RESUMO
Introducción: a pesar de que un tercer molar no erupcionado repre- senta un riesgo de formación quística, la práctica clínica desestima el análisis histopatológico de los folículos de dichos molares. Objetivo: identificar la frecuencia de lesiones quísticas en los sacos pericoronarios de terceros molares mandibulares. Material y métodos: estudio des- criptivo, transversal, analítico y observacional, en donde se incluyeron sacos pericoronarios de terceros molares mandibulares para su análisis histopatológico, descripción de características clínico-radiográficas y su asociación con la presencia de cambios histológicos o lesiones quís- ticas. Resultados: se incluyeron 48 muestras de sacos pericoronarios, la histopatología de los sacos pericoronarios mostró que 83.3% tenían algún tipo de alteración: 13 quistes paradentales (27.1%), cuatro quistes dentígeros (8.3%), 12 folículos hiperplásicos (25.0%) y 11 folículos inflamados (22.9%). La presencia de lesiones quísticas en la población fue de 35.4%. Se detectó asociación estadísticamente significativa entre el sexo y la presencia de lesiones quísticas (p = 0.039) y entre el nivel de erupción y la presencia de cambios histológicos (p = 0.046). Con- clusiones: la frecuencia de lesiones quísticas o cambios histológicos en folículos de terceros molares mandibulares es alta, principalmente en molares parcialmente erupcionados o submucosos y sin importar la ausencia de sintomatología o alteraciones radiográficas (AU))
Introduction: although a non-erupted third molar represents a risk of cystic formation; clinical practice rejects the histopathological analysis of the follicles of said molars. Objective: identify the frequency of the histopathological changes in pericoronary sacs of mandibular third molars. Material and methods: descriptive cross- sectional, observational and analytic study, where pericoronary sacs of mandibular third molars were included for histopathological analysis, description of clinical-radiographic characteristics and their association with the presence of histological changes or cystic lesions. Results: 48 samples of pericoronary sacs were included, the histopathology of the pericoronary sacs showed 83.3% had some type of alteration: 13 paradental cysts (27.1%), four dentigerous cysts (8.3%), 12 hyperplastic follicles (25.0%) and 11 inflamed follicles (22.9%). The presence of cystic lesions in the population was 35.4%. A statistically significant association was detected between sex and the presence of cystic lesions (p = 0.039); and between the level of eruption and the presence of histological changes (p = 0.046). Conclusions: the frequency of cystic lesions or histological changes in mandibular third molar follicles is high, mainly in partially erupted or submucosal molars and regardless of the absence of symptoms or radiographic alterations (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Cisto Dentígero/epidemiologia , Cistos Odontogênicos/epidemiologia , Dente Serotino , Cistos Odontogênicos/classificação , Cisto Periodontal/epidemiologia , Epidemiologia Descritiva , Estudos Transversais , Interpretação Estatística de Dados , Técnicas Histológicas/métodos , Saco Dentário/anatomia & histologia , Distribuição por Idade e Sexo , Estudo Observacional , Mandíbula , MéxicoRESUMO
The solid variant of odontogenic keratocyst (SOKC) is an extremely rare odontogenic lesion, which remains poorly defined even in the 2017 World Health Organization odontogenic tumour classification. It is difficult to distinguish between SOKC and so called keratoameloblastoma (KAB), both rare lesions that have similarities in clinical, histological and biological characteristics. Here, we report clinicopathological data and results of molecular analysis of nine cases with a literature review. First, they were compared to previously reported cases of SOKC and/or KAB, and many overlaps were found in clinical and pathological characteristics. Second, we performed PCR analysis for BRAF V600E mutation. Although ameloblastoma-like epithelia were often encountered, none exhibited BRAF V600E mutation, which has been reported to occur frequently in ameloblastomas but not in odontogenic keratocysts (OKCs). One of two cases of SOKC in the present series from which fresh frozen tissue specimens were available was found to harbour PTCH1 mutations, indicating that these were more likely to be a subtype of OKC. Moreover, we also examined the differences between SOKC and primary intraosseous carcinoma (PIOC) with regard to the expression of cytokeratins (pan-CK, CK5/6, CK7, CK8/18, CK10, CK14 and CK19), p53 and Ki-67. The proportions of p53-and Ki-67-positive cells were significantly higher in PIOC than in SOKC. These findings suggest that immunostaining for p53 and Ki-67 would be useful to differentiate between SOKC and PIOC. We also conducted a review of SOKC and KAB cases reported in the English language literature.
