each other's concerns, leads to optimizing the diagnosis and subsequently the treatment of jaw cysts. [ABSTRACT FROM AUTHOR]

Jaw cyst is a fluid-containing cystic lesion that can occur in any part of the jaw and cause facial swelling, dental lesions, jaw fractures, and other associated issues. Due to the diversity and complexity of jaw images, existing deep-learning methods still have challenges in segmentation. To this end, we propose MARes-Net, an innovative multi-scale attentional residual network architecture. Firstly, the residual connection is used to optimize the encoder-decoder process, which effectively solves the gradient disappearance problem and improves the training efficiency and optimization ability. Secondly, the scale-aware feature extraction module (SFEM) significantly enhances the network’s perceptual abilities by extending its receptive field across various scales, spaces, and channel dimensions. Thirdly, the multi-scale compression excitation module (MCEM) compresses and excites the feature map, and combines it with contextual information to obtain better model performance capabilities. Furthermore, the introduction of the attention gate module marks a significant advancement in refining the feature map output. Finally, rigorous experimentation conducted on the original jaw cyst dataset provided by Quzhou People’s Hospital to verify the validity of MARes-Net architecture. The experimental data showed that precision, recall, IoU and F1-score of MARes-Net reached 93.84%, 93.70%, 86.17%, and 93.21%, respectively. Compared with existing models, our MARes-Net shows its unparalleled capabilities in accurately delineating and localizing anatomical structures in the jaw cyst image segmentation.

Jaw cysts are mainly caused by abnormal tooth development, chronic oral inflammation, or jaw damage, which may lead to facial swelling, deformity, tooth loss, and other symptoms. Due to the diversity and complexity of cyst images, deep-learning algorithms still face many difficulties and challenges. In response to these problems, we present a horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images. First, the horizontal-vertical interaction mechanism facilitates complex communication paths in the vertical and horizontal dimensions, and it has the ability to capture a wide range of context dependencies. Second, the feature-fused unit is introduced to adjust the network's receptive field, which enhances the ability of acquiring multi-scale context information. Third, the multiple side-outputs strategy intelligently combines feature maps to generate more accurate and detailed change maps. Finally, experiments were carried out on the self-established jaw cyst dataset and compared with different specialist physicians to evaluate its clinical usability. The research results indicate that the Matthews correlation coefficient (Mcc), Dice, and Jaccard of HIMS-Net were 93.61, 93.66 and 88.10% respectively, which may contribute to rapid and accurate diagnosis in clinical practice.

Accurate segmentation of organs and lesions from medical images holds paramount importance in aiding physicians with diagnosis and monitor diseases. At present, the widespread application of deep-learning in medical image segmentation is primarily attributed to its exceptional feature extraction capability. Nonetheless, due to blurred target boundary, wide range of changes and chaotic background, the segmentation of medical images is still faced with great challenges. To address these issues, we present a multi-level feature integration network (MFI-Net) with SE-Res2Conv encoder for jaw cyst segmentation. Specifically, we replace the original convolution operation with SE-Res2Conv to better maintain model’s capacity for extracting features across multiple scales. Then, a novel context extractor module including multi-scale pooling block (MPB) and position attention module (PAM), which aims to generate more discriminative features. Finally, a multi-level feature integration block (MFIB) is implemented within the decoder to efficiently integrate low-level detail features with high-level semantic features. Numerous experiments were conducted on both the original and augmented datasets of jaw cyst to demonstrate the advantages of MFI-Net, with results consistently superior to all competitors. The Dice, IoU and Jaccard values of our method reached 93.06%, 93.47%, 87.06% in the original database and 91.25%, 91.94%, 84.06% in the augmented database. Furthermore, the computational efficiency of MFI-Net is impressive, with a speed of 106.21 FPS and 110.28 FPS at the input size of $3\times 256 \times 256$ on a NVIDIA RTX6000 graphics card.

