Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report.

BACKGROUND: Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. CASE PRESENTATION: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. DISCUSSION: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. CONCLUSION: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.

Autotransplantation for Restoration of Dentition Defects After Excision of Jaw Cysts.

Bone defect caused by jaw cystectomy has always been the main factor affecting postoperative wound healing and is also the common cause of maxillofacial bone defect, which brings challenges to the subsequent restoration of missing teeth. In this paper, the authors report a 22-year-old young woman who had a mandibular cyst in the left lower posterior tooth area. She underwent mandibular bone cyst excision and simultaneous extraction of teeth 36 and 37. One and two months after the removal of the mandibular bone cyst, autologous tooth transplantation was performed in stages from tooth 28 to tooth 36 and from tooth 18 to tooth 37. The case shows that tooth autotransplantation is a viable option for the restoration of dentition defects after the excision of jaw cysts, which can promote the healing of the bone defect after the operation.

Deep learning based diagnosis for cysts and tumors of jaw with massive healthy samples.

We aimed to develop an explainable and reliable method to diagnose cysts and tumors of the jaw with massive panoramic radiographs of healthy peoples based on deep learning, since collecting and labeling massive lesion samples are time-consuming, and existing deep learning-based methods lack explainability. Based on the collected 872 lesion samples and 10,000 healthy samples, a two-branch network was proposed for classifying the cysts and tumors of the jaw. The two-branch network is firstly pretrained on massive panoramic radiographs of healthy peoples, then is trained for classifying the sample categories and segmenting the lesion area. Totally, 200 healthy samples and 87 lesion samples were included in the testing stage. The average accuracy, precision, sensitivity, specificity, and F1 score of classification are 88.72%, 65.81%, 66.56%, 92.66%, and 66.14%, respectively. The average accuracy, precision, sensitivity, specificity, and F1 score of classification will reach 90.66%, 85.23%, 84.27%, 93.50%, and 84.74%, if only classifying the lesion samples and healthy samples. The proposed method showed encouraging performance in the diagnosis of cysts and tumors of the jaw. The classified categories and segmented lesion areas serve as the diagnostic basis for further diagnosis, which provides a reliable tool for diagnosing jaw tumors and cysts.

Effect of Application of Platelet-Rich Plasma on Bone Regeneration after Removal of Jaw Cysts.

Platelets are involved in regeneration at sites of bony defect, apart from their function in coagulation. An autologous preparation platelet-rich plasma gel applied to sites of bony defects after surgical treatment of jaw cyst. This case-control study was conducted in Bangabandhu Sheikh Mujib Medical University (BSMMU) in the department of Oral and Maxillofacial Surgery from September 2017 to August 2018. Total 30 patients were chosen having jaw cyst. They were divided into 2 groups; Group A and Group B, where Group A got the platelet rich plasma, after removal of the cystic lesion; and Group B got the normal usual treatment. Platelet rich plasma gel was prepared using a standardized technique and applied to the surgical site of the Group A. The differences of radiographic changes between the two groups at 6th, 12th, 18th and 24th weeks after surgery were analyzed. Study showed significant changes in early bone regeneration in group A at 12th and 18th weeks post operatively. Platelet rich plasma induces early bone regeneration and it has proven successful outcome.

Surgical Treatment of Voluminous Jaw Cysts with a Buccal Plate: A Study of 20 Clinical Cases.

AIM AND OBJECTIVE: The aim of this paper is to present, with a series of clinical cases, some advantages of a modified surgical technique using fixed bone flaps in an approach to voluminous maxillary or mandibular odontogenic cysts (excluding keratocysts) and highlight the positive impact on the healing of mucus and bone tissues. BACKGROUND: The surgical approach of the enucleation of voluminous maxillary cysts is generally realized with a subtractive osteoplasty. The major problem with this kind of procedure is frequent fibrous healing (or scar formation) of the cavity due to mucosal invagination, especially for large lesions more than 2 cm in diameter. Several techniques have been proposed to limit these side effects. Very contrasting results have been observed in the techniques with graft or exogenous materials, and the scarring effects on mucus and bone tissues are poorly described. In situations where a vestibular cortical bone remains, our modification of the former technique is the use of this bone like a repositioned flap. TECHNIQUE: The present study is a cases series and was carried out on 20 adult patients with maxillary or mandibular cystic lesions larger than 25 mm. For all the patients, our modified technique consisted of using a bone flap to expose more widely the site and to carry out the enucleation of the cyst. Repositioning the flap in the final stage of the operation with osteosynthesis material allowed controlled mucosal and bone healing confirmed by clinical and radiographic follow-up. CONCLUSION: In all cases of our study, no invagination of the soft tissues in the cystic cavity was observed and postoperative bone volumes were identical to the initial state. Only minor postoperative complications were observed in three cases. CLINICAL SIGNIFICANCE: A bone flap approach seems to allow a tissue interception, thus better control of mucosal and bone healing, which is borne out by the clinical and radiographic controls 24 months after surgery.

