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1.
Clin Oral Investig ; 28(4): 213, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38480533

RESUMO

OBJECTIVE: The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. RESULTS: Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). CONCLUSION: Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. CLINICAL RELEVANCE: Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.


Assuntos
Substitutos Ósseos , Minerais , Cisto Radicular , Humanos , Transplante Ósseo/métodos , Estudos Retrospectivos , Cisto Radicular/cirurgia , Substitutos Ósseos/uso terapêutico , Regeneração Óssea
2.
BMC Oral Health ; 24(1): 223, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38347494

RESUMO

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.


Assuntos
Cisto Dentígero , Cistos Odontogênicos , Tumores Odontogênicos , Cisto Radicular , Humanos , Cistos Odontogênicos/metabolismo , Cistos Odontogênicos/patologia , Osteonectina , Cisto Radicular/metabolismo
3.
Int Endod J ; 57(3): 344-354, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38204205

RESUMO

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-ß signalling and IL-1ß 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-ß1 and IL-1ß. 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-ß1/2 and their downstream signalling suppressed odontogenic epithelial cell proliferation. Moreover, TGF-ß1 stimulation induced Smad2 phosphorylation and suppressed odontogenic epithelial cell proliferation, while IL-1ß stimulation reversed these phenotypes through p65 transactivation. CONCLUSIONS: These results suggest that IL-1ß-p65 signalling promotes odontogenic epithelial cell proliferation through suppressing TGF-ß-Smad2 signalling, which would be involved in the pathogenesis of radicular cysts.


Assuntos
Cisto Dentígero , Cistos Odontogênicos , Cisto Radicular , Humanos , Animais , Camundongos , Cisto Radicular/patologia , Fator de Crescimento Transformador beta1 , Cisto Dentígero/complicações , Cisto Dentígero/metabolismo , Cisto Dentígero/patologia , Antígeno Ki-67 , Descanso , Cistos Odontogênicos/patologia , Células Epiteliais , Epitélio/patologia , Proliferação de Células , Fator de Crescimento Transformador beta/metabolismo , Interleucina-1beta
4.
Appl Immunohistochem Mol Morphol ; 32(2): 111-116, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38062794

RESUMO

Odontogenic cysts are a diverse group of pathologic entities with different proliferation potential, leading to variations in their biological behavior. One of the most cited proliferation markers used in diagnostic histopathology is Ki-67. Another group of proteins recently investigated is minichromosome maintenance (MCM-3) and its expression has been evaluated in several odontogenic lesions but the results were controversial. Thus, the present study endeavored to compare the expression of MCM-3 and Ki-67 in odontogenic cysts. Furthermore, a pioneer attempt was made to evaluate the sensitivity of these markers to inflammation. A total of 101 cases (37 dentigerous cysts, 37 odontogenic keratocysts, and 27 radicular cysts) were included. Immunohistochemical expression of Ki-67 and MCM-3 were investigated using a labeling index (LI). In addition, they were scored for inflammation, followed by correlation with both markers. The data obtained were subjected to statistical analysis ( P <0.05). Overall, a higher LI of MCM-3 than Ki-67 was obtained in all study groups along with a positive correlation of Ki-67 LI with inflammation. Thus, MCM-3 proteins proved to be a more accurate means to determine the proliferation potential and were not sensitive to external stimuli like inflammation than conventional markers, such as Ki-67.


Assuntos
Cistos Odontogênicos , Tumores Odontogênicos , Cisto Radicular , Humanos , Antígeno Ki-67 , Cistos Odontogênicos/metabolismo , Cisto Radicular/diagnóstico , Cisto Radicular/patologia , Inflamação
5.
J Endod ; 50(3): 389-394, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38141830

RESUMO

Apical lesions of endodontic origin can be classified as either granulomas or cysts. In rare cases, respiratory epithelium can proliferate and encapsulate a lesion, forming a cyst. Moreover, the innervation of apical lesions has only been previously reported in animal models of apical periodontitis. This report demonstrates an unusual case in which tooth #15 was initially treated with nonsurgical root canal therapy. Still, the patient remained in moderate to severe pain for several days following the procedure. Next, an intentional replantation was performed in which a periapical cyst was curetted from the alveolus. The patient experienced immediate pain relief following the procedure. Histological analysis revealed that the periapical cyst was lined entirely with respiratory epithelium, and immunohistochemical analysis showed it to be densely innervated. In addition, these nerve fibers expressed the LPS receptor, TLR4. This is the first demonstration of the innervation pattern of a periapical cyst. Further studies are warranted to evaluate innervation in apical lesions and its correlation with pre- and intra-operative symptoms and their participation in the pathogenesis of apical periodontitis.


