Odontogenic keratocystic can be misdiagnosed for a lateral periodontal cyst when the clinical and radiographical findings are similar.

Lateral periodontal cyst (LPC) and odontogenic keratocystic (OK) are two osteolytic lesions of the jaw with different local invasiveness and percentage of recurrence. The aim of this study was to highlight the attention on the differential diagnosis of these lesions that sometimes can have unexpected location and can lead doubts on diagnosis, therapy, and follow-up. A 34-year-old man presented to our department with a complaint of soft pain in the vestibular aspect of left mandibular second premolar and left mandibular first molar. Vital teeth in the left mandible, no mucosal swelling, and no drainage were observed. The CBCT showed a well circumscribed hypodensity area, extending between 3.5 and the apex of mesial root of 3.6. No displacement and no resorption of the roots were notified. Upon clinical and radiographical examination, a provisional diagnosis of LPC was made and enucleation of the lesion and histological examination were planned. Histologically, a cystic wall partially lined by a keratinizing squamous epithelium was observed. Surrounding and within the lesion, there was a chronic inflammatory infiltrate also of granulomatous type and with cholesterol clefts. Based on these findings, the diagnosis of odontogenic keratocystic was done. Radiolucent lesions in the premolar and canine region are frequently clinically and radiographically misdiagnosed. The identification of keratocyst in a location preoperatively favoring a lateral periodontal cyst should be suspected and biopsy must be considered in all cases to establish the nature of the lesion, the best surgical treatment, and the follow-up appointments.

[Radiolucency at both lower third molars: the paradental cyst]. / Radiolucentie bij beide derde ondermolaren: een paradentaire cyste.

A 23-year-old man presented with an irritating sensation at the third molar on the left side of the mandible and a bad taste in his mouth. Radiographic and histopathological examination revealed the abnormality was caused by a paradental cyst. The paradental cyst is located distal to a lower third molar and, together with the mandibular buccal bifurcation cyst, belongs to the inflammatory collateral cysts. Treatment consists of enucleation of the cyst and removal of the lower third molar. Recurrences do not occur.

Buccal bifurcation cyst: A case series and review of the literature.

INTRODUCTION: Buccal bifurcation cyst is an inflammatory odontogenic cyst and constitutes up to 5% of all odontogenic cysts. The aim of this study was to report a series of cases, review the recent literature, and facilitate recognition and proper treatment of this entity. METHODS: With institutional review board approval, the authors retrieved all archival cases of buccal bifurcation cyst from the oral pathology biopsy service from 1994 through 2018. Patient age and sex, cyst location, clinician's impression, radiographic appearance, diagnosis, and treatment data were recorded. RESULTS: A total of 10 cases were identified. Average patient age was 9 years. A slight male predilection was observed (n = 6, 60%). One hundred percent of cases were in the mandible, including 3 (30%) bilateral cases. CONCLUSIONS: Mandibular buccal bifurcation cyst is an important entity in pediatric patients but may be less likely to be recognized by clinicians not regularly treating children. The results of this study are mostly consistent with the literature. Treatment is typically via enucleation or even more conservative modalities, and extraction should be avoided if possible. PRACTICAL IMPLICATIONS: Buccal bifurcation cysts should be treated via enucleation or even more conservative methods. If possible, the affected teeth should be preserved.

Cysts and Pseudocysts of the Oral Cavity: Revision of the Literature and a New Proposed Classification.

This article includes a comprehensive and up-to-date review on the cysts of the oral cavity. Several classifications of odontogenic (OC) and non-odontogenic (non-OC) oral cysts and the surrounding regions have been proposed. We suggest a new critical classification based on an established relationship between anatomical area, histological origin and clinical behavior (frequency, rate of recurrence, malignant potential). Moreover, the differential cytokeratin (CKs) expression of the various cysts is reported as epithelium-specific markers of differential diagnosis. Finally, issues related to differential diagnosis and therapeutic approaches of the cysts included in the two groups are described.

Suspected Lateral Periodontal Cyst Presenting Concurrently with Canine Acanthomatous Ameloblastoma in a 2-Year-Old Standard Poodle.

Lateral periodontal cysts (LPCs) are odontogenic epithelial cysts composed of nonkeratinized epithelial cells that are in the category of developmental cysts, rather than inflammatory cysts. Lateral periodontal cysts are rare both in people and domestic animals; they are associated with vital teeth and located lateral to a tooth root. Lateral periodontal cysts are typically asymptomatic lesions that are characterized radiographically as a unilocular lucency with well-defined corticated borders. Canine acanthomatous ameloblastoma (CAA) is the most common odontogenic neoplasm in dogs and rarely presents as a cystic lesion. This case report describes the diagnosis and treatment of a cyst that occurred as a swelling apical to a gingival mass that was diagnosed histologically as CAA. Surgical management by conservative gingivectomy, cyst enucleation, and bone grafting was an effective treatment in this patient.