Non-neoplastic jaw cysts: a 30-year epidemiological study of 2150 cases in the Italian population.

Non-neoplastic jaw cyst (NJC) is one of the most common lesions in oral cavity, but there are only few detailed and extended epidemiological data based on the 2017 WHO classification. The aim of this study was to perform an epidemiological analysis of all NJCs treated from 1990 to 2019 at the Marche Polytechnic University, and to compare these data with those published in the literature. This retrospective study considered 2060 patients treated from 1990 to 2019. The NJCs were classified according to the 2017 WHO classification, and the main clinicopathological variables were analysed (sex, age, diagnosis, site of onset, size, and recurrences). Of 2150 total lesions, there were 2095 primary cysts and 55 recurrences; men are more frequently affected than women (M/F ratio of 1.73:1). The mean age of occurrence was 46.6 years, with a peak of frequency in the fifth decade. The mandible was more frequently involved than the maxilla, with a mean size of 1.9cm. Radicular cyst was the most frequently diagnosed cyst (56.6%), followed by dentigerous cyst (23.4%) and odontogenic keratocyst (12.9%). This is the first epidemiological study on NJCs in the Italian population according to 2017 WHO classification.

Quiste óseo solitario / No disponible

INTRODUCCIÓN: El quiste óseo solitario representa el 1% de todos los quistes maxilares. Es una lesión ósea benigna que aparece de forma fortuita en una radiografía de control en la primera/segunda década de la vida, aunque la lesión carezca de trascendencia en la vida del paciente requiere de abordaje quirúrgico para confirmar el diagnóstico. CASO CLÍNICO: Se presenta un caso clínico de una paciente mujer de 11 años de edad y raza negra, remitida al Servicio de Cirugía Bucal del Hospital Virgen de la Paloma tras observarse imagen radiotransparente apical a nivel de 43 y 44. Una vez realizada la exploración clínica y radiológica se propone cirugía exploratoria ante diagnóstico de presunción de quiste óseo solitario. Bajo anestesia local se procedió al abordaje quirúrgico observándose cavidad vacía en maxilar inferior sin contenido alguno, legrándose profusamente las paredes de la cavidad e introduciendo plasma rico en plaquetas obtenido previamente de la paciente. CONCLUSIONES: La cirugía exploratoria confirma el diagnóstico de presunción de quiste óseo solitario vacío al no poderse mandar a analizar a anatomía patológica

No disponible

Cisto ósseo traumático associado a odontoma composto: relato de um caso incomum / Aneurismal bone cyst with a compound odontoma: unusual case report

Introdução: o cisto ósseo traumático (COT) é um pseudocisto que se apresenta assintomático e é descoberto frequentemente em exames de rotina. Outra lesão também presente nos maxilares é o odontoma, sendo dividido em dois subtipos, o composto e o complexo; os odontomas são geralmente descobertos como um achado acidental, visto que não apresentam sintomatologia. Objetivo: relatar um caso incomum de um COT, associado à odontoma composto (OC). Relato de caso: paciente do gênero masculino, 16 anos de idade, compareceu à clínica escola de odontologia da Universidade Federal de Campina Grande (UFCG), campus Patos, PB, referenciado pelo cirurgião-dentista após solicitar exame radiográfico para tratamento ortodôntico e observar lesão radiolúcida em região anterior da mandíbula. Durante a anamnese, o paciente não relatou nenhuma alteração sistêmica ou doença de base, mas relatou trauma de infância na região acometida. No exame clínico intraoral, não foi observado nenhum aumento de volume na região. Realizou-se palpação na região, não havendo relato de dor. Ao analisar a radiografia panorâmica, observou-se a presença de pequenas estruturas calcificadas com radiopacidade semelhante às estruturas dentárias, delimitada por uma linha radiolúcida, sugestiva de OC. Para melhor localização, delimitação, relação com estruturas anatômicas e planejamento cirúrgico da lesão, foi solicitado um exame de tomografia computadorizada de feixe cônico (TCFC). Considerações finais: com base nos achados clínicos e radiográficos, optou-se por abordagem cirúrgica da lesão cística e enucleação do OC, sob anestesia local. No pós-operatório de um ano, o paciente evoluiu satisfatoriamente sem queixas clínicas.(AU)