Assuntos
Ameloblastoma/classificação , Antígeno Ki-67/metabolismo , Cistos Odontogênicos/classificação , Tumores Odontogênicos/classificação , Proteína Supressora de Tumor p53/metabolismo , Adulto , Idoso , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/patologia , Feminino , Humanos , Queratinas/metabolismo , Masculino , Pessoa de Meia-Idade , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/metabolismo , Cistos Odontogênicos/patologia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/metabolismo , Tumores Odontogênicos/patologia , Estudos Retrospectivos , Organização Mundial da SaúdeAssuntos
Cistos Odontogênicos/patologia , Adulto , Síndrome do Nevo Basocelular , Cistos/congênito , Diagnóstico Diferencial , Epitélio/patologia , Humanos , Masculino , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/epidemiologia , Dente Impactado/complicaçõesRESUMO
The 4th edition of the World Health Organization (WHO) Classification of Head and Neck Tumors was published in January 2017. The edition serves to provide an updated classification scheme, and extended genetic and molecular data that are useful as diagnostic tools for the lesions of the head and neck region. This review focuses on the most current update of odontogenic cysts and tumors based on the 2017 WHO edition. The updated classification has some important differences from the 3rd edition (2005), including a new classification of odontogenic cysts, 'reclassified' odontogenic tumors, and some new entities.
Assuntos
Cistos Odontogênicos/classificação , Cistos Odontogênicos/patologia , Tumores Odontogênicos/classificação , Tumores Odontogênicos/patologia , Humanos , Organização Mundial da SaúdeRESUMO
The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.
Assuntos
Síndrome do Nevo Basocelular/classificação , Síndrome do Nevo Basocelular/cirurgia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/cirurgia , Ácido Acético/uso terapêutico , Adolescente , Adulto , Idoso , Criança , Clorofórmio/uso terapêutico , Descompressão Cirúrgica/métodos , Etanol/uso terapêutico , Feminino , Humanos , Masculino , Doenças Mandibulares , Doenças Maxilares , Pessoa de Meia-Idade , Tumores Odontogênicos/classificação , Tumores Odontogênicos/cirurgia , Osteotomia/métodos , Fotografação , Recidiva , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Adulto JovemAssuntos
Doenças Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/diagnóstico , Diagnóstico Diferencial , Diagnóstico por Imagem , Humanos , Doenças Maxilomandibulares/classificação , Doenças Maxilomandibulares/terapia , Neoplasias Maxilomandibulares/classificação , Neoplasias Maxilomandibulares/secundário , Neoplasias Maxilomandibulares/terapia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/terapia , Tumores Odontogênicos/classificação , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/terapia , Osteomielite/classificação , Osteomielite/diagnóstico , Osteomielite/terapia , PrognósticoRESUMO
Dentigerous cysts are the most common developmental odontogenic cysts of the jaw, which usually occur in the second and third decade of life. It is most frequently associated with impacted mandibular third molar teeth and impacted canines. Bilateral/multiple dentigerous cysts are rare and typically associated with developmental syndromes. Non-syndromic dentigerous cyst occurring bilaterally or involving both arches at the same time is very rare. Here, we discuss the review of literature with a case of unusual occurrence of non-syndromic bi-maxillary dentigerous cysts in a child.
Assuntos
Cisto Dentígero/diagnóstico , Doenças Maxilares/diagnóstico , Criança , Cisto Dentígero/epidemiologia , Cisto Dentígero/patologia , Cisto Dentígero/cirurgia , Humanos , Masculino , Doenças Maxilares/epidemiologia , Doenças Maxilares/patologia , Doenças Maxilares/cirurgia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/epidemiologia , Cistos Odontogênicos/cirurgiaRESUMO
El tumor odontogénico queratoquístico, es una patología que se encuentra asociada a la retención de un órgano dentario, en especial al tercer molar, es reconocido por su potencial destructivo y extenso, erosionando placas corticales que envuelven mucosa y tejidos blandos, la etiología del tumor odontogénico queratoquístico está probablemente relacionada con el desarrollo de la lámina dental (o restos de Serres) y con una mayor recidiva dentro de los tumores odontogénicos, siendo motivo de su reclasificación en el 2005 por la OMS. Se presenta casoclínico de un tumor odontogénico queratoquístico en el seno maxilarderecho, se exponen los métodos utilizados para la exploración clínica,radiológica y el tratamiento quirúrgico elegido.