Abstract Background Gorlin syndrome (GS) is a rare genetic disorder inherited in an autosomal dominant manner caused by genetic variants in PTCH1, SUFU, or PTCH2 genes. It is characterized by multiple basal cell carcinomas, odontogenic keratocysts, skeletal abnormalities, and predisposition to neoplasms. Case presentation A novel splice-site variant in the PTCH1 gene, c.3549+1G>T classified as pathogenic, was identified in a patient with a phenotype compatible with GS (multiple basal cell carcinomas and skeletal malformations). Conclusions This case contributes to expand the spectrum of identified variants in Gorlin syndrome increasing knowledge about molecular bases and the diagnosis approach of this syndrome.

Key Clinical Message: Management of large jaw cyst is challenging since high risks including pathologic fracture, limited opening, and insufficient bone healing occur after enucleation. The current case of concentrated growth factor (CGF) gel to fill defect after enucleation of large jaw cyst is rare. A 12‐year‐old boy with pain and swelling for 4 months in the left mandible region made a medical consultation at our hospital. Computerized tomography scan indicated that cystic lesion was found in the left mandible region. In this case, we present a patient with large jaw cyst (31 mm × 44 mm × 53 mm) who received enucleation followed by CGF gel filling the defect. The patient was discharged after 13 days without discomfort symptoms. The lesion size was reduced significantly at 1‐month re‐examination. No abnormality was detected in maxillofacial region at 1‐year re‐examination. Application of CGF gel is one of the possible options for filling defect after jaw cyst enucleation. [ABSTRACT FROM AUTHOR]

Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients. [ABSTRACT FROM AUTHOR]

Background: The glandular odontogenic cyst is now a well-known entity comprising < 0.5% of all odontogenic cysts with a recent review tabulating about 200 cases in the English literature. Glandular odontogenic cyst shows epithelial features that simulate salivary gland or glandular differentiation. The importance of glandular odontogenic cyst relates to the fact that it has a high recurrence rate and shares overlapping histologic features with central mucoepidermoid carcinoma. The purpose of this paper is to describe the clinical, radiological, and histopathological features of a case of glandular odontogenic cyst with the course of treatment and 9-years follow-up, followed by a review of the literature. Methods: A 63-year-old male was referred for further investigation of a mandibular radiolucency observed by his general dental practitioner. The main complaint was a murmuring sensation in the lower jaw right side. Radiological examination revealed a well-defined, unilocular, radiolucent lesion, involving the right mandible with 17 and 68 mm in mediolaterally and anteroposterior dimension, respectively. Results: A total enucleation of the cystic lesion and surgical extraction of tooth #46, #47 and #48, was performed under local anaesthesia. Histopathologic examination revealed a glandular odontogenic cyst. Conclusions: Glandular odontogenic cyst shows no pathognomonic clinico-radiographic characteristics, and therefore in many cases it resembles a wide spectrum of lesions. Diagnosis can be extremely difficult due to histopathological similarities with dentigerous cyst, lateral periodontal cyst and central mucoepidermoid carcinoma. Therefore a careful histopathological examination and a long-term follow-up (preferably seven years) are required to rule out recurrences.

Background: The glandular odontogenic cyst is now a well-known entity comprising < 0.5% of all odontogenic cysts with a recent review tabulating about 200 cases in the English literature. Glandular odontogenic cyst shows epithelial features that simulate salivary gland or glandular differentiation. The importance of glandular odontogenic cyst relates to the fact that it has a high recurrence rate and shares overlapping histologic features with central mucoepidermoid carcinoma. The purpose of this paper is to describe the clinical, radiological, and histopathological features of a case of glandular odontogenic cyst with the course of treatment and 9-years follow-up, followed by a review of the literature. Methods: A 63-year-old male was referred for further investigation of a mandibular radiolucency observed by his general dental practitioner. The main complaint was a murmuring sensation in the lower jaw right side. Radiological examination revealed a well-defined, unilocular, radiolucent lesion, involving the right mandible with 17 and 68 mm in mediolaterally and anteroposterior dimension, respectively. Results: A total enucleation of the cystic lesion and surgical extraction of tooth #46, #47 and #48, was performed under local anaesthesia. Histopathologic examination revealed a glandular odontogenic cyst. Conclusions: Glandular odontogenic cyst shows no pathognomonic clinico-radiographic characteristics, and therefore in many cases it resembles a wide spectrum of lesions. Diagnosis can be extremely difficult due to histopathological similarities with dentigerous cyst, lateral periodontal cyst and central mucoepidermoid carcinoma. Therefore a careful histopathological examination and a long-term follow-up (preferably seven years) are required to rule out recurrences. [ABSTRACT FROM AUTHOR]