Introduction: traumatic bone cyst (TBC) is a pseudocyst that usually presents asymptomatically and is found frequently in routine exams. Another lesion also present in the jaws is odontoma. The odontoma is divided into two subtypes, the compound and the complex; odontomas are usually discovered as an accidental finding, since they do not present symptomatology. Objective: the present article aims to report an unusual case of a TBC associated with a composite odontoma. Case report: a 16-year-old male patient attended the Clinic School of Dentistry of the Universidade Federal de Campina Grande (UFCG), Patos-PB campus, referenced by the dentist after identify radiolucent lesion in the anterior region of the mandible on radiographic examination for orthodontic treatment. During the anamnesis, the patient did not report any systemic alteration or underlying disease, but reported trauma in the region affected in childhood. The intra oral clinical examination, was not observed any increase in volume in the region. Palpation was performed in the region, and there was no report of pain. When analyzing panoramic radiography the presence of small calcified structures with radiopacity similar to dental structures was observed, delimited by a radiolucent line, suggestive of compound odontoma. To better location, delimitation, compared with anatomy and surgical planning of the injury, it was requested an cone beam computed tomography (CBCT). Final considerations: based on the clinical and radiographic findings, we opted for a surgical approach to cystic lesion and enucleation of composite odontoma, under local anesthesia. In the one-year postoperative period, the patient progresses satisfactorily without clinical complaints.(AU)

Stafne's bone cyst revisited and renamed: the benign mandibular concavity.

OBJECTIVE: Stafne's bone cyst (SBC) is an asymptomatic, round or oval-shaped, well-defined, uniform radiolucent lesion, usually incidentally observed in the posterior aspects of the mandible. Radiographical appearance may be confusing though. This study aimed to review the literature on SBCs and to map the SBC as shown in their respective papers. METHODS: A Pubmed® search (1/9/2018 till 31/5/2019), mentioning SBC, was carried out. Included papers had to contain: patient's age, gender and radiographs. RESULTS: In total, 114 papers were found, but only 64 papers were retained, which contained 109 cases (95 males, 14 females). The patients' ages ranged between 14 and 89 years old (mean age being 52 years). Male patients' ages (N = 95) ranged from 14 to 89 years (mean age 52.3 years), whereas the females (N = 14) ages ranged between 22 and 68 (mean age 50.2 years). 28 combinations of locations of SBC were recorded. Only three lesions were located at the symphysis, six were bilateral, 55 appeared on the left hand side and 45 on the right hand side of the mandible.The literature mentioned that these cavities could contain salivary gland tissue, muscular tissue, lymphoid tissue, blood vessels, fat tissue or connective tissue. DISCUSSION/CONCLUSION: This study illustrates the wide variation of SBC locations across the mandible and leads us to conclude that the differential diagnosis of every asymptomatic, oval or round, well-defined, uniform radiolucent lesion on two-dimensional radiographs of the mandible should include "a benign mandibular concavity", formerly known as SBC.

Stafne Bone Defect Involving the Ascending Ramus.

