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1.
Head Neck Pathol ; 18(1): 65, 2024 Jul 29.
Article de Anglais | MEDLINE | ID: mdl-39073499

RÉSUMÉ

Adenoid ameloblastoma is a newly recognized epithelial odontogenic tumor. Herein, we present the case of a 24-year-old male patient who exhibited swelling in the anterior region and right hemi-mandible. Computed tomography demonstrated the presence of a hypodense osteolytic lesion associated with an impacted tooth. Based on the clinical hypotheses of the dentigerous cyst, odontogenic keratocyst, and ameloblastoma, an incisional biopsy was performed, and the diagnosis of ameloblastoma was rendered. A surgical resection of the tumor was performed. Histopathological examination of the specimen revealed typical areas of ameloblastoma associated with ductiform structures and cell proliferation in a solid storiform pattern, features resembling those found in adenomatoid odontogenic tumor. Based on these findings, the diagnosis of adenoid ameloblastoma was rendered. The accurate diagnosis of this locally infiltrative tumor is essential due to its similarity to other odontogenic neoplasms.


Sujet(s)
Améloblastome , Tumeurs de la mandibule , Humains , Mâle , Améloblastome/anatomopathologie , Jeune adulte , Tumeurs de la mandibule/anatomopathologie , Tumeurs odontogènes/anatomopathologie
3.
Article de Anglais | MEDLINE | ID: mdl-38845306

RÉSUMÉ

OBJECTIVE: To evaluate the diagnostic capability of artificial intelligence (AI) for detecting and classifying odontogenic cysts and tumors, with special emphasis on odontogenic keratocyst (OKC) and ameloblastoma. STUDY DESIGN: Nine electronic databases and the gray literature were examined. Human-based studies using AI algorithms to detect or classify odontogenic cysts and tumors by using panoramic radiographs or CBCT were included. Diagnostic tests were evaluated, and a meta-analysis was performed for classifying OKCs and ameloblastomas. Heterogeneity, risk of bias, and certainty of evidence were evaluated. RESULTS: Twelve studies concluded that AI is a promising tool for the detection and/or classification of lesions, producing high diagnostic test values. Three articles assessed the sensitivity of convolutional neural networks in classifying similar lesions using panoramic radiographs, specifically OKC and ameloblastoma. The accuracy was 0.893 (95% CI 0.832-0.954). AI applied to cone beam computed tomography produced superior accuracy based on only 4 studies. The results revealed heterogeneity in the models used, variations in imaging examinations, and discrepancies in the presentation of metrics. CONCLUSION: AI tools exhibited a relatively high level of accuracy in detecting and classifying OKC and ameloblastoma. Panoramic radiography appears to be an accurate method for AI-based classification of these lesions, albeit with a low level of certainty. The accuracy of CBCT model data appears to be high and promising, although with limited available data.


Sujet(s)
Intelligence artificielle , Tomodensitométrie à faisceau conique , Kystes odontogènes , Tumeurs odontogènes , Humains , Algorithmes , Améloblastome/imagerie diagnostique , Améloblastome/classification , Améloblastome/anatomopathologie , Tumeurs de la mâchoire/classification , Tumeurs de la mâchoire/imagerie diagnostique , Kystes odontogènes/classification , Kystes odontogènes/imagerie diagnostique , Tumeurs odontogènes/classification , Tumeurs odontogènes/imagerie diagnostique , Radiographie panoramique
4.
Oral Maxillofac Surg ; 28(4): 1509-1521, 2024 Dec.
Article de Anglais | MEDLINE | ID: mdl-38922493

RÉSUMÉ

PURPOSE: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings. METHODS: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed. RESULTS: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%). CONCLUSIONS: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.


Sujet(s)
Tumeurs odontogènes , Humains , Femelle , Mâle , Adulte , Tumeurs odontogènes/anatomopathologie , Tumeurs odontogènes/imagerie diagnostique , Tumeurs odontogènes/chirurgie , Adolescent , Adulte d'âge moyen , Enfant , Sujet âgé , Enfant d'âge préscolaire , Jeune adulte , Sujet âgé de 80 ans ou plus , Myxome/anatomopathologie , Myxome/chirurgie , Myxome/imagerie diagnostique , Brésil , Tumeurs de la mâchoire/anatomopathologie , Tumeurs de la mâchoire/imagerie diagnostique , Tumeurs de la mâchoire/chirurgie
5.
Head Neck Pathol ; 18(1): 40, 2024 May 10.
Article de Anglais | MEDLINE | ID: mdl-38727794

