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Odontogenic keratocysts (OKCs) are locally aggressive cysts that exhibit typical histopathological features and have a propensity for recurrence. Though histological variations are observed in OKCs, hard tissue formation and metaplastic changes are rare, and the underlying pathogenesis is not well understood. This study aimed to characterize stromal calcifications and analyze their association with odontogenic components in non-syndromic and syndrome-associated cases of OKCs. We analyzed 153 cases of OKCs from healthcare institutes in India and Japan. The epithelial and stromal features were evaluated, and the relationship of calcifications with odontogenic rests was determined. Immunohistochemistry for cytokeratin-19 and special stains including Masson Trichrome and Van Gieson, were used for identification of odontogenic rests and calcifications respectively. Stromal calcifications were observed in 29.41% OKCs. The calcification patterns included irregular dystrophic, dentinoid with linear or calcospherite-type mineralization, and psammoma calcifications. Psammoma and dentinoid calcifications were found in the proximity of cytokeratin-19-positive odontogenic rests or satellite cysts, whereas majority cases with dystrophic calcifications did not exhibit co-localization with stromal odontogenic components. Distinct patterns of calcifications were observed in OKCs. Calcifications found in proximity of the odontogenic rests were possibly indicative of an inductive or host-mediated response. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Key points Plain language summary Odontogenic cysts of the jaws are pathologies that require timely recognition and management. The initial diagnosis is based on clinical and radiographic appearance and dental history. A variety of surgical treatments are used for odontogenic keratocyst (OKC) depending on the clinical and radiographic presentation. The aim of this report and literature review is to highlight methods to treat OKC combined with guided tissue regeneration (GTR).Two cases with similar clinical presentations are included. Case 1 was a 60‐year‐old healthy Caucasian female who presented with jaw expansion around teeth #’s 21 and 22. Initial exam revealed clinical gingival health on an intact periodontium. The patient presented with enlarged gingival tissue between teeth #’s 21 and 22 measuring 9 × 12 mm and vital teeth without root displacement radiographically. Case 2 had a similar clinical and radiographic presentation located between teeth #’s 5–6.Case 1 treatment included excisional biopsy with complete enucleation of the cystic lesion. Thereafter, GTR was performed using allograft internally then covered with a xenograft externally, resorbable collagen membrane (RCM), and primary closure. Case 2 was managed with excisional biopsy with lesion enucleation, GTR with allogenic bone graft, enamel matrix derivative and RCM, and primary closure.OKC enucleation combined with GTR using mineralized allograft, enamel matrix derivative, and collagen membrane or a layering technique of allograft internally and xenograft externally covered by a collagen membrane showed proper regeneration with stable periodontium at 6–36 months. Guided tissue regeneration is an acceptable treatment for management of OKC. Complete enucleation of an OKC lesion is important to reduce recurrence. The use of allograft with xenograft or allograft with enamel matrix derivative and RCM can provide proper bone fill after OKC removal. Guided tissue regeneration is an acceptable treatment for management of OKC.Complete enucleation of an OKC lesion is important to reduce recurrence.The use of allograft with xenograft or allograft with enamel matrix derivative and RCM can provide proper bone fill after OKC removal.Odontogenic cysts are growths that can form in the jaw or soft tissues around the teeth. If not treated, they can grow larger, damage the bone, and even push teeth out of place. To prevent this, it’s important to diagnose and remove them early. The most common way to treat these cysts is through a surgical method called enucleation, where the cyst is carefully removed. In these two cases, enucleation was used along with guided tissue regeneration, a technique to help the bone and tissue heal better after surgery. In the first case, a bone graft (made from human and animal bone) and a special material called a resorbable collagen membrane were used to protect and support the healing area. In the second case, a mineralized bone graft along with a substance that helps repair tissues called an enamel matrix derivative, and the same collagen membrane were used. Both patients healed well, and over the next 6 to 36 months, their bone and tissues around the teeth regenerated properly. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of oral and maxillofacial lesions among patients at King Abdulaziz University from January 2016 to December 2022. Methods: This cross-sectional observational study included patients diagnosed with oral and maxillofacial intra-bony lesions based on radiological findings and confirmed by histopathological examination. The lesions were classified according to the fourth edition of the World Health Organization Classification of Head and Neck Tumors. Results: This study included 237 patients with a mean age of 31.53 ± 14.97 years, of which 45.1% were female. Most patients (46.7%) had mandibular lesions, followed by maxillary lesions (35.9%). Only 2.95% of the tumors were malignant. Odontogenic cysts were the most prevalent (65.40%), with radicular cysts and keratocytes being the most common types. The most prevalent tumor types were odontoma and ameloblastoma. The most malignant lesion was multiple myeloma. Conclusions: Our findings reveal that mandibular cystic lesions predominated, and emphasize the low incidence of malignancy in the study population. They provide valuable insights into the oral and maxillofacial lesion landscape at a high-volume tertiary care center. [ABSTRACT FROM AUTHOR]

Objective: To characterize the clinical, diagnostic imaging, and histologic features with description of treatment outcome of periapical cysts in dogs. Animals: Ten client-owned dogs diagnosed with periapical cysts biopsied between July 1, 2000 and June 30, 2020. Procedures: Medical records of the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania were retrospectively searched to identify dogs that had surgical biopsy specimens of cavitary lesions diagnosed as odontogenic cysts and that met additional inclusion criteria. Complete medical records were reviewed. Results: Range age and body weight of affected dogs were 2.5–12.1 years and 4.3–38.4 kg (9.5–84.7 lb), respectively. All periapical cysts were affecting the incisive bone and/or the maxilla. Nine dogs presented with a fluctuant swelling of the oral mucosa and gingiva; one dog without clinical swelling presented with a history of difficulty breathing. All cysts originated from a non-vital tooth with a structural defect (wear or fracture without pulp exposure) and/or intrinsic staining. Extraction of the associated non-vital teeth, enucleation of the cysts, and curettage of the surgical sites resulted in resolution of the clinical signs. Conclusions and clinical relevance: The findings indicate that periapical cysts are associated with a non-vital tooth without pulp exposure. Complete evaluation of the clinical, diagnostic imaging, and histologic features of the lesion in affected dogs is necessary to differentiate periapical cysts from other odontogenic cysts and tumors. [ABSTRACT FROM AUTHOR]

This study reports a rare case of a dentigerous cyst in a malformed tooth in the mandible of a 5-year-old Japanese boy. Panoramic radiography revealed a cystic lesion with hard tissues inside. The patient underwent surgery under general anesthesia. The histopathological diagnosis was dentigerous cyst associated with a malformed tooth. [ABSTRACT FROM AUTHOR]

