1/244. Radionuclide bone imaging in the surgical treatment planning of odontogenic keratocysts. Locally aggressive benign lesions of the jaws, such as odontogenic keratocysts and ameloblastomas, require complete excision in view of the high incidence of recurrence after incomplete surgical removal. Because of the limitations of conventional radiology as the sole technique for determining the extent of these lesions, the use of 99m-technetium-labeled bone-imaging agents is suggested. This method of defining the location of surgical margins is based on the agent's sensitivity as an indicator of subtle changes in bone metabolism. A case of an unusually large recurrent odontogenic keratocyst is presented in which the planning of the surgical procedure was predicated on the results of a bone scan of the jaws in addition to conventional radiology. This diagnostic procedure, especially when used in conjunction with conventional radiology, appears to be of considerable value in defining the extent of a variety of oral-maxillofacial bony lesions. ( info) |
2/244. Odontogenic keratocysts in a 5-year-old: initial manifestations of nevoid basal cell carcinoma syndrome. The purpose of this paper is to report the occurrence of odontogenic keratocysts in a young child. Odontogenic keratocysts are one of the principal features of nevoid basal cell carcinoma syndrome. Their occurrence in this syndrome is usually during the second or third decades of life. This report describes the occurrence of odontogenic keratocysts in a 5-year-old, which proved to be the initial presentation of nevoid basal cell carcinoma syndrome and highlights the need to consider this syndrome as a possible diagnosis in all cases of odontogenic keratocysts. ( info) |
3/244. Glandular odontogenic cyst: a case report. Glandular odontogenic cyst (GOC) is an extremely rare lesion occurring in the jawbones. Sialo-odontogenic cyst was first described as a multicystic lesion resembling a botryoid odontogenic cyst (BOC) or a central mucoepidermoid carcinoma by Padayachee in 1987. In 1988, Gardner used the term "glandular odontogenic cyst" and considered it as a histologic variant of BOC. Most authors agreed that GOC was odontogenic because of the concurrent ball-like epithelial structure, ameloblastoma, squamous odontogenic tumor-like proliferation in its wall, or hyaline bodies in the epithelium lining. Recently, immunohistochemical studies of the cytokeratin profiles have also supported this concept. Its aggressive behavior and the recurrent tendency make it important. A new case of GOC in a 59-year-old male presented as a multilocular radiolucency in the anterior region of the mandible, invading the marrow space by epithelial islands is described with other clinicopathologic features and the literature is briefly discussed. ( info) |
4/244. Rapid cystic involvement of a lower third molar. Cystic change can occur in association with partially and unerupted lower third molars. This case report describes an inflammatory paradental cyst which developed over a relatively short period of time and presented with acute symptoms. ( info) |
5/244. Computerized tomography in the management and follow-up of extensive periapical lesion. Radiographs are good diagnostic aids in endodontics, although they have limitations. The purpose of this article is to discuss the use of computerized tomography in differential diagnosis, treatment planning, follow-up and overall clinical management of complex periapical lesions. A clinical case of an extensive symptomatic periapical lesion of the upper jaw is presented, in which the use of computerized tomography allowed evaluation of the true extent of the lesion and its spatial relationship to important anatomical landmarks. Computerized tomography also provided specific information about the type of lesion and the degree of bone repair which had taken place 18 months after non-surgical treatment had been completed. ( info) |
6/244. Multiple odontogenic keratocysts in mental retardation-overgrowth (Simpson-Golabi-Behmel) syndrome. We report on a 10-year-old boy with mental retardation-overgrowth (Simpson-Golabi-Behmel) syndrome. The child had the typical clinical features including, postnatal overgrowth, mental retardation, and a characteristic facial appearance. He was admitted for treatment of multiple mandibular and maxillary cysts. Histopathological examination of the cyst tissue showed keratinized epithelium. Odontogenic keratocysts may have to be added to the typical features of this syndrome. ( info) |
7/244. PTCH gene mutations in odontogenic keratocysts. An odontogenic keratocyst (OKC) is a benign cystic lesion of the jaws that occurs sporadically or in association with nevoid basal cell carcinoma syndrome (NBCCS). Recently, the gene for NBCCS was cloned and shown to be the human homologue of the drosophila segment polarity gene Patched (PTCH), a tumor suppressor gene. The PTCH gene encodes a transmembrane protein that acts in opposition to the Hedgehog signaling protein, controlling cell fates, patterning, and growth in numerous tissues, including tooth. We investigated three cases of sporadic odontogenic keratocysts and three other cases associated with NBCCS, looking for mutations of the PTCH gene. Non-radioactive single-strand conformational polymorphism and direct sequencing of PCR products revealed a deletion of 5 base pairs (bp) in exon 3 (518delAAGCG) in one sporadic cyst as well as mutations in two cysts associated with NBCCS, a nonsense (C2760A) and a missense (G3499A) alteration. This report is the first to describe a somatic mutation of PTCH in sporadic odontogenic keratocysts as well as two novel mutations in cysts associated with NBCCS, indicating a similar pathogenesis in a subset of sporadic keratocysts. ( info) |
8/244. A case of glandular odontogenic cyst associated with ameloblastoma: correlation of diagnostic imaging with histopathological features. The glandular odontogenic cyst (GOC) is a rare odontogenic cyst. There has only been one reported case of the simultaneous presence of GOC and ameloblastoma. The radiographic features of GOC are well established but the MR findings have not been described. We report a case of GOC associated with ameloblastoma with special reference to the correlation of the diagnostic imaging with the histopathological features. ( info) |
9/244. Glandular odontogenic cyst: absence of PTCH gene mutation. Glandular odontogenic cyst (GOC) is a rare jawbone cyst of odontogenic origin. Human patched (PTCH) is a tumour suppressor gene that has been recently associated with signalling pathways during odontogenesis. Recently alterations of this gene were found on sporadic odontogenic keratocysts. This evidence, together with the biological behaviour similarities of both lesions, and the absence of reports on molecular analysis of GOC, led us to hypothesize that PTCH gene mutations may underlie the tumorigenesis of GOC. Therefore the aim of this study was to report one additional case of GOC and investigate the PTCH gene of the cyst. No mutations were found in the splicing and coding regions of the PTCH gene. In conclusion, the PTCH gene does not seem to be involved in GOC pathogenesis. ( info) |
10/244. Longitudinal in vivo observations on odontogenic keratocyst over a period of 4 years. A case is presented of simultaneous adjacent odontogenic keratocyst and dentigerous cyst occurring in the same quadrant. Their in vivo behaviour, influence and effect on each other, surrounding tissues and on tooth development over a period of 4 years are described. This unique case may further advance the understanding of the behaviour of the odontogenic keratocyst in vivo. ( info) |