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Aim Methodology Results Conclusions To evaluate M1 and M2 macrophage polarization in radicular cysts and periapical granulomas through an immunohistochemical analysis and the correlation between macrophage polarization and histopathological diagnosis, clinical characteristics and lesion volume using cone‐beam computed tomography.Periapical biopsies diagnosed as radicular cysts (n = 52) and periapical granulomas (n = 51) were analysed by immunohistochemical method. Teeth with periapical lesion with no history of root canal treatment (primary lesion) and lesions persistent to root canal treatment (persistent lesions) were included. Pathological diagnosis, patients' age, gender and clinical characteristics were obtained from treatment records. A cone‐beam computed tomographic periapical volume index (CBCTPAVI) score was assigned to each periapical lesion based on the volume of the lesion. Immuno‐expressions of CD68 and CD163 were quantified. The CD68/CD163 ratio was adopted to represent M1 or M2 macrophage polarization. Mann–Whitney U test was used to determine the different CD68/CD163 ratio between groups of radicular cyst and periapical granuloma. Spearman's correlation test was performed to assess the correlation between the CD68/CD163 ratio and lesion volume and CBCTPAVI score.Radicular cysts and periapical granulomas had CD68/CD163 median of 2.05 (IQR = 1.33) and 1.26 (IQR = 0.81), respectively. A significantly higher CD68/CD163 ratio was observed in radicular cysts (p < .001). In contrast, periapical granulomas had significantly lower median of CD68/CD163 ratio. Larger lesions had a higher median of CD68/CD163 ratio, while smaller lesions had lower median of CD68/CD163 ratio (p = .007, rs = .262). CD68/CD163 ratio was significantly correlated with the CBCTPAVI score in the overall periapical lesions (p = .002, rs = .306). The higher CD68/CD163 ratio in larger lesions indicated a higher degree of M1 polarization compared to smaller lesions. Regarding the pathological diagnosis, there was a significant positive correlation between CBCTPAVI score and CD68/CD163 ratio in periapical granulomas (p < .001, rs = .453), whereas the negative correlation was observed for radicular cysts (p < .001, rs = −.471).Periapical granulomas are characterized by a M2‐dominant macrophage polarization, while radicular cysts have significantly higher M1 macrophages. The higher degree of M1 macrophage polarization was significantly correlated with larger volume and higher CBCTPAVI scores of overall periapical lesion and periapical granuloma. [ABSTRACT FROM AUTHOR]

Background: Secreted protein acidic and rich in cysteine (SPARC) has been shown to modulate aggressive behavior in several benign and malignant tumors. Little is known about SPARC expression in odontogenic keratocyst (OKC), an odontogenic cyst with an aggressive nature. To the best of our knowledge, only one study has been investigated the expression of this protein in OKCs. This study aimed to characterize SPARC expression in OKCs. Additionally, to determine whether SPARC is associated with aggressive behavior in OKCs, SPARC expression in OKCs was compared with radicular cysts (RCs), dentigerous cysts (DCs) and calcifying odontogenic cysts (COCs). These odontogenic cysts showed no or less aggressive behavior. Methods: SPARC expression was evaluated in 38 OKCs, 39 RCs, 35 DCs and 14 COCs using immunohistochemistry. The percentages of positive cells and the intensities of immunostaining in the epithelial lining and the cystic wall were evaluated and scored. Results: Generally, OKCs showed similar staining patterns to RCs, DCs and COCs. In the epithelial lining, SPARC was not detected, except for ghost cells in all COCs. In the cystic wall, the majority of positive cells were fibroblasts. Compared between 4 groups of odontogenic cysts, SPARC expression in OKCs was significantly higher than those of RCs (P < 0.001), DCs (P < 0.001) and COCs (P = 0.001). Conclusions: A significant increase of SPARC expression in OKCs compared with RCs, DCs and COCs suggests that SPARC may play a role in the aggressive behavior of OKCs. [ABSTRACT FROM AUTHOR]

Introduction: Intraosseous lipomas (IL) are rare benign neoplasms of bone which very rarely occur in the facial bones such as the mandible. Of the documented cases, many are often asymptomatic and consequently, are an incidental finding discovered by the practitioner. Case Report: The following case report recounts a 22‐year‐old patient referred for extraction of a carious molar at an Oral and Maxillofacial unit with an incidental finding of pathology involving the contralateral lower left wisdom tooth (LL8) on radiographic examination. Further investigations showed associated external root resorption of the lower left wisdom tooth and a provisional diagnosis of a radicular cyst was made. The case was managed by extracting the associated tooth and enucleating the lesion. During the procedure, fatty tissue was curetted at the apex instead of the expected cystic content. Subsequent histopathology confirmed the diagnosis of an IL. Conclusion: To the authors' knowledge, this is only the second documented case of an IL associated with tooth resorption. Findings from this case further our knowledge of the relatively uncommon pathology of intraosseous lipomas in the mandible and highlight the need for histopathological documentation and reporting of apical lesions. [ABSTRACT FROM AUTHOR]

Background: Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. Material and method: 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. Result: Odontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. Conclusions: Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to develop a deep learning algorithm capable of diagnosing radicular cysts in the lower jaw on panoramic radiographs. Materials and Methods: In this study, we conducted a comprehensive analysis of 138 radicular cysts and 100 normal panoramic radiographs collected from 2013 to 2023 at Clinical Hospital Dubrava. The images were annotated by a team comprising a radiologist and a maxillofacial surgeon, utilizing the GNU Image Manipulation Program. Furthermore, the dataset was enriched through the application of various augmentation techniques to improve its robustness. The evaluation of the algorithm's performance and a deep dive into its mechanics were achieved using performance metrics and EigenCAM maps. Results: In the task of diagnosing radicular cysts, the initial algorithm performance—without the use of augmentation techniques—yielded the following scores: precision at 85.8%, recall at 66.7%, mean average precision (mAP)@50 threshold at 70.9%, and mAP@50-95 thresholds at 60.2%. The introduction of image augmentation techniques led to the precision of 74%, recall of 77.8%, mAP@50 threshold to 89.6%, and mAP@50-95 thresholds of 71.7, respectively. Also, the precision and recall were transformed into F1 scores to provide a balanced evaluation of model performance. The weighted function of these metrics determined the overall efficacy of our models. In our evaluation, non-augmented data achieved F1 scores of 0.750, while augmented data achieved slightly higher scores of 0.758. Conclusion: Our study underscores the pivotal role that deep learning is poised to play in the future of oral and maxillofacial radiology. Furthermore, the algorithm developed through this research demonstrates a capability to diagnose radicular cysts accurately, heralding a significant advancement in the field. [ABSTRACT FROM AUTHOR]

Abstract Background Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. Material and method 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. Result Odontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. Conclusions Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts.