The Stafne bone defect (SBD) classically presents as a well-defined, radiolucent lesion in the molar-mandibular angle region beneath the level of the mandibular canal. Due in large part to this prototypical appearance, most cases of SBDs are radiographically diagnostic without the need for tissue biopsy. A diagnostic challenge may arise, however, when the SBD occurs in other locations in the mandible. The authors report a case of a 57-year-old male who presented with a SBD of the left ascending ramus. The lesion was found incidentally on a panoramic radiograph. Additional imaging studies confirmed a lingual concavity of the mandibular bone consistent with a SBD, and a retrospective study of the patient's records revealed the presence of the lesion 5 years prior without any radiographic alterations. To date, only 10 documented cases of an SBD involving the ascending ramus have been reported. The rarity of such a presentation may obscure the diagnosis and lead to unwarranted surgical procedures. It is important to recognize atypically located SBDs, because unlike other radiolucent lesions, imaging studies are diagnostic. With proper diagnosis, additional surgical procedures and any associated morbidities can be avoided.

Radiological Evaluation Key to Diagnosis of Idiopathic Solitary Cyst.

Idiopathic solitary cysts have a predilection for long bones and the mandible. Although the origin of these cysts is unclear, the prognosis seems to be good, given proper diagnosis and surgical treatment. A 14-year-old female patient with a bone lesion in the right mandibular ramus was referred to the Department of Pediatric Dentistry at the Medical University of Gdansk, Poland. Due to severe headache lasting two days, the patient had previously undergone magnetic resonance imaging (MRI) examination of the head. A unilocular bone cyst in the mandible was discovered incidentally. Comparison with a previous orthopantomogram (OPG) taken two years earlier for routine dental treatment revealed a clearly visible but smaller bone lesion at the same location. Surgery was carried out in order to achieve bone regeneration. This report documents the importance of careful evaluation and assessment of all radiographs taken, as the lesion could have been diagnosed and treated much earlier, thus lowering the risk of complications.

Image segmentation-based volume approximation-volume as a factor in the clinical management of osteolytic jaw lesions.

OBJECTIVE: Size characterization of osteolytic jaw lesions (OJL), in particular of neoplastic nature, is heterogeneously performed and lacks standardization in the medical literature and clinical practice. An OJL's volume holds promise as a surrogate for treatment response and prognosis. We comparatively evaluate various methods for size characterization of odontogenic OJLs. METHODS: We retrospectively performed semiautomatic image segmentation of CBCT data sets for volume approximation of neoplastic (51) and non-neoplastic odontogenic OJLs (100). We assessed the three greatest orthogonal diameters and calculated the volume using the cuboid- and ellipsoid-formula. Image segmentation was carried out using ITK-SNAP. Image segmentation-based volume approximation served as reference. Intra- and inter-rater variability were evaluated at hand of Bland-Altman-Analysis and dice similarity coefficient (DSC). RESULTS: Concerning the intrarater variability, we found the DSC to be highest for image segmentation-based volume approximation, simultaneously showing the tightest limits of agreement and greatest reliability. The cuboid formula showed consistent overestimation of the lesion's volume with a percent mean difference of -52 % (upper and lower limits of agreement +8.57 % and -112.63%, respectively). In mean, the ellipsoid formula underestimated the lesion's volume by 10.1% (upper and lower limits of agreement +76.8% and -56.6%, respectively). Inter rater variability was higher for formula-based volume approximation. Volume and multilocularity (p = 0.001) correlate with aggressiveness and growth potential. CONCLUSIONS: Segmentation-based volume approximation holds great promise for patient individualized treatment planning and clinical management. The data suggest that maximum tumour diameter-based size characterization, especially the cuboid-formula and the maximum diameter alone, should not be recommended.

Cisto ósseo solitário em mandíbula: relato de caso clínico / Solitary bone cyst of the mandible: clinical case report

Objetivo: apresentar um caso clínico de paciente com cisto ósseo solitário em mandíbula e sua evolução após o tratamento de exploração e curetagem cirúrgica por meio de achados radiográficos. Caso clínico: paciente do sexo masculino, 45 anos, compareceu à clínica da Faculdade de Estudos Administrativos ­ Fead. Ao exame clínico, os tecidos se apresentavam dentro dos padrões de normalidade e ao exame radiográfico observou-se área radiolúcida unilocular, limites regulares e bem definidos em região anterior de mandíbula entre ápices dos dentes 33, 32, 31, 41 e 42, sem deslocamento desses. Para confirmação do diagnóstico, além do exame clínico, foi necessário realizar a tomografia de feixe cônico e exploração cirúrgica. Após a exploração cirúrgica foi realizada a curetagem das paredes ósseas e a proservação do caso para acompanhar a sua evolução. Considerações finais: por ser uma lesão de comportamento não agressivo, responde bem a este tipo de tratamento, sendo notável sua melhora durante o período de acompanhamento.(AU)