• A new approach based on U-Net architecture for pituitary tumor segmentation is proposed. • A more comprehensive semantic information capture is realized by superimposing two U-Net network structures. • The atrous spatial pyramid pooling technology is integrated to enable adjustable multi-scale feature extraction. • An adjacent auxiliary module is designed to smoothly fuse features from different levels. In the diagnosis of various diseases, accurate segmentation of lesions in medical images is crucial. However, when faced with the challenges of blurred edges, noise, and low contrast in images of pituitary tumors and jaw cysts, existing methods do not perform well in solving these problems. To overcome these problems, we present a new approach based on U-Net architecture. Firstly, a more comprehensive semantic information capture is realized by superimposing two U-Net network structures. Following that, the method incorporates atrous spatial pyramid pooling (ASSP) technology to enable adjustable multi-scale feature extraction. Thirdly, an adjacent auxiliary module (AAM) is designed to smoothly fuse features from different levels, effectively suppressing noise interference and reducing feature ambiguity. By testing on the dataset provided by Quzhou People's Hospital, the IoU, Dice, Specificity, and Mcc of the method were 77.46%, 87.18%, 99.64% and 86.97% on the pituitary tumor dataset, and 81.32%, 89.53%, 99.91% and 89.55% on the jaw cyst dataset, respectively. Compared with existing algorithms, our method exhibits superior segmentation performance and is expected to become a more reliable auxiliary tool in the diagnosis of medical diseases. [ABSTRACT FROM AUTHOR]

Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.

The metabolite profiles of various cysts and abscesses outside the jaw area have been investigated by magnetic resonance spectroscopy (MRS) using water-suppression techniques. However, metabolite profiles of jaw cysts, jaw abscesses, saliva, and urine have not yet been obtained by MRS using massive D2O dilution of samples. This study was aimed at obtaining metabolite profi les of these bio-fluids by MRS without water suppression. In total, 37 jaw cysts, 19 jaw abscesses, 10 saliva, and 10 urine samples were collected. Dilutions were prepared by adding 0.06 mL of each sample to 0.94 mL D2O. Single-pulse experiments were performed using a 400 MHz nuclear magnetic resonance (NMR) spectrometer. High-resolution metabolite profiles were obtained for most jaw abscesses (13), some jaw cysts (8), all saliva, and all urine samples. Except for one jaw cyst, the remaining samples showed a broad envelope containing various metabolites. However, high-resolution spectra for these cystic fluid samples were obtained through 40% dilution with H2O. In conclusion, to the best of our knowledge, metabolite profiles of jaw cysts, abscesses, saliva, and urine by massive D2O dilution were first presented here. The presented approach does not require water suppression and uses a relatively low-frequency NMR. It is also a simple and novel method of eliminating radiation damping, reducing experimental time, and allowing relaxation measurements. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to evaluate bone healing after jaw cyst enucleation with or without bone substitutes by cone beam computed tomography, and to analyze potential influence factors for bone formation as well. Materials and Methods: Sixty seven jaw cyst patients were randomly assigned to two groups. Thirty three patients in control group accepted cystectomy without any filling material. The rest 34 bone cavities which filled with xenograft (DBBM, Bio‐Oss®) and covered by absorbable membrane (Bio‐Gide®) were included in the guided bone regeneration (GBR) group. All patients were examined with cone bean computerized tomography before operation, 3 and 6 months after surgery. Linear regression analysis was applied to evaluate the influence factors of bone healing. Results: There was no significant difference in bone formation rate at 3 months after enucleation, with shrinkage rate (SR) of cystic lesion in control group and GBR group of 26.43 ± 14.98% and 20.78 ± 10.80%, respectively (p > 0.05). Larger shrinkage area in GBR group was detected on postoperative radiographs after 6 months with SR of 60.11 ± 19.23%, when compared to those in patients without filling (6 months SR: 48.63 ± 19.39%, p = 0.018, <0.05). Linear regression analysis showed that cyst size was negatively correlated with bone formation. Conclusion: GBR with bovine xenograft and absorbable membrane showed considerable bone regeneration property in the healing of jaw cystic defects after enucleation of radicular cysts. Cyst size showed a suppressive influence on bone formation. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of fenestration decompression and curettage of jaw cyst in the treatment of jaw cyst and the changes of serum pain mediators after operation. Methods: The clinical data of 60 patients with jaw cyst who were treated in our hospital from January 2016 to August 2019 were analyzed retrospectively. According to the difference of treatment methods, they were divided into group A (curettage of jaw cyst, 28 cases) and group B (fenestration decompression, 32 cases). The operation indexes, postoperative recovery indexes, complications and changes of serum pain mediators in the two groups were observed. Results: Compared with group A, group B had less intraoperative bleeding, shorter operation time and less postoperative pain score. There was significant difference between groups (P<0.05). Compared with group A, group B had higher bone mineral density, thicker hyperosteogeny, larger reduction rate of cyst volume and shorter cyst healing time. There was significant difference between groups(P<0.05). The levels of serum neuropeptide Y (NPY), substance P (SP) and nerve growth factor (NGF) in group B were lower than those in group A at 2 h and 12 h after operation, β Endorphins（β-EP) was higher than that in group A(P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusions: Compared with curettage for jaw cyst, fenestration decompression has significant advantages, which can reduce intraoperative bleeding, shorten operation time, reduce postoperative pain and promote postoperative recovery. [ABSTRACT FROM AUTHOR]