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment.

Background: Generative Adversarial Networks (GANs) are a class of artificial neural networks capable of generating content such as images, text, and sound. For several years already, artificial intelligence algorithms have shown promise as tools in the medical field, particularly in oncology. Generative Adversarial Networks (GANs) represent a new frontier of innovation, as they are revolutionizing artificial content generation, opening opportunities in artificial intelligence and deep learning. Purpose: This systematic review aims to investigate what the stage of development of such technology is in the field of head and neck surgery, offering a general overview of the applications of such algorithms, how they work, and the potential limitations to be overcome in the future. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in conducting this study, and the PICOS framework was used to formulate the research question. The following databases were evaluated: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, ClinicalTrials.gov, ScienceDirect, and CINAHL. Results: Out of 700 studies, only 9 were included. Eight applications of GANs in the head and neck region were summarized, including the classification of craniosynostosis, recognition of the presence of chronic sinusitis, diagnosis of radicular cysts in panoramic X-rays, segmentation of craniomaxillofacial bones, reconstruction of bone defects, removal of metal artifacts from CT scans, prediction of the postoperative face, and improvement of the resolution of panoramic X-rays. Conclusions: Generative Adversarial Networks may represent a new evolutionary step in the study of pathology, oncological and otherwise, making the approach to the disease much more precise and personalized. [ABSTRACT FROM AUTHOR]

Intravascular papillary endothelial hyperplasia (IPEH) represents an uncommon reactive endothelial hyperplastic proliferation. A 46-year-old man experienced increased volume in the right maxilla, elevation of the nasal ala, and swelling of the hard palate with a reddish hue for 3 months. Computed tomography revealed an expansive hypodense region and cortical bone destruction associated with an impacted supernumerary tooth and an endodontically treated tooth. Under the differential diagnoses of a radicular cyst, dentigerous cyst, and ameloblastoma, an exploratory aspiration and incisional biopsy were performed. This revealed the formation of blood vessels of various diameters lined by endothelium, forming intravascular papillae positive for CD-34. The definitive diagnosis was IPEH, and the patient was treated by embolization and surgery. Histological analysis confirmed the presence of IPEH associated with an odontogenic cyst. After 12 months of follow-up, no recurrence was observed. Also, we reviewed case reports of IPEH affecting the maxilla and mandible. Fourteen intraosseous cases were reported in the maxilla and mandible, with a preference for males and affecting a wide age range. Complete surgical excision was the treatment of choice, and recurrences were not reported. The pathogenesis of IPEH is controversial and may originate from trauma or inflammatory processes. To the best of our knowledge, this is the first report of an association of IPEH with an odontogenic cyst. The importance of IPEH in the differential diagnosis of intraosseous lesions in the jaws is emphasized, and preoperative semiotic maneuvers are needed to prevent surgical complications. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the indication of the endodontic treatment for vital intact teeth with the root apex involved in large radicular cystic lesions of endodontic origin. Methodology: This prospective cohort study enrolled healthy participants with radicular cysts of endodontic origin and with the root apex of vital intact teeth involved in the bone defect, as determined by cone beam computed tomography (CBCT). Thirty‐two sound vital teeth were analysed by thermal (TPT) and electric pulp tests (EPT) before surgery (T0) and 1 week (T1), 2 weeks (T2), 3 months (T3) and 6 months (T4) post‐surgery. Student's t‐test (p <.05) was used to compare the EPT values at baseline and T4. anova (p <.05) was used to analyse the EPT variations for all maxillary and mandibular teeth. McNemar test (p <.05) was used to compare the results according to variation in EPT values gathering by variation, no variation and no response. Results: At T1, 75 and 65.7% of teeth responded positively whilst 25 and 34.3% did not respond to EPT and TPT, respectively. The variation of the EPT values between T0 and T1 was observed for 50.0% of teeth, whilst no variation was noticed in 25.0% of teeth. At T4, 90.6 and 87.5% of teeth responded positively whilst 9.4 and 12.5% did not respond to EPT and TPT, respectively. At T4, variation of the EPT values between T0 and T4 was observed for 28.1%, whilst no variation was noticed in 62.5% of teeth. There were no statistical differences in EPT results between T0 and T4 (p >.05), but significant differences were observed for EPT values between T1 and T4 (p <.05), and between mandibular and maxillary teeth. The pulp sensibility of maxillary teeth worsened after surgery, before reverting progressively to T0 values, whilst no statistically significant differences were observed for mandibular teeth at the different time points. Conclusions: These data support the inconsistence of the prophylactic endodontic treatment in healthy vital teeth with apex involvement in large cystic lesions of endodontic origin. Post‐surgery follow‐up with TPT and EPT is recommended to assess pulp status. [ABSTRACT FROM AUTHOR]

