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Calcium silicate cements (CSCs) are often used in endodontics despite some limitations related to their physical properties and antibacterial efficacy. This study aimed to develop and demonstrate the viability of a series of CSCs that were produced by sol-gel method and further modified with mesoporous bioactive glass nanoparticles (MBGNs) and collagen, for endodontic therapy. Calcium silicate (CS) particles and MBGNs were synthesized by the sol-gel method, and their elemental, molecular, and physical microstructure was characterized. Three CSCs were developed by mixing the CS with distilled water (CS+H 2 O), 10 mg/mL collagen solution (CS+colH 2 O), and MBGNs (10 %) (CSmbgn+colH 2 O). The mixing (MT) and setting (ST) times of the CSCs were determined, while the setting reaction was monitored in real-time. Antibacterial efficacy against Enterococcus faecalis (E. faecalis) and regenerative potential on dental pulp stem cells (DPSCs) were also analyzed. The CS+H 2 O displayed a ST comparable to commercial products, while CSmbgn+colH 2 O achieved the longest MT of 68 s and the shortest ST of 8 min. All the experimental CSCs inhibited the growth of E. faecalis. Additionally, compared to the control group, CSCs supported cell proliferation and spreading and mineralized matrix production, regardless of their composition. Tested CSCs presented potential as candidates for pulp therapy procedures. Future research should investigate the pulp regeneration mechanisms alongside rigorous antibacterial evaluations, preferably with multi-organism biofilms, executed over extended periods. [Display omitted] • Novel dental cements developed from calcium silicate, bioactive glass and collagen. • 10 % bioactive glass nanoparticles shorten the setting time of calcium silicate cement. • Developed calcium silicate cements are antimicrobial against E. faecalis. • Modest regeneration effect of mesoporous bioactive glass and collagen inclusion. [ABSTRACT FROM AUTHOR]

To determine which types of bone lesion (spicules, lobules, porous bone) in the maxillary sinus indicate sinusitis Subadjacent dental disease is a cause of maxillary sinusitis; if a lesion type indicates sinusitis it should be more common above diseased posterior maxillary teeth than a lesion type that is not indicative of sinusitis. The study sample is a British Mediaeval human skeletal collection. Porous bone lesions (chiefly new bone deposits) in maxillary sinuses are associated with subadjacent dental disease; spicules/lobules of bone in the sinus are not. The results support the idea that porous lesions indicate sinusitis but the spicules/lobules may not. Spicules, lobules and porous lesions within the maxillary sinus should be analysed separately in biocultural studies; it would be prudent to regard only the porous lesions as indicative of sinusitis. Maxillary sinusitis is commonly used as a health indicator in palaeopathology, and spicular deposits are generally the most common type of alterations. By assuming that they are indicative of sinusitis we may have been greatly overestimating the prevalence of bony sinusitis in the past. These conclusions are provisional. Further work on larger, more diverse samples, together with more detailed anatomical studies on lesion location and structure is ongoing. [ABSTRACT FROM AUTHOR]

Background: The current study aims at investigating gap junctions which allow cells to connect with one another. Such process is essential for cell differentiation and the preservation of diverse cell functions. It is noticeable that connexin 43 (Cnx43) was differentially expressed in ameloblasts and odontoblasts in the processes of odontogenesis. Moreover, in carcinoma in situ (CIS) and oral squamous cell carcinoma (SCC), Cnx43 expression apparently thought to be a defining feature of the neoplastic state of squamous epithelial cells. Aim: Therefore, the study has postulated that Cnx43 may be involved in the pathophysiology of ameloblastoma and certain odontogenic cysts whose epithelial constituents exhibit squamous cells. Materials and methods: In order to prove the foregoing hypothesis, the study explored the immunohistochemical profiles of Cnx43 in ameloblastoma as well as some odontogenic cysts to assess Cnx43 trafficking and its relation with characteristic tissue architectures of odontogenic lesions. Results: The study has concluded that Cnx43 was down regulated significantly in follicular ameloblastoma with obvious ameloblasts-like cell components as well as in odontogenic keratocyst with palisaded basal cells. Additionally, other patterns of ameloblastoma (plexiform and desmoplastic) and different types of odontogenic cysts manifest heavy trafficking for Cnx43. Conclusion: Finally, altered Cnx43 expression between various patterns of ameloblastoma and odontogenic cysts might be related to their pathogenesis and is responsible for their morphological diversity.

Introduction: The purpose of this study was to determine if there is a relation between odontogenic infection severity score (OISS) and the time interval from patient‐reported symptom onset to emergency department (ED) presentation. The working hypothesis was that higher OISSs would be found in patients who developed symptoms and delayed ED presentation compared with patients who presented earlier. Materials and Methods: The study population was composed of consecutive patients who were admitted to the University of Texas Southwestern Medical Center and surgically treated in the operating room for severe odontogenic infections from January 2016 to December 2020. Odontogenic infection severity was measured using a numerical severity index. Three cohort groups were predefined to evaluate the relation between patient‐reported symptom onset in days and OISS. Results: There were 115 patients who met the inclusion and exclusion criteria. There was no significant difference in the OISSs between the three cohorts. In patients who received antibiotics prior to ED presentation, there was no difference in OISS. Male sex and diabetes diagnosis were related to higher OISSs. Conclusions: Patient‐reported symptom onset is unrelated to OISS in patients treated surgically for severe odontogenic infections. Other patient‐specific factors such as diabetes diagnosis are related to higher OISSs. [ABSTRACT FROM AUTHOR]