RÉSUMÉ

BACKGROUND: Odontogenic lesions constitute a heterogeneous group of lesions. CLIC4 protein regulates different cellular processes, including epithelial-mesenchymal transition and fibroblast-myofibroblast transdifferentiation. This study analyzed CLIC4, E-cadherin, Vimentin, and α-SMA immunoexpression in epithelial odontogenic lesions that exhibit different biological behavior. METHODS: It analyzed the immunoexpression of CLIC4, E-cadherin, and Vimentin in the epithelial cells, as well as CLIC4 and α-SMA in the mesenchymal cells, of ameloblastoma (AM) (n = 16), odontogenic keratocyst (OKC) (n = 20), and adenomatoid odontogenic tumor (AOT) (n = 8). Immunoexpressions were categorized as score 0 (0% positive cells), 1 (< 25%), 2 (≥ 25% - < 50%), 3 (≥ 50% - < 75%), or 4 (≥ 75%). RESULTS: Cytoplasmic CLIC4 immunoexpression was higher in AM and AOT (p < 0.001) epithelial cells. Nuclear-cytoplasmic CLIC4 was higher in OKC's epithelial lining (p < 0.001). Membrane (p = 0.012) and membrane-cytoplasmic (p < 0.001) E-cadherin immunoexpression were higher in OKC, while cytoplasmic E-cadherin expression was higher in AM and AOT (p < 0.001). Vimentin immunoexpression was higher in AM and AOT (p < 0.001). Stromal CLIC4 was higher in AM and OKC (p = 0.008). Similarly, α-SMA immunoexpression was higher in AM and OKC (p = 0.037). Correlations in these proteins' immunoexpression were observed in AM and OKC (p < 0.05). CONCLUSIONS: CLIC4 seems to regulate the epithelial-mesenchymal transition, modifying E-cadherin and Vimentin expression. In mesenchymal cells, CLIC4 may play a role in fibroblast-myofibroblast transdifferentiation. CLIC4 may be associated with epithelial odontogenic lesions with aggressive biological behavior.


Sujet(s)
Améloblastome , Cadhérines , Canaux chlorure , Transition épithélio-mésenchymateuse , Tumeurs odontogènes , Vimentine , Humains , Transition épithélio-mésenchymateuse/physiologie , Canaux chlorure/métabolisme , Canaux chlorure/analyse , Cadhérines/métabolisme , Tumeurs odontogènes/anatomopathologie , Tumeurs odontogènes/métabolisme , Améloblastome/anatomopathologie , Améloblastome/métabolisme , Vimentine/métabolisme , Adulte , Femelle , Kystes odontogènes/anatomopathologie , Kystes odontogènes/métabolisme , Mâle , Actines/métabolisme , Jeune adulte , Adulte d'âge moyen , Antigènes CD/métabolisme , Adolescent
6.
Rev. Asoc. Odontol. Argent ; 112(1): 1120431, ene.-abr. 2024. ilus, tab
Article de Espagnol | LILACS | ID: biblio-1563426

RÉSUMÉ

Objetivo: Presentar un caso clínico de un tumor odon- togénico epitelial calcificante (TOEC), así como una revisión de la literatura disponible sobre esta neoplasia para contribuir al análisis del mejor método de tratamiento de la patología. Caso clínico: Se presenta el caso de una paciente mujer de 35 años con un tumor odontogénico epitelial calcifican- te que recibió tratamiento de enucleación quirúrgica con una evolución favorable y seguimiento de 5 años por medio de evaluación clínica y radiológica. La elección terapéutica se basó en el resultado de un análisis exhaustivo de la literatura para determinar el mejor abordaje de la neoplasia (AU)


Aim: To present a clinical case of a calcifying epithelial odontogenic tumor (CEOT), as well as a review of the availa- ble literature on this neoplasia to contribute to the analysis of the best treatment method for the pathology. Clinical case: The case of a 35-year-old patient with a calcifying epithelial odontogenic tumor who received surgical enucleation treatment with a favorable evolution and 5-year follow-up through clinical and radiological evaluation is pre- sented. The therapeutic choice was based on the result of an exhaustive analysis of the literature to determine the best ap- proach to the neoplasia (AU))