The keratocystic odontogenic tumor is a condition associated withtooth retention, particularly of the third molar. It is recognized as beingpotentially highly destructive, by eroding cortical plates overlying theoral mucosa and soft tissues. The etiology of keratocystic odontogenictumor is probably related to the development of the dental lamina (orremains of Serres) and the recurrence rate is high compared to that ofother odontogenic tumors, the reason for their reclassifi cation by theWHO in 2005. We present a clinical case of a keratocystic odontogenictumor in the right maxillary sinus, including an explanation of themethods used for clinical and radiological examination, and the chosensurgical treatment.
Assuntos
Humanos , Masculino , Adulto Jovem , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico por imagem , Seio Maxilar/patologia , Descompressão Cirúrgica/métodos , México , Procedimentos Cirúrgicos Bucais/métodos , RecidivaRESUMO
PURPOSE: The aim of this study was to evaluate the impact of the reclassification of odontogenic keratocyst (OKC) as a tumor on the prevalence profile of odontogenic cysts (OCs) and odontogenic tumors (OTs). STUDY DESIGN: Two referral Oral and Maxillofacial Pathology services in Brazil were evaluated. All cases diagnosed as OCs or OTs were selected and classified according to the 1992 WHO-classification (cases before 2005 WHO classification of tumors excluding OKC) and the 2005 WHO classification of tumors, going forward including cases of odontogenic keratocyst tumor (KCOT). The frequency and prevalence of OCs and OTs were compared before and after the reclassification. RESULTS: Among 27,854 oral biopsies, 4920 (17.66%) were OCs and 992 (3.56%) were OTs. The prevalence of OTs before 2005 WHO classification of tumors was 2.04%, while the prevalence after 2005 WHO classification was 11.51% (p < 0.0001). Before 2006, the most frequent tumor diagnosed was odontoma with 194 cases (39.67%), and after 2005 WHO classification of tumors the KCOT was the most frequent with 207 cases (41.07%). CONCLUSIONS: The increase in the prevalence of OTs after 2005 WHO is related to the improvement of pathology services and to the inclusion of KCOT in the OTs group.
Assuntos
Doenças Maxilomandibulares/epidemiologia , Neoplasias Maxilomandibulares/epidemiologia , Cistos Odontogênicos/epidemiologia , Tumores Odontogênicos/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Feminino , Humanos , Doenças Maxilomandibulares/classificação , Neoplasias Maxilomandibulares/classificação , Masculino , Pessoa de Meia-Idade , Cistos Odontogênicos/classificação , Tumores Odontogênicos/classificação , Prevalência , Fatores Sexuais , Adulto JovemRESUMO
Abstract: The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Idoso , Adulto Jovem , Síndrome do Nevo Basocelular/cirurgia , Síndrome do Nevo Basocelular/classificação , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/classificação , Osteotomia/métodos , Recidiva , Fatores de Tempo , Fotografação , Doenças Mandibulares , Doenças Maxilares , Tumores Odontogênicos/cirurgia , Tumores Odontogênicos/classificação , Clorofórmio/uso terapêutico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Medição de Risco , Ácido Acético/uso terapêutico , Descompressão Cirúrgica/métodos , Etanol/uso terapêutico , Pessoa de Meia-IdadeRESUMO
El quiste odontogénico ortoqueratinizado es un quiste de desarrollo poco común de los maxilares. Descrito en 1956 por Philipsen como una variante del queratoquiste odontogénico (tumor odontogénico queratinizante) y posteriormente identifi cado como una entidad totalmente aparte por Wrigth, sigue siendo hoy en día una lesión en controversia. En este trabajo se reporta el caso de un paciente masculino de 15 años de edad que acude al Servicio de Cirugía Maxilofacial del Hospital Regional®Lic. Adolfo López Mateos¼, ISSSTE, el cual es diagnosticado como un quiste odontogénico ortoqueratinizado. Tener una adecuada ruta clínica para el diagnóstico clínico, complementado por imagen, y sobre todo contar con el resultado de la biopsia incisional son pasos fundamentales para poder diagnosticar y no sobretratar padecimientos que, con procedimientos menos invasivos y agresivos, tienen mejor pronóstico...
