Quiste óseo simple de resolución espontánea: reporte de caso y revisión de la literatura / Simple bone cyst of spontaneous resolution: case report and literature review

Introducción: El quiste óseo simple (QOS) es un pseudoquiste intraóseo, de etiología desconocida que representa el 1% de los quistes maxilares. Radiográficamente se observa una imagen radiolúcida de bordes bien definidos, irregulares o festoneados. Su tratamiento consiste en la exploración quirúrgica y curetaje de paredes óseas. En pocas ocasiones se ha descrito resolución espontánea. El propósito de este documento es presentar un caso de QOS de resolución espontánea y realizar una revisión de literatura.Reporte de caso:Mujer de 12 años consulta para evaluación odontológica de rutina. En radiografía panorámica se observa lesión radiolúcida entre raíces de dientes 4.4 y 4.5, de límites bien definidos corticalizados. Se complementó con tomografía computarizada de haz cónico, donde se observó adelgazamiento de tablas óseas. Se realizó un diagnóstico presuntivo de QOS. Se controló a los 3 y 3,5 años observándose hueso de leve mayor densidad que el hueso circundante.Materiales y métodos:Se realizó una revisión de literatura sobre QOS de resolución espontánea en PubMed, Scopus y Web of Science, relacionando los términos libres “simple bone cyst” “spontaneous resolution” “jaws” y sus variantes.Resultados:Se encontraron 13 casos de QOS de resolución espontánea. Las características clínicas y radiográficas de los casos coinciden con la literatura. El 54% de los casos tuvo resolución espontánea en un periodo menor o igual a 5 años.Conclusión:En el presente caso se realizó el seguimiento radiográfico del paciente, demostrando que controlar en el tiempo puede considerarse como tratamiento, ya que la lesión podría resolverse espontáneamente.(AU)

Introduction: Simple bone cyst (SBC) is an intraosseous pseudocyst, of unknown etiology, which represents 1% of maxillary cysts. Radiographically, a radiolucent image with well-defined, irregular or scalloped edges is observed. Treatment consists of surgical exploration and curettage of bone walls. Spontaneous resolution has rarely been described. The purpose of this paper is to present a case of spontaneous resolution of SBC and perform a literature review.Case Report:A 12-year-old woman attends to a routine dental evaluation. Panoramic radiography shows a radiolucent image between roots of teeth 4.4 and 4.5, of well-defined corticated borders. It was complemented with cone-beam computed tomography examination, where thinning of cortical bone was observed. A presumptive diagnosis of SBC was performed. Controls at 3 and 3,5 years were performed and bone of slightly higher density than the surrounding bone was observed.Materials and methods:A literature review on SBC of spontaneous resolution was performed in PubMed, Scopus and Web of Science, relating the free terms “simple bone cyst” “spontaneous resolution” “jaws” and their variants.Results:13 cases of spontaneous resolution of SBC were found. The clinical and radiographic characteristics of the cases coincide with the literature. 54% of cases had spontaneous resolution in a period of 5 years or less.Conclusion:In the case presented, radiographic follow-up of the patient was performed, demonstrating that following-up can be considered as treatment, since the lesion could resolve spontaneously.(AU)

Stafne’s bone defect: a systematic review

Background: This systematic review integrated the available data published in the literature on Stafne's bone defect (SBD), considering the clinical, imaging and histopathological results. Material and methods: An electronic search was undertaken in six databases. Eligibility criteria were: articles in English, Spanish, and Portuguese describing case reports or case series of SBD, reported up to September/2021. Risk of bias was assessed using the Joanna Briggs Institute tool. Results: A total of 98 articles were retrieved, involving 465 individuals with SBD and were included for quantitative analysis. Mean age was 52.78 years (range: 11-89 years), with male predilection (n=374/80.85%). Radiographs were the most frequent imagiological exams (n=298/64.09%), followed by computed tomography (n=98/21.08%). SBD was more prevalent in the posterior mandible (n=361/93.77%) as a hypodense radiolucent lesion (n=250/77.40%). Mean size was 1.58 cm (range: 0.3-.8.0 cm). Two-hundred-and-two lesions (97.37%) were unilocular and 126 (91.97%) were classified as well-defined. Clinical symptoms were reported in 73 cases, while 68 cases (93.15%) were asymptomatic. Only 34 cases (12.32%) were submitted to histopathological examination. Mean follow-up time was 26.42 ±25.39 months. Conclusions: SBD is more frequent in male patients in the fifth and sixth decade of life. Classic SBD is radiographically characterized as a single, unilocular and well-defined lesion in the posterior region of the jaw with a radiolucent/hypodense appearance. (AU)