Nasopalatine duct cyst, which is also known as incisive canal cyst, is the most common developmental cyst of the maxilla. It arises from the proliferation of the remnants of the nasopalatine duct stimulated by trauma or infection. In this article, the authors report a rare case of an extensive nasopalatine duct cyst in a 57-year-old Male associated with non-vital tooth. Clinical examination revealed facial asymmetry associated with swelling that is painful and tender. Correlating clinical and radiological findings, a diagnosis of nasopalatine duct cyst was formed, and the histopathological examination confirmed the diagnosis of nasopalatine duct cyst. This case highlights the importance of knowing that nasopalatine duct cyst can be associated with non-vital teeth, challenging the assumption that they are exclusively associated with vital teeth. [ABSTRACT FROM AUTHOR]

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment. [ABSTRACT FROM AUTHOR]

Introduction. A postsurgical ciliated cyst (PSCC) is an epithelial cyst that usually develops in the maxilla, although in rare cases, it can affect the mandible or other facial bones. The typical age of diagnosis is 40-50 years, with no gender prevalence, and the mean cyst development occurs approximately 10-15 years following a surgical or traumatic event. Some epithelial respiratory cells can be trapped into the bone tissue during maxillary surgical procedures or maxillary fractures. The pathogenetic mechanism can be attributed to an inflammatory process that stimulates epithelial proliferation, leading to cyst expansion caused by osmotic pressure difference. Methods. This study presents case series involving three surgical ciliated cysts located in the left maxilla, affecting two female patients (aged 49 and 55 years) and one male patient (aged 39 years). In all three cases, symptoms such as pain or swelling were mild and not consistently present. Two cases showed cyst development 10 and 15 years after implant placement, while one case was not associated with any surgical or traumatic event. CT scan identified well-defined unilocular lesions in the maxillary bone in each patient. Results. Histopathological examination of the surgical specimens confirmed the suspected diagnosis of a PSCC of maxilla. The cystic walls consisted of fibrous connective tissue with chronic inflammatory infiltrate, lined exclusively by a thin layer of ciliated pseudostratified columnar epithelium. In the third patient, it was not possible to rule out an unusual radicular cyst. Conclusions. Although PSCCs are not commonly encountered in daily practice, clinicians should consider this possibility including it in the differential diagnosis of odontogenic jaw cysts and benign jaw tumors, particularly in patients who have undergone previous surgeries in the maxillary area. [ABSTRACT FROM AUTHOR]

Study Design.: Experimental study of the role and mechanism of spinal NFκB-CXCL1/CXCR2 in rats with nucleus pulposus-induced radicular pain. Objective.: This study investigated the role and mechanism of spinal NFκB-CXCL1/CXCR2 in autologous nucleus pulposus-induced pain behavior in rats and to clarify the involvement and regulation of spinal NFκB as an upstream molecule of CXCL1 in autologous nucleus pulposus-induced radicular pain in rats. Summary of Background Data.: The inflammatory response of nerve roots is an important mechanism for the occurrence of chronic pain. NFκB-CXCL1/CXCR2 pathway plays an important role in the development of radicular pain, but its regulatory mechanism in the model of radicular pain induced by autologous nucleus pulposus is still unclear. Materials and Methods.: We established a rat model of autologous medullary nucleus transplantation. We observed and recorded the changes in 50% mechanical withdrawal threshold and thermal withdrawal latency before and after the administration of CXCL1-neutralizing antibodies, CXCR2 inhibitor, and NFκB inhibitor in each group of rats and evaluated the expression of NFκB, CXCL1, and CXCR2 in the spinal dorsal horn using immunofluorescence and Western blot. To compare differences between groups in behavioral testing, analysis of variance was employed. Dunnett's method was used to compare differences at different time points within a group and between different groups at the same time point. A comparison of the relative concentration of protein, relative concentration of mRNA, and semiquantitative data from immunofluorescence staining was conducted utilizing one-way ANOVA and Dunnett's pairwise comparison. Results.: Autologous nucleus pulposus transplantation can induce radicular pain in rats and upregulate the expression of CXCL1, CXCR2, and NFκB in the spinal cord. CXCL1 is co-expressed with astrocytes, CXCR2 with neurons, and NFκB with both astrocytes and neurons. The application of CXCL1 neutralizing antibodies, CXCR2 inhibitors, and NFκB inhibitors can alleviate pain hypersensitivity induced by autologous nucleus pulposus transplantation in rats. Inhibitors of NFκB could downregulate the expression of CXCL1 and CXCR2. Conclusions.: We found that spinal NFκB is involved in NP-induced radicular pain in rats through the activation of CXCL1/CXCR2, enriching the mechanism of medullary-derived radicular pain and providing a possible new target and theoretical basis for the development of more effective anti-inflammatory and analgesic drugs for patients with chronic pain following LDH. [ABSTRACT FROM AUTHOR]

Radicular cysts are the most common cystic lesions in the oral cavity, and have a rare occurrence in the primary dentition. We report a case of radicular cyst of mandible in child by multimodal imaging including panoramic radiography, CT, and MR imaging. A 7-year-old girl presented with swelling and without pain, and hypoesthesia on the right side of the mandible. On clinical examination, an expansive lesion with undulation was found to the buccal cortex of the right side of the mandible. Panoramic radiograph showed a unilocular radiolucency with well-defined margin, displaced tooth, and root resorption in the right mandible. Regarding CT imaging, axial soft tissue algorithm CT and bone tissue algorithm CT showed a low-attenuation internal structure and expansion of the buccal cortex of the right side of the mandible. Three-dimensional-CT showed expansion of the buccal cortex of the right side of the mandible. Multiplanar reformation imaging showed displaced tooth, root resorption, and expansion of the buccal cortex of the right side of the mandible. On T1-weighted image, the expansive lesion showed low signal intensity, and T2-weighted and STIR images revealed high signal intensity. A partial biopsy of the mandibular region was performed. Histopathological diagnosis was radicular cyst caused by apical periodontitis with abscess. This case suggests that multimodal imaging, especially CT and MR imaging, could be effective for evaluating mandibular lesions in child. [ABSTRACT FROM AUTHOR]