Assuntos
Humanos , Masculino , Adolescente , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/patologia , Biópsia/métodos , Unidade Hospitalar de Odontologia , Técnicas Histológicas , México , Procedimentos Cirúrgicos Bucais/métodos , Cistos Odontogênicos , Radiografia PanorâmicaRESUMO
La Organización Mundial la Salud (OMS) a través del Centro Internacional de Referencia de los Tumores Odontogénicos en su última clasificación 2005, ha decidido incluir al Quiste Odontogénico queratoquístico Paraqueratinizado dentro del grupo de los Tumores Odontogénicos, como Tumor Odontogénico Queratoquístico y ha permanecido el Quiste Odontogénico Queratoquístico Ortoqueratinizado, como una entidad se-parada dentro de los Quistes Odontogénicos ya existente, es decir uno pasa a ser una neoplasia benigna y otro una entidad quística.Los autores presentamos un caso clínico quirúrgico de un tumor Odontogénico Queratoquístico...
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/diagnóstico , Biópsia/métodos , Diagnóstico Diferencial , Descompressão Cirúrgica/métodos , Classificação Internacional de Doenças , Procedimentos Cirúrgicos Bucais/métodos , Cistos Odontogênicos/tratamento farmacológico , Cistos Odontogênicos , Tomografia Computadorizada por Raios X , Organização Mundial da SaúdeRESUMO
El ameloblastoma es un tumor odontogénico benigno de origen epitelialcon estroma fi broso maduro sin ectomesénquima odontogénico, decomportamiento localmente agresivo e infi ltrante con alta capacidad de recidiva. Representa entre 11 y 13 por ciento de los tumores odontogénicosmandibulares y 1 por ciento de los tumores y quistes maxilomandibulares. El tratamiento debe orientarse de acuerdo con el potencial del tumor,las características del crecimiento según su variable clínica y el tipo histológico. Debe ser un tratamiento que asegure un mejor pronóstico para el paciente
The ameloblastoma is a benign odontogenic tumor of epithelial origin with mature fi brous stroma, without odontogenic ectomesenchyme. It exhibits locally aggressive and invasive behavior, with a high level of recurrence. Ameloblastomata account for between 11 and 13% of mandibular odontogenic tumors, and 1% of maxillo-mandibular tumors and cysts. Treatment should be guided by the potential of the tumor and its growth characteristics based on the clinical variable and histological type, the preferred treatment being that which ensures the best prognosis for the patient.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ameloblastoma/cirurgia , Ameloblastoma/diagnóstico , Ameloblastoma/patologia , Cistos Odontogênicos/classificação , Biópsia/métodos , Técnicas de Fixação da Arcada Osseodentária , Prótese Maxilofacial , Osteotomia/métodos , Prognóstico , Procedimentos Cirúrgicos Bucais/métodos , Radiografia PanorâmicaRESUMO
Cystic conditions of the jawbones were recognized long before the establishment of the American Academy of Oral Pathology (AAOP) in 1948, but it was around this time when they were studied, characterized, and classified. The history of the classification systems implemented by oral pathologists to study the cystic conditions of the maxillary bones is intimately related with the birth of oral and maxillofacial pathology as a specialty of dentistry. The purpose of this paper is to review the early classification systems proposed for the cystic conditions of the jawbones.
Assuntos
Cistos Maxilomandibulares/história , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Cistos Maxilomandibulares/classificação , Cistos não Odontogênicos/classificação , Cistos não Odontogênicos/história , Cistos Odontogênicos/classificação , Cistos Odontogênicos/históriaRESUMO
O cisto dentígero é uma lesão ósseo-destrutiva, classificada como cisto odontogênico de de senvolvimento de etiopatogênia desconhecida. É o segundo cisto odontogênico mais frequente nos maxilares. Apresenta radiograficamente imagem radiotransparente, unilocular, observados geralmente em exames de rotina ou pelo atraso de erupção de um dente. Acomete indivídu os nas três primeiras décadas de vida, apresenta crescimento lento e indolor. As modalidades terapêuticas mais utilizadas são a marsupialização, descompressão e enucleação, porém o tra tamento varia conforme a idade, tamanho do cisto, proximidade com estruturas anatômicas e condições clinicas do dente envolvido. Sendo assim o objetivo desse artigo é relatar um caso clinico com inusitada reabsorção radicular desde o seu diagnostico até a fase de reabilitação e preservação...