Assuntos
Periodontite Periapical , Cisto Radicular , Humanos , Cisto Radicular/patologia , Nociceptores/patologia , Periodontite Periapical/terapia , Tratamento do Canal Radicular/métodos , Dor
6.
Swiss Dent J ; 133(12): 810-815, 2023 Dec 04.
Artigo em Alemão | MEDLINE | ID: mdl-38051006

RESUMO

The radicular cyst is the most common odontogenic cyst and is caused by inflammation. It can become atypically large, although the size of the radiographic osteolysis says nothing about the entity of the lesion. This case shows an unusually large multilocular radicular cyst expanding buccally from tooth 46 in a patient with severe autism who can only be treated under general anesthesia. The clinical and radiological picture as well as the intraoperative situation was more indicative of an aggressive cyst or benign tumor. The lesion was surgically completely removed and the teeth 46, 47 and 48 were extracted because of poor compliance and prognosis. Histopathology revealed a radicular cyst. There were no postoperative complications. After eight months, the lesions had almost completely reossified.


Assuntos
Cistos Odontogênicos , Cisto Radicular , Humanos , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/cirurgia , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/patologia , Mandíbula/patologia , Radiografia , Cabeça/patologia
7.
J Pak Med Assoc ; 73(11): 2269-2272, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38013545

RESUMO

Periapical diseases ranges from mild granulomatous lesions to large cystic ones, with the treatments corresponding to their respective pre-operative diagnoses. However, the determination of cause of periapical radiolucency is impossible on pre-operative clinical and radiographic examinations. We present a case highlighting the difficulties encountered in treating a periapical cyst using the current evidence in literature. It demonstrates the uncertainty involved in treating such lesions, owing to the impossible nature of determining the histopathological nature of the cyst, i.e., being either true cysts or pocket cysts. This case includes orthograde re-treatment; decompression of the cystic lesion, followed by peri-apical surgery of two teeth over a course of three years; and the uncertain outcomes encountered after each phase of the treatment.


Assuntos
Doenças Periapicais , Cisto Radicular , Humanos , Incerteza , Cisto Radicular/patologia , Cisto Radicular/terapia , Doenças Periapicais/patologia , Doenças Periapicais/cirurgia
8.
Niger J Clin Pract ; 26(8): 1152-1156, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37635610

RESUMO

Background: Odontogenic cysts (OCs) are commonly encountered lesions affecting the human jaws having special clinical and radiographic features depending on cyst type. The aim of this study was to determine the prevalence of odontogenic jaw cysts in a Libyan population in Benghazi and to compare these data with previously published reports from Libyan and other geographic areas. Materials and Methods: This is a descriptive study where screening of 2189 biopsies (retrieved from the archives of The Department of Oral Pathology/University of Benghazi, Libya) was performed for the sake of recognizing the three cysts chosen for the purpose of this study. Results: : Out of the screened lesions, 276 cases (12.6%) were diagnosed as odontogenic cysts in the period from 2006 to 2019. Of those, 67.39% were inflammatory and 32.61% were developmental in nature. Radicular cysts (60.5%) were the most frequent cysts followed by dentigerous cysts (14.8%) and keratocysts (14.5%). The mean ages of the patients were 32.3, 29.7, and 33.2 years, respectively. Occurrence of the cysts was noticed more in the maxilla than in the mandible (1.3:1). The overall male-to-female ratio was 1.1:1. Conclusions: The prevalence of odontogenic cysts was similar to that reported in a previous study in Libya and other countries irrespective to WHO (2017) classification of odontogenic cysts.