Odontogenic Keratocysts (OKCs) are known for their aggressive behavior along with rapid expansion. Subepithelial hyalinization (SEH) is one of the causes of recurrence. The ability to predict this biological behavior histologically may help medical experts choose the best course of action. To investigate the aggressiveness of odontogenic keratocyst caused by SEH and its recurrence tendency in the north Indian population, this study will link differential staining methods with immunohistochemistry biomarkers that can be used in routine investigative procedures. Consequently, the evaluation and grading of SEH were established by measuring from the basement membrane to the extent of connective tissue. The levels were correlated to Ki67, Alcian blue, and O -safranine for validation. Forty OKCs were examined for the histological investigation of SEH using the immunohistochemical marker Ki67 and differential staining with O-safranine and Alcian Blue. The histological trait of separation of epithelium from the connective tissue interface due to SEH was noted. SEH-positive cases that were evaluated with Ki67, had increased proliferative activity. The differential staining techniques were validated with Ki67, cross-tabulations in SPSS, and kappa statistic value was given to analyze the results. Spearman's rank correlation was done between Ki67 vs Alcian blue and O-Safranine. A p value of less than < 0.05 was considered statistically significant. In SEH-positive cases, a higher proliferative index was observed. Additionally, histological metrics were statistically significantly higher in SEH-positive cases. Consequently, SEH is a reliable histopathological indicator in OKC for predicting recurrence. The presence of SEH indicates that OKCs are more likely to recur. [ABSTRACT FROM AUTHOR]

Glandular odontogenic cysts(GOC) are among the rarest odontogenic cysts defined by the presence of glandular epithelium in the epithelial lining posing some diagnostic difficulties. GOC associated with ameloblastoma is extremely rare with only 5 cases reported. This report deals with this rare occurrence of GOC along with unicystic ameloblastoma. [ABSTRACT FROM AUTHOR]

Background and Clinical Significance: Among the odontogenic tumors, ameloblastoma is one of the most notorious, although it remains relatively rare, accounting for approximately one percent of all oral tumors. This neoplasm, derived from odontogenic epithelium, may arise from the developing enamel organ, epithelial cell rests of dental lamina, epithelial lining of odontogenic cysts, and basal cells of oral epithelium. This is a case presentation of a mural unicystic ameloblastoma, the most aggressive subtype and the one with the highest chance of recurrence. Case Presentation: A patient was referred by his dentist for root canal treatment at the Emergency Dental Clinic of Boston University. The patient complained of mandibular numbness. A panoramic radiograph was acquired, revealing a radiolucent lesion in the right mandible. Clinical examination detected a soft swelling perforating the buccal cortex in the area of #27–#30. A Cone-Beam CT (CBCT) was acquired in the Oral and Maxillofacial Radiology Clinic revealing a well-defined, partially corticated entity in the periapical area of teeth #27 through #30, with evidence of scalloping borders. The internal structure was unilocular and uniformly low-density. The entity caused interruption of the lamina dura of the associated teeth and inferior displacement of the inferior alveolar canal. Differential diagnoses included unicystic ameloblastoma (UA) and central giant cell granuloma as a second less likely diagnosis. An incisional biopsy was performed for further evaluation. Biopsy confirmed UA with mural involvement. Conclusions: UAs typically exhibit less aggressive behavior. However, cases like this one, where mural involvement is noted and no associated impaction is detected, underline the possibility of variable radiographic presentation and the significance of a multidisciplinary approach in correct diagnosis and treatment. Histological subtyping is crucial for guiding treatment. [ABSTRACT FROM AUTHOR]

Cherubism is a skeletal dysplasia limited to the maxilla and mandible, affecting children and adolescents. A 13-year-old male patient was referred to the Oxford University Hospitals Oral and Maxillofacial Surgery Department, by his orthodontist, following an incidental finding of bilateral multilocular radiolucencies of the mandible. This led to multiple clinical, radiographic, histopathological, genetic and biochemical investigations involving various medical and dental specialities. The multidisciplinary approach led to the successful management of this patient. Even though cherubism is self-limiting, long-term radiographic and clinical surveillance is required. CPD/Clinical Relevance: Dentists should understand the clinico-radiographic presentation of cherubism and have an awareness of how the possible functional and aesthetic complications associated with the condition are managed. [ABSTRACT FROM AUTHOR]

Background: Odontogenic keratocyst (OKC) is considered an odontogenic cyst, with the unique clinical characteristics of this entity being local destruction, aggressive behavior, a high recurrence rate, specific histopathologic features, and the tendency for multiple lesions when associated with syndromes. Odontogenic keratocyst accounts for 12-14% of all cysts in the jaws. Purpose: The aim of this case report is to present an unusual odontogenic keratocyst associated with impacted maxillary central incisor, case management of anterior maxilla odontogenic keratocyst involving an adjacent tooth, and its postoperative six-month follow-up. Case: A 13-yearold female patient was referred to the Universitas Airlangga Hospital with a complaint that her upper front teeth had not erupted. The parents revealed that the patient had suffered trauma from falling down the stairs at the age of four, i.e., eight years ago. Case Management: The cyst was enucleated together with the associated permanent upper right central incisor, retained deciduous upper right central incisor, the permanent upper right lateral incisor, and upper right canine. Post surgical treatment, the patient used a partial denture to increase her self-confidence. Conclusion: Enucleation of the cyst with extraction of the permanent teeth should be performed to avoid recurrence of the OKC. Periodic radiographic evaluation is required with long-term follow-up. [ABSTRACT FROM AUTHOR]

Objective: Odontogenic cyst surgeries are commonly performed procedures, but they may present challenges with wound healing during the postoperative period. However, insufficient research exists on this topic. This study aimed to determine the risk factors linked to incomplete wound healing after removing a benign odontogenic cyst in the maxilla. Methods: This study involved patients who underwent transoral Caldwell-Luc surgery and endoscopic endonasal surgery to treat benign odontogenic cysts located in the maxilla between 2014 and 2024 at the University Hospital. Investigated risk factors included demographic factors (gender, age), medical history (comorbidities, smoking habits), cyst size, and serum inflammatory markers like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and systemic immune-inflammation index (SII). After 3 months of the postoperative period, patients were classified as either having incomplete or optimal healing. Results: Smoking affected incomplete wound healing (χ² = 6.09, P = .0136). Large cysts are associated with the development of poor healing (odds ratio (OR) = 7.5, 95% confidence interval (CI) 1.20 to 47.05, P=.0473). Also, high NLR and SII levels were found to be essential factors in suboptimal wound healing (OR=4.667, 95% CI 0.42 to 52.12, P=.294; OR = 9.1, 95% CI 1.39 to 59.62, P=.037, respectively). Conclusion: This study emphasized the significance of assessing cyst size, smoking status, and inflammatory metrics like serum NLR and SII before benign odontogenic cyst surgeries. Neutrophil-to-lymphocyte ratio and SII, easily obtained from routine serum tests, may serve as cost-effective prognostic values for wound healing, replacing expensive immunological biomarkers. [ABSTRACT FROM AUTHOR]