The dentigerous cyst is abone destructive lesions classified as odontogenic cyst develo pment of unknown etiopathogenesis. It is the second most common odontogenic cyst in the jaws. Presents radiographically radiolucent image, unilocular usually seen in routine screening or the eruption delay of a tooth. Affects individuais in the first three decades of life, its growth is slow and painless. The most common therapeutic modalities are marsupialization, decompres sion and enucleation, but treatment varies according to age, cyst size, proximity to anatomical structures and clinical conditions of the involved tooth. Thus the aim of this paper is to report a clinical case since its diagnosis until the phase of rehabilitation and proservation...
Assuntos
Cisto Dentígero/complicações , Cisto Dentígero/diagnóstico , Cistos Odontogênicos/classificação , Cistos Odontogênicos/complicações , Dilatação e Curetagem/métodos , Dilatação e Curetagem , Reabilitação Bucal/métodos , Reabilitação BucalRESUMO
As our knowledge of disease improves, its classification continually evolves. The last WHO classification of odontogenic tumors was 9 years ago and it is time for revision. We offer the following critique as a constructive, thought provoking challenge to those chosen to provide contemporary insight into the next WHO classification of odontogenic cysts, tumors, and allied conditions.
Assuntos
Tumores Odontogênicos/classificação , Tumores Odontogênicos/patologia , Humanos , Cistos Odontogênicos/classificação , Cistos Odontogênicos/patologia , Organização Mundial da SaúdeAssuntos
Doenças Estomatognáticas/patologia , Humanos , Doenças da Boca/patologia , Neoplasias Bucais/classificação , Neoplasias Bucais/patologia , Cistos não Odontogênicos/classificação , Cistos não Odontogênicos/patologia , Cistos Odontogênicos/classificação , Cistos Odontogênicos/patologia , Tumores Odontogênicos/classificação , Tumores Odontogênicos/patologiaRESUMO
Odontogenic cysts originate from remnants of the tooth forming epithelium in the jaws and gingiva. There are various kinds of such cysts with different biological behaviours that carry different patient risks and require different treatment plans. Types of odontogenic cysts can be distinguished by the properties of their epithelial layers in H&E stained samples. Herein we detail a set of image features for automatically distinguishing between four types of odontogenic cyst in digital micrographs and evaluate their effectiveness using two statistical classifiers - a support vector machine (SVM) and bagging with logistic regression as the base learner (BLR). Cyst type was correctly predicted from among four classes of odontogenic cysts between 83.8% and 92.3% of the time with an SVM and between 90 ± 0.92% and 95.4 ± 1.94% with a BLR. One particular cyst type was associated with the majority of misclassifications. Omission of this cyst type from the data set improved the classification rate for the remaining three cyst types to 96.2% for both SVM and BLR.
Assuntos
Epitélio/patologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Cistos Odontogênicos/classificação , Cistos Odontogênicos/patologia , Reconhecimento Automatizado de Padrão/métodos , Máquina de Vetores de Suporte , Algoritmos , Humanos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Tumors arising from epithelium of the odontogenic apparatus or from its derivatives or remnants exhibit considerable histologic variation and are classified into several benign and malignant entities. A high proliferative activity of the odontogenic epithelium in ameloblastoma (AM) and keratocystic odontogenic tumor (KCOT) has been demonstrated in some studies individually. However, very few previous studies have simultaneously evaluated cell proliferation and apoptotic indexes in AM and KCOT, comparing both lesions. The aim of this study was to assess and compare cell proliferation and apoptotic rates between these two tumors. Specimens of 15 solid AM and 15 KCOT were evaluated. The proliferation index (PI) was assessed by immunohistochemical detection of Ki-67 and the apoptotic index (AI) by methyl green-pyronin stain. KCOT presented a higher PI than AM (P < .05). No statistically significant difference was found in the AI between AM and KCOT. PI and AI were higher in the peripheral cells of AM and respectively in the suprabasal and superficial layers of KCOT. In conclusion, KCOT showed a higher cell proliferation than AM and the AI was similar between these tumors. These findings reinforce the classification of KCOT as an odontogenic tumor and should contribute to its aggressive clinical behavior.