Assuntos
Cistos Odontogênicos , Cisto Radicular , Humanos , Feminino , Masculino , Estudos Retrospectivos , Prevalência , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/epidemiologia , Biópsia
9.
Acad Radiol ; 30(10): 2329-2339, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37394410

RESUMO

RATIONALE AND OBJECTIVES: This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular cysts from granulomas. MATERIALS AND METHODS: This study included 109 teeth with periapical lesions of endodontic origin from 109 patients scheduled for apical microsurgery. Ultrasonic outcomes were analyzed and categorized after thorough clinical and radiographic examinations using US. B-mode US images reflected the echotexture, echogenicity, and lesion margin, while color Doppler US assessed the presence and features of blood flow of interested areas. Pathological tissue samples were obtained during apical microsurgery and subjected to histopathological examination. Fleiss' κ was used to measure interobserver reliability. Statistical analyses were performed to assess the diagnostic validity and the overall agreement between US and histological findings. The reliability of US compared to histopathological examinations was assessed based on Cohen's κ. RESULTS: The percent accuracy of US for diagnosing cysts, granulomas, and cysts with infection based on histopathological findings was 89.9%, 89.0%, and 97.2%, respectively. The sensitivity of US diagnoses was 95.1% for cysts, 84.1% for granulomas, and 80.0% for cysts with infection. The specificity of US diagnoses was 86.8% for cysts, 95.7% for granulomas, and 98.1% for cysts with infection. The reliability for US compared to histopathological examinations was good (κ = 0.779). CONCLUSION: The echotexture characteristics of lesions in US images correlated with their histopathological features. US can provide accurate information on the nature of periapical lesions based on the echotexture of their contents and the presence of vascularity. It can help improve clinical diagnosis and avoid overtreatment of patients with apical periodontitis.


Assuntos
Granuloma Periapical , Cisto Radicular , Humanos , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/patologia , Granuloma Periapical/diagnóstico por imagem , Granuloma Periapical/patologia , Reprodutibilidade dos Testes , Granuloma , Ultrassonografia
10.
Sci Rep ; 13(1): 10722, 2023 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-37400519

RESUMO

Recently, 1-nonadecene and L-lactic acid were identified as unique metabolites in radicular cysts and periapical granuloma, respectively. However, the biological roles of these metabolites were unknown. Therefore, we aimed to investigate the inflammatory and mesenchymal-epithelial transition (MET) effects of 1-nonadecene, and the inflammatory and collagen precipitation effects of L-lactic acid on both periodontal ligament fibroblasts (PdLFs) and peripheral blood mononuclear cells (PBMCs). PdLFs and PBMCs were treated with 1-nonadecene and L-lactic acid. Cytokines' expression was measured using quantitative real-time polymerase chain reaction (qRT-PCR). E-cadherin, N-cadherin, and macrophage polarization markers were measured using flow cytometry. The collagen, matrix metalloproteinase (MMP)-1, and released cytokines were measured using collagen assay, western blot, and Luminex assay, respectively. In PdLFs, 1-nonadecene enhances inflammation through the upregulation of some inflammatory cytokines including IL-1ß, IL-6, IL-12A, monocyte chemoattractant protein (MCP)-1, and platelet-derived growth factor (PDGF) α. 1-Nonadecene also induced MET through the upregulation of E-cadherin and the downregulation of N-cadherin in PdLFs. 1-Nonadecene polarized macrophages to a pro-inflammatory phenotype and suppressed their cytokines' release. L-lactic acid exerted a differential impact on the inflammation and proliferation markers. Intriguingly, L-lactic acid induced fibrosis-like effects by enhancing collagen synthesis, while inhibiting MMP-1 release in PdLFs. These results provide a deeper understanding of 1-nonadecene and L-lactic acid's roles in modulating the microenvironment of the periapical area. Consequently, further clinical investigation can be employed for target therapy.