The purpose of this scientific research was drawing up of algorithm of optimum planning of a technique of operation at patients with extensive cysts of jaws, comparison of indicators of an information of most often carried-out beam methods of research in particular is made at this pathology. Hi-tech methods of beam research – a computer tomography showed the greatest information and diagnostic value. Efficiency of treatment depends on a right choice of a technique of operation. In turn, the method of operative intervention depends on anatomotopographical relationship of pathological process. Thus, the more information it is received in inspection, the more it is possible to avoid complications and recurrence, to create favorable conditions for bone regeneration.

Background: Decompression is an effective treatment for jaw cysts. Many studies have reported its effectiveness as a preliminary treatment followed by secondary enucleation. This study aimed to explore long-term bone remodeling after definitive decompression for jaw cysts based on a three-dimensional (3D) analysis., Methods: This was a retrospective study. The clinical and radiological data of patients with jaw cysts who underwent decompression and were followed up for two years or more at Peking Union Medical College Hospital between January 2015 and December 2020 were reviewed. The 3D radiological data before and after decompression were analyzed to study the long-term reduction in cysts, especially after one year of decompression., Results: A total of 17 patients with jaw cysts were included in this study. The radiological data showed a mean reduction rate of 78% one year after decompression. At the final examination, which was 36.1 months after decompression on average, the mean reduction rate was 86%. The unossified lesions could still ossify slowly after one year of decompression. The recurrence rate was 5.9% (1/17)., Conclusions: Bone remodeling continued for a long time after decompression. Definitive decompression could be an option for most patients with jaw cysts. Long-term follow-up is required., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest related to this article., (Copyright © 2023. Published by Elsevier Masson SAS.)

Background: Jaw cysts often deeply involve adjacent tooth roots, making it difficult to preserve them. The purpose of this retrospective study was to investigate the effectiveness of an intentional replantation (IR) strategy combined with cyst enucleation in preserving cyst-involved teeth during jaw cyst removal., Materials and Methods: Fifteen patients with jaw cysts and deeply involved teeth were treated with IR and cyst enucleation. All patients received root canal therapy prior to surgery, except for one patient who received it during surgery. The involved teeth were extracted, and the root surface was carefully cleaned before IR and cyst enucleation. Patients were followed up for 12-14 months, with indicators including clinical complaints, replanted tooth stability, and root resorption., Results: No cyst recurrence was observed, and all replanted teeth survived with good local gingival condition and no marked swelling or recession. Radiographic findings showed clear periodontal space surrounding the replanted teeth. One replanted tooth exhibited slight root resorption due to occlusal trauma, but the resorption ceased after occlusal adjustment., Conclusions: IR combined with cyst enucleation is an effective strategy for thoroughly cleaning jaw cysts and preserving teeth involved in the cyst., Competing Interests: Declaration of Competing Interest We declare that none of the work contained in this manuscript is published in any language or currently under consideration at any other journal. And there are no conflicts of interest to declare. All authors have contributed to, read, and approved this submitted manuscript in its current form., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: The treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts., Methods: Odontogenic cysts with lesion sizes ranging 2-4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups., Results: Out of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon's preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05)., Conclusions: There is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest related to this article., (Copyright © 2024. Published by Elsevier Masson SAS.)