Sujet(s)
Humains , Femelle , Adulte , Tumeurs de la mandibule/chirurgie , Tumeurs odontogènes/classification , Procédures de chirurgie maxillofaciale et buccodentaire/méthodes , Biopsie/méthodes , Tumeurs odontogènes/imagerie diagnostique , Études de suivi
7.
Oral Dis ; 30(7): 4538-4546, 2024 10.
Article de Anglais | MEDLINE | ID: mdl-38297810

RÉSUMÉ

OBJECTIVE: To analyze the immunohistochemical expression of YAP and its correlation with markers involved in cell proliferation and apoptosis in benign epithelial odontogenic lesions. STUDY DESIGN: The sample consisted of 95 cases of odontogenic lesions (25 dentigerous cysts, 30 non-syndromic odontogenic keratocysts, 30 conventional ameloblastomas, and 10 unicystic ameloblastomas) and 10 dental follicles used as normal odontogenic tissue. The histological sections were submitted to immunohistochemistry with YAP, cyclin D1, Ki-67, and Bcl-2 antibodies. Immunoexpression was analyzed qualitatively and quantitatively using an adapted method. The collected data were analyzed descriptively and statistically (p ≤ 0.05). RESULTS: The highest YAP expression was observed in odontogenic keratocysts, followed by unicystic ameloblastomas and conventional ameloblastomas, which exhibited moderate immunoreactivity predominantly in peripheral cells. Furthermore, significant differences in YAP immunoexpression were observed between the groups analyzed, with significant positive correlations between YAP and cyclin D1 in dentigerous cysts and unicystic ameloblastomas and between YAP and Ki-67 in unicystic ameloblastomas (p < 0.05). However, there were no statistically significant correlations between YAP and Bcl-2 immunoexpression in the groups studied. CONCLUSION: YAP may influence epithelial cell proliferation in odontogenic cysts and tumors, suggesting its possible participation in the progression of the odontogenic lesions studied.


Sujet(s)
Protéines adaptatrices de la transduction du signal , Améloblastome , Apoptose , Prolifération cellulaire , Cycline D1 , Kyste dentigère , Antigène KI-67 , Kystes odontogènes , Protéines proto-oncogènes c-bcl-2 , Protéines de signalisation YAP , Humains , Améloblastome/anatomopathologie , Améloblastome/métabolisme , Kystes odontogènes/anatomopathologie , Kystes odontogènes/métabolisme , Kyste dentigère/anatomopathologie , Kyste dentigère/métabolisme , Antigène KI-67/métabolisme , Antigène KI-67/analyse , Cycline D1/métabolisme , Protéines adaptatrices de la transduction du signal/métabolisme , Protéines proto-oncogènes c-bcl-2/analyse , Protéines proto-oncogènes c-bcl-2/métabolisme , Facteurs de transcription/analyse , Sac dentaire/anatomopathologie , Sac dentaire/métabolisme , Immunohistochimie , Tumeurs odontogènes/anatomopathologie , Tumeurs odontogènes/métabolisme , Cellules épithéliales/anatomopathologie , Cellules épithéliales/métabolisme
8.
Int J Mol Sci ; 25(4)2024 Feb 17.
Article de Anglais | MEDLINE | ID: mdl-38397053

RÉSUMÉ

Odontogenic keratocyst (OK) is a benign intraosseous cystic lesion characterized by a parakeratinized stratified squamous epithelial lining with palisade basal cells. It represents 10-12% of odontogenic cysts. The changes in its classification as a tumor or cyst have increased interest in its pathogenesis. OBJECTIVE: Identify key genes in the pathogenesis of sporadic OK through in silico analysis. MATERIALS AND METHODS: The GSE38494 technical sheet on OK was analyzed using GEOR2. Their functional and canonical signaling pathways were enriched in the NIH-DAVID bioinformatic platform. The protein-protein interaction network was constructed by STRING and analyzed with Cytoscape-MCODE software v 3.8.2 (score > 4). Post-enrichment analysis was performed by Cytoscape-ClueGO. RESULTS: A total of 768 differentially expressed genes (DEG) with a fold change (FC) greater than 2 and 469 DEG with an FC less than 2 were identified. In the post-enrichment analysis of upregulated genes, significance was observed in criteria related to the organization of the extracellular matrix, collagen fibers, and endodermal differentiation, while the downregulated genes were related to defensive response mechanisms against viruses and interferon-gamma activation. CONCLUSIONS: Our in silico analysis showed a significant relationship with mechanisms of extracellular matrix organization, interferon-gamma activation, and response to viral infections, which must be validated through molecular assays.