An apicoectomy involves surgical intervention to treat a tooth afflicted with a periapical lesion that remains unresolved despite standard endodontic procedures. The primary objective of apical surgery is to prevent the spread of bacteria and their associated by-products from the root canal system into the surrounding periradicular tissues. This research endeavours to underscore the potential efficacy of endodontic surgical intervention in cases where nonsurgical treatment of the right maxillary anterior teeth is ineffective. [ABSTRACT FROM AUTHOR]

Background: Odontogenic cysts are characterized by their sluggish growth and ability to enlarge, primarily affecting the oral and maxillofacial tissues. Timely diagnosis and treatment are crucial to prevent potentially serious consequences. The present study aimed to evaluate and compare the immunohistochemical expression of cytokeratin 19 in the epithelium of odontogenic keratocyst, dentigerous, and radicular cysts. Methods: This study analyzed forty-five formalin-fixed, paraffin-embedded tissue blocks containing odontogenic cysts. The sample consisted of fifteen odontogenic keratocysts, fifteen dentigerous cysts, and fifteen radicular cysts. Immunohistochemical analysis was performed to assess the expression of the cytokeratin 19 epithelial marker in these samples. Statistical analyses were conducted using Statistical Package for Social Sciences version 26, employing the Chi-square test for comparative analysis of cytokeratin 19 expression among the odontogenic keratocyst, dentigerous cyst, and radicular cyst. Results: This study showed that 80% of basal layer tissue samples in the odontogenic keratocyst group had negative cytokeratin 19 biomarker scores. In contrast, 60% of dentigerous cyst tissue blocks and 53.3% of radicular cyst tissue blocks were +1. This difference was statistically significant (P = 0.034). In comparison, between groups, there was no significant difference (P = 0.103) in CK19 expression in the surface and spinous layers. Conclusion: The level of epithelial differentiation is correlated with cytokeratin 19 expression. The cysts with well-differentiated epithelium (radicular cyst and dentigerous cyst) express cytokeratin 19, whereas those with less well-differentiated epithelium (odontogenic keratocyst) exhibit low positives. Thus, it serves as a diagnostic tool for distinguishing these three lesions. [ABSTRACT FROM AUTHOR]

Abstract Background Secreted protein acidic and rich in cysteine (SPARC) has been shown to modulate aggressive behavior in several benign and malignant tumors. Little is known about SPARC expression in odontogenic keratocyst (OKC), an odontogenic cyst with an aggressive nature. To the best of our knowledge, only one study has been investigated the expression of this protein in OKCs. This study aimed to characterize SPARC expression in OKCs. Additionally, to determine whether SPARC is associated with aggressive behavior in OKCs, SPARC expression in OKCs was compared with radicular cysts (RCs), dentigerous cysts (DCs) and calcifying odontogenic cysts (COCs). These odontogenic cysts showed no or less aggressive behavior. Methods SPARC expression was evaluated in 38 OKCs, 39 RCs, 35 DCs and 14 COCs using immunohistochemistry. The percentages of positive cells and the intensities of immunostaining in the epithelial lining and the cystic wall were evaluated and scored. Results Generally, OKCs showed similar staining patterns to RCs, DCs and COCs. In the epithelial lining, SPARC was not detected, except for ghost cells in all COCs. In the cystic wall, the majority of positive cells were fibroblasts. Compared between 4 groups of odontogenic cysts, SPARC expression in OKCs was significantly higher than those of RCs (P

Background Methods and Results Conclusions Key points Dens invaginatus (DI), an unusual developmental anomaly is a challenge for the operating dentist with regard to its diagnosis and treatment. This case report presents the successful management of a Type‐3b DI in a permanent maxillary lateral incisor associated with a large radicular cyst and communicating apico‐marginal defect (Von Arx type IIb).A 19‐year‐old female patient reported pain and palatal swelling. During the clinical examination, tooth #12 exhibited tenderness to percussion, and presented a deep periodontal pocket depth (PPD) of 12 mm, along with grade I mobility. Radiographic examination revealed a large peri‐radicular radiolucency with atypical tooth morphology. Cone beam computed tomography clarified the complicated root canal anatomy to be Type‐3b DI associated with an apico‐marginal defect. The case was managed successfully by non‐surgical endodontic therapy followed by surgical intervention utilizing a guided bone regenerative (GBR) approach. Eighteen‐month follow‐up showed an asymptomatic and functional tooth with a significant reduction in pocket depth. The periapical radiographs showed continued healing of the osseous defect.The successful healing outcome of a challenging case, characterized by a complex DI morphology, a large peri‐radicular lesion, a through‐and‐through defect, and a combined endodontic‐periodontal apico‐marginal defect was achieved through accurate diagnosis, treatment planning, and execution using contemporary endodontic and periodontal treatment techniques. The application of GBR techniques during the surgical phase of treatment may have contributed to the improved regenerative healing outcome in this case, which was initially considered prognostically questionable.Why is this case new information? Type‐3b DI exhibits a complex root canal structure, each case displaying unique characteristics, necessitating a case‐specific treatment plan. In this case report the Type‐3b DI morphology was associated with a large peri‐radicular, through and through defect and combined endodontic periodontal apico‐marginal defect. The treatment approach involved incorporating guided bone regenerative (GBR) principles during the surgical phase. This case report contributes to the existing evidence on the diagnosis and successful management of Type‐3b DI with a concurrent apico‐marginal defect. What are the keys to successful management of this case? The successful management of a prognostically challenging case was achieved through a closely integrated multidisciplinary coordination between the endodontist and periodontist. Utilization of contemporary techniques and tools contributed to the successful management The use of three‐dimensional radiological examination through cone beam computed tomography enabled a precise preoperative assessment, facilitating the formulation of a treatment plan for managing both the Type‐3b DI morphology and the associated peri‐radicular lesion. Employing GBR techniques in peri‐radicular surgery may have assisted in the healing of through‐and‐through periapical defects with concurrent apico‐marginal defects (Von Arx type IIb). What are the primary limitations to the success of this case? A complex root canal anatomy associated with Type‐3b DI morphology A large peri‐radicular through and through defect with concurrent apico‐marginal defect. Difficulty in weekly and long‐term follow‐up of the patient. [ABSTRACT FROM AUTHOR]

