Orofacial Cysts: A Single Institution Experience of 85 Cases in Enugu, Nigeria.

BACKGROUND: Orofacial cysts are pathologic cavities that could be symptomatic and may cause facial disfigurement. The only epidemiologic report of such lesions in Southeast Nigeria studied jaw cysts from 1987 to 1996. New studies reflecting recent research findings and classifications on the subject in Southeast Nigeria are lacking. AIM: To determine the prevalence and distribution of orofacial cysts in a tertiary hospital in Enugu, Southeast Nigeria. METHODS: A 10-year retrospective study of patients with orofacial cysts diagnosed by histology was carried out. RESULTS: Orofacial cysts constitute 9.5% (85) of 897 orofacial lesions identified. The male-to-female gender ratio was 1.2:1. The mean age (± standard deviation) at the onset of the cystic lesion was 28.58 (±16.98) years. Developmental odontogenic cysts 52.9% (45) and salivary cysts 18.8% (16) were the most common group of orofacial cysts. The most prevalent orofacial cysts were odontogenic keratocysts at 25.9% (22), mucoceles 16.5% (14), and dentigerous cysts 14.1% (12). Straw-colored aspirates 34.8% (16) and dark brown aspirates 28.3% (13) were the predominant cystic contents. The mandible 45.9% (39) and maxilla 27.1% (23) were the commonest sites for orofacial cysts, while the lip 9.4% (8) was the most frequent soft tissue site. A significant association exists between anatomical site and cyst type at a 95% confidence interval with P = 0.000, X2 = 247.17. Unilocular radiolucency 62.5% (20) and multilocular radiolucency 34.4% (11) were the most common radiographic features. CONCLUSION: Developmental odontogenic cysts particularly odontogenic keratocysts were most prevalent while mucocele was the most common soft tissue cyst.

Oral and maxillofacial lesions in a Thai pediatric population: a retrospective review from two dental schools.

OBJECTIVE: To determine the prevalence of oral and maxillofacial lesions in a Thai pediatric population. MATERIAL AND METHOD: Oral biopsy records from pediatric patients between the ages of 0 and 15 years in the files ofFaculty of Dentistry, Mahidol University, and the files of Faculty of Dentistry, Khon Kaen University were reviewed. The patients were divided into three age groups, including 0 to 5, 6 to 10, and 11 to 15 years. Excluding the diagnosis of normal tissues, the oral and maxillofacial lesions were classified into nine categories. RESULTS: Of 13,050 biopsied oral and maxillofacial lesions, 1,389 cases (10.6%) came from pediatric patients. The largest number of lesions was odontogenic cysts and tumors, followed by inflammatory and reactive lesions, and salivary gland pathology The top ten most prevalent lesions contributed 73% of all oral biopsies. The most common lesion was dentigerous cyst, followed by mucocele and pyogenic granuloma. CONCLUSION: The vast majority of oral diseases in children were benign and related to either developmental or tissue reaction, while malignant lesions were found in a very small proportion of all oral biopsies.

Pathological findings in a sample of Mexican pediatric patients. Clinical and radiographic survey.

AIM: The findings of a clinical-radiological review of 467 children attending the Oral Diagnosis Clinic of the Facultad de Odontología, UNAM, Mexico, are presented. METHODS: All patients were clinically reviewed, clinical history was taken, and an orthopantomogram obtained by last year dentistry students. Patients and radiographs were then reviewed by the panel and all alterations in teeth, soft tissues and bone were recorded. RESULTS: Clinical and/or radiographic alterations were found in 132 (28.26%) children. The main alterations were developmental (75%) and inflammatory/infectious and traumatic (6.06% each). The most common entities were: supernumeraries (30.77%); hypodontia (29.7%); osteosclerotic lesions and microdontia (4.4% each). CONCLUSION: The data on the frequency of alterations in the pediatric population attending at our institution reinforce the importance of this kind of study in efforts to improve the quality of stomatologic services in the pediatric population.

Oral mucoceles: A Brazillian Multicenter Study of 1,901 Cases.

Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.

Oral mucoceles: a clinicopathologic review of 1,824 cases, including unusual variants.