Purpose: This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023. Methods: Histopathological records from the Oral Pathology Centre, University of Otago (2008–2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS. Results: Of the 34,225 biopsies over the 15-year period, 1.8% were identified as OTs, COC and OKCs and accounted for 47%, 1.5% and 51.5% respectively. The most prevalent OT types were odontoma (43.7%), ameloblastoma (27%) and cemento-ossifying fibroma (7.5%). Malignant OT, ameloblastic carcinoma, constituted 1.4% of OT. The average age at diagnosis for OKC, COC and OT patients were 48.2 ± 20.9, 33.7 ± 23.3 and 28.9 ± 19.3 years. Overall, male and mandibular site predilections were observed. Recurrence of OKC and ameloblastoma occurred in 15.2% and 13.7% of patients. The time for recurrence for OKC and Ameloblastoma were 61.7 ± 56.5 months and 122 ± 152 months respectively. Conclusion: The demographic features and range of OT, COC and OKC in New Zealand align with those of other western countries. The study also confirms need for long term follow up for patient with OKC and ameloblastoma. [ABSTRACT FROM AUTHOR]

Background: This research aimed to investigate the concordance between clinical impressions and histopathologic diagnoses made by clinicians and artificial intelligence tools for odontogenic keratocyst (OKC) and Odontogenic tumours (OT) in a New Zealand population from 2008 to 2023. Methods: Histopathological records from the Oral Pathology Centre, University of Otago (2008–2023) were examined to identify OKCs and OT. Specimen referral details, histopathologic reports, and clinician differential diagnoses, as well as those provided by ORAD and Chat-GPT4, were documented. Data were analyzed using SPSS, and concordance between provisional and histopathologic diagnoses was ascertained. Results: Of the 34,225 biopsies, 302 and 321 samples were identified as OTs and OKCs. Concordance rates were 43.2% for clinicians, 45.6% for ORAD, and 41.4% for Chat-GPT4. Corresponding Kappa value against histological diagnosis were 0.23, 0.13 and 0.14. Surgeons achieved a higher concordance rate (47.7%) compared to non-surgeons (29.82%). Odds ratio of having concordant diagnosis using Chat-GPT4 and ORAD were between 1.4 and 2.8 (p < 0.05). ROC-AUC and PR-AUC were similar between the groups (Clinician 0.62/0.42, ORAD 0.58/0.28, Char-GPT4 0.63/0.37) for ameloblastoma and for OKC (Clinician 0.64/0.78, ORAD 0.66/0.77, Char-GPT4 0.60/0.71). Conclusion: Clinicians with surgical training achieved higher concordance rate when it comes to OT and OKC. Chat-GPT4 and Bayesian approach (ORAD) have shown potential in enhancing diagnostic capabilities. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions Odontogenic keratocyst (OKC) is a partial manifestation of Gorlin syndrome (GS), resulting from the abnormal activation of the hedgehog signaling pathway. OKC predominantly occurs in young adults and is mostly asymptomatic at the time of initial diagnosis. As OKC is asymptomatic, GS can be challenging to diagnose in certain instances. In this study, we attempted to identify asymptomatic GS from sporadic OKC cases using a previously developed gene panel for GS.Genomic DNA was extracted from patient samples. These DNA samples were analyzed using the AmpliSeq Custom DNA Panel (Illumina), which was specifically designed to target four previously established genes (PTCH1, PTCH2, SMO, and SUFU). Mutations from patients were predicted using tools, such as MutationTaster, CADD, and Polyphen‐2.Thirty‐one patients with OKC were included: 22 sporadic, 9 syndromic, 14 cases with dentigerous cysts, and 3 patients with orthokeratinized odontogenic cysts. One patient with sporadic OKC carried 50% genetic mutation in the cyst and blood, indicative of GS. PTCH1 mutations were found in one of the 14 patients with dentigerous cysts, 3 of the 17 first‐time sporadic cases, and all four recurrent cases. Resected OKC tissues revealed a PTCH1 mutation.We found one patient with GS from those diagnosed with sporadic OKC. Our findings suggest that PTCH1 mutations are associated with postoperative recurrence of OKC, implying that hedgehog‐related gene variations may contribute to jaw cyst development and improve the prognosis of OKC. [ABSTRACT FROM AUTHOR]

The root canal systems of maxillary first molar (MFM) and maxillary second molar (MSM) variations represent a clinical challenge for endodontists, especially the prevalence of fused C-shaped roots. Having a thorough knowledge of root canal configuration is an extremely important point for a successful root canal treatment to avoid missing extra canals. The aim of this article was to present 2 cases of maxillary molar with an unusual C-shaped configuration diagnosed during root canal retreatment/treatment and conduct a literature review of the MFM and MSM anatomy. Case 1 reports that three separate palatal root canals fused into a C-shaped configuration in the MFM, which with an enamel pearl in the furcation, was classified as Type D and first reported in MFM. Case 2 reflects the fusion of all three buccal canals of the MSM into a C-shaped configuration that finally formed an apical foramen with a supernumerary tooth, and the configuration was Type B. Evaluation at an 18-month and a 9-month recall revealed that two patients were symptom-free after the conduct of a non-surgical retreatment/treatment, and the X-ray revealed normal periapical tissue. In addition, the thickness of the Schneiderian membrane due to odontogenic maxillary sinusitis returns to normal after an effective retreatment in case 1. These reports serve to remind endodontists of the importance and complexity of anatomical variations, which should always be considered when formulating an effective root canal treatment plan. The combined use of cone-beam computerized tomography (CBCT) and a dental operating microscope (DOM) will be profitable to locate and identify extra canals when a periapical radiograph shows signs of an unusual canal morphology. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyse the clinical characteristics of different types of odontogenic jawbone cysts (OJCs) and to provide a theoretical basis for prevention and clinical treatment. Methods: Data from 1,038 patients with OJCs were collected, and relevant information, such as sex, age, clinical symptoms and signs, imaging data, number of lesions, lesion location, pathological diagnosis, clinical treatment and prognosis, was statistically analysed. Results: According to the World Health Organization (WHO) classification of OJCs in 2022, the highest incidence rate was observed for radicular cysts (RCs), accounting for 58.96% of the total number of cases, followed by dentigerous cysts (DCs), accounting for approximately 23.22% of cases. lateral periodontal cysts (LPCs) and calcifying odontogenic cysts (COCs) comprised the lowest number of cases. The age distribution of patients was between 4 and 89 years, and the high incidence age group was youth and middle age, accounting for 66.67% of the total number of cases. The male-to-female ratio of patients was 1.51:1, and there was a statistically significant difference between the sexes(p < 0.05).In terms of the site of incidence, odontogenic keratocysts (OKCs) were prevalent in the mandibular molar region. In addition, mandibular ramus, inflammatory collateral cysts (ICCs) and dentigerous cysts (DCs) were more common in the mandibular third molar, and radicular cysts (RCs) and calcifying odontogenic cysts (COCs) were prevalent in the maxillary anterior region. On imaging, 955 (92.0%) lesions were solitary, and 83 (8.0%) were multiple. The treatment included four types of surgery, including simple curettage, marsupialization, marsupialization followed by secondary curettage, and partial resection of the jaw, and a total of 921 patients were followed up, with a recurrence rate of 2.82%. Conclusions: OJCs are more common in males than in females, and a statistically significant difference is observed in the most prevalent types of cysts occurring at different ages and in various regions of the jawbone (p < 0.05). Early diagnosis should be made with the help of X-rays, age, location, and clinical symptoms. In addition, appropriate treatment methods should be selected, and long-term follow-up observation is needed. [ABSTRACT FROM AUTHOR]