Assuntos
Granuloma Periapical , Cisto Radicular , Humanos , Granuloma Periapical/metabolismo , Leucócitos Mononucleares/metabolismo , Virulência , Citocinas , Inflamação , Ácido Láctico , Microambiente Tumoral
11.
J Dent ; 135: 104581, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37295547

RESUMO

OBJECTIVES: Dentists and oral surgeons often face difficulties distinguishing between radicular cysts and periapical granulomas on panoramic imaging. Radicular cysts require surgical removal while root canal treatment is the first-line treatment for periapical granulomas. Therefore, an automated tool to aid clinical decision making is needed. METHODS: A deep learning framework was developed using panoramic images of 80 radicular cysts and 72 periapical granulomas located in the mandible. Additionally, 197 normal images and 58 images with other radiolucent lesions were selected to improve model robustness. The images were cropped into global (affected half of the mandible) and local images (only the lesion) and then the dataset was split into 90% training and 10% testing sets. Data augmentation was performed on the training dataset. A two-route convolutional neural network using the global and local images was constructed for lesion classification. These outputs were concatenated into the object detection network for lesion localization. RESULTS: The classification network achieved a sensitivity of 1.00 (95% C.I. 0.63-1.00), specificity of 0.95 (0.86-0.99), and AUC (area under the receiver-operating characteristic curve) of 0.97 for radicular cysts and a sensitivity of 0.77 (0.46-0.95), specificity of 1.00 (0.93-1.00), and AUC of 0.88 for periapical granulomas. Average precision for the localization network was 0.83 for radicular cysts and 0.74 for periapical granulomas. CONCLUSIONS: The proposed model demonstrated reliable diagnostic performance for the detection and differentiation of radicular cysts and periapical granulomas. Using deep learning, diagnostic efficacy can be enhanced leading to a more efficient referral strategy and subsequent treatment efficacy. CLINICAL SIGNIFICANCE: A two-route deep learning approach using global and local images can reliably differentiate between radicular cysts and periapical granulomas on panoramic imaging. Concatenating its output to a localizing network creates a clinically usable workflow for classifying and localizing these lesions, enhancing treatment and referral practices.


Assuntos
Aprendizado Profundo , Granuloma Periapical , Cisto Radicular , Humanos , Granuloma Periapical/diagnóstico por imagem , Granuloma Periapical/patologia , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/patologia , Radiografia , Redes Neurais de Computação
12.
J Endod ; 49(9): 1138-1144, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37331649

RESUMO

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.


Assuntos
Granuloma Periapical , Periodontite Periapical , Cisto Radicular , Estruturas Linfoides Terciárias , Humanos , Granuloma Periapical/metabolismo , Ligantes , Cisto Radicular/metabolismo
13.
Int Endod J ; 56(8): 980-990, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37171246

RESUMO

AIM: Periapical granuloma (PG) and cyst (PC) are formed as a protective response consequent to pulpal infection leaching through the apical foramen and lateral canals. Various inflammatory mediators like mast cells and cyclooxygenase (COX)-2 are involved in this intricate process. This pilot study aimed to evaluate and compare the immunoexpression of tryptase and COX-2 in periapical granuloma and periapical cyst, and also correlate them with intensity of inflammatory infiltrate and thickness of cystic epithelial lining. METHODOLOGY: An observational and cross-sectional study was conducted on paraffin-embedded tissue sections of 50 PGs and 50 PCs submitted for morphological and immunohistochemical analysis using anti-tryptase and anti-COX-2 antibodies. The mean number of mast cells (total, granulated and degranulated), mean COX-2 expression and inflammatory score was calculated. The data obtained were analysed using Mann Whitney U, Student's T, Chi-square and Spearman correlation test (p < .05). RESULTS: The inflammatory score, total mast cells and COX-2 expression were similar in PGs and PCs (p = .352, .339 and .352) however, the degranulated mast cells were highly significant in PC while granulated mast cells were highly significant in PG respectively (p < .001 in both). Although a non-significant correlation existed between COX-2 and total mast cells in both groups but, total mast cells were significantly correlated with epithelial thickness in PC (p = .029). CONCLUSIONS: Mast cells and cyclooxygenase-2 proved to be independent inflammatory markers in periapical lesions. Further studies should be planned on mast cell and COX-2 inhibitors as treatment modalities of periapical lesions.