PURPOSE: To review the clinicopathologic features of oral mucoceles, with special consideration given to unusual variants and exclusion of salivary duct cysts. MATERIALS AND METHODS: This was a retrospective consecutive case review of all oral mucoceles diagnosed by the Medical University of South Carolina, Oral Pathology Biopsy Laboratory, from 1997 to 2006. The following data were recorded: patient demographics, clinical features (anatomic location, color, size, and consistency), clinical impression, history of trauma, history of periodic rupture, and occurrence of unusual mucocele variants. RESULTS: During the study period, 1,824 oral mucoceles were diagnosed. Of these cases, 1,715 represented histopathologically confirmed cases that were not recurrences. There was no significant gender predilection, and the average age was 24.9 years. The most common locations were the lower labial mucosa (81.9%), floor of mouth (5.8%), ventral tongue (5.0%), and buccal mucosa (4.8%); infrequent sites included the palate (1.3%) and retromolar area (0.5%). The lesions most often were described as blue/purple/gray or normal in color. The mean maximum diameter was 0.8 cm (range, 0.1 to 4.0 cm). In 456 cases, a history of trauma was reported, and in 366 cases a history of periodic rupture was reported. Unusual variants included superficial mucoceles (n = 3), mucoceles with myxoglobulosis (n = 6), and mucoceles with papillary synovial metaplasialike change (n = 2). CONCLUSIONS: Our results confirm the findings of previous investigators regarding the major clinicopathologic features of oral mucoceles. Special variants of oral mucoceles occur infrequently, although it is important to recognize these variants to avoid misdiagnosis.

Mucus extravasation and retention phenomena: a 24-year study.

BACKGROUND: Mucoceles are benign lesions related to the minor salivary glands and their respective ducts frequently affecting oral structures which are generally asymptomatic. Mucoceles are generally characterized by swollen nodular lesions preferentially located on the lower lip and differ from the so-called ranulas, which are lesions located on the floor of the mouth and related to the sublingual or submandibular glands. METHODS: The objective of the present study was to analyze data such as age, gender, race and site of the lesion of 173 mucocele cases diagnosed at the Discipline of Stomatology, São José dos Campos Dental School, UNESP, over a period of 24 years (April 1980 to February 2003). RESULTS: Of the 173 cases analyzed, 104 (60.12%) were females and 69 (39.88%) were males. Age ranged from 4 to 70 years (mean +/- SD: 17 +/- 9.53) and most patients were in the second decade of life (n = 86, 49.42%); white (n = 124, 71.68%). The lower lip was the site most frequently affected by the lesions (n = 135, 78.03%), whereas the lowest prevalence was observed for the soft palate, buccal mucosa, and lingual frenum. CONCLUSION: In this study, mucoceles predominated in white female subjects in the second decade of life, with the lower lip being the most frequently affected site.

Retrospective review of pediatric oral lesions from a dental school biopsy service.

UNLABELLED: This report presents a review of the results from 5457 biopsies of patients, 0-16 years of age, received over 15 years at the University of the Pacific School of Dentistry (Pacific Oral and Maxillofacial Pathology Laboratory). PURPOSE: To carry out the largest and most up to date U.S. survey of oral specimens from children. METHOD: The computerized data was retrieved and compiled for age and diagnoses. The lesions were divided by the MIND classification system into 1) Metabolic 2) Inflammatory 3) Neoplastic and 4) Developmental. RESULTS: Inflammatory lesions formed the largest group of biopsies (2758, 51%) followed by Developmental conditions (1928, 35%) and Neoplasms (734, 13%). Dentigerous cysts were the most common lesions, followed by the mucous retention phenomenon (mucocele). The 15 most frequently occurring lesions accounted for 80% of all biopsies. Eight malignancies and 22 benign aggressive tumors were also included. CONCLUSIONS: 1. Pathoses increase with age. 2. Results from our study are similar to most of the other studies. 3. More serious pathoses occur in some countries where there is limited access to care, resulting in patients seeking care only when symptomatic. 4. Oral malignancies are rare, but as with any malignancy, early diagnosis renders a more favorable prognosis.

Oral mucoceles; extravasation cysts and retention cysts. A study of 298 cases.