Sujet(s)
Kystes odontogènes , Tumeurs odontogènes , Humains , Interféron gamma , Kystes odontogènes/génétique , Kystes odontogènes/anatomopathologie , Tumeurs odontogènes/anatomopathologie , Cartes d'interactions protéiques/génétique
9.
Rev. ADM ; 81(1): 55-60, ene.-feb. 2024. ilus
Article de Espagnol | LILACS | ID: biblio-1556493

RÉSUMÉ

El fibroma ameloblástico (FA) se describe como una neoplasia benigna de origen odontogénico mixto que suele presentarse entre la primera y segunda década de vida, frecuentemente en los molares permanentes inferiores. Por lo general es asintomático, pero las lesiones de gran tamaño suelen acompañarse con dolor e inflamación. Su tratamiento por lo regular es conservador. Se describe el caso de un fibroma ameloblástico en un paciente de 13 años de edad, que involucraba cuerpo y ángulo mandibular izquierdo, tratado de manera conservadora, se realiza extirpación del tumor, regeneración ósea guiada y rehabilitación con implante dental (AU)


Ameloblastic fibroma (AF) is described as a benign neoplasm of mixed odontogenic origin that usually presents between the first and second decade of life, frequently in lower permanent molars. It is usually asymptomatic, but large lesions are usually accompanied by pain and inflammation. His treatment is generally conservative. The clinical case of an ameloblastic fibroma in a 13-year-old patient is described, involving the left mandibular body and angle, treated conservatively, tumor removal, guided bone regeneration and rehabilitation with dental implants are performed (AU)


Sujet(s)
Humains , Mâle , Adolescent , Régénération osseuse , Tumeurs de la mandibule/chirurgie , Tumeurs odontogènes/classification , Fibrome/chirurgie , Pronostic , Pose d'implant dentaire endo-osseux/méthodes , Diagnostic différentiel , Fibrome/rééducation et réadaptation
10.
J Oral Pathol Med ; 53(1): 70-78, 2024 Jan.
Article de Anglais | MEDLINE | ID: mdl-38163857

RÉSUMÉ

BACKGROUND: Ameloblastoma and ameloblastic carcinoma are epithelial odontogenic tumors that can be morphologically similar. In the present study, we evaluated the DNA content and Ki-67 index in the two tumors. METHODS: The paraffin blocks of the tumors were selected to obtain sections for the immunohistochemical reactions and preparation of the cell suspension for acquisition in a flow cytometer. The Random Forest package of the R software was used to verify the contribution of each variable to classify lesions into ameloblastoma or ameloblastic carcinoma. RESULTS: Thirty-two ameloblastoma and five ameloblastic carcinoma were included in the study. In our sample, we did not find statistically significant differences in Ki-67 labeling rates. A higher fraction of cells in 2c (G1) was correlated with the diagnosis of ameloblastoma, whereas higher rates of 5c-exceeding rate (5cER) were correlated with ameloblastic carcinoma. The Random Forest model highlighted histopathological findings and parameters of DNA ploidy study as important features for distinguishing ameloblastoma from ameloblastic carcinoma. CONCLUSION: Our findings suggest that the parameters of the DNA ploidy study can be ancillary tools in the classification of ameloblastoma and ameloblastic carcinoma.


Sujet(s)
Améloblastome , Carcinomes , Tumeurs odontogènes , Humains , Améloblastome/diagnostic , Améloblastome/génétique , Améloblastome/anatomopathologie , Antigène KI-67/génétique , Tumeurs odontogènes/génétique , Carcinomes/anatomopathologie , Ploïdies , ADN
12.
J Oral Pathol Med ; 53(1): 20-30, 2024 Jan.
Article de Anglais | MEDLINE | ID: mdl-38164057

RÉSUMÉ

BACKGROUND: The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS: Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION: Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.