Odontogenic Cysts and Neoplasms.

This article reviews a myriad of common and uncommon odontogenic cysts and tumors. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts (periapical cyst, mandibular infected buccal cyst/paradental cyst), developmental cysts (dentigerous, lateral periodontal, glandular odontogenic, orthokeratinized odontogenic cyst), benign tumors (keratocystic odontogenic tumor, ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibroma and fibroodontoma, odontoma, squamous odontogenic tumor, calcifying cystic odontogenic tumor, primordial odontogenic tumor, central odontogenic fibroma, and odontogenic myxomas), and malignant tumors (clear cell odontogenic carcinoma, ameloblastic carcinoma, ameloblastic fibrosarcoma).

Inflammatory collateral cyst associated with a palatoradicular groove: report of a case and discussion of nomenclature.

The aims of this article are to present a case demonstrating the connection between palatoradicular grooves and inflammatory collateral cysts and to discuss the related nomenclature. Radiographs in a 21-year-old man revealed a radiolucent, unilocular, well-defined area near the vital maxillary right lateral incisor and canine. Palatal swelling was present, and a 6-mm-deep periodontal pocket was found at the palatal surface of the right lateral incisor. The differential diagnoses were keratocystic odontogenic tumor, developmental lateral periodontal cyst, and inflammatory lateral periodontal cyst. The area was explored surgically, and the lesion was excised. Surgical exploration revealed a palatoradicular groove, which was scaled and planed with the aid of manual curettes with the intention of creating a flat surface to promote insertion of the periodontal fibers. Histopathologic analysis revealed that the lesion was an inflammatory cyst. The presence of a palatoradicular groove can put the periodontium at risk because a resulting lack of fiber insertion makes oral hygiene difficult. This established inflammatory process can initiate development of an inflammatory collateral cyst that may be misdiagnosed, hindering successful management. In this case, bone grafting and placement of a resorbable membrane were used to promote bone formation and subsequent sealing of the periodontal space.

Odontogenic Cysts - An Overview.

This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.

Gingival Cysts of Adults: Retrospective Analysis from Two Centers in South Brazil and a Review of the Literature.

Gingival cysts of adults are rare developmental cysts, with an incidence of 0.3% among all odontogenic cysts. They are benign, well-defined nodules located on the attached gingiva with a fluid-filled appearance. The aim of the present study was to perform an analysis of gingival cysts in adults diagnosed at an oral pathology laboratory and a hospital pathology service in order to determine the frequency of occurrence of this lesion, and to perform a literature review to correlate the present findings with those described in the literature. This study emphasizes the low frequency of gingival cysts in adults and the importance of gathering clinical, radiographic and histopathological information to define the final diagnosis.

Giant cemento-ossifying fibroma of the maxilla.

INTRODUCTION: Fibro-osseous lesions of the skull and facial bones are benign tumors, but they can be mistaken for malignant tumors due to their clinically aggressive behavior. Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion characterized by slow growth and fibrous and calcified tissue content. COFs are locally destructive lesions causing deformities in the bones. The recurrence risk is high if they are not completely removed. CASE REPORT: In this case report we describe a giant COF mimicking chondrosarcoma in the oral cavity of a 55-year-old woman causing significant facial deformity and feeding problems. CONCLUSIONS: Giant COF occurs rarely in the jaws and given that this lesion has similar imaging and clinical features to several other tumors, the diagnosis is always a challenge for clinicians, radiologists and pathologists.

[Juvenile paradental cysts in children after mandible distraction: case-control study and clinical cases presentation].

Seventy-five children aged 6-17 years (mean age 9.8±4.1 years) that received mandible distraction (MD) at the age of 0-17 years (mean age at MD 6.1±4.3) were included in the study. Indication for MD were hemifacial microsomia (n=41), Goldenhar syndrome (n=4), Robin sequence (n=10), Treacher, Collins syndrome (n=7) or acquired mandible underdevelopment (n=13). Control groups consisted of 22 children aged 5-14 years (mean age 7.0±3.7 years) with mandible underdevelopment of similar origin (hemifacial microsomia (n=15), Goldenhar syndrome (n=2), Robin sequence (n=4), Treacher, Collins syndrome (n=1)) with no history of MD and 80 healthy children aged 6-10 years (mean age 7.1±2.2 years). Case-control study results proved MD to be the risk factor for juvenile paradental cysts (JPCs) with the risk more prominent in early MD cases. JPCs often do not manifest clinically and may resolve spontaneously but in refractory cases lesion curettage without endodontic treatment is an adequate approach, as JPCs are usually not associated with pulp necrosis.

Large buccal bifurcation cyst in a child: a case report and literature review.