Quiste óseo solitario / No disponible

INTRODUCCIÓN: El quiste óseo solitario representa el 1% de todos los quistes maxilares. Es una lesión ósea benigna que aparece de forma fortuita en una radiografía de control en la primera/segunda década de la vida, aunque la lesión carezca de trascendencia en la vida del paciente requiere de abordaje quirúrgico para confirmar el diagnóstico. CASO CLÍNICO: Se presenta un caso clínico de una paciente mujer de 11 años de edad y raza negra, remitida al Servicio de Cirugía Bucal del Hospital Virgen de la Paloma tras observarse imagen radiotransparente apical a nivel de 43 y 44. Una vez realizada la exploración clínica y radiológica se propone cirugía exploratoria ante diagnóstico de presunción de quiste óseo solitario. Bajo anestesia local se procedió al abordaje quirúrgico observándose cavidad vacía en maxilar inferior sin contenido alguno, legrándose profusamente las paredes de la cavidad e introduciendo plasma rico en plaquetas obtenido previamente de la paciente. CONCLUSIONES: La cirugía exploratoria confirma el diagnóstico de presunción de quiste óseo solitario vacío al no poderse mandar a analizar a anatomía patológica

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Oral pulse granuloma and oral pulse granuloma associated with odontogenic keratocyst: two clinical cases and a review of the literature / Granuloma oral pulse y granuloma oral pulse asociado a un queratoquiste odontogénico: 2 casos clínicos y revisión de la literatura

Two cases of oral pulse granuloma (OPG) or vegetable granuloma (VG) are presented, one of which was concomitant with an odontogenic keratocyst (OKC), which is an unusual finding. OKC is characterized by the presence of hyaline rings which include vessels, giant cells, other inflammatory cells and collagen fibres. There are two hypotheses as to its histogenesis: firstly, as a reaction to vegetable matter, such as legumes (thus the nomenclature "pulse" or edible seed) and secondly as a degenerative change in the vessel walls as a result of localized vasculitis. Due to the deceptive appearance of OPG, diagnosis can be challenging

En este artículo breve se presentan 2 casos de granuloma oral pulse (GOP) o granuloma vegetal, uno de ellos asociado a un queratoquiste odontogénico. Esta entidad está caracterizada por la presencia de estructuras hialinas en anillo que incluyen vasos, células gigantes, otras células inflamatorias y haces de fibras de colágeno. Sobre su origen todavía se barajan 2 hipótesis: una en la que se sospecha que se producen como reacción a estructuras vegetales como legumbres (de donde toma el nombre de «pulse» o semilla comestible de una leguminosa), y otra en la que se trataría de un cambio degenerativo de las paredes vasculares, resultado de una vasculitis localizada. Debido a la apariencia engañosa del GOP es fácil que a los patólogos les suponga un esfuerzo su diagnóstico. Se describe a continuación un hallazgo inusual de un GOP relacionado con un queratoquiste odontogénico

Fractura mandibular tardía post exodoncia de molares inferiores. Caso clínico / Late mandibular fracture after lower third molar extraction: a case report