Oral mucoceles can be divided in two different forms, extravasation and retention cysts. The aim of this study was to identify the frequency of each form, sex- and age distribution, location, recurrences, referent and the differences between the two forms. A total of three-hundred-five cases were retrieved from the Department of Oral Pathology at the Institution of Odontology, The Sahlgrenska Academy at Göteborg University between 1993 and 2003. Seven referrals were disregarded because there was insufficient information, leaving 298 cases for this study. In relation to other studies, our study investigated a larger number of cases. Extravasation cysts were the most common type (258 cases). There was a slight predominance among women (55%) and the most frequent location was the lower lip (71%). 84% occurred between the ages of 0 and 40 years with peak incidence in the second decade (34%). 62% of the referrals came from specialists, 28% from general practitioners, and 10% from the Department of Oral Medicine. Retention cysts were not found as frequently as extravasation cysts (40 cases) and the occurrence in women was also a bit higher (58%). We found a more even distribution regarding age and location. The most common locations were floor of the mouth (25%), cheek (20%), and lower lip (18%). They occurred more often between the ages of 11 and 30 (31%), and between 50 and 80 (50%). 75% of the referrals came from specialists, 15% from general practitioners,and 10% from the Department of Oral Medicine. Recurrences were unusual for both cyst types. 17 cases of extravasation cysts were reported as recurrences and one case of retention cyst.

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population.

The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Retrospective review of oral and maxillofacial pathology in a Brazilian paediatric population.

AIM: To describe the relative frequencies of oral biopsies among a sample of children aged 0-16 years and compare the results with an adult population as well as with previous studies. METHODS: Information about age, gender, anatomic site, and histopathological diagnosis was retrieved from the files of the Oral Pathology Laboratory of the University of Fortaleza (Brazil). Diagnosis data of 1240 biopsies were classified into eight groups. RESULTS: Relative frequencies of biopsies increased with age. The 16 most frequent lesions accounted for 70% of all biopsies. The most frequent diagnostic group was salivary gland pathology (30.4%). Mucocele was the most common lesion (27.1%), followed by dental follicle (5.6%) and fibroma (4.4%). These results were statistically different from those of the comparable adult population (p < 0.05). CONCLUSIONS: The most frequent lesion was mucocele, and this result is in agreement with the literature. There was a significant difference between the study paediatric and adult populations. The variations in distribution of lesions observed between the several studies were probably due to cultural differences between geographic areas but also to differing elements of the study design.

Distribution of oral and maxillofacial lesions in pediatric patients from a Brazilian southeastern population.

OBJECTIVES: Oral lesions affecting infants account for approximately 10% of all samples from diagnostic services and studies investigating the distribution of these lesions in pediatrics from different geographic areas are desired to improve the diagnostic knowledge of clinicians. Therefore, the aim of this study is to describe the distribution of oral lesions in a southeastern Brazilian population. METHODS: The oral pathology files of the University of Campinas was retrospectively reviewed for all cases diagnosed from 2000 to 2014 affecting patients 16-years-old and younger. Data on gender and diagnosis were retrieved from patients' oral pathology reports and included in a Microsoft Excel® database. RESULTS: Out of 34,138 cases, 2539 affected pediatric patients (7.4%) with a higher incidence in those with 13-16 years-old. Salivary gland disease was the most common group of lesions (37.1%), followed by mucosal pathology (13.6%) and odontogenic cysts (11.3%). Mucous extravasation cyst was the most common lesion (36.3%), followed by fibrous hyperplasia (5.6%) and dental follicle (5.2%). Dental lesions were uncommon (7.9%) and malignancies rare (0.4%). CONCLUSIONS: Our results were similar to previous studies and the small differences observed were more likely result of methodological variability and characteristics of the service of origin from where samples were collected.

Oral mucocele/ranula: Another human immunodeficiency virus-related salivary gland disease?