Assuntos
Granuloma Periapical , Cisto Radicular , Humanos , Mastócitos/patologia , Granuloma Periapical/metabolismo , Ciclo-Oxigenase 2 , Estudos Transversais , Projetos Piloto , Cisto Radicular/patologia , Contagem de Células
14.
Pediatr Dev Pathol ; 26(6): 609-620, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37212213

RESUMO

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


Assuntos
Cisto Dentígero , Cistos Odontogênicos , Tumores Odontogênicos , Cisto Radicular , Humanos , Criança , Cisto Dentígero/diagnóstico , Cisto Dentígero/patologia , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/patologia , Cisto Radicular/patologia , Epitélio/patologia
15.
Pathol Res Pract ; 245: 154456, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37116367

RESUMO

Radicular cysts are characterized by significant levels of changes in inflammatory biomarkers. Among them, interleukins and growth factors have been reported to be deregulated in radicular cyst tissues. Moreover, long non-coding RNAs are recently discovered non-coding RNA molecules that regulate various intracellular stimuli to keep homeostasis in balance. A growing body of evidence suggests that lncRNAs are significantly involved in the regulation of inflammation by targeting various inflammatory biomarkers. Accordingly, the present study was aimed to investigate the gene expression levels of inflammation-related lncRNAs in radicular cysts and show their possible roles in the development of radicular cysts. For the study, a total of 25 patients with a radiologically and pathologically confirmed radicular cyst were enrolled. For the determination of non-coding RNA expression levels, real-time qPCR was used. As a result of the current study, expression levels of PACER and THRIL were found to be significantly elevated in radicular cyst tissues compared to control tissue samples. However, MALAT1, ANRIL, and NEAT1 expression levels were not significantly altered in radicular cyst tissues compared to control tissue samples. In conclusion, long non-coding RNAs, PACER and THRIL, seem to have significant pathophysiological roles by acquiring molecular changes during inflammation and might be involved in the development and formation of radicular cysts.


Assuntos
RNA Longo não Codificante , Cisto Radicular , Humanos , Cisto Radicular/genética , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Inflamação/genética , Biomarcadores
16.
BMJ Case Rep ; 16(4)2023 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-37041037

RESUMO

Radicular cysts are the most common cystic lesions which affect the jaw. Traumatic dental injuries cause injury to the periodontal ligament and dental pulp often leads to pulpal necrosis. The necrosed pulp eventually becomes the nidus of infection and irritates the periapical epithelial cell remnants, which in turn develops into a cyst eventually. This case report presents the successful conservative surgical management of a large infected radicular cyst which was associated with traumatised, necrotic, permanent maxillary lateral incisor with open apex by Partsch II surgical procedure followed by a combination of retrograde and orthograde root canal obturation. This report will guide the clinicians in the arena of surgical endodontics in a conservative approach.


Assuntos
Cisto Radicular , Humanos , Incisivo
17.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 48(2): 302-310, 2023 Feb 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-36999478

RESUMO

Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.


Assuntos
Cistos , Cisto Radicular , Humanos , Incisivo , Abscesso , Raiz Dentária/cirurgia , Raiz Dentária/anormalidades , Tratamento do Canal Radicular , Maxila
18.
J Craniofac Surg ; 34(5): e423-e425, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36872521

RESUMO

Squamous cell carcinomas (SCCs) are common malignant tumors in the oral and maxillofacial region. However, SCCs secondary to marsupialization of odontogenic radicular cysts are extremely rare. The authors report an unusual case of a 43-year-old male presented with dull pain in the right molar region of the mandible without numbness of lower lips, who had a long history of smoking, alcohol consumption, and betel nut chewing. Computerized tomography revealed a round well-defined unilocular radiolucent at the apex of lower right premolars, 2 nonvital teeth. The clinical diagnosis was the radicular cyst of the right mandible. The patient was initially treated with root canal therapy of the teeth followed by marsupialization with a mandibular vestibular groove incision. While the patient did not follow the instruction of irrigation of the cyst and had no regular follow-up. The reexamination of computerized tomography indicated a round well-defined unilocular radiolucent at the apex of lower right premolars and filled with a soft tissue without clear boundary with buccal muscles at 31 months follow-up. There were no masses or ulcer around the mandibular vestibular groove incision and the patient had no sign of numbness of lower lips. The clinical diagnosis was the radicular cyst of right mandible with infection. A curettage was performed. However, the pathologic diagnosis was well-differentiated SCC. An extended radical surgical resection including segmental resection of the right mandible was performed. The histopathology was well-differentiated SCC without the cyst epithelium and invasion of bone, which can be distinguished from primary intraosseous SCC. The case indicates that marsupialization performed in patients with a history of smoking, alcohol consumption, and betel nut chewing, has a risk of suffering from oral SCC.


