Evaluation of CT and MRI Imaging Results of Radicular Cysts, Odontogenic Keratocysts, and Dentigerous Cysts and their Contribution to the Differential Diagnosis.

AIM: This study aimed to evaluate the contribution of the MRI and CT results to the differential diagnosis of histopathologically different odontogenic cysts. BACKGROUND: Odontogenic cysts are commonly seen in the jaw bone and their surgical operations have an important place in the practice of maxillofacial surgery; treatment options for these cysts differ according to their histopathology. Differential results that can be obtained from the radiological evaluations of different cyst groups will allow the surgeon to plan a more accurate approach at the beginning of the operation. In this study, computed tomography (CT) and magnetic resonance imaging (MRI) results of different cyst groups were interpreted together with their histopathological diagnosis. METHODS: CT and MRI results of 17 patients aged between 19-61 were evaluated, whose histopathological diagnosis consisted of 3 radicular cysts (RC), a total of 9 odontogenic keratocysts (OKC) of which 4 were inflamed, and a total of 5 dentigerous cysts (DC) of which one of them was inflammatory. RESULTS: In the CT scan, all cysts showed lytic, a sclerotic surrounding, and showed MRI peripheral enhancement, whereas solid nodular enhancement was only observed in OKCs. Edema and/or air in the surrounding bone medulla was observed in the infected lesions. OKC was heterogeneous, whereas RC and DC were more homogeneous. Diffusion restriction was observed to be frequent in OKCs. The OKCs were ellipsoidal in appearance and were located parallel to the long axis of the bone, and their dimensions were observed to be larger than the other cysts. OKCs may be accompanied by unerupted teeth. Radicular cysts were located perpendicular to the long axis of the bone and were globular in appearance, and their dimensions were smaller and more homogeneous compared to the OKCs. Dentigerous cysts are also accompanied by an unerupted tooth, and their peripheral enhancement is minimal and homogeneous. However, dentigerous cysts can be dense in content and smaller in size, and ellipsoidal localization is more common than OKCs. CONCLUSION: In addition to classic panoramic radiography in the evaluation and differential diagnosis of maxillary and mandibular lesions, CT and MRI evaluations can provide helpful information to the surgeon and pathologist in making the diagnosis and may further help plan the operation.

Evaluation of the hemostatic effects of Ankaferd blood stopper during dental extractions in patients on antithrombotic therapy.

This study evaluated the early hemostatic effects of a novel hemostatic agent (Ankaferd blood stopper [ABS]) during dental extractions in patients on antithrombotic therapy, without interruption or diminution of the medication. In total, 25 patients, who are on antithrombotic therapy and in need of simple dental extractions, were randomized into 2 groups. In group I (control group), which consisted of 10 patients, local hemostasis was achieved with direct packing with gauze. In group II, which consisted of 15 patients, local hemostasis was achieved by the local application of ABS on the extraction sockets. The bleeding time was compared between 2 groups following the tooth extraction. The bleeding time in the dental sockets treated with ABS was statistically lower compared to the sockets of the control group (p = 0.0001). It is concluded that the dental extractions could be performed without interruption of the medication in patients on antithrombotic therapy. The ABS appears to be sufficient as an alternative hemostatic agent.