Objective: To present a clinical case report of a patient with solitary bone cyst of the mandible and its evolution after exploration and surgical curettage treatment through radiographic findings. Case report: A 45-year-old male patient attended the clinic of the School of Administrative Studies - FEAD. The clinical examination showed normal tissues and the radiographic examination showed unilocular radiolucent area and regular and well-defined boundaries in the anterior mandible between the apexes of teeth 33, 32, 31, 41, and 42, without displacement. To confirm the diagnosis, in addition to the clinical examination, cone beam tomography and surgical exploration were required. After the surgical exploration, bone wall curettage and case proservation were performed to monitor the evolution. Final considerations: Considering it is a non-aggressive lesion, it responds well to this type of treatment, with considerable improvement during follow-up.(AU)

Defeito ósseo de Stafne e a importância da tomografia no diagnóstico: um relato de caso / Stafne's bone defect and importance of tomography in diagnosis: a case report

Objetivo: relatar o caso de um paciente idoso portador de defeito ósseo de Stafne. Relato de caso: paciente do sexo masculino, 74 anos de idade, foi atendido na Clínica de Odontologia da União Metropolitana de Educação e Cultura, e, após realização de radiografia panorâmica, foi evidenciada uma imagem sugestiva do defeito, sendo o paciente orientado a realizar a tomografia computadorizada fan beam para a confirmação diagnóstica. Considerações finais: o defeito ósseo de Stafne é definido como uma depressão lingual na mandíbula, de forma arredondada ou ovoide, que varia de 1 a 3 cm em diâmetro, com margens ósseas muito densas e bem definidas. Apresenta-se, radiograficamente, como uma imagem radiolúcida, circunscrita e unilocular na região posterior da mandíbula, abaixo do canal mandibular. É geralmente detectado em exames radiográficos de rotina, como a radiografia panorâmica, e a confirmação do diagnóstico geralmente é obtida pela realização da tomografia computadorizada fan beam ou de cone beam, por conta da obtenção de imagens que possibilitam a avaliação tridimensional, descartando, assim, outros tipos de lesões. Por se tratar de uma variação anatômica, a conduta é proservar o caso. (AU)

Objective: the objective of the following work was reported in the case of an elderly male patient. Clinical case: male patient, 74 years-old, who was attended at the Dentistry Clinic of the Metropolitan Union of Education and Culture, and after a panoramic radiograph, an image suggestive of the defect was evidenced. patient oriented to perform a Fan Beam Computed Tomography scan for diagnostic confirmation. Final considerations: the Stafne bone defect is defined as a lingual depression in the mandible, rounded or ovoid, ranging from 1 to 3 cm in diameter, with very dense and well defined bone margins. It presents, radiographically, as a radiolucent, circumscribed and unilocular image in the posterior region of the mandible, below the mandibular canal. It is usually detected in routine radiographic examinations as a panoramic radiograph, being a confirmation of the diagnosis obtained by performing the Fan Beam Computed Tomography or Cone Beam, due to obtaining images that allow a three-dimensional evaluation, thus discarding other types of injuries. Because it is an anatomical variation, the conduct is to preserve the case. (AU)

Implants placed simultaneously with maxillary sinus floor augmentation in the presence of antral pseudocysts: Presentation of a case series.

OBJECTIVE: To report the outcome of simultaneous placement of dental implants with maxillary sinus elevation in the presence of antral pseudocysts. METHOD AND MATERIALS: This case series involved 14 patients with 28 implants placed simultaneously with maxillary sinus elevation. The psuedocysts were treated by cystic fluid extraction. Postoperative examinations were performed at 3, 6, and 12 months. RESULTS: All restorations were finished 6 to 9 months after implant placement. Nine antral pseudocysts disappeared and five decreased in size. All implants were deemed successful at 1 year postoperatively, showing osseointegration and masticatory function. No mobility was found during the follow-up period. CONCLUSION: In the absence of maxillary sinus infection, the combination of cystic fluid extraction, maxillary sinus elevation, and immediate implantation showed an acceptable clinical outcome in this series of patients.