Sujet(s)
Carcinosarcome , Tumeurs de la bouche , Tumeurs odontogènes , États-Unis , Humains , Mâle , Adulte , Tumeurs odontogènes/imagerie diagnostique , Tumeurs odontogènes/anatomopathologie , Carcinosarcome/imagerie diagnostique , Carcinosarcome/thérapie
13.
Pesqui. bras. odontopediatria clín. integr ; 24: e200113, 2024. tab, graf
Article de Anglais | LILACS, BBO - Ondontologie | ID: biblio-1550589

RÉSUMÉ

ABSTRACT Objective: To perform the epidemiological and clinicopathological analyses of odontogenic tumors in Kerman for 20 years. Material and Methods: The present study investigated collected records from pathology departments of the Faculty of Dentistry, Bahonar, and Shafa teaching-medical hospitals for 20 years. Data on odontogenic tumors was recorded based on age, sex, and tumor location in the information forms. The statistical t-test and the Kappa coefficient computer codes were utilized for data analysis. Results: 38 samples of odontogenic tumors were considered in the present study. The mean age of participants was 31.7± 10.3 years. The frequency of tumors was higher in women (63.2%) and in the lower jaw) 78.9%). Among various tumors, ameloblastoma (63.1%) and odontoma (18.4%) were the most common tumors, respectively. The correlation between clinical and histopathologic diagnoses was 71.8% using the kappa coefficient. Conclusion: Ameloblastoma is the most common odontogenic tumor. The incidence of lesions was higher in the mandible, and odontogenic tumors were higher in women. Since the diagnosis of odontogenic tumors is based on radiographic and histologic appearances, clinical physicians and pathologists should collaborate for the definitive diagnosis of the disease.


Sujet(s)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Améloblastome/diagnostic , Tumeurs odontogènes/diagnostic , Épidémiologie/statistiques et données numériques , Traumatismes mandibulaires , Études épidémiologiques , Dossiers médicaux , Études transversales/méthodes , Études rétrospectives , Analyse de variance
14.
Head Neck Pathol ; 17(4): 1000-1010, 2023 Dec.
Article de Anglais | MEDLINE | ID: mdl-38057461

RÉSUMÉ

BACKGROUND: The BRAF p.V600E genetic variant facilitates the pathogenesis of various tumors by triggering tumor proliferation and progression. The aim of this study was to analyze the prevalence of BRAF p.V600E in benign mixed epithelial and mesenchymal and malignant odontogenic tumors. In addition, we discussed the different detection methods used to assess for aberrant BRAF. METHODS: This systematic review followed the PRISMA guidelines and was registered in Prospero (CRD42023445689). A comprehensive search of the PubMed/MEDLINE, Scopus, Web of Science, and Embase electronic databases was performed to answer the question "What is the prevalence of the BRAF p.V600E mutation in benign mixed and malignant odontogenic tumors?" The methodological quality of the selected studies was assessed using the JBI's Critical Appraisal Tool. RESULTS: Initially, 387 records were identified, but only 11 articles met the inclusion criteria. A total of 70 patients with benign mixed epithelial and mesenchymal odontogenic tumors and 63 with malignant odontogenic tumors were included in the analysis. We found that the BRAF p.V600E mutation had a prevalence of 31.42% in mixed tumors and 26.98% in malignant odontogenic tumors. Moreover, immunohistochemistry showed high concordance with DNA-based molecular methods. CONCLUSION: In general, the BRAF p.V600E variant exhibited a prominent prevalence in mixed and malignant odontogenic tumors. However, most of the findings are based on small cohorts of patients and further studies with larger cohorts are needed.


Sujet(s)
Tumeurs de la bouche , Tumeurs odontogènes , Humains , Mutation , Protéines proto-oncogènes B-raf/génétique , Prévalence , Tumeurs odontogènes/épidémiologie , Tumeurs odontogènes/génétique
15.
BMC Oral Health ; 23(1): 1013, 2023 12 18.
Article de Anglais | MEDLINE | ID: mdl-38110933