Background: Recently, there is increasing evidence that the proportion of odontogenic brain abscesses is greater than previously known. In this study, we aim to differentiate the oral infections as triggers more precisely and to classify them in the clinical setting. Methods: For analysis, we conducted a retrospective single center study. We reviewed patients with brain abscesses who have undergone treatment in the University Hospital of Freiburg, Germany in the period between 2000–2021. Inclusion required two main criteria: 1. The brain abscess must not have an other focus than odontogenic. 2. The microbial spectrum identified in the brain abscess must be consistent with an odontogenic origin. Results: Of 217 brain abscess patients, 26 met the inclusion criteria. 42% (11 patients) suffered from immunosuppressive conditions. Odontogenic foci were diagnosed in 18 cases (69%). Neurologic deficits included vigilance reduction and hemiparesis. Pathogens of the Streptococcus anginosus group were the most frequent causative agent (21 cases, 81%). Metronidazole (54%) and ceftriaxone (42%) were part of the targeted antibiotic therapy. All brain abscesses were surgically treated. Teeth were extracted in 14 of 17 cases for focus control. 18 cases (72%) showed complete or partial resolution of neurologic symptoms and 3 cases were fatal. Conclusion: Apparently silent or chronic oral infections are sufficient to cause bacterial colonization of the brain, especially in immunocompromised patients. Therefore, special care should be taken to maintain good oral health. An interdisciplinary management should become a standard to prevent and treat the occurrence of brain abscesses. [ABSTRACT FROM AUTHOR]

The current study aims at investigating gap junctions which allow cells to connect with one another. Such process is essential for cell differentiation and the preservation of diverse cell functions. It is noticeable that connexin 43 (Cnx43) was differentially expressed in ameloblasts and odontoblasts in the processes of odontogenesis. Moreover, in carcinoma in situ (CIS) and oral squamous cell carcinoma (SCC), Cnx43 expression apparently thought to be a defining feature of the neoplastic state of squamous epithelial cells. Aim : Therefore, the study has postulated that Cnx43 may be involved in the pathophysiology of ameloblastoma and certain odontogenic cysts whose epithelial constituents exhibit squamous cells. In order to prove the foregoing hypothesis, the study explored the immunohistochemical profiles of Cnx43 in ameloblastoma as well as some odontogenic cysts to assess Cnx43 trafficking and its relation with characteristic tissue architectures of odontogenic lesions. Results : The study has concluded that Cnx43 was down regulated significantly in follicular ameloblastoma with obvious ameloblasts-like cell components as well as in odontogenic keratocyst with palisaded basal cells. Additionally, other patterns of ameloblastoma (plexiform and desmoplastic) and different types of odontogenic cysts manifest heavy trafficking for Cnx43. Conclusion : Finally, altered Cnx43 expression between various patterns of ameloblastoma and odontogenic cysts might be related to their pathogenesis and is responsible for their morphological diversity. [ABSTRACT FROM AUTHOR]

Objective: Deep neck space infections (DNSI), caused by the spread of an odontogenic infection to the floor of the mouth and neck, are potentially life-threatening but preventable. We explored the total cost of illness (COI) for patients with DNSI of odontogenic origin. Material and methods: Cross-sectional, register-based, multi-centre study of the health economics of DNSI treatment. Included were patients aged > 18 years who were treated in hospital for DNSI of odontogenic origin. Subjects were identified from the regional healthcare database VEGA based on the International Classification of Diseases (ICD) codes and surgical procedure codes. The cost per patient (CPP) values for the hospital care, prescription medications and sick leave were extracted. Results: In total, 148 patients were included. The average length of the hospital stay was 6 days. Total COI was estimated as 15,400 EUR per patient and 2,280,000 EUR in total. Direct costs accounted for 93% of the COI, and indirect costs were 7%. Conclusion: The total COI for patients with DNSI of odontogenic origin was six-fold higher than the average COI for patients in otorhinolaryngology (ORL) care. Preventing DNSI will entail substantial cost savings for the specialised healthcare units and will have a significant impact on the patients.

Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. There is no standard treatment protocol for this lesion but radicalsurgical excision with or without radiotherapy is reported in the majority of cases. In this paper, we present a case of a 22 year old male diagnosed with Ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive destruction. Histopathological examination of the incised biopsy showed a parakeratinized stratified squamous epithelium with underlying fibrous connective tissue stroma. The stroma is highly myxomatous and exhibits islands of odontogenic epithelium and chronic inflammatory cell infiltrates. Interlacing strands of odontogenic epithelium shows stellate reticulum-like cells and occasional areas of squamous metaplasia with cellular and nuclear pleomorphism. In addition, mitotic figures were noted. With the correlation of clinical, radiographic, and histological features, the lesion is diagnosed as ameloblastic carcinoma. The lesion was surgical excised and post-treatment follow-up for 6 months revealed no recurrence of the malignancy.

Introduction: Procalcitonin (PCT) as a marker of inflammation has not been studied and analyzed in purulent inflammations of the head and neck of odontogenic origin, which is the aim of this original article. Materials and methods: This retrospective study includes 31 men with odontogenic abscesses of the head and neck with a mean age of 42 years. As a control group, 31 healthy men are used. In all of them, leukocytes (WBC), neutrophils (Neu), C-reactive protein (CRP), and procalcitonin (PCT) are tested. Results: The average values of the studied indicators in the patients are: CRP - 89.45±85.15 mg/l, WBC - 11.78±4.61x103/L, Neu - 8.79±4.58x103/L and PCT - 0.8±0.8 ng/ Jr. The average values of the same indicators in the control group are: CRP - 0.9±1.17 mg/l, WBC - 7.37±1.9x103/L, Neu - 4.13±1.43x103/L and PCT - 0.18±1.27 ng/ml. There is no positive correlation between PCT on the one hand and CRP, WBC and Neu on the other hand. Discussion: The mean values of CRP, WBC, Neu and PCT are higher in men with odontogenic abscesses compared to the healthy controls, and this is statistically significant. Although PCT does not correspond to WBC, Neu and CRP, it has a number of advantages over them - it increases its concentration only in infections of bacterial origin, it increases its levels earlier and reaches its highest concentration earlier, it has a longer half-life, and its level declines more rapidly after infections. Conclusions: All this suggests that PTC may soon become the most accurate marker in diagnosing, treating, and follow-up of patients with head and neck odontogenic abscesses.