Assuntos
Carcinoma de Células Escamosas , Cistos Odontogênicos , Cisto Radicular , Masculino , Humanos , Adulto , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/cirurgia , Mucosa Bucal/patologia , Hipestesia , Cistos Odontogênicos/cirurgia , Mandíbula/cirurgia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Epitélio
19.
Histol Histopathol ; 38(8): 889-892, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36880590

RESUMO

AIM: Our aim was to investigate how bacterial lipopolysaccharide (LPS) is immunoexpressed in periapical lesions. By surprise we detected Rushton bodies (RBs) whose origin has been debatable to be positive for LPS. METHODOLOGY: Samples of radicular cysts (N=70) were stained in order to identify variations in LPS immunoexpression indicating bacterial background. For immunostaining, we used an anti-LPS antibody from Escherichia coli, and for visualization Horse Radish Peroxidase labeled polymer as the secondary antibody. RESULTS: RBs showed positivity for LPS in radicular cysts. After collection of radicular cyst samples (70 in total), we noted that all RBs (N=25) histologically detected in tissue samples were positive for LPS. Furthermore, calcification in the cyst capsule showed immunopositivity. CONCLUSION: We demonstrate for the first time that LPS is present in RBs, indicating that host response to bacteria might be the initial cause of the formation of these hyaline bodies in the cyst epithelium and cyst capsule calcifications.


Assuntos
Calcinose , Cisto Radicular , Humanos , Cisto Radicular/patologia , Lipopolissacarídeos , Epitélio/patologia , Calcinose/patologia
20.
Int Endod J ; 56(6): 710-721, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36806027

RESUMO

AIM: As a key DNA sensor, cyclic GMP-AMP synthase (cGAS) has emerged as a major mediator of innate immunity and inflammation. Human apical periodontitis has yet to be studied for the presence of cGAS. This investigation was conducted to determine if cGAS is involved in the pathological process of human apical periodontitis. METHODOLOGY: Sixty four human periapical lesions, comprising 20 periapical granulomas and 44 radicular cysts, were employed in this investigation. Healthy gingiva (n = 6), dental pulp (n = 3), and apical papilla (n = 3) were used as control samples. The expression of cGAS in the periapical tissues was discovered using immunohistochemical staining. mRNA-Sequencing and qRT-PCR were utilized to determine the differentially expressed genes (DEGs) associated with DNA-sensing signalling in periapical lesions compared to the healthy control. Immunofluorescence labelling was used to identify the co-expression of cGAS, interleukin-1ß, and interleukin-18. RESULTS: A significantly greater expression level of cGAS was discovered in the periapical lesions, with no significant difference between radicular cysts and periapical granulomas. mRNA-Sequencing analysis and qRT-PCR identified differentially expressed mRNA, such as cGAS and its downstream DEGs, between periapical lesions and healthy control tissues. Immunofluorescence labelling further revealed that cGAS, interleukin-1, and interleukin-18 were co-localized. CONCLUSIONS: These observations imply that along with the synthesis of interleukin-1 and interleukin-18, cGAS may be involved in the aetiology of apical periodontitis.


Assuntos
Granuloma Periapical , Periodontite Periapical , Cisto Radicular , Humanos , Granuloma Periapical/metabolismo , Cisto Radicular/patologia , Interleucina-18 , Periodontite Periapical/metabolismo , Nucleotidiltransferases
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