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

Aim: Cyst formation of the jaws is frequently accompanied by the proliferation of odontogenic epithelial cells located in the periodontal ligament (PDL), which consists of heterozygous cells and includes the most fibroblasts. The lining epithelium of radicular cyst, an odontogenic cyst of inflammatory origin, is derived from the proliferation of the remnants of the Hertwig epithelial root sheath (odontogenic epithelial cell rests of Malassez; ERMs) in the PDL. ERMs are maintained at a lower proliferative state under physiological conditions, but the regulatory mechanisms underlying the inflammation‐dependent enhanced‐proliferative capabilities of ERMs are not fully understood. The aim of this study was to evaluate the effects of cytokine pathway association between TGF‐β signalling and IL‐1β signalling on the regulation of odontogenic epithelial cell proliferation using radicular cyst pathological specimens and odontogenic epithelial cell lines. Methodology: Immunofluorescence analyses were performed to clarify the expression levels of Smad2/3 and Ki‐67 in ERMs of 8‐week‐old mouse molar specimens. In radicular cyst (n = 52) and dentigerous cysts (n = 6) specimens from human patients, the expression of p65 (a main subunit of NF‐κB), Smad2/3 and Ki‐67 were investigated using immunohistochemical analyses. Odontogenic epithelial cells and PDL fibroblastic cells were co‐cultured with or without an inhibitor or siRNAs. Odontogenic epithelial cells were cultured with or without TGF‐β1 and IL‐1β. The proliferative capabilities and Smad2 phosphorylation levels of odontogenic epithelial cells were examined. Results: Immunohistochemically, Smad2/3‐positivity was increased, and p65‐positivity and Ki‐67‐positivity were decreased both in ERMs and in the epithelial cells in dentigerous cysts, a non‐inflammatory developmental cyst. In contrast, p65‐positive cells, along with the expression of Ki‐67, were increased and Smad2/3‐positive cells were decreased in the lining epithelia of radicular cysts. Co‐culture experiments with odontogenic epithelial cells and PDL fibroblastic cells revealed that PDL cells‐derived TGF‐β1/2 and their downstream signalling suppressed odontogenic epithelial cell proliferation. Moreover, TGF‐β1 stimulation induced Smad2 phosphorylation and suppressed odontogenic epithelial cell proliferation, while IL‐1β stimulation reversed these phenotypes through p65 transactivation. Conclusions: These results suggest that IL‐1β‐p65 signalling promotes odontogenic epithelial cell proliferation through suppressing TGF‐β‐Smad2 signalling, which would be involved in the pathogenesis of radicular cysts. [ABSTRACT FROM AUTHOR]

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

Purpose: The aims of this study were to create a deep learning model to distinguish between nasopalatine duct cysts (NDCs), radicular cysts, and no-lesions (normal) in the midline region of the anterior maxilla on panoramic radiographs and to compare its performance with that of dental residents. Materials and Methods: One hundred patients with a confirmed diagnosis of NDC (53 men, 47 women; average age, 44.6±16.5 years), 100 with radicular cysts (49 men, 51 women; average age, 47.5±16.4 years), and 100 with normal groups (56 men, 44 women; average age, 34.4±14.6 years) were enrolled in this study. Cases were randomly assigned to the training datasets (80%) and the test dataset (20%). Then, 20% of the training data were randomly assigned as validation data. A learning model was created using a customized DetectNet built in Digits version 5.0 (NVIDIA, Santa Clara, USA). The performance of the deep learning system was assessed and compared with that of two dental residents. Results: The performance of the deep learning system was superior to that of the dental residents except for the recall of radicular cysts. The areas under the curve (AUCs) for NDCs and radicular cysts in the deep learning system were significantly higher than those of the dental residents. The results for the dental residents revealed a significant difference in AUC between NDCs and normal groups. Conclusion: This study showed superior performance in detecting NDCs and radicular cysts and in distinguishing between these lesions and normal groups. [ABSTRACT FROM AUTHOR]

Aim: In this study, in radicular cyst cases in our department; It was aimed to evaluate the severity of inflammation (active and chronic inflammation) and to investigate its relationship with age and gender. Material and Method: Radicular cyst cases between 01.01.2013 and 31.01.2022 in Ordu University, Faculty of Medicine, Department of Pathology were included in the study. Ethical approval was taken from Ordu University Medical School, Clinical Trials Ethical Committee (2022/82). Preparations of the cases were found from the archive and examined microscopically to score the severity of inflammation. To examine any relationships that existed between categorical variables, Chi-square test was used. To determine any relationships between the score variables, correlation analysis was done. Results: A statistically significant moderate negative correlation was observed between age and chronicity in women (r=-0.410, p=0.013). A statistically significant moderate positive correlation was observed between activity and chronicity scores in men (r=0.592, p<0.001). When all patients were considered, weakly significant negative correlation was found between activity and chronicity (r=0.312, p<0.001). While one was increasing, the other was increasing. Conclusion: In radicular cyst cases, the severity of inflammation may differ from case to case. In our study, the severity of chronic inflammation was observed as high-grade (grade 3) in most of the cases, acute inflammation was found to be mild (grade 1) in most of the cases. It is thought that determining the severity and type of inflammation in the histopathological evaluation may be beneficial for diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Aim: The objective of this review is to conduct a thorough systematic literature search and evaluate the risks and benefits of replanting avulsed primary teeth, which will aid clinicians in proper decision-making. Materials and Methods: In this review, a systematic search of five electronic databases (Web of Science, PubMed-MEDLINE, Scopus, Ovid SP, and Embase) was independently conducted by two reviewers. After following the eligibility criteria, the collated data was uploaded to Zotero and Excel Workbooks. Any disagreement was resolved through adjudication by the third reviewer. For case reports and case series, the Joanna Briggs Institute checklist was used to assess quality. Results: Following the application of the eligibility criteria, 15 papers were deemed eligible for final analysis, and full texts were acquired. Among 26 replanted teeth, adverse effects were seen in 19 primary teeth and 7 permanent successors. The primary teeth that were replanted had the following unfavorable effects: mobility, resorption of the bone, fistula formation, radicular cyst formation, crown discoloration, and pulp necrosis. Similarly, the adverse effects on the permanent successors were impaction, enamel hypoplasia, dilacerations, and infra-occlusion. Conclusions: Following the biological principles, such as the condition of the tooth, the time elapsed since avulsion and age of the child, and replantation of avulsed primary teeth, can be a feasible treatment option. However, the feasibility is case-dependent and cannot be generalized because of the paucity of high-quality research with sufficient sample sizes and long follow-up periods. [ABSTRACT FROM AUTHOR]

