Cases reported "Periodontal Cyst"

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1/10. The lateral periodontal cyst: aetiology, clinical significance and diagnosis.

    The lateral periodontal cyst (LPC) is a relatively uncommon but widely recognized odontogenic cyst of developmental origin. It is found mostly in adults and has no sex predilection. LPC is usually discovered during routine radiographic examination, is located mainly between the roots of vital mandibular canines and premolars, and seldom causes pain or other clinical symptoms. The defect appears on radiographs as a round or teardrop-shaped, well circumscribed radiolucency. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. In this paper, two cases of lateral periodontal cysts are presented. In the first case, the patient (woman, 62 years old) complained of an asymptomatic gingival swelling in the region between the right maxillary canine and premolar. The radiographic examination revealed a well circumscribed radiolucency with a radiopaque margin between the roots of the canine and premolar. The adjacent teeth had vital pulp. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin". In the second case, the patient (women, 44 years old) complained of a swelling in the area of tooth 32. During radiographic examination a well circumscribed radiolucency between the roots of the lateral incisor and the canine was discovered. Surgical enucleation of the lesion was performed and the histological examination revealed that the lesion was a "lateral periodontal cyst of developmental origin".
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2/10. Paradental cyst mimicking a radicular cyst on the adjacent tooth: case report and review of terminology.

    A distinctive form of paradental cyst can occur on the buccal and apical aspects of erupted mandibular molars. This cyst has peculiar clinical and radiographic features, although the microscopic findings are the same as those of odontogenic inflammatory cysts. Diagnostic and therapeutic problems can occur when this lesion is misinterpreted as a radicular cyst. The purpose of this paper is to present an additional case of a paradental cyst in the buccal and mesial aspects of a mandibular second molar involving the apical area of a mandibular first molar. The difficulty of diagnosis, treatment, and controversies regarding terminology are also discussed.
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3/10. Cutaneous draining sinus tract of odontogenic origin: unusual presentation of a challenging diagnosis.

    A 44-year-old woman presented with a chronically draining lesion on her cheek just lateral to the nasofacial sulcus. The lesion was refractory to treatment with oral antibiotics. physical examination revealed poor dentition, and a panoramic radiograph demonstrated periapical abscesses in the maxillary right lateral incisor and canine. A diagnosis of cutaneous fistula of odontogenic origin was made, and the patient was treated with tooth extraction. The cutaneous fistula subsequently resolved. Intraoral examinations and radiographs are critical for making the diagnosis of cutaneous draining sinus tract of odontogenic origin. Many patients undergo unnecessary surgical therapies before having the correct diagnosis made, but root canal therapy or surgical extraction is the treatment of choice. A dental origin must be considered for any chronically draining sinus of the face or neck.
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4/10. Squamous cell carcinoma presenting as an endodontic-periodontic lesion.

    BACKGROUND: Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates for oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was conducted in accordance with the helsinki declaration of 1975, as revised in 2000. methods: Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the local hospital for histological analysis. RESULTS: The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of tumor for 5 years after the initial presentation. CONCLUSIONS: Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or radiographically as a common periodontal or endodontic lesion.
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5/10. Paradental cyst: report of two cases.

    BACKGROUND: The paradental cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space. methods: In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis. RESULTS: In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst. CONCLUSIONS: The presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.
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6/10. Paradental cysts on mandibular first molars in children: report of five cases.

    Five cases of paradental cyst are reported which were found to arise buccal to a mandibular first permanent molar in children under the age of 10 years. The justification for calling these lesions paradental cysts is discussed. Since the histopathological findings of this lesion are non-specific, the clinical and radiographic features are of prime importance in diagnosis when the lesion occurs in this site in patients of this age. Buccal swelling adjacent to a mandibular first molar which is partially erupted or which has a soft tissue cover is a common clinical finding. Occlusal projections generally give the best presurgical diagnostic information, demonstrating the presence of a radiolucent lesion with a periosteal bone reaction buccal to the involved tooth and displacement of the roots to the lingual. The cyst can be successfully treated by simple enucleation without disturbing the associated tooth.
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7/10. Lateral periodontal cyst. review of the literature and report of a case.

    The lateral periodontal cyst is a rare odontogenic cyst of developmental origin. It occurs on the lateral periodontal region of a vital tooth and has specific histologic features. In this paper a case of a lateral periodontal cyst is presented and cases previously reported in the literature are reviewed. The present case concerns a 50-year old woman who presented for an asymptomatic gingival swelling of the left canine mandibular region of 2 month's duration. X-ray examination showed a well circumscribed radiolucency with a radiopaque margin lying between the roots of the lateral incisor and canine. The associated teeth were vital. Enucleation of the lesion was performed. The histologic examination of the specimen showed a cyst lined by thin non-keratinized epithelium with focal thickenings containing clear cells.
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8/10. A lateral periodontal cyst in association with a follicular cyst.

    A case is described in which two separate developmental odontogenic cysts were associated with an unerupted lower third molar tooth. Radiological and histological examination showed that these were a lateral periodontal cyst and a follicular (dentigerous) cyst. This unusual occurrence provides substantial evidence that the periodontal cyst may have an origin from the cell rests of Malassez.
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9/10. Mandibular infected buccal cyst and paradental cyst: the same or separate entities?

    The WHO classification of odontogenic cysts includes the radicular (residual) and paradental (inflammatory collateral; mandibular infected buccal) cysts as inflammatory odontogenic cysts. Because the paradental group of inflammatory cysts may clinically cause diagnostic and therapeutic problems when they are associated with first and second molar teeth it was decided to review the literature and present an additional case. The aetiology and histological features of the inflammatory collateral cyst, the paradental cyst and the mandibular infected buccal cyst are identical and the differences that exist in their clinical and radiological presentation can be related to the different teeth that are involved and the difference in the ages at which these teeth erupt. These cysts represent the same entity and their treatment is dependent on the tooth involved. With the aid of magnetic resonance imaging (MRI) the distinction between a paradental cyst on the buccal aspect of a molar tooth and a periodontitis can be made.
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10/10. 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, Sandor 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.
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