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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.)

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., (© 2022 Wiley Periodicals LLC.)

Background: To evaluate hyperbaric oxygen therapy (HBOT) on infection rates and repair rates during the treatment of large jaw cysts. Methods: A prospective randomized, non-blinded, controlled clinical trial included 90 patients with jaw cysts, randomly divided into three groups. Patients were treated with enucleations and bone substitute was used in the experimental and control groups. The experimental group received HBOT. The primary predictor variable was HBOT. The infection rate, repair rate, preoperative volume of the jaw cysts, age, and sex were statistically analyzed. The Fisher exact test was used to compare the infection rate and postoperative complications. The repair rate of the bone defects was analyzed using the repeated-measures analysis of variance and the least significant difference tests. The Kendall's coefficient of concordance and Kappa statistics were calculated to evaluate the consistency between the two investigators. Results: The infection rate was 3.4% in the experimental group, 14.3% in the blank group, and 32.1% in the control group (P<0.05). The repair rate in the experimental group was significantly higher than in the control and blank groups at 1, 3 and 6 months after surgery (P<0.05). Conclusion: The results showed that HBOT reduced the postoperative infection rate following the enucleation of large jaw cysts with bone substitute filling, and it also improved the bone repair rate., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Összefoglaló. Bevezetés: Az állcsonti cysták helytálló diagnosztikája a klinikai, radiológiai és patológiai leletek együttes értékelésével lehetséges. Korábbi munkánk során többször tapasztaltuk a klinikoradiopatológiai kommunikáció és korreláció hiányát, és ez olykor inadekvát diagnózisok felállításához vezetett. Célkitűzés: Célunk ezen kommunikációs probléma mértékének becslése és annak bemutatása, hogy ez a hiányosság hogyan befolyásolhatja a diagnosztikát. Módszer: Korábbi, más célú retrospektív elemzés újraértékelése történt a klinikai (radiológiai) adatközlés, a revízió kapcsán módosuló diagnózisok számszerűsítése céljából, valamint további 3 egyetemi patológiai intézet 10-10 anonimizált leletének vizsgálata az adatközlések vonatkozásában. Eredmények: 2 intézményben 85 odontogen cysta diagnózisakor csupán a betegek életkora, neme volt 100%-osan ismert. A lokalizációra vonatkozó adekvát információ 62%-ban, a méretre vonatkozó csupán 29%-ban fordult elő a szövettani kérőlapokon. Összességében a diagnózist segítő releváns információt csak 52%-ban adtak meg. Az utólagos klinikoradiopatológiai korrelációra törekvő revízió során 38/85 esetben (45%) módosult a végső diagnózis kisebb vagy nagyobb mértékben. A megküldött leletek alapján a klinikai/radiológiai adatok közlése <50% és 100% közöttinek becsülhető más intézetekben is. Az 5 intézmény közül csak az egyikben utalt specializációra az, hogy minden leletet egy patológus véleményezett, általában sok patológus (n = 25) valamelyike véleményezte a kevés tömlőt (n = 105). A diagnózis kommunikáció hiányán alapuló kisiklásának lehetőségét 5 példával illusztráljuk: cysta radicularisként leletezett paradentalis, lobos follicularis és lateralis periodontalis cysta, ductus nasopalatinus cysta és radicularis cysta differenciáldiagnosztikáját példázó tömlő, valamint botryoid odontogen cysta kerül bemutatásra. Következtetés: Az odontogen tömlők precíz diagnosztikája mind a klinikai, mind a patológiai oldalról javítást igényel, amelynek egyik része az ilyen irányú képzés lehet. Orv Hetil. 2021; 162(12): 458-467. Summary. Introduction: Proper diagnosis of jaw cysts requires the parallel evaluation of clinical, radiological and histopathological findings. Lack of clinico-radio-pathological correlation can lead to inconsistent diagnoses. Objective: To evaluate the rate of lacking clinico-pathological communication and demonstrate how this may influence diagnostics. Method: Data of a former retrospective analysis were re-evaluated to quantify the lack of clinical data communicated to pathologists and estimate the rate of final diagnoses requiring alteration after review of all available clinical data. 10 anonymized reports on odontogenic cysts from 3 university pathology departments each were analysed for the lack of relevant clinical information. Results: Only the age and gender of patients were documented in 100% for 85 jaw cysts diagnosed in 2 departments of pathology. Adequate information about cyst localization and size were communicated in 62% and 29%, respectively. Overall, information relevant to the diagnosis was given in 52% of the cases. Revision based on clinico-radio-pathological correlation led to alterations of the diagnosis in 38/85 cases (45%). Based on reports from other institutions, the communication of clinical data is estimated to be between <50% and 100%. 25 pathologists were involved in reporting 105 cysts. 5 cases illustrate how diagnosis may fail without good communication: a paradental, an inflamed dentigerous and a lateral periodontal cyst, each misdiagnosed as radicular cyst; a cyst raising the differential diagnosis of nasopalatine duct versus radicular cyst; a botryoid odontogenic cyst. Conclusion: Proper diagnosis of jaw cysts requires improvements from both pathological and clinical sides, and could probably be improved through education. Orv Hetil. 2021; 162(12): 458-467.