La extracción del tercer molar es un procedimiento común en cirugía oral. Una de las complicaciones es la fractura mandibular. Con una incidencia postoperatoria menor a un 0.005%. Los factores que contribuyen al riesgo de fractura del ángulo mandibular después de una extracción del tercer molar incluyen el nivel de impactación, la anatomía del diente, infecciones locales previas, edad, sexo, presencia de formaciones quísticas y bruxismo entre otras. Presentamos un caso clínico de fractura mandibular postoperatoria a las cinco semanas tras la exodoncia del 47 y 48 incluidos en posición horizontal. El objetivo final del tratamiento de una fractura mandibular es la consolidación ósea manteniendo la oclusión dental. En nuestro caso, al no tratarse de una fractura que sobrepasaba las corticales y sin desplazamiento mandibular, no fue subsidiaria de un tratamiento quirúrgico y se resolvió con reposo funcional

The lower third molar extraction is a common procedure in oral surgery. One of its complications, although uncommon, is the mandibular fracture. Postoperatively, it has an incidence lower than 0.005%. The factors that may contribute to the risk of the mandibular angle fracture after an extraction of the third molar include the level of impaction are the anatomy of the tooth, previous local infections, age, sex, cysts and bruxism among others. We present a clinical case of postoperative mandibular fracture at five weeks after the extraction of 47 and 48 included in horizontal position. The ultimate treatment goal of a mandibular fracture is to reach a bone consolidation with the premorbid dental occlusion. In our case, as it was not a fracture that surpassed the cortical and there was not a mandibular displacement, it was not need a surgical treatment so it was resolved with functional rest

The effectiveness of decompression as initial treatment for jaw cysts: A 10-year retrospective study

Background: To assess the effectiveness of a psychoeducational intervention program designed to facilitate the performance of a series of steps of oral examination in children, adolescents and adults with autism spectrum disorder (ASD), in the Bio-Bio region, Chile. Material and Methods: A prospective, quasi-experimental study with pre-intervention, post-intervention and maintenance tests was carried out. Behavior was measured using Frankl’s scale and the number of steps of a dental examination completed (1-10 steps) was also recorded. Only 104 of the 188 subjects with ASD that agreed to participate in the study met all the inclusion criteria. Results: 82 people with ASD completed the psychoeducational intervention. The mean number of steps achieved pre- and post-intervention was 4.1 and 9.4, resulting in a clinically and statistically significant difference. Regarding behavior, the median in the pre-test was 2 (negative behavior) and in the post-test it increased to 3 (positive behavior), this difference being relevant and statistically significant. A maintenance test one month later on 63 people with ASD found no variations in behavior and in the number of examination steps completed. Conclusions: The proposed intervention was effective as an increase of more than 5 in the number of steps of examination completed was achieved. Frankl's behavior rating also increased, from negative to positive, in a group of children, adolescents and adults with ASD

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Quiste bucal mandibular infectado bilateral en segundos molares permanentes: reporte de un caso / Bilateral mandibular infected buccal cyst in second permanent molars: a case report

El quiste bucal mandibular infectado corresponde a una lesión poco frecuente, de etiología desconocida, que se presenta en niños de 6 a 13 años, generalmente de forma unilateral, durante el proceso de erupción de los primeros molares permanentes. Con menor frecuencia puede afectar a segundos molares permanentes. El diente asociado a la lesión se encuentra vital, presentando un patrón alterado de erupción. Puede presentarse sintomatología, sensibilidad, incremento en la profundidad del saco periodontal, aumento de volumen en fondo de vestíbulo y supuración. Además, puede observarse un retraso en la erupción del molar involucrado, con inclinación de su corona hacia vestibular. Al examen imagenológico se observa una lesión radiolúcida sobre la corona del molar comprometido, rodeada por un halo radiopaco de concavidad superior sobreproyectado parcialmente sobre sus raíces. Este quiste no presenta características histológicas específicas, por lo que el diagnóstico de esta lesión debe realizarse en base a las características clínicas, imagenológicas e histopatológicas. Se presenta un particular caso clínico de quiste bucal mandibular infectado bilateral en segundos molares permanentes