Background and Objectives: Odontogenic infections (OIs) can lead to severe complications, especially in elderly patients due to age-related physiological changes and comorbidities. This study aims to evaluate the predictive accuracy of inflammatory scores—APACHE II, CURB-65, SOFA, and NEWS2—in determining the severity of odontogenic infections among elderly patients (>70 years) compared to younger patients (<70 years). Materials and Methods: A retrospective cohort study was conducted on patients diagnosed with an OI at the Maxillofacial Surgery Department between January 2018 and January 2024. Patients were divided into two groups: elderly patients (>70 years, n = 49) and younger patients (<70 years, n = 64). The Symptom Severity score (SS) of odontogenic infections was calculated for all patients. Inflammatory scores—APACHE II, CURB-65, SOFA, and NEWS2—were assessed at admission and correlated with infection severity. Additional subgroup analyses were performed based on comorbidities and infection sites. Results: Elderly patients exhibited significantly higher SS scores (mean 12.47 ± 2.93) compared to younger patients (mean 7.82 ± 2.17, p < 0.001). APACHE II, CURB-65, SOFA and NEWS2 scores were significantly elevated in the elderly group (all p < 0.001). The SOFA score demonstrated the highest predictive accuracy for severe OIs in elderly patients, with an area under the curve (AUC) of 0.89 (95% CI: 0.82–0.95). Subgroup analyses revealed that comorbidities such as diabetes mellitus and cardiovascular disease significantly influenced infection severity (p < 0.05). Conclusions: Inflammatory scores, particularly SOFA, are effective in predicting the severity of odontogenic infections in elderly patients. The integration of these scores into clinical practice may enhance early identification of high-risk patients and improve management strategies. [ABSTRACT FROM AUTHOR]

Abstract Background This study aims to analyse the clinical characteristics of different types of odontogenic jawbone cysts (OJCs) and to provide a theoretical basis for prevention and clinical treatment. Methods Data from 1,038 patients with OJCs were collected, and relevant information, such as sex, age, clinical symptoms and signs, imaging data, number of lesions, lesion location, pathological diagnosis, clinical treatment and prognosis, was statistically analysed. Results According to the World Health Organization (WHO) classification of OJCs in 2022, the highest incidence rate was observed for radicular cysts (RCs), accounting for 58.96% of the total number of cases, followed by dentigerous cysts (DCs), accounting for approximately 23.22% of cases. lateral periodontal cysts (LPCs) and calcifying odontogenic cysts (COCs) comprised the lowest number of cases. The age distribution of patients was between 4 and 89 years, and the high incidence age group was youth and middle age, accounting for 66.67% of the total number of cases. The male-to-female ratio of patients was 1.51:1, and there was a statistically significant difference between the sexes(p

Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized by islands of ameloblastoma-like epithelial cells that resemble the enamel organ, the presence of ghost cells, and dentinoid material. This article reports a rare case of dentinogenic ghost cell tumor as sociated with an odontoma in an adult patient, with a review of the literature. To the best of the authors' knowledge, there have only been four case reports of DGCT associated with odontoma, all of which occurred in children and adults younger than 30 years old. [ABSTRACT FROM AUTHOR]

Abstract Background Podoplanin (PDPN) is a transmembrane glycoprotein implicated in the pathogenesis of odontogenic lesions (OL). It is localized at the membrane and cytoplasmic level, and its interaction with other proteins could trigger cell proliferation, invasion and migration. The main objective of this systematic review is to explore the immunoexpression pattern of podoplanin in OL. In addition, as secondary objectives, we aimed to compare the immunostaining intensity of PDPN in OL, to analyze its interaction networks by bioinformatic analysis and to highlight its importance as a potential diagnostic marker useful in the pathogenesis of OL. Methods The protocol was developed following PRISMA and Cochrane guidelines. The digital search was performed in the databases: PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science and Google Schoolar from August 15, 2010 to June 15, 2023. We included cross-sectional and cohort studies that will analyze the pattern of PDPN immunoexpression in OL. Two investigators independently searched for eligible articles, selected titles and abstracts, analyzed full text, conducted data collection, and performed assessment of study quality and risk of bias. In addition, part of the results were summarized through a random-effects meta-analysis. STRING database was used for protein-protein interaction analysis. Results Twenty-nine relevant studies were included. The ages of the subjects ranged from 2 to 89 years, with a mean age of 33.41 years. Twenty-two point two percent were female, 21.4% were male, and in 56.4% the gender of the participants was not specified. A total of 1,337 OL samples were analyzed for PDPN immunoexpression pattern. Ninety-four (7.03%) were dental follicles and germs, 715 (53.47%) were odontogenic cysts, and 528 (39.49%) were odontogenic tumors. Meta-analysis indicated that the immunostaining intensity was significantly stronger in odontogenic keratocysts compared to dentigerous cysts (SMD=3.3(CI=1.85-4.82, p=0.000*). Furthermore, bioinformatic analysis revealed that PECAM-1, TNFRF10B, MSN, EZR and RDX interact directly with PDPN and their expression in OL was demonstrated. Conclusions The results of the present systematic review support the unique immunoexpression of PDPN as a potential useful diagnostic marker in the pathogenesis of OL.