Introduction: simple bone cyst is a non-neoplastic, asymptomatic lesion, which is usually detected by radiographic finding. It is characterized by slow growth and non-expandable, which does not cause functional alteration. Presentation of the case: an 11-year-old female patient with a unicameral bone cyst that has atypical characteristics, at the level of the left mandibular ramus, with extension to the condyle and coronoid process, and with severe expansion of the bone tables. Treatment was surgical, by simple curettage. Two years after the treatment, there is no recurrence. Conclusions: diagnosis of cysts in the maxilla and mandible are common in oral and maxillofacial pathology, whose treatment is surgical. [ABSTRACT FROM AUTHOR]

Hyaline ring granuloma is a rare oral lesion with an unclear and controversial etiology, characterized by the presence of rings of palely eosinophilic structure less material (the so-called hyaline rings) with multinucleated giant cells around and within the very same rings. Various theories have been proposed about the pathogenesis of hyaline ring granulomas. Many authors consider a vegetable origin, suggesting that it may represent a reaction to foreign material such as food (and in particular pulses). Instead, other authors deny this possibility, proposing that the hyaline rings might represent degenerated blood vessels, degenerated collagen, or fibrosed extravasated serum proteins. The aim of this article is to present a case of hyaline ring granuloma and to briefly review the literature.

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Odontogenic cysts are categorized as inflammatory and developmental. Of the developmental odontogenic cysts, the dentigerous cyst is the most common and by definition is attached to the cervical region of an unerupted tooth. The cyst envelops the crown forming a sac. However, there are other developmental cysts, and rarely, odontogenic tumors, that can have a similar clinical and radiographic presentation as dentigerous cyst, including odontogenic keratocyst, orthokeratinized odontogenic cyst and ameloblastoma, unicystic type. Understanding the key histologic differences of these cysts will aid the pathologist to correctly diagnose these lesions, ensuring appropriate clinical management. [ABSTRACT FROM AUTHOR]

Although schistosomiasis is the second most frequent tropical disease worldwide it is infrequently diagnosed in the industrialized world. Depending on the species involved, schistosomiasis usually presents with urological or intestinal symptoms. Here we report, to the best of our knowledge, the first case of schistosomiasis presenting with an oral cyst in a migrant.

Non-neoplastic jaw cyst (NJC) is one of the most common lesions in oral cavity, but there are only few detailed and extended epidemiological data based on the 2017 WHO classification. The aim of this study was to perform an epidemiological analysis of all NJCs treated from 1990 to 2019 at the Marche Polytechnic University, and to compare these data with those published in the literature. This retrospective study considered 2060 patients treated from 1990 to 2019. The NJCs were classified according to the 2017 WHO classification, and the main clinicopathological variables were analysed (sex, age, diagnosis, site of onset, size, and recurrences). Of 2150 total lesions, there were 2095 primary cysts and 55 recurrences; men are more frequently affected than women (M/F ratio of 1.73:1). The mean age of occurrence was 46.6 years, with a peak of frequency in the fifth decade. The mandible was more frequently involved than the maxilla, with a mean size of 1.9 cm. Radicular cyst was the most frequently diagnosed cyst (56.6%), followed by dentigerous cyst (23.4%) and odontogenic keratocyst (12.9%). This is the first epidemiological study on NJCs in the Italian population according to 2017 WHO classification. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical application of large-scale jaw cyst fenestration and the use of nasal endoscope for removing the low-impacted wisdom teeth. Methods: Nine patients with large jaw dentigerous cysts were treated with a drainage channel at the site of the molar or posterior molar or the posterior vestibular groove of the molar. The nasal endoscope was used to connect each pocket of cyst and remove the low-impacted wisdom teeth being squeezed by the cyst. The occluder was used to maintain the open window and keep daily flushing treatment. The size of the cyst and the bone changes around the wall were observed to evaluate the clinical effect of this method. Results: After 6-18 months of follow-up, the treatment of 9 cases of dentigerous cysts was effective, and the effective rate was 100%. Postoperative reexamination showed that the cystic cavity was significantly reduced. Local deformity and injury were also restored. None of the 3 patients underwent a secondary curettage and no recurrence was observed. Conclusion: The fenestration treatment of the jaw cyst preserves the shape and function of the jaw bone, and has obvious effects on the improvement of the quality of life of the patient. It is a clinically operative and therapeutically effective treatment method. In the meantime, nasal endoscope also plays a key role in guiding the connection of each pocket of cyst and extracting the impacted teeth displaced by the cyst. [ABSTRACT FROM AUTHOR]