The mandibular infected buccal cyst is an infrequent lesion, of unknown etiology, presented usually in 6-13-year-old children. Generally, this cyst occurs unilaterally, in association with tooth eruption of first lower permanent molars. With a lower frequency, it can affect second lower permanent molars. The associated tooth is found to be vital, with an altered eruption pattern. This tooth may show some symptoms, such as sensitivity, clinical appearance of periodontal pocket, swelling of the buccal vestibule and suppuration. Moreover, a delayed eruption of the involved molar can be seen, with its crown buccally tilted. The imaging examination shows a radiolucent lesion over the crown and rootsof the involved tooth, surrounded by a concave up radiopaque inferior margin. This cyst does not have any specific histological features; thus, its diagnosis should be performed based on its clinical, histological and imaging features. An unusual clinical case of a mandibular infected buccal cyst involving both second permanent mandibular molars is reported

Marsupialization facilitates movement of the cystic lesion-associated deeply impacted mandibular third molar in spite of its mature roots

Background: The odontogenic cystic lesions happened in the angle and ramus region are frequently associated with impacted mandibular third molars. The treatment plan was difficult to work out for the huge cystic lesions with deeply impacted third molars, since the enucleation with simultaneously removing the deeply impacted teeth may cause serious complications. Therefore, the marsupialization of the cystic lesions followed by enucleation with tooth removal has also been advocated. The aim of this study was to explore the movement of cystic lesion associated deeply impacted mandibular third molars (IMTM) after marsupialization. Material and Methods: Between July 2009 and December 2015, patients who had mandibular cystic lesion associated with IMTM and underwent marsupialization followed by enucleation with tooth extraction were included in our retrospective study. The clinical and pathological data was collected. The distance and direction of movement of the IMTM after marsupialization was measured on panoramic radiograph and computed tomography. Results: Four male and six female patients whose ages ranged from 14 years to 67 years were enrolled in this study. Among the all impacted molars, there were 3 cases with mature roots. After marsupialization, all the cystic lesions shrunk and all impacted teeth moved toward the bony windows, and the distance of tooth movement were from 8.3mm to 12.1mm. The complications included swelling and pain, while no numbness of the ipsilateral lower lip was happened. Conclusions: Marsupialization can promote the movement of impacted teeth with or without mature roots, and may be an optimal treatment approach for the huge posterior mandibular cystic lesions with deeply impacted third molar (AU)

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Reduction rate by decompression as a treatment of odontogenic cysts

Background: Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization or decompression of odontogenic cyst are treatment approach to this pathology. The aim of this study was to evaluate the effectiveness of the decompression as the primary treatment of the cystic lesions of the jaws and them reduction rates involving different factors. Material and Methods: 23 patients with odontogenic cysts of the jaws, previously diagnosed by anatomical histopathology (follicular cysts (7) and radicular cysts (16)) underwent decompression as an initial treatment. Clinical examination and pre and post panoramic radiograph were measured and analyzed. In addition, data as gender, age, time reduction and location of the lesion were collected. Results: Significant results were obtained in relation to the location of lesions and the reduction rate (p< 0.01). In a higher initial lesion, a greater reduction rate was observed (p< 0.05). Conclusions: Decompression as an initial treatment of cystic lesions of the jaws was effective; it reduces the size of the lesions avoiding a possible damage to adjacent structures. Cystic lesions in the mandible, regardless of the area where they occur will have a higher reduction rate if it is compared with the maxilla. Similar behavior was identified in large lesions compared to smaller (AU)

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Simple and aneurysmal bone cyst: Aspects of jaw pseudocysts based on an experience of Brazilian pathology service during 53 years

BACKGROUND: Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. MATERIAL AND METHODS: A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. RESULTS: Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. CONCLUSIONS: The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws

Presentación de un quiste óseo aneurismático mandibular de gran tamaño. Reporte de un caso y revisión de la literatura / Presentation of an aneurysmal bone cyst mandibular of great size. A case report and review of the literature

