Calcifying cystic odontogenic tumor radiographically mimicking a lateral periodontal cyst: clinical case report / Tumor odontogênico cístico calcificante mimetizando radiograficamente o cisto periodontal lateral: relato de caso clínico

The calcifying cystic odontogenic tumor (CCOT) is a rare odontogenic lesion derived from the remaining odontogenic epithelium of the maxilla or mandible. Its occurrence in the maxilla and mandible is similar, however, the canine region is the most affected when compared with other regions. The aim of this paper is to relate the case of a patient who presented a CCOT in the left region of the maxilla, between the canine and the first premolar, characterized by an increase in volume that was painful on palpation. The lesion presented a well circumscribed radiolucent radiographic image, however, presented no root resorption and radiopacities suggestive of dystrophic calcification, common signs in this tumor. With the diagnostic hypothesis of a lateral periodontal cyst, enucleation of the lesion was performed. The patient has been followed-up for around 15 months without signs of recurrence.

O tumor odontogênico císto calcificante (TOCC) é uma lesão odontogênica rara derivada do epitélio odontogênico remanescente da maxila ou mandíbula. Possui ocorrência semelhante em maxila e mandíbula, porém a região de canino é a mais afetada quando comparada com outras regiões. O objetivo deste estudo é relatar um caso de um paciente que apresenta um TOCC em região esquerda de maxila, entre o canino e o primeiro pré-molar, caracterizado com aumento de volume doloroso à palpação. Radiograficamente a lesão apresentava imagemradiográfica radiolúcida bem circunscrita, no entanto não apresentava reabsorção radicular e radiopacidades sugestivas de calcificação distrófica, sinais comuns neste tumor. Com hipótese diagnóstica de cisto periodontal lateral, foi feita enucleação da lesão. O paciente está em acompanhamento há cerca de 15 meses sem sinais de recorrência.

Cisto periodontal lateral: relato de caso clínico / Lateral periodontal cyst: clinical report

O objetivo deste estudo foi descrever um caso clínico de Cisto Periodontal Lateral encontrado em uma paciente de 47 anos, que foi confirmado por exames radiográfico e histopatológico. O Cisto Periodontal Lateral é um tipo raro de cisto odontogênico de desenvolvimento, não ceratinizado, que ocorre adjacente ou lateral a uma raiz dentária de dente vital e corresponde a 1,5% dos cistos dos maxilares. É encontrado principalmente em adultos entre a 5ª e a 7ª décadas de vida, sem distinção quanto ao sexo. Sem sinais dolorosos ou sintomas clínicos, são normalmente diagnosticados durante exames radiográficos de rotina, porém, para um diagnóstico correto é preciso também avaliar as características histopatológicas. O tratamento se faz por enucleação cirúrgica. Apesar de não tender à recorrência, recomenda-se a proservação por alguns anos.

The objective of this study was to describe a clinical case of Lateral Periodontal Cyst found in a 47 year-old patient, which was confirmed by radiographic and histopathologic examinations. The Lateral Periodontal Cyst is a rare type of odontogenic cyst of development, not keratinized, adjacent or lateral to a root of vital tooth and corresponds to 1.5% of cysts in jaws. It is found mainly in adults between 5 th and 7 th decades, without distinction related to sex. With no painful signs or clinical symptoms, these cyst are usually diagnosed during a routine radiographic examination, however, for a correct diagnosis, the histopathologic characteristics must be assessed. The treatment is done by enucleating surgery. Although there is no trend to recurrence, it is recommended to follow-up for some years.

Use of guided tissue regeneration in the treatment of a lateral periodontal cyst with a 7-month reentry.

BACKGROUND: The lateral periodontal cyst (LPC) is an unusual cyst of odontogenic origin, most frequently encountered in the mandible between the roots of canines and premolars. The most common treatment for LPC is surgical enucleation. This article reports a case of an LPC treated with guided tissue regeneration (GTR) and bone allograft. METHODS: A 74-year-old woman presented for periodontal examination. Radiographs revealed a cystic lesion with LPC characteristics. After surgical incisions and flap reflection, the cyst was removed and sent for biopsy. Because of the anatomy of the resulting intrabony defect, GTR was considered the ideal treatment. RESULTS: The biopsy revealed the histologic features of an LPC. Radiographs at 7 months post-treatment indicated bone fill of the initial defect. Although some attachment loss occurred, the reentry demonstrated a high percentage of bone fill of the defect after 7 months. CONCLUSION: Depending on the anatomy of the defect left after the removal of an LPC, GTR, along with bone grafting, can be a very useful tool for its treatment by reducing the attachment loss observed after simple enucleation of the cyst.

The buccal bifurcation cyst: in non-surgical treatment an option?

The mandibular buccal bifurcation cyst (BBC) was first described by Stoneman and Worth in 1983. It is a lesion with a specific location, classically the buccal surface of the mandibular first molar and less frequently the mandibular second molar. There have been numerous reports in the literature describing the BBC and its treatment. Treatment advocated thus far includes extraction of the involved first molar, marsupialization and enucleation of the cyst. In their most recent article, Pompura, Sándor and Stoneman reported on the successful treatment of 44 cysts with enucleation without tooth extraction. This article will describe the diagnostic features of the BBC and present three cases with a total of five cysts, which were treated non-surgically and ultimately resolved. The authors, therefore, propose that a more conservative non-surgical approach to these lesions may be considered.