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 1.9cm. 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., (Copyright © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: This study aims to evaluate the clinical effect of oral repair membrane and β-tricalcium phosphate (β-TCP) on the treatment of jaw cyst., Methods: A retrospective analysis was performed on 81 cases of jaw cysts, and clinical data were collected for the comparison of traditional surgical curettage (group A, 27 cases), biofilm covering bone wounds after curettage (group B, 27 cases), and β-TCP filling combined with biofilm covering., Results: No recurrence occurred in 81 patients, and no significant difference in preoperative CT value among the three groups (P<0.05). Follow-up CT reexamination 3, 6, and 12 months after operation showed significant differences among the three groups of CT values (P<0.05). Group C was better than Group B or Group A (P<0.05)., Conclusions: In traditional jaw cyst curettage, the application of biofilm exhibited good osteogenesis effect, and the combined application of β-TCP and biofilm exerted a better effect.

Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a "three-step method" to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.

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]

Background: Removal of jaw cysts that reach large sizes, result in facial deformity, injury to the adjacent neurovascular bundles or jaw fracture. Marsupialization means creating a window into the cyst for decompression and is an adjuvant treatment. Limitations of this technique are not explained completely. Materials and Methods: Patients suffering from a variety of jaw cysts that were managed by marsupialization with or without subsequent enucleation were included in this study between 2007 and 2014. At the 3rd and 6th month, follow-up radiographs were ordered. Results: There were 16 patients (20 cysts) that were included in this study. There were two cases (2/16) that decision was made to change the treatment planning. Half the cysts were histologically proven odontogenic keratocyst. Two-thirds of the patients, who needs to enucleation subsequent to the successful marsupialization, were managed under general anesthesia. Conclusion: Limitations of this technique are: Inability to examine the whole cyst microscopically, questionable eruption of the permanent tooth involved with the cyst, dependency on the patient cooperation, and difficulty of irrigation fluid circulation in multilocular jaw cysts, and finally, if the created window has large dimensions then soft tissue closure after final cyst enucleation is the problem. [ABSTRACT FROM AUTHOR]

The standard management for the majority of benign jaw cysts is enucleation, marsupialisation, curettage and decompression. Enucleation has the advantage that the whole specimen is sent for microscopic evaluation so that more sinister pathological processes (i.e. squamous cell carcinoma) may not be missed. In a large cystic lesion, enucleation is still possible, but technical difficulties might be encountered. In such instances, inevitable damage can occur to the surrounding structures. We report a case of a large radicular cyst of the maxilla that was enucleated via endoscopic assistance through the Caldwell Luc approach. [ABSTRACT FROM AUTHOR]

Aneurysmal bone cyst (ABC) is an uncommon non-neoplastic lesion of the bones, usually affecting the long bones and spine. The rare jaw lesions are encountered in the body and ramus of the mandible. Commonly reported in the second and third decades of life, ABC's are characterized by a rapid growth pattern with resultant bony expansion and facial asymmetry. Surgical management usually consists of surgical curettage or resection. This paper describes a case of ABC in a 21-year-old female, that presented as an expansile bony mass in the parasymphyseal region. A brief review of existing literature on ABC is also made. [ABSTRACT FROM AUTHOR]

Neutral salt extracts of 14 specimens of jaw cysts were prepared. Histopathological analysis showed that the specimens consisted of 6 radicular cysts, 6 dentigerous cysts, 1 residual cyst, and 1 odontogenic keratocyst. One periapical granuloma, 1 dental follicle and a sample of clinically healthy oral mucosa were similarly processed and used as controls. Measurement of collagenase activity by monitoring the formation of specific degradation products of type I and II collagen in solution by SDS-PAGE demonstrated that all the cyst extracts contained collagenase, some of which was endogenously activated. Cyst wall collagenase preferably degraded type I over type II collagen, which suggests that the degradation was due to MMP-1 (matrix metalloproteinase-1) rather than the MMP-8 type. This was further supported by the doxycycline-inhibition profile of cyst collagenase, which was similar to that of MMP-1. Part of the cyst wall collagenase was in latent proenzyme form and probably derived, at least in part, from the newly synthesized intracellular collagenase pool. Latent cyst collagenase was efficiently activated with phenylmercuric chloride and to a lesser extent by gold (I) thioglucose and NaOCI. Western-blotting, using specific antibodies against collagenase from human polymorphonuclear neutrophilic leukocytes (MMP-8) and from fibroblasts (MMP-1), revealed a typical 55/45 kDa doublet: also MMP-8 in the latent 80 kDa form and fragmented to 65 kDa active species were found. These results suggest the presence of MMP-1 and, to a lesser extent, MMP-8 type collagenase in the cyst wall. The presence of partially activated interstitial collagenases in the cyst wall may contribute to cyst wall remodeling and may thus, in part, regulate cyst growth. [ABSTRACT FROM AUTHOR]

The clinico-pathologic, immunohistochemical and radiological features of 12 jaw cysts with a prominent orthokeratinized epithelial lining were studied and compared with those of typical odontogenic keratocysts and dentigerous cysts. They differed significantly from odontogenic keratocysts in terms of biologic behavior and histopathologic findings. Although immunohistochemical staining of the epithelial linings for cytokeratins, EMA. CEA and involucrin has not shed any light on the histogenesis of these lesions, staining patterns for these markers were significantly different from those of odontogenic keratocysts and non-keratinized dentigerous cysts. Radiologically, nine cases appeared as dentigerous cysts; two cases, one with sebaceous differentiation, as non-dentigerous unilocular cysts, and the remaining one was exceptional as it showed multiple epidermal cysts with prominent dermal appendages histologically. It is suggested that most of the orthokeratinized jaw cysts may belong to clinico-pathological entities different from odontogenic keratocysts with the majority representing dentigerous cysts with orthokeratinization. The possibility of the existence of rare central dermoid or epidermoid cysts is also to be considered. [ABSTRACT FROM AUTHOR]