Un quiste es una cavidad patológica que puede contener una sustancia líquida, semilíquida o gaseosa. Aparecen como consecuencia de una reacción inflamatoria (quistes inflamatorios) o por causa no conocida (quistes del desarrollo). Comúnmente la cavidad está recubierta por una cápsula constituida por un tejido conectivo subyacente y un epitelio en el lumen, excepto en los pseudoquistes que carecen de tejido epitelial, como es el caso que nos ocupa donde presentamos un paciente con quiste óseo aneurismático (QOA). Esta lesión se presenta con una frecuencia del 1,2% de los quistes maxilares y 2% de los que aparecen en todo el organismo. El objetivo de este trabajo es elaborar una revisión de la literatura y presentar un caso clínico de un paciente de 21 años de raza negra, masculino que consultó al servicio de cirugía maxilofacial de la Facultad de Odontología de la Universidad de Antioquia, por presentar un aumento de volumen en cuerpo mandibular derecho. Al examen radiográfico se encuentra una imagen radiolúcida de gran tamaño. Al paciente se le practicaron dos biopsias previas que dieron un diagnóstico distinto (tumor odontogénico queratoquístico y quiste radicular inflamatorio) pero el diagnóstico definitivo del espécimen quirúrgico fue quiste óseo aneurismático (QOA). Se escribe su manejo y se hace una revisión de la literatura (AU)

A cyst is a pathologic cavity that can contain a liquid substance, semi-liquid or gaseous. Appear as a result of an inflammatory reaction (inflammatory cysts) or for reasons not known (cysts of development). Commonly the cavity is covered by a capsule formed by connective tissue and underlying a epithelium in the lumen, except in the pseudocysts that lack of epithelial tissue, as is the case where we present a patient with aneurysmal bone cyst (QOA). This injury occurs with a frequency of 1.2 % of the cysts maxillary and 2% of those who appear throughout the body. The objective of this paper is to present a clinical case of a patient of 21 years of black male that consulted to the maxillofacial surgery service of the Faculty of Dentistry at the University of Antioquia, by presenting a volume increase in right mandibular body. The radiographic examination is a radiolucent image of great size. The patient will be practiced two previous biopsies that gave a diagnosis other than (odontogenic tumor queratocyst and radicular cyst inflammatory) but the definitive diagnosis of the surgical specimen was aneurysmal bone cyst (QOA). It describes its handling and is performed a review of the literature (AU)

Demographic profile of oral nonodontogenic cysts in a Brazilian population

OBJECTIVES: The purpose of this study was to determine the clinical and demographic characteristics of oral nonodontogenic cysts (ONOC) in a Brazilian population over a 53-year period and to compare this data with the literature.Study DESIGN: A total of 20.391 biopsies records were evaluated, from April/1959 to August/2012. Cases of oral developmental cysts were selected. Data regarding age, gender, time of evolution, and anatomic site of all cases were collected. The data were analyzed by descriptive statistics. RESULTS: Among 20.391 oral biopsies, 71 (0.35%) met the criteria of ONOC. Females accounted for 50.70% of all cases. The mean age observed was 38.14 years (range: 5-88 years). Nasopalatine duct cysts, oral lymphoepithelial cysts and epidermoid cysts were the most common ONOC, accounting for 63 cases (88.73%). Nasopalatine duct cysts occurred in 31 cases (43.66%), followed by 22 patients with oral lymphoepithelial cysts (30.99%) and 10 cases of epidermoid cysts (14.08%). Nasopalatine duct cysts revealed predominance among males (58.06). Oral lymphoepithelial cysts were more commonly observed in tongue (50%). Epidermoid cysts were most frequently found in the buccal mucosa (40.00%).CONCLUSIONS: The differential diagnosis of ONOC is based on the clinical, radiological, and histological findings. It is difficult to establish an epidemiological profile of ONOCs, considering the low frequency of these lesions and the divergences in the demographic and clinical presentation data among different populations

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Aparición inusual de queratoquiste odontogénico / Unusual appearance of odontogenic keratocyst