The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.

Introduction:Tartrate-resistant acid phosphatase (TRAP) is an acid phosphatase metalloprotein enzyme expressed in osteoclasts and is related to bone resorption. The molecular mechanisms involved in the different behavior of odontogenic keratocysts have not yet been fully elucidated. The purpose of this study was to compare TRAP expression in odontogenic keratocysts, radicular cysts, and dentigerous cysts.Materials and Methods:In this cross-sectional study, we selected 60 samples, including 20 cases of each one of the odontogenic keratocysts (OKC), radicular cysts (RC) and dentigerous cysts (DC). The samples were stained with TRAP monoclonal antibodies using immunohistochemistry. The data were analyzed using the Chi-Square and Kruskal-Wallis tests.Results: In this study, TRAP expression was observed in the lining epithelium of 50% of OKC cases and 5% of RC cases, while it was negative in the lining epithelium of DC. This difference was statistically significant (p

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Purpose : In this study, we prospectively investigated the relationship between bone marrow edema (BME) and odontogenic cysts and explored the possibility of using dual-energy computed tomography (DECT) as an auxiliary tool for the diagnosis of odontogenic cysts. Methods: This cross-sectional study included 73 patients who underwent the DECT scan and surgery for odontogenic cysts or odontogenic tumors. The virtual noncalcium (VNCa) computed tomography (CT) values and CT values were measured at several sites. The predictor variable was diagnosis, and the other variables included age, sex, and sites. The primary outcome was VNCa CT value. Variables were tested using the chi-square test or the Kruskal–Wallis test. The VNCa CT and CT values were tested using the Scheffe test for multiple comparisons. All variables were analyzed as independent variables affecting the VNCa CT values around the lesion in the multiple regression analysis. Result: There were 35 men and 38 women. The mean patient age was 50.0 ± 19.5 years (range: 8–86). The VNCa CT values (− 6.2 ± 34.3) around the lesion in patients with RCs were significantly higher than those in patients with dentigerous cysts (− 44.4 ± 28.6) and odontogenic keratocysts (− 67.3 ± 19.5). In multiple regression analysis, the VNCa CT values around the lesion showed a significant positive correlation with histological results (regression coefficient: − 0.605, P < 0.001). Conclusion: The presence of BME is associated with radicular cysts, and DECT can be used as an auxiliary tool for radicular cyst diagnosis. [ABSTRACT FROM AUTHOR]

Background and Objectives: The purpose of this study was to develop and evaluate a deep learning model capable of autonomously detecting and segmenting radiolucent lesions in the lower jaw by utilizing You Only Look Once (YOLO) v8. Materials and Methods: This study involved the analysis of 226 lesions present in panoramic radiographs captured between 2013 and 2023 at the Clinical Hospital Dubrava and the School of Dental Medicine, University of Zagreb. Panoramic radiographs included radiolucent lesions such as radicular cysts, ameloblastomas, odontogenic keratocysts (OKC), dentigerous cysts and residual cysts. To enhance the database, we applied techniques such as translation, scaling, rotation, horizontal flipping and mosaic effects. We have employed the deep neural network to tackle our detection and segmentation objectives. Also, to improve our model's generalization capabilities, we conducted five-fold cross-validation. The assessment of the model's performance was carried out through metrics like Intersection over Union (IoU), precision, recall and mean average precision (mAP)@50 and mAP@50-95. Results: In the detection task, the precision, recall, mAP@50 and mAP@50-95 scores without augmentation were recorded at 91.8%, 57.1%, 75.8% and 47.3%, while, with augmentation, were 95.2%, 94.4%, 97.5% and 68.7%, respectively. Similarly, in the segmentation task, the precision, recall, mAP@50 and mAP@50-95 values achieved without augmentation were 76%, 75.5%, 75.1% and 48.3%, respectively. Augmentation techniques led to an improvement of these scores to 100%, 94.5%, 96.6% and 72.2%. Conclusions: Our study confirmed that the model developed using the advanced YOLOv8 has the remarkable capability to automatically detect and segment radiolucent lesions in the mandible. With its continual evolution and integration into various medical fields, the deep learning model holds the potential to revolutionize patient care. [ABSTRACT FROM AUTHOR]

This study aimed to clarify the perceptibility of periapical foreign materials in imaging compared with histopathology. We hypothesized that dentoalveolar imaging is sufficient to detect periapical foreign bodies. Radiological and histopathological records of patients diagnosed with periapical granuloma or radicular cyst from 2000 to 2013 were evaluated retrospectively. Patients with histologically verified foreign bodies were included in the study and their pathological samples and radiological images were reviewed. The outcome variable was radiologically detectable foreign material. The predictor variables were histopathological diagnosis, type of inflammation, type and number of foreign bodies, imaging modality, and site of foreign material. Compared to the histopathological diagnosis of foreign bodies as the gold standard, the level of radiologic detectability was mild. Histologically verified foreign material could be detected by imaging in 32/59 (53.5%) patients. Histological diagnosis, type of inflammation, type or number of foreign bodies, imaging modality or site of foreign material had no association with radiological detectability (p > 0.05). According to our results, histopathology is a more accurate diagnostic tool than radiology in periapical foreign bodies or foreign body reactions. Clinicians should keep in mind the limitations of imaging when setting the diagnosis and planning treatment. [ABSTRACT FROM AUTHOR]