Background: POT is a relatively newly described benign odontogenic tumor with very few cases registered to date. We present the 1st case of Primordial odontogenic tumor (POT) from Sub-Saharan Africa with unique clinicopathological features; also, this is the first case to report POT's existence as a Hybrid Odontogenic lesion (HOL), with a pertinent review of the literature. Case presentation: This was a 17-year-old patient who presented with slow-growing, painless posterior mandibular swelling. The imaging revealed a well-defined, unilocular, expansile, lytic lesion with internal calcific foci surrounding an impacted #36, indicating a calcifying odontogenic cyst. The incisional biopsy revealed the presence of POT. The tumor was excised along with the involved tooth. Conclusion: POT is predominantly a non-aggressive and mostly affects the pediatric population. Hence, clinicians must be updated on all the aspects of this tumor to diagnose it appropriately and avoid any undue over—or under-treatment. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the trabeculation increase of treated mandibular cysts. Material and method: The study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization (n = 29) and enucleation (n = 30). Four groups in cyst types: dentigerous cyst (n = 21), keratocyst (n = 19), radicular cyst (n = 15) and residual cyst (n = 4). Cyst size was divided into two categories: smaller than 5.5 cm (n = 31) and larger than 5.5 cm (n = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month. Result: At the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time. Conclusions: FA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types. Clinical trial number: Clinical trial number: Not applicable [ABSTRACT FROM AUTHOR]

ABSTRACT The acetylation of histones H2A on lysine 5 (H2AacK5) and H3 on lysine 27 (H3AcK27) modulate several cellular mechanisms through the p300 enzyme in pathological lesions; however, their role in odontogenic lesions has not been addressed. This study aims to evaluate the immunoexpression of p300, H2AacK5, and H3AcK27 in samples of ameloblastoma (AMB) (n = 30), odontogenic keratocyst (OK) (n = 15), adenomatoid odontogenic tumor (AOT) (n = 10), odontogenic fibroma (OF) (n = 8), calcifying odontogenic cyst (COC) (n = 8), odontogenic myxoma (MIX) (n = 10), and ameloblastic fibroma (AF) (n = 06). The percentage of p300‐positive cells was higher in AOT and decreased in COC, OK, AMB, AF, OF, and MIX. H2AacK5‐positive cells were higher in AF and decreased in AOT, COC, OK, OF, AMB, and MIX, whereas H3acK27‐positive cells were higher in AOT and decreased in COC, OK, AF, OF, AMB, and MIX. The expression of these proteins was higher in nonaggressive lesions in comparison to aggressive lesions. There was a positive correlation between p300 and H2AacK5, and H3acK27 in AMB, MIX, and OF, whereas there was a positive correlation between p300 and H2AacK5 in AOT and COC. The histone acetylation may be involved in the biological behavior of these lesions, which could be used to improve their diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Dentigerous cysts (DCs) are among the most frequently odontogenic cysts in young and middle-aged individuals. Marsupialization and enucleation are the main treatment options in clinical practice. However, there are few reports on preserving molars severely involved by the cyst. Case presentation: A 35-year-old male patient with a large odontogenic cyst that was successfully treated using a multidisciplinary approach. The patient's chief complaint was discomfort during mastication in the lower left molar region for a month. Clinical examination revealed that teeth 36 and 37 were intact without pain upon percussion, while tooth 38 was unerupted. The radiology examination illustrated a typical well-defined oval radiolucent lesion surrounding the crown of unerupted tooth 38, extending to the distal root of tooth 37. The treatment was divided into two parts: removal of the cyst and the impacted third molar, followed by filling with collagen bone particles; and preserving the tooth 37 via hemisection, root canal treatment and crown restoration. Pathological examination indicated a dentigerous cyst. After 18 months of treatment, the bone defect completely recovered and tooth 37 functioned well following the hemisection. Conclusions: Hemisection effectively preserves the cyst-associated molars and maintains oral function. This article underscores the significance of collaboration among various departments in the treatment of odontogenic cysts, ultimately aiming to achieve minimally invasive and functional surgery. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions The epidemiology of cysts and odontogenic tumors is important for differential diagnosis and treatment strategies. We aimed to describe the epidemiological features of cysts and odontogenic tumors in the Chilean population using the current WHO classification.We reviewed 22,914 biopsy requests received between January 1984 and September 2023 at the oral pathology department, School of Dentistry, Universidad Mayor, Santiago, Chile. Patients diagnosed with cysts of the jaws and odontogenic tumors were selected and information regarding age, sex, and location was recorded.4226 (18.4%) were cysts, and 551 (2.4%) were odontogenic tumors, ranging from 2 to 97 years old. Males represented 54.4% and females 45.7% of the total sample. The most prevalent cysts were radicular cysts (58.6%), dentigerous cysts (17.9%), and odontogenic keratocysts (13.3%). The most prevalent odontogenic tumors were odontomas (40.1%) and conventional ameloblastoma (17.6%).Our study was the first retrospective analysis to determine the epidemiological features of both cysts and odontogenic tumors together, based on the 2022 WHO classification. This is relevant as it offers a potential basis for comprehensive comparisons of the epidemiological features of these entities, which could contribute to an accurate differential diagnosis, therefore, leading to more effective therapeutic interventions. [ABSTRACT FROM AUTHOR]

Central mucoepidermoid carcinoma is a relatively rare salivary gland tumour of the jawbone. Glandular odontogenic cyst is another unique odontogenic developmental cyst characterised by glandular differentiation. Both entities share several histological characteristics, and a pre-existing Glandular odontogenic cyst can evolve into Central mucoepidermoid carcinoma. Case 1: A 56-year-old male presented with chief complaint of swelling in lower left facial region since 1 year. Histopathology revealed multicystic compartments resembling mucoepidermoid carcinoma, but strong positive expression of Cytokeratin 13 upon immunohistochemistry helped us in rendering the final diagnosis as Glandular odontogenic cyst Case 2: A 34-year-old female presented with a lesion on right side of face. Histologically, the biopsy specimen revealed both typical findings of a Glandular odontogenic cyst component and a recognizable component of Mucoepidermoid carcinoma. The results from cytokeratin profiling demonstrated that, while both Mucoepidermoid carcinoma and Glandular odontogenic cyst expressed Cyokeratins 7, 18, and 19. Cytokeratin 13 was interestingly exclusively expressed in Glandular odontogenic cyst. Present case findings showed that central mucoepidermoid carcinoma and Glandular odontogenic cyst may be part of the same disease spectrum. However, because the expression profile of Cytokeratin13 in mucoepidermoid carcinoma and Glandular odontogenic cyst was so diverse, it can be used to differentiate both. [ABSTRACT FROM AUTHOR]