El queratoquiste KCOT (siglas en inglés) es una forma de desarrollo de un quiste odontogénico, debido a sus características histopatológicas específicas, un comportamiento biológico agresivo y un alto grado de recurrencia. La localización más frecuente del KCOT es el cuerpo posterior de la mandíbula y la rama. El KCOT muestra a menudo un área radiolúcida bien definida con márgenes lisos y escleróticos mientras que una gran lesión puede aparecer multilocular. El tratamiento puede ser conservador tales como la enucleación, las descompresiones y marsupialización o tratamientos agresivos que incluyen ostectomía periférica con instrumentos rotatorios, crioterapia con nitrógeno líquido, la aplicación de solución fijadora de Carnoy y resección mandibular. La erradicación del quiste y la reducción de los riesgos de recurrencia y morbilidad de la cirugía son los objetivos principales de todas las técnicas. Se reporta caso de un KCOT localizado en región anterior del maxilar superior en un paciente masculino de 26 años de edad, el cual es remitido al servicio de Estomatología y Cirugía Oral de la Universidad de Cartagena

Keratocyst is a development odontogenic cyst, because of their specific histopathology features, aggressive biological behavior and a high degree of recurrence. The most common site is the body KCOT posterior mandible and ramus. KCOT shows a well-defined radiolucent area with sclerotic margins smooth and often while a large lesion may appear multilocular. Treatment may be conservative such as enucleation (with or without curettage), the decompression and marsupialization or aggressive treatments including peripheral ostectomy with rotary instruments, cryotherapy with liquid nitrogenand application of Carnoy's fixative and jaw resection. The eradication of the cyst and the reduction of risk of recurrence and morbidity of surgery are the main objectives of all techniques. We report a case of KCTO located in anterior maxilla in a male patient of 26 years old, which is sent to the service of Stomatology and Oral Surgery, University of Cartagena

Prevalencia de tumores odontogénicos en el Hospital Base Valdivia, periodo 1989-2008 / Odontogenic tumors in Valdivia: Prevalence from 1989 to 2008

Objetivo: Este artículo corresponde a un estudio observacional de tipo descriptivo de corte transversal, tiene como objetivo determinar la prevalencia de tumores odontogénicos en la población atendida en el Hospital Base Valdivia, en un periodo de 20 años (1989-2008), según la nueva clasificación de lesiones tumorales de la WHO, 2005. Metodología: Se revisaron 2.078 informes de biopsias correspondientes a lesiones de la cavidad oral de los archivos de informes del servicio de Anatomía Patológica, Hospital Base Valdivia entre enero del año 1989 y diciembre del año 2008. Como criterios de inclusión están la presencia de un diagnóstico histopatológico en la ficha y legibilidad de ésta. Las variables a analizar incluyen: edad, género, diagnóstico histopatológico, tipo de tumor y área de localización. Los datos recolectados fueron tabulados en planilla de base de datos, para su posterior análisis estadístico. Resultados: De las 2.078 biopsias del territorio bucal, 31 corresponden a tumores odontogénicos, lo que representa un 1,5% de todas las lesiones biopsiadas del territorio oral. Una lesión maligna fue encontrada y corresponde a carcinoma ameloblástico infiltrante. La lesión más frecuente correspondió a tumor odontogénico queratoquístico (41,9%), seguido por el ameloblastoma (22,6%) y, por último, odontoma (16,1%). El promedio de edad de 35,7 años. El área más frecuente de presentación es el área molar mandibular (54,8%). Conclusión: Los tumores odontogénicos son de baja prevalencia en la población valdiviana atendida en el Hospital Base Valdivia entre los años 1989-2008. No tiene predilección por género. La lesión más prevalente es el tumor odontogénico queratoqísitico (AU)