Aim: To determine if small and medium field of view (FOV) cone beam computed tomography (CBCT) adjusted grey density values can be used to distinguish between periapical cystic and solid lesions. Methodology: Fifty‐seven patients with periapical lesions having retrievable small or medium FOV CBCT images and biopsy samples were included. Two oral and maxillofacial pathologists examined the biopsy samples to provide the gold standard diagnosis of cystic or solid lesion. From the CBCT images, two independent examiners recorded the minimum adjusted grey density value of each lesion twice. Intra‐examiner and inter‐examiner reliability of the measurements were analysed, and sensitivity, specificity and accuracy of the minimum grey values in distinguishing a solid from cystic lesion were calculated. A receiver operating curve for diagnostic ability of adjusted grey density values to differentiate between periapical cystic and solid lesions was obtained, and the area under the curve (AUC) was calculated. Results: The intra‐ and inter‐examiner reliability of the grey density values of the lesions and dentine were excellent. The AUC was 0.44 (P‐value = 0.45). The adjusted grey density value with the greatest accuracy for differentiating between cystic and solid lesions had an accuracy, sensitivity and specificity of 0.54, 1.00 and 0.075, respectively. Conclusions: Small FOV CBCT adjusted grey density values obtained by the device used in the study could not distinguish between periapical cystic and solid lesions. Further developments in CBCT devices are needed to improve the accuracy of grey density measurements. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the operative effect, quality of life and prognosis of patients with cyst of jaw treated by fenestration and decompression and traditional curettage. Methods: The clinical data of 90 patients with jaw cyst who were admitted to our hospital from January 2016 to July 2018 were retrospectively selected. The patients were divided into group A (n=45, traditional curettage) and group B (n=45, fenestration and decompression) according to different surgical methods. The curative effect, clinical indicators, quality of life and prognosis were compared between the two groups. Results: The total clinical effective rate of group B was 97.78% (44/45), which was higher than 84.44%(38/45) of group A (P<0.05). The wound healing time, the operation time in group B were shorter than those in group A, the intraoperative blood loss was less than that in group A(P<0.05). The scores of emotion, appearance, taste, pain, saliva, chewing and other items in the last follow-up of the two groups were higher than those in group A (P<0.05). The rate of complications and recurrence in group B was lower than that in group A (P<0.05). Conclusions: Compared with the traditional curettage, the fenestration and decompression has a significant effect on the operative effect, quality of life and prognosis, and has a higher clinical application value. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ameloblastoma is a most common benign odontogenic tumour. It is slow growing but aggressive tumour which causes destruction of jaw bones. Clinically it is asymptomatic and can be noticed when the tumour increases gradually in size and causes facial asymmetry or detected during dental radiographic procedures for evaluating the missing or impacted teeth, especially third molar. Unicysticameloblastomas account for 10-15 % of all intraosseousameloblastomas. Here we discuss a case report of unicystic ameloblastoma with its clinical and radiological features along with emphasizing the threedimensional imaging assessmentof the case. [ABSTRACT FROM AUTHOR]