The article presents a case study of a 1-year-old feline with maxillary mass in a 1-year-old feline, with topics including the history of the mass, clinical and gross findings, and diagnostic imaging findings. The history includes the excision of the mass three years prior, followed by progressive swelling, dysphagia, and epiphora. Transgingival fine needle aspirate showed blood and mild mixed inflammation.

OBJECTIVE To characterize the epidemiologic features of rabbits with odontogenic abscesses. ANIMALS 72 client-owned rabbits. METHODS The medical record database of a veterinary teaching hospital was searched to identify rabbits with odontogenic abscesses characterized by a palpable facial mass and confirmed via CT scan. Data reviewed included age, breed, presenting complaint, abscess location, bacterial culture results, treatment, and outcome. RESULTS Lop-eared rabbits were the most common breeds affected (20/72 [28%]), and mini lop rabbits were significantly overrepresented. The mandibular quadrants were more frequently affected (65/92 [71%]), and osteomyelitis was a common comorbidity on CT (53/72 [74%]). The most common aerobic and anaerobic isolates were Streptococcus spp ( 17/40 [43%]) and Fusobacterium splp ( 10/22 [45%]), respectively. Systemic antibiotic therapy alone was performed in 35 of 62 (56%) treated cases, with documented resolution in 25%. Abscess packing with antibiotic-soaked gauze in conjunction with systemic antibiotic therapy was performed in 20 of 62 (32%) treated cases. Resolution of the odontogenic abscesses with this treatment protocol was documented in 17 of 20 (85%) cases. The number of packing procedures used to obtain resolution of infection was 4 (IQR, 3 to 5). CLINICAL RELEVANCE A combination of the abscess-packing technique, which avoids extensive surgery and extraction of the involved elodont teeth, with systemic antibiotic therapy can be an effective treatment option for rabbits with palpable odontogenic abscesses and can result in a high cure rate comparable to more invasive surgical treatments. Antibiotic treatment alone is not recommended, as it has a low chance of abscess resolution. [ABSTRACT FROM AUTHOR]

Ameloblastoma in dogs most often has a highly conserved acanthomatous cell morphology and is recognized as canine acanthomatous ameloblastoma (CAA) while conventional ameloblastoma (CA) makes up a smaller yet morphologically diverse group of epithelial odontogenic tumors. In humans, a rare desmoplastic histological subtype has distinctive clinical, radiological, and microscopic features. Desmoplastic ameloblastoma (DA) has not previously been described in dogs, although it has been rarely referenced in the veterinary literature. This is the first thorough description of a case series of DA in dogs and describes clinical presentation, diagnostic imaging findings, histopathological features for diagnosis, and treatment outcome. Clinically, DA most often presents as a mass or swelling in the rostral mandible or maxilla of middle age to older dogs. On diagnostic imaging, the lesion has a radiolucent or mixed pattern with well-defined borders and variable loculation. As a solid, fibrous tumor with obscured odontogenic epithelium, DA is challenging to diagnose histologically and can mimic several other oral tumors, both benign and malignant. As an ameloblastoma, the biological behavior of DA is locally destructive yet benign and prognosis is favorable following surgical excision. [ABSTRACT FROM AUTHOR]

Background: The primary lesions of the mandible have a wide range of pathological features but similar imaging appearances, which often pose a great diagnostic dilemma. Objective: To devise a diagnostic algorithm using audit information obtained by correlating clinical, radiological and pathological characteristics of mandibular lesions and subsequent histopathological diagnosis available. Methods: A total of 64 cases were taken. Out of the 64 cases, 4 (6 %) had only OPG available, 42 (65 %) cases had only CT and 5 (7.8 %) patients had only MRI available. Results: The most common lesions encountered were Ameloblastoma comprising of 25 cases (39 %), followed by Osteosarcoma-7 (10.9 %) and Odontogenic keratocyst-5 (7.8%). The majority of the cases had both OPG and CT done, whereas in 3 (4%) cases all three imaging modalities were performed. Conclusions: Imaging is very helpful in diagnosis of the primary lesion of the jaw. It gives a clue about the type of periosteal reaction and effect on the surrounding bone (lytic, blastic or mixed tumors). [ABSTRACT FROM AUTHOR]

Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. There is no standard treatment protocol for this lesion but radicalsurgical excision with or without radiotherapy is reported in the majority of cases. In this paper, we present a case of a 22 year old male diagnosed with Ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive destruction. Histopathological examination of the incised biopsy showed a parakeratinized stratified squamous epithelium with underlying fibrous connective tissue stroma. The stroma is highly myxomatous and exhibits islands of odontogenic epithelium and chronic inflammatory cell infiltrates. Interlacing strands of odontogenic epithelium shows stellate reticulum-like cells and occasional areas of squamous metaplasia with cellular and nuclear pleomorphism. In addition, mitotic figures were noted. With the correlation of clinical, radiographic, and histological features, the lesion is diagnosed as ameloblastic carcinoma. The lesion was surgical excised and post-treatment follow-up for 6 months revealed no recurrence of the malignancy. [ABSTRACT FROM AUTHOR]

Odontogenic sarcomas are exceedingly rare and account for less than 5% of all Maxillofacial Sarcomas. It usually affects the younger population. The posterior mandible is the most commonly affected site. Radiographically, it appears as a large destructive radiolucent lesion with ill-defined margins. Histopathological diagnosis is usually difficult. Surgery is the mainstay treatment. The role of chemotherapy and radiation therapy is not clear. Here, we present a case study of a 30-year-old female patient diagnosed with odontogenic sarcoma that impinged on her airway. The treatment and postoperative course will be discussed in detail. [ABSTRACT FROM AUTHOR]

Aneurysmal Bone Cysts (ABCs) are uncommon benign bone lesions primarily affecting children and adolescents. They are distinguished by severe bone breakdown and expansive tissue growth, resulting in clinical symptoms and potential complications. ABCs typically occur in long bones, but reports have also documented their presence in the jaws, particularly the mandible. These lesions are commonly considered non-cancerous and are characterized by cystic or blood-filled chambers. There are two clinicopathological variations of ABC: primary ABC and secondary ABC. Primary ABC originates independently, while secondary ABC develops as a result of a pre-existing lesion such as a cyst, tumor, or Fibro-Osseous Lesions (FOL) like solitary bone cyst, ossifying fibroma, or giant cell granuloma. When ABC coexists with another bone lesion believed to be its precursor, it is referred to as an “ABC plus lesion”. In this case report, a 75-year-old patient, presented with a painful growth in the lower anterior region of the jaw for the past 18 months. The diagnosis was established through clinical, radiological, and histopathological examinations. A complete surgical resection was performed, followed by uneventful reconstruction. Histopathological examination confirmed the presence of ABC with ossifying fibroma (ABC plus lesion). It is important to address ABC plus lesions as they can cause significant pain, deformity, and discomfort. Although non-cancerous, they can still disrupt normal bone structure and function. This case report emphasizes the clinical, radiographic, and histopathological features of ABC plus lesions, aiding in disease identification.