BACKGROUND: WHO defines the mandibular buccal bifurcation cyst as a cyst occurring near the cervical margin of the lateral aspect of a root as a consequence of inflammatory process in a periodontal pocket. The pathogenesis of these cysts is still debated, but they are most likely originated from reduced enamel epithelium or from inflammatory proliferation of epithelial cell rests of Malassez that come from the superficial mucosa of a tooth in eruption. The aim of this article was to describe a case of large buccal bifurcation cyst of a permanent mandibular first molar. CASE REPORT: A 6-year-old boy was referred to Department of Oral Riabilitation of the Istituto Stomatologico Italiano, University of Milan, Italy, with the complaint of hard swelling over the buccal gingiva and a deep probing depth located on the buccal aspect. Radiograph revealed a well-defined semilunar-shaped radiolucency, marked by a fine radiopaque line on the buccal aspect of the partially-erupted lower right first molar and it was large enough to include a small part of the crown of the second right molar. As reported in the literature the treatment of choice is enucleation and curettage of the lesion without extraction of the vital involved tooth. This procedure has shown excellent results in both the short- and long-term. The definitive diagnosis of paradental cysts can be assessed by histopathologic analysis.

Inflammatory paradental cyst of the first molar (buccal bifurcation cyst) in a 6-year-old boy: case report with respect to immunohistochemical findings.

The inflammatory paradental cyst (IPC) is a relatively rarely reported lesion arising from the lateral periodontium of vital teeth. However, IPC appear to be under-represented in registers of odontogenic cysts due to the misinterpretation of IPC as infected dentigerous cysts, in particular IPC originating from third molars. IPCs exhibit some temporospatial associations with tooth eruptions and occur almost exclusively in the mandible. The IPC of the first molar is predominantly diagnosed in children younger than 10 years. Bony bulging in the area of cyst formation may alert parents to seek medical advice. This case report details the characteristic clinical and radiological features of a first molar IPC arising in a child. The features of the presented cyst correspond well to the attributes qualifying for a so-called buccal bifurcation cyst. A conservative treatment regimen proved to be successful. Certain immunohistochemical markers are reported to further characterize this entirely benign lesion.

Tratamento conservador de lesão perirradicular extensa por meio da irrigação/aspiração – relato de dois casos / Conservative treatment of extensive periradicular lesion using irrigation/aspiration– report of two cases

O tratamento cirúrgico dos cistos radiculares tem sido feito por meio da enucleação, descompressão ou marsupialização. A irrigação/aspiração é um procedimento descrito na literatura para tratamento de lesões apicais de grande volume com o objetivo de evitar a realização da cirurgia parendodôntica, o qual tem mostrado resultados bastante favoráveis. O objetivo deste trabalho ‚ apresentar dois casos clínicos de lesões periapicais extensas tratadas por meio da irrigação-aspiração

The surgical treatment of radicular cysts has been made through enucleation, decompression, and marsupialization. Irrigation/aspiration is a procedure described in the literature as a treatment of large periapical lesions aiming at avoiding endodontic surgery, and has presented favorable results. This procedure has the advantage of prevent periapical surgery with favorable results. The aim of this study was to present two clinical cases of extensive periapical lesions treated using the irrigation-aspiration technique

An unusual case of ameloblastoma observed in the left anterior mandible.

AIM: To report a small intaalveolar ameloblastoma which resembled cystic lesion, and to emphasize the value of Computed tomography (CT) in radiographic examination. BACKGROUND: Ameloblastoma is a slow-growing, locally invasive odontogenic neoplasm that accounts for approximately 10% of all tumors detected in the jaws. Radiographically, those tumors are usually well-defined. Computerized tomography is highly recommended to confirm the diagnosis. CASE DESCRIPTION: A 48-year-old female attended with a chief complaint of painless swelling in the left anterior of mandible, 1 month duration. In intraoral examination, non-fluctuant, immobile, approximately 1 × 1 cm in dimension, painless, swelling which had a bone-like hardness and located in the mandibular canine region was detected. Panoramic radiography revealed a well circumscribed unilocular radiolucent lesion located in the inter-radicular area of left mandibular lateral and canine teeth. In CT examination it was realized that the lesion was multilocular. Histopathological examination of the biopsy specimen was reported as ameloblastoma. CLINICAL SIGNIFICANCE: It is extremely difficult to find such an ameloblastoma in small dimension in alvolar bone.

An unfamiliar presentation of a lateral periodontal cyst.

Lateral periodontal cyst, developmental in origin, typically is observed in the cuspid-bicuspid region of the mandible and less frequently in the maxilla. It may arise initially as a dentigerous cyst developing by expansion of the follicle along the lateral surface of the crown which eventually comes to lie on the lateral aspect of the root if tooth eruption is normal. Alternatively, it may arise from the cell rests of malassez. The incidence of lateral periodontal cysts has been reported to be less than 1% and these cysts represent nearly 0.8% of all central cysts of the maxillary bone. Here we present one such case with unusual findings.