Objectives: There is a long history of studies into cystic lesions of the jaws. However, there is little data on postoperative bone regeneration. The aim of the study was to calculate the size of the residual bone lesions after cystostomies and cystectomies to predict the postoperative bone healing. Material and methods: This retrospective study focused on patients undergoing cystectomy (n = 114) or cystostomy (n = 86), who were treated for cystic lesions between 2010 and 2015. New formulas were developed to measure the decrease in lesion sizes using the craniocaudal and mesiodistal diameters from preoperative as well as postoperative radiographs (panoramic radiographs, CT scans, CBCT). With these predictive models (calculated by linear regression analyses), it is possible to calculate how the lesions would shrink using initial size of the cyst and time after surgery for both dimensions. Results: After cystostomy, the mesiodistal size was initial size 6.0 + 0.7 × initial size − 9.4 × time. The craniocaudal size was 5.1 + 0.7 × initial size − 7.3 × time. After cystectomy, the mesiodistal size was 0.4 + 0.7 × initial size − 8.4 × time. The craniocaudal size was 0.4 + 0.5 × initial size − 6.4 × time (R2 = 0.59 and 0.67, respectively). Conclusion: These formulas are suggested to be used to calculate residual size of bone lesion after cystostomy and cystectomy to predict postoperative bone healing. Clinical relevance: The formulas are based on deliberately simple measurement using only panoramic radiographs to encourage their application in daily clinical practice. [ABSTRACT FROM AUTHOR]

The orthokeratinized odontogenic cyst is a relatively rare developmental odontogenic cyst of the jaws that occurs predominantly in males between the third and fourth decades. According to the 2005 World Health Organization’s classification, orthokeratinized odontogenic cyst is not a part of the keratocystic odontogenic tumor spectrum. We present a case of a 41-year-old male with a history of remarkable lingual expansion in the anterior part of the maxilla since last year with rapid growth in the last three months as a unilocular well–defined radiolucent lesion extending from maxillary left central incisor to the right second premolar. Orthokeratinized odontogenic cyst is a specific type of keratinized odontogenic cysts which is completely different from keratocystic odontogenic tumor from the viewpoint of the clinical and pathological features.

Jaw cysts are mainly caused by abnormal tooth development, chronic oral inflammation, or jaw damage, which may lead to facial swelling, deformity, tooth loss, and other symptoms. Due to the diversity and complexity of cyst images, deep-learning algorithms still face many difficulties and challenges. In response to these problems, we present a horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images. First, the horizontal-vertical interaction mechanism facilitates complex communication paths in the vertical and horizontal dimensions, and it has the ability to capture a wide range of context dependencies. Second, the feature-fused unit is introduced to adjust the network's receptive field, which enhances the ability of acquiring multi-scale context information. Third, the multiple side-outputs strategy intelligently combines feature maps to generate more accurate and detailed change maps. Finally, experiments were carried out on the self-established jaw cyst dataset and compared with different specialist physicians to evaluate its clinical usability. The research results indicate that the Matthews correlation coefficient (Mcc), Dice, and Jaccard of HIMS-Net were 93.61, 93.66 and 88.10% respectively, which may contribute to rapid and accurate diagnosis in clinical practice.

Glandular odontogenic cyst (GOC) is an extremely rare lesion occurring in the jawbones. The present paper is a review of 181 cases of GOCs reported in English literature, since it was first reported by Padayache and Van Wyk in 1987. Mandible was involved in 130 cases and maxilla in 51 cases. Anterior mandible was the most common area of involvement. Radiographic appearance was that of a unilocular radiolucency in 98 of 176 reported cases. Rest presented as multilocular radiolucency. Cortical expansion was observed in 136 of the 180 reported cases while cortex breach or perforation was seen in 81 cases. The treatment of choice was that of minor procedures that included enucleation with or without curettage, peripheral ostectomy, cryotherapy, etc. in 157 of the total 177 reported cases. Marginal jaw resection, segmental mandibulectomy etc. was reported in 20 cases. Although minor surgical procedures were the treatment of choice in most studies, two major studies of Kaplan et al. and Fowler et al. involving 111 and 46 cases, recorded a recurrence rate of 35.9 and 19.6%, respectively. The age range was between 11 and 82 years. The respective mean age of patients in the above mentioned studies was 45.7 for Kaplan's and 51 years for Fowler's whereas in our study, the mean age was 45.9 years. Very rarely does GOC presents itself in a paediatric patient. The paper also reports a case of an 11-year-old child whose histopathogy came out to be a case of a GOC.