The microscopic diagnostic differentiation of odontogenic cysts from other cysts is intricate and may cause perplexity for both clinicians and pathologists. Of particular interest is the odontogenic keratocyst (OKC), a developmental cyst with unique histopathological and clinical characteristics. Nevertheless, what distinguishes this cyst is its aggressive nature and high tendency for recurrence. Clinicians encounter challenges in dealing with this frequently encountered jaw lesion, as there is no consensus on surgical treatment. Therefore, the accurate and early diagnosis of such cysts will benefit clinicians in terms of treatment management and spare subjects from the mental agony of suffering from aggressive OKCs, which impact their quality of life. The objective of this research is to develop an automated OKC diagnostic system that can function as a decision support tool for pathologists, whether they are working locally or remotely. This system will provide them with additional data and insights to enhance their decision-making abilities. This research aims to provide an automation pipeline to classify whole-slide images of OKCs and non-keratocysts (non-KCs: dentigerous and radicular cysts). OKC diagnosis and prognosis using the histopathological analysis of tissues using whole-slide images (WSIs) with a deep-learning approach is an emerging research area. WSIs have the unique advantage of magnifying tissues with high resolution without losing information. The contribution of this research is a novel, deep-learning-based, and efficient algorithm that reduces the trainable parameters and, in turn, the memory footprint. This is achieved using principal component analysis (PCA) and the ReliefF feature selection algorithm (ReliefF) in a convolutional neural network (CNN) named P-C-ReliefF. The proposed model reduces the trainable parameters compared to standard CNN, achieving 97% classification accuracy. [ABSTRACT FROM AUTHOR]

Introduction: Tartrate-resistant acid phosphatase (TRAP) is an acid phosphatase metalloprotein enzyme expressed in osteoclasts and is related to bone resorption. The molecular mechanisms involved in the different behavior of odontogenic keratocysts have not yet been fully elucidated. The purpose of this study was to compare TRAP expression in odontogenic keratocysts, radicular cysts, and dentigerous cysts. Materials and Methods: In this cross-sectional study, we selected 60 samples, including 20 cases of each one of the odontogenic keratocysts (OKC), radicular cysts (RC) and dentigerous cysts (DC). The samples were stained with TRAP monoclonal antibodies using immunohistochemistry. The data were analyzed using the Chi-Square and Kruskal-Wallis tests. Results: In this study, TRAP expression was observed in the lining epithelium of 50% of OKC cases and 5% of RC cases, while it was negative in the lining epithelium of DC. This difference was statistically significant (p<0.001). Moreover, the TRAP staining intensity in the lining epithelium had a significant difference between the groups (P<0.001). TRAP expression in the connective tissue of OKC, RC, and DC was positive in 35%, 30%, and 20% of the cases, respectively. This difference was not statistically significant (P=0.788). Also, staining intensity of TRAP-positive cells in the connective tissue of the lesions was not significant (P=0.634). Conclusion: In this study, we found a higher expression of TRAP in the lining epithelium of OKC, which may be one of the reasons for the aggressive behavior of OKC compared to other cysts. This finding supports the classification of OKC as an odontogenic tumor. [ABSTRACT FROM AUTHOR]

Background: This study is done to evaluate the immunohistochemical expression of E-cadherin and N-cadherin in glandular odontogenic cysts (GOC), inflammatory periodontal (IPDL) cysts, and dental follicles (DF), and if there is a correlation with their biological behavior GOC, IPDL cysts, and DF cases were collected and investigated by immunohistochemistry. The area percent of immunoexpressed markers was calculated by SPSS version 25. Results: The statistical analysis revealed a clear, statistically significant difference between the studied groups regarding the area percentage of the two immune-expression markers (p value = 0.000). The highest area percentage of the mean value of E-cadherin was recorded in IPDL cysts group with the most negligible value recorded in the group of GOC. On the other hand, the highest area percentage of the mean value of N-cadherin was documented in the group of GOC with the least recorded value was noted in the group of DF. Conclusion: We noted that the cadherin switch mechanism in the epithelial lining of odontogenic cysts is a critical step in the epithelial mesenchymal transition process which may associates with clinical behavior and may also impact the mode of treatment. [ABSTRACT FROM AUTHOR]

Background: Periapical lesions develop in response to chronic stimulation of an infected root canal in the periapical tissue. Two of the most common periapical inflammatory lesions are periapical cysts and granulomas. A mast cell is a round to elliptical immune cell that originates from bone marrow stem cells and enters peripheral blood, secreting histamine, heparin, cytokines, and chemokines under the influence of triggers. The present study aimed to evaluate mast cell density in periapical cysts and granulomas.Materials and Methods: This descriptive cross-sectional study was performed on 60 samples of periapical inflammatory lesions, including radicular cysts and periapical granulomas. Sections were stained with Giemsa and then the number of mast cells were counted in five random areas of the cyst and granuloma walls. The results were analyzed in SPSS software (version 23) using the Mann-Whitney test. P-value

The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period. [ABSTRACT FROM AUTHOR]