OBJECTIVES/HYPOTHESIS: To describe clinical characteristics of oral mucoceles/ranulas, with a focus on human immunodeficiency virus (HIV)-related salivary gland diseases. STUDY DESIGN: A descriptive and clinical study, with review of patient data. MATERIAL AND METHODS: We reviewed 113 referred cases of oral mucocele. The following anatomical sites were identified: lip, tongue, and floor of the mouth (simple ranulas), as well as plunging ranulas. The age and gender data of the patients with oral mucoceles were recorded. The HIV status of the patients and other information were reviewed. RESULTS: There were 30 (26.5%) males and 83 (73.5%) females. Most patients were below 30 years of age, with the peak frequency in the first and second decade. Ranula (simple and plunging) represented 84.1% of the mucocele locations. Mucocele on the lips represented 10.6%. Seventy-two (63.7%) patients were HIV positive; and 97.2% of them had ranulas. Thirty-eight (33.6%) patients presented with plunging ranulas; and 92.1% of them were HIV positive, compared with two patients presenting with plunging ranulas in the HIV-negative group. These results strongly suggest that an HIV-positive patient is statistically (P < 0.001) more at risk of presenting with not only a simple, but also a plunging ranula type. CONCLUSION: This study presents a different clinical picture of oral mucoceles/ranulas, as observed in HIV-positive patients. Additionally, it suggests a possible clinical link between the two pathologies. The authors strongly support the suggestion that oral mucocele/ranula is an HIV-related salivary gland disease. LEVEL OF EVIDENCE: 4.

Prevalence of oral lesions in a selected Vietnamese population.

Clinical examination of the oral and peri-oral regions of a cohort of 550 Vietnamese living in a refugee camp in Hong Kong was conducted. They comprised 216 (39 per cent) males and 334 (61 per cent) females and their age ranged from 2 to 60 years. A positive clinical finding was observed in 14 per cent, 35 males and 43 females. The most common condition observed was periapical infection (36 per cent), either with an abscess or a sinus. Other lesions noted include mucocele (10 per cent), traumatic ulcers (9 per cent), tori, either palatal (6 per cent) or mandibular (3 per cent), lymph node enlargement (7 per cent), pulp polyp (6 per cent), angular cheilitis (4 per cent), papillomas (3 per cent), cellulitis (3 per cent) and herpes lesions (2 per cent), 7 out of 9 (78 per cent) mucoceles were found in females. No malignant lesions were noted.

A review of pediatric oral biopsies from a surgical pathology service in a dental school.

This report presents a review of results from 2370 biopsies of patients up to 20 years of age received over 11 years in the biopsy service at the University of Illinois at Chicago. The computerized data were retrieved and compiled for site, age, sex, race, and diagnosis of the biopsies. The lesions were divided into 1) inflammatory and reactive, 2) cystic, 3) neoplastic, and 4) other anomalies. The patients were divided into three racial groups: whites, blacks, and Hispanics. Whites were in the majority (57%), blacks were the next most prevalent (26%), and Hispanics were the smallest group (17%). Private practitioners were the major source of the biopsies. The predominant site of the biopsies was periodontium followed by the lips. Inflammatory and reactive lesions formed the largest group of biopsies (66.1%) followed by neoplasms (11.2%) and cystic lesions (10.7%). Mucus extravasation phenomenon was the most common lesion followed by periapical granuloma, periapical cyst, dentigerous cyst, pyogenic granuloma, and papilloma. Three malignancies and five ameloblastomas also were found.

A retrospective study of oral and maxillofacial biopsy lesions in a pediatric population from southern Taiwan.

This is a retrospective study of biopsied oral lesions (N = 534) in a pediatric population (0-15 years old) in southern Taiwan. In this study, we included 6% of the 9672 biopsies performed from 1985 through 1996. The lesions were divided into three groups according to patients' ages, 0-5 years old; 6-10 years old; and 11-15 years old The majority of the samples were from the oldest age group (273/518). With the exclusion of normal tissues (N = 26), 518 samples were classified into four categories: inflammatory lesions, cystic lesions, tumor or tumor-like lesions, and other lesions. The largest number of lesions occurred in the inflammatory lesion group (46%). The 12 most frequently occurring lesions contributed about 78% of all the biopsies in the three age groups (0-15 years old). Frequencies of the lesions of mucous extravasation phenomenon, dentigerous cyst, fibrous dysplasia, and odontonia in our three pediatric age groups showed a significant proportion in the biopsies of the same lesions in the group of patients of all ages. These information may be valuable for both epidemiology and teaching.

A retrospective study of oral cysts in Nigerian children.

A retrospective analysis of oral cysts that were seen over an 11-year period in children at a dental institution in Nigeria was carried out. In general, oral cysts accounted for only 2.6% of the total biopsied lesions during the period under review. The most common oral cysts were the mucous retention cysts, the gingival cysts of infants and the dentigerous cyst. The commonest sites were the maxilla, the mandible and the floor of the mouth respectively and there was no significant difference in sex preference. Most of the cases were seen in the age group 11-16 years while the least was in the group aged 6-10 years.