Objective: Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with an excellent prognosis, often seen in children and young adults. The aim was to examine the spectrum of clinical, radiographic, and histologic attributes of AOT and assess clinician recognition of this entity. In addition, diagnostic considerations and treatment modalities were explored. Method and materials: With Institutional Review Board approval, archival cases of AOT from the University of Florida Oral Pathology Biopsy Service (1994-2019) were examined. Clinical and demographic data along with accompanying radiographs and original slides were reviewed. Results: A total of 28 cases of AOT were identified. These were all solitary in nature, with a mean age of 20.6 years (range 12-67 years). Most patients were under 20 (75.0%) with a definite female predilection (64.3%). Anterior jaws remained the most common location (85.2%), with a higher maxillary predilection (57.1%). Clinical impression included odontogenic lesions such as dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst. Conclusion: The spectrum of features of AOT is described. As clinicians were unfamiliar with AOT, highly characteristic features of AOT and more unique variants are discussed extensively to improve diagnostic aptitude. Clinicians must remain aware of this entity, as treatment is minimal compared to other odontogenic entities. [ABSTRACT FROM AUTHOR]

PurposeTo present a case of periorbital and orbital necrotizing fasciitis (PONF) from an odontogenic source with a distinct microbiologic profile and highlight the need for emergent multidisciplinary management.ObservationsA 39-year-old man presented with periorbital swelling, pain, and erythema following facial trauma. Imaging revealed peri-dental collections, accompanying maxillary sinusitis, and pre- and post-septal involvement. Immediate surgical debridement of necrotic tissue along with broad-spectrum antibiotics were pursued for management. Cultures grew multiple organisms, most notably Streptococcus milleri group and Staphylococcus lugdunensis.Conclusions and importancePONF is a rare yet potentially fatal disease. Streptococcus milleri group and a fulminant course are to be suspected when the source is odontogenic. Timely multidisciplinary surgical debridement and medical management with intravenous antibiotics is critical for best outcomes.

Introduction: The objective was to evaluate the efficacy of biochemical markers (WBC, CRP and fibrinogen) and the course of odontogenic space infections in 50 patients. Material and Methods: Blood samples were taken preoperatively and postoperatively at day 0, day 4, day 8 and day 12 for measuring the levels of all three biomarkers. The trends of the biomarkers were observed and compared with assessment parameters such as dental etiology, number of teeth involved, number of spaces involved, mouth opening and pain. Active pus discharge, dysphagia, hoarseness and swelling were assessed and scored accordingly. Results: The data were subjected to paired 't' test, McNemar's and Pearson's bivariate correlation as appropriate. Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection. All three biomarkers (WBC, CRP and fibrinogen) are significant markers for hospital stay (p < 0.01). Prospective analysis indicates that only one biomarker cannot be used to rule out specific diagnosis. Conclusion: The combination of three biochemical markers assessed in the present study (WBC, CRP and fibrinogen) should be used as prognostic factor in assessment, clinical severity and efficacy of treatment regime for patients as these can reliably predict the clinical course of odontogenic infection. [ABSTRACT FROM AUTHOR]

Odontogenic myxomas (OMs) represent asymptomatic, slowly expanding gnathic lesions with aggressive biological behaviour. Though the spectrum of OMs remains classical with multilocular radiolucency and presentation of stellate-shaped cells embedded in a mucoid stroma, they may mimic many other lesions radiographically or histopathologically. We hereby discuss a case of OM in a 28-year-old woman with special emphasis on pathogenesis and differential diagnosis. [ABSTRACT FROM AUTHOR]

Aneurysmal Bone Cysts (ABCs) are uncommon benign bone lesions primarily affecting children and adolescents. They are distinguished by severe bone breakdown and expansive tissue growth, resulting in clinical symptoms and potential complications. ABCs typically occur in long bones, but reports have also documented their presence in the jaws, particularly the mandible. These lesions are commonly considered non-cancerous and are characterized by cystic or blood-filled chambers. There are two clinicopathological variations of ABC: primary ABC and secondary ABC. Primary ABC originates independently, while secondary ABC develops as a result of a pre-existing lesion such as a cyst, tumor, or Fibro-Osseous Lesions (FOL) like solitary bone cyst, ossifying fibroma, or giant cell granuloma. When ABC coexists with another bone lesion believed to be its precursor, it is referred to as an “ABC plus lesion”. In this case report, a 75-year-old patient, presented with a painful growth in the lower anterior region of the jaw for the past 18 months. The diagnosis was established through clinical, radiological, and histopathological examinations. A complete surgical resection was performed, followed by uneventful reconstruction. Histopathological examination confirmed the presence of ABC with ossifying fibroma (ABC plus lesion). It is important to address ABC plus lesions as they can cause significant pain, deformity, and discomfort. Although non-cancerous, they can still disrupt normal bone structure and function. This case report emphasizes the clinical, radiographic, and histopathological features of ABC plus lesions, aiding in disease identification. [ABSTRACT FROM AUTHOR]