Aim: The present study was conducted for assessing variability in calretinin expression among odontogenic cysts as well as tumor cases. Materials and Methods: Fifteen cases were included in the present research consisting of cases like – dentigerous cyst, odontogenic keratocyst, apical radicular cyst along with tumors like ameloblastoma, ameloblastic carcinoma, adenomatoid odontogenic tumor. Calretinin antibody was used for immunohistochemical staining. The amount of expression of this calretinin was statistically analyzed with the help of Chi-square test where P < 0.05 was considered noteworthy statistically. Results: Most cases of ameloblastomas were highly positive for calretinin expression as compared to other cysts and tumors. Therefore, the correlation of this variation of expression of calretinin was statistically noteworthy (P = 0.00). Conclusion: In this study, we concluded that for ameloblastomas, calretinin can be a specific marker immunohistochemically and can help in identifying the amount of aggressive spread of various odontogenic tumors. [ABSTRACT FROM AUTHOR]

Radicular cysts are the most common odontogenic cyst arising from epithelial cell rests of Malassez in the periodontal ligament and proliferate peripherally as a result of inflammation caused by infection at the root apices. They slowly grow apically causing bone resorption and displacement of the adjacent teeth which radiographically is seen as a radiolucent unilocular lesion. Management of such bone defects can be done by using various bone graft substitutes such as autogenous, allografts, xenografts and alloplasts. Taking account of the benefits of using synthetic bone graft substitutes, the following case represents the successful management of a radicular cyst, which includes endodontic treatment and cyst enucleation, chemical cauterization followed by introduction of antibiotic (Vancomycin) releasing calcium sulfate filler beads into the defect.

Teeth with persistent apical periodontitis represent a challenge in clinical practice, because bone repair cannot be promoted in certain situations with endodontic retreatment alone. Thus, periapical surgical approaches are needed, especially when dealing with true cysts, or in cases of extraradicular biofilm. This case report describes a case of endodontic surgery on teeth 11, 21 and 22, by using leukocyte and platelet-rich fibrin (L-PRF), considering previous endodontic retreatment. The planning included cone beam computed tomography images, surgical treatment with periapical lesion curettage, apicoectomy, retrograde preparation, retrograde filling, and grafting with plugs and L-PRF membranes. A 2-year clinical, radiographic and tomographic follow-up showed bone repair and absence of clinical signs of infection. The use of contemporary techniques, combined with modern imaging resources in diagnosis, planning and follow-up favored the success of the treatment. [ABSTRACT FROM AUTHOR]

Periapical cysts or radicular cysts are inflammatory processes formed in the periapex of a tooth that presents pulp necrosis. They start from the proliferation of epithelial remnants of Malassez through the inflammatory process. This study aims to demonstrate a clinical case of inflammatory periapical cyst associated with a treatment of (GTR), in which the diagnostic hypothesis and the determination of the correct treatment plan will be confirmed through images from the Cone Beam Computed Tomography. After local anesthesia with 2% lidocaine, a horizontal intrasulcular incision and a vertical relaxant beyond the mucogingival junction were performed to fold the flap. Osteotomy for widening access to the cyst region, wound curettage, and decontamination of the root surface. Insertion of the biomaterial and covering with an absorbable collagen membrane. The use of the RTG technique associated with the assessment of CBCT, and the trans and postoperative care proved to be effective for a correct prognosis. [ABSTRACT FROM AUTHOR]

This study examines oral cavity pathologies' prevalence and age distribution in pediatric patients. All biopsy records performed in Tokat Gaziosmanpaşa University Faculty of Dentistry, Oral and Maxillofacial Surgery clinic between 2013-2023 were obtained from patient files and electronic databases. The files of patients aged 0-18 were selected, and demographic data and biopsy results were examined. The study population was divided into three groups according to the condition of the dentition. Pathology results were analyzed in 4 groups: developmental odontogenic cysts, inflammatory odontogenic cysts, tumoral lesions, and others. Obtained data and classifications were subjected to statistical analysis. A total of 411 biopsy results in pediatric patients were included in the study. Compared to all biopsies taken, a rate of 17.5% was observed. Since only three patients in the 0-6 age group were observed, they were not included in the statistical analysis. 69.3% of all pathologies were observed in the 12-18 age group and 30% in the 6-12 age group. The most common pathologies were radicular cysts (37.9%), dentigerous cysts (17.9%), and giant cell granulomas (7%). An increase in the prevalence and diversity of pathologies was observed with increasing age. In addition, developmental odontogenic cysts had significantly larger lesion sizes compared to inflammatory odontogenic cysts and other groups in terms of pathology dimensions (p:0.001 and p:0.000). In patients under 18 years of age, the prevalence of pathologies and diagnostic diversity increase as age progresses. Radicular cysts, dentigerous cysts, and giant cell granulomas are among the most common lesions. [ABSTRACT FROM AUTHOR]

Bone loss is strongly associated with the immunologic milieu in apical periodontitis (AP). Tertiary lymphoid structures (TLSs) are organized lymphoid cell aggregates that form in nonlymphoid tissues under persistent inflammatory circumstances. To date, there has been no relevant report of TLSs in periapical lesions. This work aimed to investigate the formation and potential function of TLSs in AP. Tissues from human apical lesions (n = 61) and healthy oral mucosa (n = 5) were collected. Immunohistochemistry and multiplex immunofluorescence were used to detect the formation of TLSs. Correlation analyses were performed between clinical variables and TLSs. In addition, immunohistochemistry was used to evaluate the expression of interleukin-1 beta, interleukin-6, receptor activator of nuclear factor kappa-B ligand, and macrophage subsets in the apical lesions. Periapical granulomas (n = 24) and cysts (n = 37) were identified by histologic evaluation. TLSs, composed of B-cell and T-cell clusters, developed in periapical granulomas and radicular cysts. The CXC-chemokine ligand 13, its receptor CXC-chemokine receptor 5, follicular dendritic cells, and high endothelial venules were localized in TLSs. The quantity and size of TLSs were positively associated with bone loss in AP. Moreover, proinflammatory cytokines and macrophage subsets were also substantially elevated in TLS regions of apical lesions. The formation of TLSs in periapical granulomas and cysts was closely associated with persistent immune responses and bone loss in apical lesions. TLSs provide an updated insight into the complicated immune response process in AP. [ABSTRACT FROM AUTHOR]