Pediatric oral lesions: a 15-year review from São Paulo, Brazil.

There are few studies on pediatric oral pathologies in the literature. This study presents data from a review of 2,356 biopsies of young patients (birth to 14 years) received over 15 years (1985-2000) in the Oral Pathology Service at the University of Sao Paulo, Brazil. Information about patients (sex, age, race) and histopathological diagnosis was retrieved. Diagnosis data of 2,356 biopsies were classified into 20 groups. There was no significant difference between male (50.0%) and female (49.0%) patients. White is the predominant race (69.0%), and patients ages were concentrated between 9 and 14 years old (70%). Mucocele was the most frequent (13.5%), followed by dentigerous cyst (6.5%) and fibrous hyperplasia (5.4%). Papilloma and Langerhans cells histiocytosis were the most common non-odontogenic benign and malignant tumors, respectively. In the group of odontogenic tumors, odontoma was the most frequent, and ameloblastoma had a significant incidence (27 cases). These data are important in order to detect differences in geographic areas, diagnosis line tendencies and for clinicians to perform judgment to evaluate of the pediatric patients before the biopsy and management of pediatric oral lesions.

Oral mucoceles: a clinical, histopathological and immunohistochemical study.

The aim of study was to evaluate the clinicopathological features of oral mucoceles and the immunohistochemical expression of cellular and extracellular matrix components in these lesions. One hundred cases of oral mucoceles were examined for clinicopathological features. The expression of mast cell tryptase, CD68, MMP-1 (matrix metalloproteinase-1), MMP-9 (matrix metalloproteinase-9) and CD34 was investigated immunohistochemically in 32 cases. The lesions arose as nodules or blisters of variable color. The mean age was 23.2 years and a higher male frequency was observed. The most common locations were the lower lip (92%), followed by the floor of the mouth (7%), and palate (1%). The lesion size ranged from 0.4 to 3.0cm. Unusual histopathological findings as superficial mucoceles (n=16, 16%), pseudopapillary projections (n=3, 3%), epithelioid histiocytes (n=4, 4%), multinucleated giant cells (n=1, 1%) and myxoglobulosis (n=9, 9%) were also seen. Mast cells and CD68-positive macrophages, MMP-1, MMP-9 and CD34-positive blood vessels were seen in all cases. A significant association was seen between mast cells and MMP-1 (p=0.03) and between macrophages and MMP-1 (p=0.01). This study provided important insight into the demographic and histopathological occurrence of oral mucoceles. The tissue remodeling seen in these lesions mainly involved the migration and interaction of mast cells, macrophages and MMP-1.

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Mucocele--a study of 36 cases.

BACKGROUND: Mucocele is one of the most common benign soft tissue tumor present in the oral cavity. They are of two types - one is extravasation and second one is retention type but the majority are extravasation type. AIMS: The objective is to determine various factors related to mucocele such as role of trauma due to nearby teeth, recurrence, duration, and to find out whether there is any role of psychological stress which initiates trauma like lip or cheek biting. MATERIALS AND METHODS: 36 cases of mucocele diagnosed at the Department of the Oral Pathology, Govt. Dental College and Hospital, Ahmedabad, between 2004 and 2008 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. STATISTICAL ANALYSIS USED: Data analysis tool, Microsoft Office Excel 2007. RESULTS: A diagnosis of mucocele was established in 36 cases with male-to-female ratio of 1.77:1. Most common type was extravasation in 30 (83.33%) cases. The peak age of occurrence was between 1st and 3rd decade. Lateral side of the lower labial mucosa was the most affected site in 34 (94.44%) cases. The history of trauma appeared the major etiological factor seen in 28 (77.77%) cases. CONCLUSION: We conclude that there was male predominance and they were more affected in 2nd and 3rd decade. The lateral side of lower labial mucosa was the commonest site and the trauma due to teeth or lip biting was the major etiological factor for the occurrence of the mucocele. The article highlights role of psychological stress in occurrence of mucocele. The reader should understand the importance of histopathology examination and should try to control the psychological stress in such mucocele patients.