Ameloblastoma in dogs most often has a highly conserved acanthomatous cell morphology and is recognized as canine acanthomatous ameloblastoma (CAA) while conventional ameloblastoma (CA) makes up a smaller yet morphologically diverse group of epithelial odontogenic tumors. In humans, a rare desmoplastic histological subtype has distinctive clinical, radiological, and microscopic features. Desmoplastic ameloblastoma (DA) has not previously been described in dogs, although it has been rarely referenced in the veterinary literature. This is the first thorough description of a case series of DA in dogs and describes clinical presentation, diagnostic imaging findings, histopathological features for diagnosis, and treatment outcome. Clinically, DA most often presents as a mass or swelling in the rostral mandible or maxilla of middle age to older dogs. On diagnostic imaging, the lesion has a radiolucent or mixed pattern with well-defined borders and variable loculation. As a solid, fibrous tumor with obscured odontogenic epithelium, DA is challenging to diagnose histologically and can mimic several other oral tumors, both benign and malignant. As an ameloblastoma, the biological behavior of DA is locally destructive yet benign and prognosis is favorable following surgical excision.

Objectives: The aim of the current study was to identify the expression of P63 and its relation to odontogenic epithelial cell proliferation, severity of the inflammatory infiltrate and size of radicular cysts (RCs). Methods: In this retrospective cross-sectional study, 30 cases of paraffin-embedded RCs were randomly selected from the archive. P63 and Ki-67 expression was assessed by immunohistochemistry. Results: Epithelial P63 expression was absent in four (13.3%), weak in 10 (33.3%), and moderate in 16 (53.3%) cases. In the connective tissue wall of RC, P63 expression was absent in two (6.7%) cases, weak in 24 (80.0%) cases, and moderate in four (13.3%) cases. Ki-67 was found to be weakly expressed in 12 (40.0%) cases, moderately expressed in 13 (43.3%), and strongly expressed in five (16.7%) cases. No correlation was found between Ki-67 expression in odontogenic epithelium and P63 expression in the odontogenic epithelium (rho = 0.110, p = .563) or fibrous capsule (rho = 0.160, p = .399). Nevertheless, we found a positive correlation between Ki-67 expression in the odontogenic epithelium and the size of the RC (rho = 0.450, p = .013). The inflammatory infiltrate was negatively correlated with P63 expression in the odontogenic epithelium (rho = −0.428, p = .018), and with the size of cysts (rho = −0.728, p

Objective: To describe the epidemiological, diagnostic and therapeutic aspects of odontogenic cervicofacial cellulitis in rural Togo, and more specifically in the town of Dapaong. Method: This was a monocentric, retrospective, descriptive study conducted at the Dapaong regional hospital over 03 years from January 2019 to December 2021. Results: A total of 103 cases were collected, representing an annual frequency of 34.33 cases per year. The mean age of the patients was 45.69 ± 17.49 years. We reported a male predominance, with a male/female sex ratio of 2.03. We had high exposure to risk factors for cervicofacial cellulitis (92.23%), with HIV infection predominating. Anti-inflammatory drugs and traditional therapy concerned 43.68% and 48.54% of our sample respectively. The average consultation time was 16.17 ± 7.42 days. Pain (100%) and swelling (84.46%) were the clinical signs most frequently encountered. Involvement was predominantly hemifacial, with diffuse cellulitis predominating (56.31%). The maxillary molars (38.83%) were the main site of infection. Resuscitation and triple antibiotic therapy concerned 23.30% of patients, and surgery 59.22%. The in-hospital mortality rate for odontogenic cervicofacial cellulitis in our study was 11.65%. Conclusion: Although odontogenic cervicofacial cellulitis is uncommon in the town of Dapaong, it is associated with a delay in treatment and a high mortality rate.

Objectives: Compare recognized microscopic parameters, including variations in width, plaque‐like thickenings, intra‐epithelial microcysts, clefts, mucous, hob‐nail, ciliated and clear cells, between glandular odontogenic cyst (GOC) and GOC‐like cysts, investigate the extent of cyst circumference exhibiting these features, and inflammation. Materials and Methods: Archival records of cysts with histological features of GOC evaluated between 2000 and2020 were retrieved. Slides were revised, and the expression of features throughout the cyst wall was analyzed. Cysts with at least 5 features were classified as GOC, cysts with 3–4 features as GOC‐like. Results: The study included 74 cysts, 47 males M, 25 females (2 unknown gender), aged 19–81 years, 62 (83.8%) GOC, 12 (16.2%) GOC‐like. Mandible was involved in 44 (59.5%), maxilla in 30 (40.5%), 18 (25%) were associated with unerupted teeth. Cyst classified as GOC had significantly higher rates of all parameters investigated, (except ciliated and clear cells), than GOC‐like cysts (p ≤ 0.05). 26 (40.6%) cases showed GOC features in >50% of cyst circumference, 21 (32.8%) involved 25–50%, 17 (26.6%) <25%. More than 50% circumference involvement was highly and independently predictive for a diagnosis of GOC, <25% was highly and independently predictive for GOC‐like (p = 0.003). Hobnail cells (p = 0.008) and plaque‐like thickenings (p = 0.038) were significantly more frequent in inflamed cysts. Conclusion: Besides the number and type of histological features, GOC can be characterized by their distribution within the cyst circumference (focal Vs diffuse), and it may serve as a new diagnostic aid. It is suggested that GOC and GOC‐like may represent a single spectrum. [ABSTRACT FROM AUTHOR]

Tumors and cysts with odontogenic origin represent a family of lesions with specific histo-genetic and clinical characteristics. Among them, ameloblastomas are common benign neoplasms, predominantly detected in the anatomic areas of the jaws and also in the mandible and maxilla. Although they are characterized by a slow and stable growing pattern, a subset of them shows a tendency for local tissue invasiveness and partially increased recurrence rates after surgical excision. Furthermore, heat shock proteins (HSPs) are potentially implicated in ameloblastoma onset and progression. HSPs regulate the folding and refolding of proteins and are induced in response to oxidative stress. They are crucial members of the chaperone intracellular system and are categorized based on their molecular weight (i.e., HSP27, HSP60, HSP70, HSP90). In the current review, we describe HSPs origin and function, focusing on their deregulation mechanisms and impact predominantly on ameloblastomas and also on inflammatory and developmental odontogenic cystic lesions. [ABSTRACT FROM AUTHOR]

Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton. [ABSTRACT FROM AUTHOR]

Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon. [ABSTRACT FROM AUTHOR]

The aim of the current study was to identify the expression of P63 and its relation to odontogenic epithelial cell proliferation, severity of the inflammatory infiltrate and size of radicular cysts (RCs). In this retrospective cross-sectional study, 30 cases of paraffin-embedded RCs were randomly selected from the archive. P63 and Ki-67 expression was assessed by immunohistochemistry. Epithelial P63 expression was absent in four (13.3%), weak in 10 (33.3%), and moderate in 16 (53.3%) cases. In the connective tissue wall of RC, P63 expression was absent in two (6.7%) cases, weak in 24 (80.0%) cases, and moderate in four (13.3%) cases. Ki-67 was found to be weakly expressed in 12 (40.0%) cases, moderately expressed in 13 (43.3%), and strongly expressed in five (16.7%) cases. No correlation was found between Ki-67 expression in odontogenic epithelium and P63 expression in the odontogenic epithelium (rho = 0.110, p =.563) or fibrous capsule (rho = 0.160, p =.399). Nevertheless, we found a positive correlation between Ki-67 expression in the odontogenic epithelium and the size of the RC (rho = 0.450, p =.013). The inflammatory infiltrate was negatively correlated with P63 expression in the odontogenic epithelium (rho = −0.428, p =.018), and with the size of cysts (rho = −0.728, p <.001). There is a high expression of P63 throughout the odontogenic epithelium and connective tissue capsule of the RC. P63 expression in the odontogenic epithelium is negatively correlated with the degree of the inflammatory infiltrate but not with epithelial cell proliferation or the size of the cyst. [ABSTRACT FROM AUTHOR]

Odontogenic sarcomas are exceedingly rare and account for less than 5% of all Maxillofacial Sarcomas. It usually affects the younger population. The posterior mandible is the most commonly affected site. Radiographically, it appears as a large destructive radiolucent lesion with ill-defined margins. Histopathological diagnosis is usually difficult. Surgery is the mainstay treatment. The role of chemotherapy and radiation therapy is not clear. Here, we present a case study of a 30-year-old female patient diagnosed with odontogenic sarcoma that impinged on her airway. The treatment and postoperative course will be discussed in detail.

Resumen: Antecedentes: el odontólogo juega un papel fundamental en el diagnóstico y tratamiento del dolor orofacial, sobre todo en el dolor de origen pulpar o periodontal (odontogénico). En el caso del dolor clasificado habitualmente como crónico (no odontogénico), un elevado porcentaje de estudiantes de Odontología se sienten «en absoluto» o «algo» preparados para afrontar su diagnóstico y tratamiento. Objetivo: proponer una breve guía para diferenciar clínicamente el dolor odontogénico del dolor orofacial, que sea de utilidad tanto para el estudiante de Odontología como para el profesional. Material y método: se elaboró un vídeo educativo de apoyo a la docencia dentro de un proyecto de innovación docente de la Universidad de Valencia titulado «El dolor orofacial para estudiantes del grado de Odontología: dolor agudo frente a dolor crónico» (UV-SFPIE_PID-1640062. Núm. Registro: 64155). Se establecieron 11 características fundamentales del dolor odontogénico y otras 11 del no odontogénico, que pretenden servir de orientación para el diagnóstico en situaciones en las que el dolor no presenta las características habituales. Resultados: la proyección del vídeo tuvo una buena acogida por parte de los estudiantes, entendiéndolo como una herramienta atractiva de aprendizaje que favorece la motivación y la adquisición de responsabilidades. El 75,3% consideró que era «muy interesante», otorgando la máxima puntuación. Conclusión: con los datos disponibles actualmente en la literatura científica en relación a las características del dolor facial atípico, consideramos que la guía aportada en este proyecto puede ser de utilidad en el diagnóstico de estos procesos. Abstract: Background: Dentists play a fundamental role in the diagnosis and treatment of orofacial pain, especially in pain of pulp or periodontal (odontogenic) origin. In the case of pain usually classified as chronic (non-odontogenic), a high percentage of dental students feel “not at all” or “somewhat” prepared to carry out a diagnosis and treatment. Objective: To propose a brief guide to clinically differentiate odontogenic pain from orofacial pain, which is clinically useful for both dental students and professionals. Material and method: An educational video was developed to support teaching within a teaching innovation project at the University of Valencia entitled “Orofacial Pain for Dentistry Degree Students: Acute Pain Versus Chronic Pain” (UV-SFPIE_PID-1640062. Reference No.: 64155). Eleven fundamental characteristics of odontogenic pain and another 11 of non-odontogenic pain were established, which are intended to serve as guidelines for the diagnosis in situations in which the pain does not present the usual characteristics. Results: The video was well accepted among students and it was understood to be an attractive learning tool that enhances motivation and the acquisition of responsibilities. 75.3% considered it to be “very interesting”, giving it the highest score. Conclusion: According to the data currently available in the scientific literature regarding the characteristics of atypical facial pain, we believe that the guidelines provided in this project may be useful in the diagnosis of these processes.