Fate of mandibular canals displaced by enlarged cystic lesions: does the inferior alveolar neurovascular bundle relocate to its original position?

Our aim was to identify the positional changes of the inferior alveolar neurovascular bundle and evaluate the relocation of the displaced mandibular canal after enucleation of a cyst. Seventy patients (72 sites) who had had cysts enucleated were divided into three groups based on the degree of encroachment of the cystic lesion into the mandibular canal and whether a bone graft had been inserted after the cyst had been enucleated. The mean (range) of patients' ages was 45 (18-75) years, and there were 29 male and 41 female patients. Group A comprised cysts with encroachment on the mandibular canal that were enucleated without a bone graft; Group B consisted of cysts with no encroachment of the mandibular canal, but were enucleated without a bone graft; and Group C comprised cysts with encroachment of the mandibular canal that were enucleated with a bone graft. The displacement of the mandibular canal was identified from analysis of computed tomographic (CT) images. Changes in the position of the mandibular canal were measured on panoramic radiographs. The mandibular canal was repositioned superiorly by a mean (SD) of 2.4 (1.65)mm after enucleation of the cyst, which was significant in Group A (p<0.001), but not in Groups B and C. These results indicate that the displaced inferior alveolar neurovascular bundles that were not surrounded by bony canal tended to relocate towards a supposedly normal position, and after enucleation of the cyst the mandibular canal was remodelled in this new location. This tendency to relocate was blocked by bone grafting. Bone grafts are therefore recommended in cases where enough bony height is required for future insertion of implants.

Quiste bucal mandibular infectado bilateral en segundos molares permanentes: reporte de un caso / Bilateral mandibular infected buccal cyst in second permanent molars: a case report

El quiste bucal mandibular infectado corresponde a una lesión poco frecuente, de etiología desconocida, que se presenta en niños de 6 a 13 años, generalmente de forma unilateral, durante el proceso de erupción de los primeros molares permanentes. Con menor frecuencia puede afectar a segundos molares permanentes. El diente asociado a la lesión se encuentra vital, presentando un patrón alterado de erupción. Puede presentarse sintomatología, sensibilidad, incremento en la profundidad del saco periodontal, aumento de volumen en fondo de vestíbulo y supuración. Además, puede observarse un retraso en la erupción del molar involucrado, con inclinación de su corona hacia vestibular. Al examen imagenológico se observa una lesión radiolúcida sobre la corona del molar comprometido, rodeada por un halo radiopaco de concavidad superior sobreproyectado parcialmente sobre sus raíces. Este quiste no presenta características histológicas específicas, por lo que el diagnóstico de esta lesión debe realizarse en base a las características clínicas, imagenológicas e histopatológicas. Se presenta un particular caso clínico de quiste bucal mandibular infectado bilateral en segundos molares permanentes

The mandibular infected buccal cyst is an infrequent lesion, of unknown etiology, presented usually in 6-13-year-old children. Generally, this cyst occurs unilaterally, in association with tooth eruption of first lower permanent molars. With a lower frequency, it can affect second lower permanent molars. The associated tooth is found to be vital, with an altered eruption pattern. This tooth may show some symptoms, such as sensitivity, clinical appearance of periodontal pocket, swelling of the buccal vestibule and suppuration. Moreover, a delayed eruption of the involved molar can be seen, with its crown buccally tilted. The imaging examination shows a radiolucent lesion over the crown and rootsof the involved tooth, surrounded by a concave up radiopaque inferior margin. This cyst does not have any specific histological features; thus, its diagnosis should be performed based on its clinical, histological and imaging features. An unusual clinical case of a mandibular infected buccal cyst involving both second permanent mandibular molars is reported

Transnasal endoscopic removal of bilateral postoperative maxillary cysts after aesthetic orthognathic ssurgery: Differences from that of Caldwell-Luc operations.

Postoperative maxillary cysts (PMCs) after orthognathic surgery are a rare disease condition. In this study, we reported first case of bilateral PMCs after cosmetic orthognathic surgery which was treated via the intranasal endoscopic approach. In addition, we compared the characteristics of PMCs after aesthetic orthognathic surgery with those of PMCs after Caldwell-Luc operation. We expect that this case will be helpful to surgeons who encounter similar cases.