RÉSUMÉ

BACKGROUND: Ameloblastoma (AM), the benign counterpart of ameloblastic carcinoma, is a benign odontogenic tumor of epithelial origin, naturally aggressive, with unlimited growth potential and a high tendency to relapse if not adequately removed. Patients with AM treated surgically can benefit from dental implant therapy, promoting oral rehabilitation and improving their quality of life. The present study aimed to determine the survival rate of dental implants placed after surgical treatment of patients affected by AM. In addition, there were two secondary objectives: 1) To evaluate which dental implant loading protocols are most frequently used and 2) To determine the type of prosthetic restoration most commonly used in these patients. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the study. Searches were performed in three databases (PubMed/MEDLINE, Scopus, and Google Scholar) until November 2023. Additionally, the electronic search was enriched by an iterative hand search of journals related to oral pathology and medicine, maxillofacial surgery, and oral prosthodontics and implantology. Only reports and case series in English from January 2003 to date were included. The Joanna Briggs Institute tool (JBI-Case Reports/Case Series) was used for the study quality assessment. RESULTS: The total number of patients and implants studied were 64 and 271, respectively, all with surgically treated AM. The patient's ages ranged from 8 to 79 years, with a mean (SD) age of 37.3 ± 16.4. Fifty-three percent were male and 47% were female. The range of follow-up duration was 1 to 22 years. An implant survival/success rate of 98.1% was reported. In addition, most of them were conventionally loaded (38.3%). Hybrid implant-supported fixed dentures were the most commonly used by prosthodontists (53%). CONCLUSIONS: Oral rehabilitation with dental implants inserted in free flaps for orofacial reconstruction in surgically treated patients with AM can be considered a safe and successful treatment modality.


Sujet(s)
Améloblastome , Implants dentaires , Tumeurs odontogènes , Adolescent , Adulte , Sujet âgé , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Améloblastome/chirurgie , Pose d'implant dentaire endo-osseux/méthodes , Implants dentaires/effets indésirables , Prothèse dentaire implanto-portée , Échec de restauration dentaire , Récidive tumorale locale/induit chimiquement , Qualité de vie , Résultat thérapeutique
16.
Med Oral Patol Oral Cir Bucal ; 28(6): e596-e606, 2023 Nov 01.
Article de Anglais | MEDLINE | ID: mdl-37823289

RÉSUMÉ

BACKGROUND: Odontogenic tumours are infrequent lesions. Studies on the frequency of odontogenic tumours from Latin America are scarce. This work aimed to determine the relative frequency of odontogenic tumours in a Chilean population using the 2022 World Health Organization classification. MATERIAL AND METHODS: This is a case series retrospective study. We reviewed 35,530 samples from 1975 to 2022 from the Oral Pathology Referral Institute and the Pathological Anatomy Service, Faculty of Dentistry, University of Chile. We utilized the 2022 World Health Organization classification for histological typification. RESULTS: According to 2022 World Health Organization classification, 544 odontogenic tumours were confirmed. The most frequent odontogenic tumours were: odontoma (n=241; 44.3%), ameloblastoma (n=109; 20.0%) and cemento-ossifying fibroma (n=71; 13.1%). Benign odontogenic tumours corresponded to 538 cases (98.9%) and malignant tumours were only six cases (1.1%). CONCLUSIONS: In our population, odontoma was the most frequent odontogenic tumour followed by ameloblastoma and cemento-ossifying fibroma. Malignant odontogenic tumours were very rare. The results of this study are similar to reports from America, but there are some differences concerning the data from Africa and Asia.


Sujet(s)
Améloblastome , Cémentome , Tumeurs odontogènes , Odontome , Humains , Améloblastome/épidémiologie , Odontome/épidémiologie , Études rétrospectives , Chili/épidémiologie , Tumeurs odontogènes/épidémiologie , Tumeurs odontogènes/anatomopathologie , Organisation mondiale de la santé
17.
Oral Surg Oral Med Oral Pathol Oral Radiol ; 136(6): e171-e176, 2023 12.
Article de Anglais | MEDLINE | ID: mdl-37891120

RÉSUMÉ

Lowe syndrome (LS) is a rare disease (1:500,000) with X-linked recessive inheritance involving the kidneys, eyes, and nervous system. A Mexican 25-year-old male patient presented for diagnosis of multiple radiolucent lesions observed on routine radiographic examination. General aspects revealed cognitive delay, eye alterations, and kidney involvement, which support the diagnosis of LS. Radiolucent well-delimited lesions were observed in both mandibular angle and symphysis. Under general anesthesia, incisional biopsy and decompression were performed. Histological aspects led to diagnosing odontogenic keratocyst (OKC) for all lesions. The lesions in the right and left mandibular angles were decompressed, and the symphyseal lesion was enucleated. A 2-month follow-up shows the bone healing process. There are few reports detailing oral findings in LS. Here, we reported the first case of multiple OKC in a patient with LS. In addition, we performed a literature review on odontogenic lesions in patients affected by LS.