BACKGROUND: Recent studies have revealed that Distal-less(Dlx) homeobox genes play an important role in the induction of osteogenic differentiation of odontogenic cells and can participate in the regulation of various osteogenic-related signaling pathways or affect the expression of key osteogenic transcription factors. The regulatory effects of Dlx genes may provide new ideas and methods for clinical periodontal tissue regeneration studies. OBJECTIVE: To review research progress on the role and mechanisms of the Dlx gene family in the osteogenic differentiation of odontogenic cells. METHODS: Literature retrieval was conducted in PubMed, CNKI, and WanFang databases. The search terms were “distal-less homeobox gene, distal-less homeobox, Dlx, Dlx gene, bone-formation, osteogenesis, bone formation, ossification, ossifications, osteoclastogenesis, osteoclastogeneses, endochondral ossification, dental,oral, odontogenic, dental stem cell” in English and Chinese, respectively. Studies of low quality and irrelevant to the topic of the article were excluded. Finally, the included 82 articles were read, analyzed and summarized. RESULTS AND CONCLUSION: (1) Homeobox genes are important genes that determine the growth and development of the body. Homeobox genes are composed of many families. Among them, the important osteogenic gene family is the Dlx gene family. The development of tooth germ is mainly related to two homeobox genes: MSX gene family and Dlx gene family. The latter plays an important role in the development of tooth germ and the differentiation of odontogenic cells. (2) The positive and negative feedback regulation of Dlx3 gene on BMP and Notch signaling pathway, and the osteogenic induction mechanism of Dlx3 gene overexpression on transcription factors zbtb16 and EGR1 are clarified. (3) Dlx2/3/5 can affect osteogenesis in dental follicle cells, which may be due to similar homologous domain external structure and chromosome localization. (4) Exploring the effects of of Dlx genes on dental tissues revealed that these complex molecular signaling and cell-cell ordering interactions involve the disturbance of the behavior of neural crest mesenchymal or its connective tissue matrix, resulting in many abnormalities of oral tooth morphology and maxillofacial bone. Therefore, all kinds of odontogenic transcription factors need to be strictly regulated in time and space and in their quantitative output. (5) Studies have confirmed the mechanism of Dlx gene family in the osteogenic differentiation of osteoblasts, chondroblasts and mesenchymal stem cells. With the continuous development of technology and in-depth research, the regulation and molecular signal mechanism of Dlx gene family on osteogenic differentiation of odontogenic cells will be further clarified. [ABSTRACT FROM AUTHOR]

Human dentin is a natural acellular matrix with excellent reported biocompatibility. The aim was to fabricate a novel dentin matrix material from human dentin and investigate its applicative potential for vital pulp therapy. Digested dentin matrix extract (DDME) was fabricated using controlled enzymatic digestion under acidic conditions. The surfaces and biocompatibility of DDME were then investigated, with its effects on the odontogenic differentiation of human dental pulp cells (hDPCs) also studied. The ability of DDME to induce mineralization was assessed in a nude mouse model. The performance of DDME as a pulp capping agent was evaluated in an in situ rat model. The molecular mechanism was verified by mRNA sequencing. A novel type of dentin matrix material with a uniform size of 8 μm was fabricated. DDME had a similar band compared with grinded dentin matrix, with a smaller size, and more uneven surface, as detected by Fourier-transform infrared spectrometer and X-ray photoelectron spectroscopy. DDME at low concentrations did not affect hDPC viability or proliferation, but enhanced runt-related transcription factor 2, dentin matrix acidic phosphoprotein 1, and COL1A1 (collagen type I alpha 1 chain) expression in hDPCs in vitro. DDME was superior to HA-TCP (hydroxyapatite-tricalcium phosphate) in dentin-like mineralized tissue formation after subcutaneous transplantation. In the rat model of pulpotomy, DDME showed visible curative effects. The underlying mechanism may be the inhibition of Hippo signaling following DDME treatment. DDME promoted Yes-associated protein (YAP) 1 nuclear influx, thereby enhancing the expression of DMP-1 (dentin matrix acidic phosphoprotein 1), which was reversed by YAP inhibitor treatment. Human DDME can be used as a biomaterial for dentin regeneration. The combined application of DDME and current pulp capping agents is a potential choice for vital pulp therapy. [ABSTRACT FROM AUTHOR]

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Introduction: WHO in 2005 included Odontogenic Keratocyst under odontogenic tumors and named it as Keratocystic Odontogenic Tumor because of its aggressive biologic behaviour. But this is not accepted by many researchers and it was removed from the WHO Odontogenic Tumor classification in 2017. Background: The reported case was radiographically mimicking residual cyst and histopathology confirmed the diagnosis of infected odontogenic keratocyst. Case Presentation: A 40 year old male patient reported with the chief complaint of broken restoration in relation to upper right back tooth region. Intraoral examination revealed missing mandibular first molar and a mild cortical expansion in the same area. Radiographic diagnosis was given as residual cyst. Management and prognosis: Surgical enucleation was performed and no recurrence was reported in 3 years of follow up. Odontogenic Keratocyst is usually asymptomatic initially but there is high tendency to recur after treatment. Knowledge of pathogenesis, thorough management and periodic follow up is mandatory. Conclusion: Histopathological examination is important to differentiate between odontogenic cysts of varying biological behaviour. [ABSTRACT FROM AUTHOR]

Infections of the deep spaces of the neck often present a true clinical challenge to a Head and Neck surgeon which may rapidly spread due to the various connections between the spaces resulting in morbidity and mortality. This study aims to obtain knowledge about various DNSI's and their predisposing factors.. It was a hospital based retrospective cross-sectional study done in Goa Medical College, India. A total of 300 patients who presented with DNSI's over the past 7 years were studied. Simple proportions and percentages were calculated and Chi-square test was used to study associations. A total of 300 patients were evaluated and male preponderance was seen. Most of the patients were seen belonging to the pediatric age group (26%). Infections of dental origin (45.67%) were the most common etiological factor associated with poor oral hygiene and tobacco chewing (12.67%). Major comorbidities were anemia (34%) and diabetes (19.3%) which were directly related to the complications. The most common complication was airway compromise (14.66%) which was treated by tracheostomy. DNSI should be treated like a medical as well as a surgical emergency which can be life-threatening especially in diabetics and elderly who are immunocompromised and need special attention. Odontogenic infections associated with poor oral hygiene and tobacco chewing could be prevented by educating the population about oral hygiene. [ABSTRACT FROM AUTHOR]