Objetive: This article corresponds to a descriptive cross sectional study , which aims to determine the prevalence of primary odontogenic tumors in population attending Hospital Base Valdivia, during a period of 20 years (1989-2008), based on the WHO´s 2005 new classification of tumors. Methodology: 2,078 reports of biopsies for lesions oral cavity from Pathology Service Hospital Valdivia Base, between January 1989 and December 2008 were reviewed. The presence of an histologically confirmed diagnosis in the patient´s chart and readability of it were considered as inclusion criteria. The variables analyzed included age, gender, histological diagnosis tumor type and location of this area. The collected data was tabulated in database spreadsheet for subsequent statistical analysis. Results: Of the 2,078 biopsies of oral territory, 31 correspond to tumors odontogenic, representing 1.5% of all biopsied lesions territory oral. A malignant lesion was found and corresponds to ameloblastic carcinoma infiltrating. The most frequent lesion corresponded to odontogenic keratocyst tumours (41.9%), followed by ameloblastoma (22.6%), and finally odontoma (16.1%). The average presentation age is 35.7 years. The most common area of presentation is the mandibular molar area (54.8%). Conclusion: Odontogenic tumors are of low prevalence in Hospital Base Valdivia between 1989 to 2008. It´s more often in men, no gender predilection, being the most prevalent lesion tumor odontogenic keratocysts (AU)

Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus

Objective: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT).Study Design: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for followup. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. Results: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). Conclusion: CBCT scanning detect MRCMS more accurately than panoramic radiography (AU)

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Diagnóstico diferencial inmunomorfológico de las lesiones quísticas maxilares con queratinización / Immunomorphological differential diagnosis of maxillary cystic lesions with keratinization

Objetivos. Los quistes maxilares con queratinización son formas lesionales de carácter controvertido y de relevancia clínica, dada la implicación clínico-evolutiva del llamado tumor odontogénico queratoquístico (TOQ). En el presente estudio nos planteamos valorar la utilidad de las técnicas inmunohistoquímicas en la identificación de estas lesiones. Material y métodos. Se analizan de forma retrospectiva las lesiones quísticas maxilares dotadas de fenómenos de queratinización interna, diagnosticadas en un mismo centro hospitalario, a lo largo de un periodo de 4 años, realizando un estudio inmunohistoquímico mediante la aplicación de un panel de cinco anticuerpos (Ki67, Bcl-2, p53, CK19, D2-40). Resultados. De un total de 410 lesiones quísticas maxilares, se seleccionaron 22 casos (5,36%) en los que existían rasgos morfológicos de queratinización interna. Aplicando los criterios morfológicos de la clasificación histológica de la OMS (2005) se diagnosticaron 15 TOQ y 4 quistes odontogénicos ortoqueratósicos (QOO), existiendo 3 observaciones con rasgos morfológicos híbridos de TOQ y de QOO. El estudio inmunohistoquímico llevado a cabo permitió realizar un certero diagnóstico diferencial entre el TOQ y el QOO, y además su empleo posibilitó adscribir de forma correcta las formas híbridas a cada uno de estos dos tipos lesionales. Conclusiones. El análisis inmunohistoquímico, con la aplicación de un panel de cinco anticuerpos, permite un diagnóstico certero de las lesiones quisticas maxilares con queratinización, permitiendo la diferenciación del TOQ frente al QOO, así como la correcta identificación de las lesiones de carácter morfológico híbrido(AU)

Objectives. Maxillary cystic lesions with keratinization are controversial lesions that are clinically relevant due to the prognostic implication of the so-called keratocystic odontogenic tumor (KOT). The aim of this study was to assess the usefulness of immunohistochemistry in the identification of KOTs. Material and methods. Retrospective study of all maxillary cystic lesions exhibiting keratinization diagnosed over a 4-year period in one hospital center. Immunohistochemical study using a panel of five antibodies (Ki67, Bcl-2, p53, CK19, D2-40) was performed. Results. Of a total of 410 maxillary cystic lesions, 22 cases (5.36%) showing morphological features of internal keratinization were selected. Using WHO-2005 histological criteria, 15 KOTs and 4 orthokeratotic odontogenic cysts (OOC) were diagnosed, as well as 3 cases with hybrid morphological characteristics. Immunohistochemical results accurately differentiated between KOT and OOC and allowed the hybrid forms to be correctly identified. Conclusions. Immunohistochemical analysis with a panel of five antibodies allows an accurate diagnosis of maxillary cystic lesions with keratinization, enabling the differentiation between KOT and OOC and the correct identification of cases of hybrid morphological characteristics(AU)