Zusammenfassung Den Zahn- und Kieferherden müssen in der Ganzheitsmedizin v.a. in der Regulationsmedizin, zu welcher auch die Osteopathie zählt, mehr Bedeutung geschenkt werden. Die Diagnose solcher Herde ist nicht immer einfach und erfordert eine enge interdisziplinäre Zusammenarbeit. Hier sind gerade wir Osteopathen gefordert, da uns Menschen oft mit Dysfunktionen bis hin zu chronischen Beschwerdebildern aufsuchen. In diesem Zusammenhang ist es unbedingt notwendig, daran zu denken, dass diese Herde unsere Arbeit behindern und zu schwerwiegenden Krankheiten führen können, die unseren Patienten einen enormen Leidensweg bescheren. Gerade in der Osteopathie, die den Anspruch auf Ganzheitlichkeit stellt, ist es daher dringend notwendig, über den Tellerrand hinweg zu sehen und sich auch andere diagnostische Hilfsmittel anzueignen. Abstract In the holistic or rather regulatory medicine, like ostheopathy is, we have to care more about the dysfunctions in the field of the teeth and the jawbone. The diagnosis of such dysfunction is not always easy and we have to work in multidisciplinary teams. Just osteopaths have a special rule, because patients visiting us are suffering from body dysfunction up to chronic deseases. Therefore it is absolutely necessary to attach importance to these problems which can restrain our treatment and lead to serous medical conditions which results in a life of suffering for our patients. Especially in osteopathy, which claims to be holistic, it is therefore necessary to think outside the box and to acquire other diagnostic additives. [ABSTRACT FROM AUTHOR]

Objective: To describe the endoscopic approach for management of large jaw cysts and assess the feasibility of endoscopic enucleation as well as analyze its outcome on a wide scale at Mansoura University Hospital MUH.Methods: This prospective cohort study was done on 23 consecutive cases presenting with different types of large jaw cysts in the period from January 2013 to July 2016 at ENT Department, Mansoura University Hospital. All patients, (16 maxillary & 7 mandibular) cysts, were managed endoscopically. Follow up ranged from 6 to 48 months.Results: All patients showed complete resolution of their symptoms postoperatively except for 2 maxillary case who didn't undergo an antrostomy and 1 mandibular indicated a second look.Conclusion: Large jaw cysts lie at the border line of management options. Resection of the affected segment is a radical option but the most deforming. On the other hand, conservative procedures are prolonged and not definitive. To our knowledge this is the first case series of endoscopic enucleation of large maxillary and mandibular cysts, highlighting its advantages in variable types. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Three-dimensional (3D) printing is now a widely recognized surgical tool in oral and maxillofacial surgery. However, little is known about its benefits for the surgical management of benign maxillary and mandibular tumors and cysts., Purpose: The objective of this systematic review was to assess the contribution of 3D printing in the management of benign jaw lesions., Methods: A systematic review, registered in PROSPERO, was conducted using PubMed and Scopus databases, up to December 2022, by following PRISMA guidelines. Studies reporting 3D printing applications for the surgical management of benign jaw lesions were considered., Results: This review included thirteen studies involving 74 patients. The principal use of 3D printing was to produce anatomical models, intraoperative surgical guides, or both, allowing for the successful removal of maxillary and mandibular lesions. The greatest reported benefits of printed models were the visualization of the lesion and its anatomical relationships to anticipate intraoperative risks. Surgical guides were designed as drilling locating guides or osteotomy cutting guides and contributed to decreasing operating time and improving the accuracy of the surgery., Conclusion: Using 3D printing technologies to manage benign jaw lesions results in less invasive procedures by facilitating precise osteotomies, reducing operating times, and complications. More studies with higher levels of evidence are needed to confirm our results., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest, (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)