Ameloblastic carcinoma is a rare malignant neoplasm arising from the odontogenic epithelium. Ameloblastic carcinoma commonly occurs de novo affecting the posterior segments of the mandible. Presently, only less than 100 cases have been reported arising from the maxilla. We report a unique case of maxillary ameloblastic carcinoma in a 68-year-old male with a 5.6 cm positron emission tomography (PET) avid left maxillary sinus mass. The patient underwent a left maxillectomy which revealed hyperchromatic and pleomorphic tumor cells arranged in a nested and trabecular architecture. The tumor cells showed distinct peripheral palisading with reverse polarization. Areas of bone destruction, necrosis, lymphovascular and perineural invasions, as well as atypical mitoses, were identified. Immunohistochemically, the tumor cells were positive for keratin cocktail (AE1/AE3 and CAM 5.2), keratin 19, p40, and weakly positive for MDM2, while negative for calretinin. Molecular analysis revealed wild-type BRAF ; however, alterations in CDKN2A / B, MTAP, RB1, SMARCA4, STK11, FGF12, SETD2, and TP53 were present. This histopathologic and molecular profile supported the diagnosis of ameloblastic carcinoma. There has been no evidence of disease recurrence or metastasis eleven months after the initial diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Odontogenic cystic lesions requiring conservative management were treated with a novel technique of modified decompression and assessed. Aims and Objective: This study aimed to evaluate the resolution of the lesion, recurrence, and complications in patients treated with the novel modified decompression technique. Materials and Methods: The retrospective study included patients treated with the novel modified decompression technique between 2004 and 2022. The cystic lesions were packed with chlorhexidine acetate gauze dressing (Bactigras), and patients were prescribed a combination of Calcium, Vitamin C, and Vitamin D. Pack was changed periodically until a reduction of at least 80% in the volume of the lesion was achieved. Period of decompression, volume at each follow-up, and lesion size were recorded. In addition, inter-group significance co-relating the size and diagnosis of the lesions with the rate and duration of healing were derived by ANOVA test. Results: OKC, unicystic ameloblastoma, and dentigerous cysts were included, and the follow-up period ranged from one year to eighteen years. 25 cases (83.33%) showed full resolution, whereas five cases (16.17%) showed more than 80% resolution. The period of decompression and the rate of decompression was found to correlate with both the diagnosis and the size of the lesion. Conclusions: The modified decompression technique is superior to traditional decompression with a high rate of resolution of cystic lesions and no recurrence over a long follow-up period.

Objectives: Cysts seen in the jaws may be odontogenic or non-odontogenic, depending on the tissue of origin. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient. Although there are different methods to diagnose these lesions, histopathological examination of tissue biopsy of the lesion is accepted as the 'gold standard' in cases where the diagnosis is insufficient. Materials and Methods: Pathology results of 436 patients who applied to Zonguldak Bülent Ecevit University Faculty of Dentistry, Oral and Maxillofacial Radiology Clinic between 2016-2021 for any reason and underwent biopsy were retrospectively scanned using digital archives. While classifying the cyst, the criteria published by the World Health Organization (WHO) in 2017 were taken into account. Obtained results were recorded for statistical analysis. SPSS 22.0 Software Package Program (SPSS 22.0 Software Package Program, Inc. Chicago, IL, USA) was used as statistical software in the study. Results: Of the 436 patients included in the study, 250 (57.3%) were male and 186 (42.7%) were female. The ages of the patients ranged between 7 and 82 years, and the mean age of the patients was 35.5±15.8. As a result of the findings, it was determined that the most common cysts were radicular cysts (53.7%). Radicular cysts were most commonly located in the posterior mandible and anterior maxilla anatomically. Conclusions: In addition to clinical and radiological examination, histopathological examination of biopsy samples taken from tissues is of great importance in the correct diagnosis and treatment planning of jaw cysts.

Background Aims: Diseases of the oral cavity are heterogenous regarding their etiology, pathogenesis, histogenesis and clinical outcomes. The aim of this study was to examine the frequency of oral diseases encountered in our experience. Methods: The archives of pathology at Jordan University Hospital were retrospectively searched for oral cavity specimens from 2013–2020. Fisher’s exact test was performed to examine the statistical difference between the pathologic diagnosis and clinical variables. One-way ANOVA was used to analyze the differences in the mean of age between the different pathologic groups. Results: A total of four-hundred and forty-two cases were retrieved. There were 232 (52%) females and 210 (48%) males, ranging in age from 3–87 years (mean 43). Inflammatory and reactive diseases were the most common, constituting 147 (33%) of all specimens, followed by 139 (31%) benign neoplasms, 114 (26%) cysts, and 42 (10%) malignant diseases. Lichen planus was the most common inflammatory disease (26/147, 18%) in patients older than 40 (p=0.0039). Keratocysts predominated in children and adolescents more than adults (p=0.0015). Buccal mucosa represented the most frequent site for biopsy (76, 17%), followed by tongue and maxillary bone, respectively at 70 (16%) each. Conclusion: Inflammatory and benign neoplasms were the most common lesions in oral diseases. Oral malignancy appeared in low to intermediate frequency compared to previous reports. The study provides a general overview of the spectrum of oral pathology specimens and points to some novel epidemiologic findings that suggest further investigation. [ABSTRACT FROM AUTHOR]

Feline cystic oral lesions are uncommon and include odontogenic cysts and cystic odontogenic tumors. Accurate diagnosis requires close collaboration between the clinician's clinical and radiographic findings and the pathologist's histologic interpretations. The odontogenic cysts identified in this series include a periapical cyst, dentigerous cysts and a type of unclassified collateral cyst that appears to be a previously undefined, distinct entity in cats (UCC). Many of the cysts (52%) were unable to be classified due to insufficient diagnostic information, which often related to the associated tooth being unavailable for evaluation. Cystic odontogenic tumors included ameloblastomas, amyloid producing ameloblastomas (APA), and feline inductive odontogenic tumors (FIOT). The purpose of this case series was to assess correlations between clinical and radiographic findings, histopathologic interpretation and signalment to identify common characteristics and provide recommendations for clinicians and pathologists to optimize diagnostic efficiency and accuracy for cystic oral lesions in cats. [ABSTRACT FROM AUTHOR]