Objectives: Ameloblastoma (AM), a locally aggressive tumor with extensive growth capacity, causes significant damage to the jaw and affects facial appearance. Although the high prevalence of BRAF V600E mutation in AM is known, its specific impacts on patients with AM remain unclear. Thus, the present study investigated the role of BRAF V600E mutation, thereby focusing on its impact on AM invasion and growth. Materials and Methods: Immunohistochemical analysis was used to compare BRAF V600E, MMP2, MMP9, and Ki‐67 expressions in AM (n = 49), normal oral mucosa (NOM) (n = 10), and odontogenic keratocyst (OKC) (n = 15) tissues. AM was further classified according to the presence or absence of BRAF V600E. The relationship between BRAF V600E and invasion as well as growth was evaluated. In addition, correlation analysis was performed using immunohistochemistry and confirmed via double‐labeling immunofluorescence. Finally, comparative analyses using mass spectrometry, immunohistochemistry, and immunofluorescence were performed to explore and identify underlying mechanisms. Results: AM exhibited a higher incidence of BRAF V600E mutation than NOM and OKC. BRAF V600E expression was positively correlated with the invasion‐associated proteins MMP2 and MMP9 and the growth‐related protein Ki‐67. Proteomic data revealed that BRAF V600E primarily activates the MAPK signaling pathway in AM, particularly driving the phosphorylation of extracellular signal‐regulated kinase 1/2 (ERK1/2). Conclusions: In summary, the findings suggested that the BRAF V600E mutation enhances the invasion and growth abilities of AM via the MAPK/ERK signaling pathway. Thus, targeting BRAF V600E or the MAPK/ERK pathway may be a potential AM therapy. [ABSTRACT FROM AUTHOR]

Objective: To analyze the immunohistochemical expression of YAP and its correlation with markers involved in cell proliferation and apoptosis in benign epithelial odontogenic lesions. Study Design: The sample consisted of 95 cases of odontogenic lesions (25 dentigerous cysts, 30 non‐syndromic odontogenic keratocysts, 30 conventional ameloblastomas, and 10 unicystic ameloblastomas) and 10 dental follicles used as normal odontogenic tissue. The histological sections were submitted to immunohistochemistry with YAP, cyclin D1, Ki‐67, and Bcl‐2 antibodies. Immunoexpression was analyzed qualitatively and quantitatively using an adapted method. The collected data were analyzed descriptively and statistically (p ≤ 0.05). Results: The highest YAP expression was observed in odontogenic keratocysts, followed by unicystic ameloblastomas and conventional ameloblastomas, which exhibited moderate immunoreactivity predominantly in peripheral cells. Furthermore, significant differences in YAP immunoexpression were observed between the groups analyzed, with significant positive correlations between YAP and cyclin D1 in dentigerous cysts and unicystic ameloblastomas and between YAP and Ki‐67 in unicystic ameloblastomas (p < 0.05). However, there were no statistically significant correlations between YAP and Bcl‐2 immunoexpression in the groups studied. Conclusion: YAP may influence epithelial cell proliferation in odontogenic cysts and tumors, suggesting its possible participation in the progression of the odontogenic lesions studied. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the effects of the inflammatory microenvironment of moderate pulpitis on biological properties of human dental pulp stem cells (DPSCs) and further explored the mechanism involved in osteo‐/odontogenic induction of the inflammatory microenvironment. Methodology: Healthy DPSCs (hDPSCs) and inflammatory DPSCs (iDPSCs) were isolated from human‐impacted third molars free of caries and clinically diagnosed with moderate pulpitis, respectively. Healthy DPSCs were treated with lipopolysaccharides (LPS) to mimic iDPSCs in vitro. The surface markers expressed on hDPSCs and iDPSCs were detected by flow cytometry. A CCK‐8 assay was performed to determine cell proliferation. Flow cytometric analysis was used to evaluate cell apoptosis. The osteo‐/odontogenic differentiation of DPSCs was evaluated by western blot, alkaline phosphatase staining, and Alizarin Red S staining. The functions of the genes of differentially expressed mRNAs of hDPSCs and iDPSCs were analysed using gene set enrichment analysis. Transmission electron microscopy and western blot were used to evaluate the autophagy changes of LPS‐treated DPSCs. Results: Compared with hDPSCs, iDPSCs showed no significant difference in proliferative capacity but had stronger osteo‐/odontogenic potential. In addition, the mRNAs differentially expressed between iDPSCs and hDPSCs were considerably enriched in autophagosome formation and assembly‐related molecules. In vitro mechanism studies further found that low concentrations of LPS could upregulate DPSC autophagy‐related protein expression and autophagosome formation and promote its odontogenic/osteogenic differentiation, whereas the inhibition of DPSC autophagy led to the weakening of the odontogenic/osteogenic differentiation induced by LPS. Conclusions: This explorative study showed that DPSCs isolated from teeth with moderate pulpitis possessed higher osteo‐/odontogenic differentiation capacity, and the mechanism involved was related to the inflammatory microenvironment‐mediated autophagy of DPSCs. This helps to better understand the repair potential of inflamed dental pulp and provides the biological basis for pulp preservation and hard tissue formation in minimally invasive endodontics. [ABSTRACT FROM AUTHOR]

Background/Objectives: Odontogenic abscesses are a common cause of emergency visits to oral and maxillofacial surgery departments and can lead to life-threatening complications if they are not recognized and treated promptly. The aim of this study was to evaluate the prognostic value of the Aggregate Index of Systemic Inflammation (AISI) in comparison to other systemic inflammatory indices, including the Systemic Immune Inflammation Index (SII), the Neutrophil-to-Lymphocyte Ratio (NLR), the Platelet-to-Lymphocyte Ratio (PLR), and the Lymphocyte-to-Monocyte Ratio (LMR), in predicting the severity of odontogenic abscesses. Methods: This retrospective study included 221 patients hospitalized for odontogenic abscesses at Dubrava University Hospital between January 2019 and December 2023. Clinical and laboratory data, including AISI, SII, NLR, PLR, and LMR, were collected. The severity of the abscesses was assessed using the Symptom Severity (SS) Score and patients were categorized into less severe and severe groups based on their scores. An ROC curve analysis was used to assess the predictive accuracy of each inflammatory index. Results: The AISI was identified as the most effective predictor of abscess severity and had the highest sensitivity (SE = 82.93) and specificity (SP = 81.63) among the indices analyzed. It outperformed C-reactive protein (CRP) in predicting severe abscesses with an AUC of 0.90 compared to 0.74 for CRP. In addition, AISI showed significant correlations with length of hospital stay and the occurrence of systemic inflammatory response syndrome (SIRS). Conclusions: The AISI index is a better predictor of odontogenic abscess severity compared to other systemic inflammatory markers and CRP. Its integration into clinical practice could improve the early detection of high-risk patients, leading to better treatment outcomes and lower risks of complications. [ABSTRACT FROM AUTHOR]