Sujet(s)
Syndrome de Lowe , Kystes odontogènes , Tumeurs odontogènes , Mâle , Humains , Adulte , Kystes odontogènes/imagerie diagnostique , Kystes odontogènes/chirurgie , Kystes odontogènes/anatomopathologie , Mandibule/anatomopathologie , Diagnostic différentiel
18.
Clin Oral Investig ; 27(11): 6951-6959, 2023 Nov.
Article de Anglais | MEDLINE | ID: mdl-37855921

RÉSUMÉ

OBJECTIVES: This multicenter study aimed to evaluate cases of non-syndrome and syndromic odontogenic keratocyst, as well as cases of recurrence within these two groups. METHODS: This descriptive, analytical, retrospective cross-sectional study evaluated the sex, age and presence of multiple lesions in 1,169 individuals seen at 10 Brazilian oral and maxillofacial pathology centers. Of these, 1,341 odontogenic keratocysts were analyzed regarding clinical diagnosis, size, site, imaging appearance, signs and symptoms, type of biopsy, treatment, and recurrence. RESULTS: There was a similar distribution by sex. The median age of non-syndromic and syndromic patients was 32 and 17.5 years, respectively. The posterior mandible was the site most affected by small and large lesions in both groups and in recurrent cases. Unilocular lesions were more frequent, also in recurrent cases. Mainly small lesions showed this imaging appearance. Signs and symptoms were absent in most cases. Conservative treatment was the most frequent modality in all age groups, regardless of the patient's condition and recurrence. Recurrences were uncommon. CONCLUSION: This study showed a higher frequency of non-syndromic keratocysts in the population. Clinicopathological features related to the involvement of multiple sites, age, and recurrence may differ between syndromic and non-syndromic cases. Furthermore, we found an association between lesion size and some clinical features and between the time interval to recurrence and the syndromic spectrum. CLINICAL RELEVANCE: To contribute to a better understanding of the distribution and association between clinical, imaging, and sociodemographic characteristics in each spectrum of the lesion.


Sujet(s)
Kystes odontogènes , Tumeurs odontogènes , Humains , Études rétrospectives , Brésil , Études transversales , Kystes odontogènes/anatomopathologie
19.
Head Neck Pathol ; 17(4): 1067-1070, 2023 Dec.
Article de Anglais | MEDLINE | ID: mdl-37768443

RÉSUMÉ

Squamous odontogenic tumor (SOT) is a rare benign but locally infiltrative tumor often misdiagnosed as other entities, such as ameloblastoma and squamous cell carcinoma, due to overlapping morphological findings. We document here the clinicopathological and imaging findings of an aggressive intraosseous SOT in the posterior left region of the maxilla in a 25-year-old male patient. On intraoral examination, the tumor extended from the region of the left lateral incisor to the upper left premolar and was covered by reddish mucosa, with discrete areas of ulceration. Imaging exams revealed an osteolytic lesion causing thinning, erosion, and buccal and lingual cortical plate perforation associated with an impacted canine. Microscopically, the tumor showed a proliferation of islands of well-differentiated squamous epithelium in a variably collagenized background. The peripheral cells of the islands were flat or slightly cuboidal and did not exhibit nuclei with peripheral palisade and reverse polarization. The diagnosis of SOT was rendered. The patient underwent surgical resection and has been under clinical follow-up for approximately 12 months with no signs of recurrence. A careful morphological evaluation is essential to avoid misdiagnosis and ensure a satisfactory treatment approach.


Sujet(s)
Améloblastome , Tumeur odontogène spinocellulaire , Tumeurs odontogènes , Mâle , Humains , Adulte , Tumeur odontogène spinocellulaire/anatomopathologie , Maxillaire/anatomopathologie , Tumeurs odontogènes/anatomopathologie , Améloblastome/anatomopathologie , Épithélium/anatomopathologie
20.
J Oral Pathol Med ; 52(10): 988-995, 2023 Nov.
Article de Anglais | MEDLINE | ID: mdl-37712132

RÉSUMÉ

BACKGROUND: Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra-and inter observer variability and improve diagnostic objectivity and reproducibility. METHODS: Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma). RESULTS: The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1-score, respectively. CONCLUSIONS: The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models.


Sujet(s)
Améloblastome , Carcinomes , Apprentissage profond , Tumeurs odontogènes , Humains , Améloblastome/imagerie diagnostique , Améloblastome/anatomopathologie , Intelligence artificielle , Reproductibilité des résultats , Tumeurs odontogènes/imagerie diagnostique , Tumeurs odontogènes/anatomopathologie
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