Jaw cysts at children and adolescence: A single-center retrospective studyof 152 cases in southern Bulgaria

One hundred fifty two cysts of the upper and lower jaw were examined at patients up to 18 years old treated in theClinics of Maxillo-Facial Surgery, University Hospital, Plovdiv, Bulgaria for the period 1998 – 2007. Patients weredistributed in four age groups (up to 4 years old, from 5 to 9 years old, from 10 to 14 years old, from 15 to 18 yearsold). Both sexes were constantly affected (52% male, 48% female). The biggest number cystic lesions were foundin the third age group (48.7%). The mandible was preferable localization of the lesions (69.7%). Dentigerous cystspredominated (61.8%) – more affected was third age group (31.6%). Radicular cysts were observed two times less(31.6%) – more affected were third (15.8%) and fourth (12.5%) age groups. The most frequently observed clinicalsymptom was presence of painless swelling (59.9%). The operative interventions were carried out predominantlyunder general anesthesia (81.6%) by intraoral approach (97.4%). The extraoral surgical approach was preferred infour cases only – three in third and one in fourth age groups (AU)

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Quiste óseo simple: Reporte de un caso y revisión de la literatura / Simple bone cyst: a case report and a literature review

El quiste óseo simple, es una cavidad intraósea sin recubrimiento epitelial, siendo considerado un pseudoquiste. Clínicamente, la lesión suele ser asintomática y descubierta por casualidad en un examen radiológico de rutina. Su etiología y patogenia no están aun definitivamente establecidas. El tratamiento tradicional consiste en realizar una exploración quirúrgica y curetaje de la pared ósea. En este artículo se presenta un caso de quiste óseo simple localizado en la sínfisis mandibular, de dimensión mediana, que acomete a un paciente de sexo masculino de 14 años de edad, revelando datos clínicos, aspectos diagnósticos, imagenológicos, así como su tratamiento (AU)

The simple bony cyst is an intraosseous cavity without epithelial lining, being considered a pseudocyst. Clinically, the lesion is usually asymptomatic and discovered by accident in a routine radiological examination. Its etiology and patogenesis are not yet definitely established. The traditional treatment consists of realizing a surgical exploration and curettage of the bony wall. This article presents a case of simple bony cyst located in the mandibular symphysis, of median dimension of a masculine patient of 14 years of age, describing clinical, diagnostic aspect, imaging, as well as the treatment (AU)

Retrospective clinicopathological study of 418 odontogenic cysts

Objectives: To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona(Spain).Study design: A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables,using the SPSS version 15.0.Results: The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm,with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%).Conclusions: The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to beslightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment (AU)

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Quiste globulomaxilar de localización inusual: Reporte de un caso / An unusual case of globulomaxillary cyst: a case report

El quiste globulomaxilar es un quiste no odontogénico localizado entre el incisivo lateral y canino del maxilar superior, radiográficamente aparece como una lesión radiolúcida unilocular que desplaza las mencionadas piezas dentarias mostrando una imagen de pera invertida característico de la lesión cuya lámina dura es continua y raras veces interrumpida. La valoración clínica radiográfica es importante para plantear en el diagnóstico diferencial la probable presencia del quiste globulomaxilar. La muestra anatomopatológica debe ser remitida íntegramente para su estudio y diagnóstico definitivo demostrando la presencia de tejido epitelial. Se presenta caso clínico de quiste globulomaxilar en un paciente femenino de 19 años de edad localizado entre canino y primer premolar superior izquierdo (AU)

Globulomaxillary cyst is a no odontogenic cyst usually located between maxillary lateral incisor and canine. Radiographic images appears like an unilocular radiolucent lesion that displaced dental teeth showing a invert pear image characteristic of the lesion. X ray and clinical examinations are important to establish the differential diagnosis of globulomaxillary cyst. The hystological examination must be send to its study and definitive diagnoses showing the presence of epithelial tissue. A clinical case of globulomaxillary cyst is presented in a 19–year– old female patient located between canine and left first premolar maxillary region (AU)