Objectives: Ameloblastoma is the second most frequent type of odontogenic tumors. They are thought to be formed by epithelium of ectodermal origin, Histopathologically, ameloblastoma has plexiform, follicular, acanthomatous, desmoplastic, granular cell, and basal cell subtypes. Adenoid ameloblastoma, also called dentinal adenoid ameloblastoma, is a rare odontogenic tumor. About 40 cases have been reported, with the highest incidence in the fourteenth year of life (age range:25-52 years), indicating a small female population and a similar population for ameloblastoma. The differential diagnosis includes odontogenic lesions such as calcifying odontogenic cyst, calcified epithelial odontogenic tumor, ameloblastoma and adenomatoid odontogenic tumor (AOT). Histopathological results show that odontogenic epithelial tumors consist of nests, islands, cords, anastomotic chains and large areas of epithelium, ameloblast-like cells in the periphery, stellate reticulum-like cells in the space and cystic/microcystic patterns, acanthomatous changes and ductal patterns similar to AOT. Case: The aim of this report was to present a unique case of adenoid ameloblastoma affecting the right side of mandible in a 47 y.o woman which had a previous pathology diagnosis of adenoid cystic carcinoma for this lesion in her medical history. Conclusion: Such rare cases of adenoid ameloblastoma can pose challenges in the initial diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to clarify numerical values for differentiating nasopalatine duct cysts (NPDCs) from radicular cysts (RCs) arising in the anterior maxilla on computed tomography (CT) or cone-beam CT (CBCT) images. Methods: CT or CBCT images of histologically proven NPDCs (n = 30) and RCs (n = 33) beyond the midline of the maxilla were investigated to determine two asymmetry indices on axial images of the maximum lesion area. The lateral asymmetry index was calculated based on two distances from each of the lateral ends of the lesion to the midsagittal plane. The index was defined as the difference between the two distances divided by their sum. The labio-palatal asymmetry index was determined by the distance between the labial and palatal ends of the lesion and the coronal plane passing through the central incisor root apex. The performance of these indices was assessed by receiver operating characteristic (ROC) analysis. The cutoff values for differentiating NPDCs from RCs were determined with the Youden procedure on the ROC curve. Results: The area under the ROC curve was 0.97 for the lateral asymmetry index and 0.88 for the labio-palatal asymmetry index. The cutoff values for differentiation were 0.36 and 0.68 for the lateral and labio-palatal asymmetry indices, respectively. Conclusion: The lateral asymmetry index appeared to be an effective reference for differentiating NPDCs from RCs on CT or CBCT images. When the index was less than the cutoff value, a diagnosis of NPDC was strongly suggested. [ABSTRACT FROM AUTHOR]

Odontogenic keratocyst (OKC) is an uncommon developmental cyst with a high recurrence rate. Epithelial dysplasia is a rarely recognized phenomenon in OKCs, with only a few acceptable cases reported in the literature. The exact pathogenesis of dysplastic changes in epithelial lining is difficult to explain, in the absence of molecular analyses. Here, we report a rare case of maxillary OKC with multiple cystic compartments displaying epithelial dysplasia in a 62-year-old man with immunohistochemical analyses and a comprehensive review of the literature. It may be prudent to believe that the aggressive behaviour in the epithelial lining of OKC is an inherent property of all OKCs, which is only dictated by the epithelium but is also determined by the stromal cells of the cyst wall; the dysplastic changes, however, could be resultant to chronic inflammatory reaction and inflammation-mediated carcinogenesis mechanism. It is recommended that the dysplastic features in the epithelial lining of all odontogenic cysts must be addressed in all pathology reports along with close clinical follow-up. [ABSTRACT FROM AUTHOR]

Context: Marsupialization and decompression are treatments designed to reduce hydrostatic pressure which results in reducing the cystic size and increasing the bone density of the lesion. Aims: To compare the percentage of cystic size reduction and the percentage of change in radiographic density from marsupialisation and two types of decompression: tube drain and stent. Settings and Design: Retrospective analysis of panoramic films was conducted to evaluate cystic size and intralesional density. Materials and Methods: Data were analysed from 40 cases, including 31 cases of odontogenic cyst and 9 cases of cyst-like tumour, treated at Chulalongkorn University's Faculty of Dentistry from 2009 to 2019. The percentage of cystic size reduction and percentage of change in radiographic density were analysed before the procedure and three months after treatment. The density and size of the odontogenic cysts were determined using Image J software version 1.43. Statistical Analysis: Data were analysed using Kruskal–Wallis test. Results: The percentage of cystic size reductions when using marsupialisation, decompression with a tube drain and decompression with a stent were 31.49 ± 7.43, 35.42 ± 10.58 and 30.99 ± 7.16, respectively (P = 0.366). The percentage of change in radiographic density was 25.21 ± 7.04, 27.09 ± 7.96 and 24.94 ± 5.35, respectively (P = 0.661). There was no statistically significant difference in outcomes between the groups. Conclusions: Decompression with a tube drain yielded both the highest percentage of size reduction and the highest percentage of change in radiographic density in the cyst, although this better performance was not statistically significant. We recommend decompression with a tube drain, as it effectively maintains an open drainage pathway and prevents collapse of the cyst opening. This continuous release of hydrostatic pressure is beneficial in promoting gradual bone healing and regeneration. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al‐Qassim region, Saudi Arabia. Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients' data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel. Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological‐mediated lesion category (13%). The sub‐diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively. Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al‐Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region. [ABSTRACT FROM AUTHOR]

An 81-year-old male patient presented with a well-demarcated, unilocular radiolucent lesion in the right mandibular body, identified during a routine radiographic examination. Based on the clinical hypothesis of a residual cyst, enucleation with curettage was performed, and the specimen was submitted for histopathological analysis. Microscopically, the cystic lesion was predominantly lined by ameloblastomatous epithelium with numerous ghost cells and dentinoid. Additionally, other cystic cavities lined by stratified squamous epithelium with corrugated parakeratin were observed in the fibrous capsule. Based on these features, a final diagnosis of a calcifying odontogenic cyst with odontogenic keratocyst-like areas was established. No recurrence was observed over a 9-year follow-up period. The association of a calcifying odontogenic cyst with odontogenic keratocyst or odontogenic keratocyst-like areas is very rare. To date, this is the second case report in the literature presenting these findings. [ABSTRACT FROM AUTHOR]

Background: Ameloblastoma and odontogenic keratocyst (OKC) are odontogenic tumors that develop from remnants of odontogenic epithelium. Both display locally invasive growth characteristics and high predilection for recurrence after surgical removal. Most ameloblastomas harbor BRAFV600E mutation while OKCs are associated with PATCH1 gene mutation but distinctive indicators of ameloblastoma growth characteristics relative to OKC are still unclear. The aim of this study was to assess hub genes that underlie ameloblastoma growth characteristics using bioinformatic analysis, ameloblastoma samples and mouse xenografts of human epithelial-derived ameloblastoma cells. Methods: RNA expression profiles were extracted from GSE186489 gene expression dataset acquired from Gene Expression Ominibus (GEO) database. Galaxy and iDEP online analysis tools were used to identify differentially expressed genes that were further characterized by gene ontology (GO) and pathway analysis using ShineyGO. The protein-protein interaction (PPI) network was constructed for significantly upregulated differentially expressed genes using online database STRING. The PPI network visualization was performed using Cytoscape and hub gene identification with cytoHubba. Top ten nodes were selected using maximum neighborhood component, degree and closeness algorithms and analysis of overlap was performed to confirm the hub genes. Epithelial-derived ameloblastoma cells from conventional ameloblastoma were transplanted into immunocompromised mice to recreate ameloblastoma in vivo based on the mouse xenograft model. The top 3 hub genes FN1, COL I and IGF-1 were validated by immunostaining and quantitative analysis of staining intensities to ameloblastoma, OKC samples and mouse ameloblastoma xenografts tissues. Results: Seven hub genes were identified among which FN1, COL1A1/COL1A2 and IGF-1 are associated with extracellular matrix organization, collagen binding, cell adhesion and cell surface interaction. These were further validated by positive immunoreactivity within the stroma of ameloblastoma samples but both ameloblastoma xenograft and OKC displayed only FN1 and IGF-1 immunoreactivity while COL 1 was unreactive. The expression levels of both FN1 and IGF-1 were much lower in OKC relative to ameloblastoma. Conclusion: This study further validates a differentially upregulated expression of matrix proteins FN1, COL I and IGF-1 in ameloblastoma relative to OKC. It suggests that differential stromal architecture and growth characteristics of ameloblastoma relative to OKC could be an interplay of differentially upregulated genes in ameloblastoma. [ABSTRACT FROM AUTHOR]

Background: The use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA's recommendations. Methods: For each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading "other". Results: The most common indication was the "other" category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was "orofacial cleft" (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed. Conclusions: Although the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed. [ABSTRACT FROM AUTHOR]

Calcifying odontogenic cyst, also known as Gorlin cyst is a rare benign cystic lesion primarily found in the jawbones, accounting less than 1% of odontogenic cysts. It can be associated with odontogenic tumors such as odontomas. We report a rare case of COC associated with complex odontoma in a young patient and discuss its clinical features, diagnosis, and treatment options. An 18-year-old female patient presented with a painless radiopaque lesion of the right mandibular bone at Oral Medicine and Oral Surgery department. Radiographs revealed irregular tooth-like structures in the canine-premolar area. The lesion was surgically removed, and histopathology confirmed COC with a complex odontoma. As of the World Health Organization's 2022 definition, COC is a developmental odontogenic cyst characterized by calcified ghost cells. It typically affects individuals during their second and third decades of life, with no gender preference, almost equally in the maxilla and the mandible. The main treatment is total enucleation, with a generally favorable prognosis. Histopathology is essential for diagnosis due to its mimicry of other jaw conditions. Long-term follow-up is needed to prevent recurrences. [ABSTRACT FROM AUTHOR]

Central retinal vein occlusion typically manifests in older individuals with underlying systemic pathology, leading to a spectrum of symptoms ranging from blurred vision to complete vision loss. While odontogenic infections are recognized for causing complications affecting the eye and vision, their potential role as an etiological factor in cases of sudden vision impairment merits consideration. This article presents a case involving central retinal vein thrombosis, wherein resolution was achieved through a combination of ophthalmic therapy and the surgical removal of a concurrently existing large inflamed odontogenic cyst located in the ipsilateral hemimaxilla. This case underscores the importance of recognizing odontogenic factors in the assessment of sudden vision impairment and the efficacy of a multidisciplinary therapeutic approach. [ABSTRACT FROM AUTHOR]

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic tumors. The aim of this paper is to report a new case occurring in an adult, analyzing the clinical, radiographic, and histopathological features as guidelines for a differential diagnosis. We report a 49-year-old patient complaining of a small, pigmented lesion localized on the attached gingiva with no history of trauma, which was surgically excised and histologically diagnosed as a gingival cyst. A differential diagnosis may be challenging for clinicians it includes a wide spectrum of inflammatory and non-inflammatory lesions, so a correct diagnostical–therapeutical approach is needed to avoid possible overtreatment and minimize the recurrence rate. [ABSTRACT FROM AUTHOR]

The article focuses on evaluating the high frequency of stromal myofibroblasts in odontogenic keratocysts (OKCs) associated with an impacted tooth compared to other odontogenic cysts and pericoronal follicles (PFs). It highlights that OKCs associated with impacted teeth (OKC-a) exhibit a significantly higher number of α-SMA positive cells than those not associated with impacted teeth (OKC-na) and dentigerous cysts (DCs).

Background: Odontogenic cysts can cause thinning and expansion of the surrounding cortical bone; however, bone formation extending into the submandibular region, resembling periosteal reactions, is rarely observed in odontogenic cysts. Case Presentation: A 52‐year‐old man presented with painful submandibular swelling and dyspnea. Computed tomography revealed an extensive mandibular cystic lesion extending to the submandibular region accompanied by thickened bone formation, mimicking lobulated shell‐type periosteal reaction. Percutaneous cystectomy with extensive mandibular bone resection was performed. Conclusion: Prolonged existence of extensive cystic lesion and inflammatory stimulation may result in bone elongation into the submandibular region, mimicking periosteal reaction. [ABSTRACT FROM AUTHOR]