• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.76-80
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• 2005

Dentigerous cyst is one of the most prevalent types of odontogenic cysts in the jaw. Usually dentigerous cysts begin to develope through an accumulation of fluid between remnants of the enamel organ and subjacent tooth crown which is developing or submerged. The teeth most often involved are mandibular third molars, maxillary canines, and mandibular premolars. And the cysts usually occur in the second or third decade of life. The treatment of dentigerous cysts-enucleation, marsupialization, and fenestration-is dictated by the size, environmental structures of the lesion, and desirability of conserving involved tooth. Marsupialization is a conservative technique which allows the reduction or elimination of cystic lesion by making it an accessory compartment of the oral cavity in the case where complete enucleation is not desirable. Marsupialization is thought to be the most suitable method of treatment for the conserving of the involved tooth, thus guiding eruption of it. We report the positive outcome got from marsupialization in dentigerous cysts with review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.301-309
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• 2000

This clinical study was made of 214 cases of the jaw cysts which were diagnosed histopathologically in the Department of Oral and Maxillofacial Surgery, Wonkwang University Dental Hospital from Jan. 1, 1991 to Dec. 31, 1998. Medical records, radiographs, histopathological reports of 214 cases with jaw cysts were retrospectively reviewed. The results were as follows : 1. Among the total patient of 214 cases, male were 143 cases, and female are 71 cases, male predominated by the ratio of 2.04. 2. The periapical cysts and the dentigerous cyst are the most common cyst, irrespective of 116 cases(54.2%) and 58 cases(27.1%). 3. The periapical cyst has no gender prediction, male were 70 cases and female were 54 cases, the mean ages were 39.3 years(SD=18.4). The most common involving teeth were maxillary anterior teeth(59.7%). 4. The dentigerous cyst predominantly occurred in third decade (18 cases : 31%), and the mean ages were 31.9 years(SD=14.8). Dentigerous cysts predominantly occurred in male by the ratio of 7.29 (male : 51 cases, female : 7 cases). Maxillary anterior teeth(43.1%) and mandibular molars(32.8%) were most frequently involved. 5. The odontogenic keratocyst predominantly occurred in second and third decade and mean ages were 23.5 years(SD=17.2). The mandibular molars(60%) were most frequently involved. 6. All nasopalatine cyst occurred after fourth decade, mean ages were 49.5years(SD=10.4). In the gender incidence of nasopalatine cyst, 1 case occurred in female and 10 cases occurred in male. 7. In the surgical intervention of jaw cyst, cyst enucleation and marsupialization performed in 156 cases. Cyst enucleation with bone graft performed in 58 cases and iliac autogenous bone grafts most frequently performed in 29cases. 8. The diameter range of cyst enucleation with bone graft were from 15mm to 120mm with a cyst diameter of 33.3mm. (SD=15.2) The diameter range of cyst enucleation and marsupialization were from 7mm to 82mm with a cyst diameter of 20.4mm.(SD=9.0) The diameter of cyst enucleation with bone graft were significantly greater than diameter of cyst enucleation. (p<0.05) 9. Post-operative complications occurred in 9 cases(15.5%) in which cyst enucleation with bone grafts performed and occurred in 31 cases(19.9%) in which cyst enucleation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.77-82
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• 2011

A long-term follow-up study of a case of impacted teeth associated with a large dentigerous cyst in the left maxilla is presented. The patient was a 30-year-old man who had a large dentigerous cyst in the premaxilla and left posterior maxilla, which impacted the canine and supernumerary tooth. This is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars. The other teeth commonly affected in order of frequency are the maxillary canines, maxillary third molars and rarely, the central incisor. Radiographically, the cyst appears as huge ovoid well-demarcated unilocular radiolucency with a sclerotic border and causes ectopic displacement of the inferior border of the maxillary sinus without destruction. Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. These cysts appear to be associated with a supernumerary tooth in the maxillary anterior incisors region called the mesiodens and impacted canine. The present case report describes the surgical enucleation of a dentigerous cyst involving the permanent maxillary left canine and mesioden. After surgery, left maxillary sinus recovered their normal size and apposition of bone was observed around the apex of the posterior teeth. During the subsequent years, there was no recurrence of the cystic lesion but the inflammation was evoked in the anterior maxilla after 42 months. This complication appeared to have correlated with bony healing in the enucleation site of the cyst. We report the healing status of a huge dentigerous cyst in the maxilla for 5 years with a review of the relevant literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.5
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• pp.417-421
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• 2005

This study was to analyze the changes of levels of alkaline phosphatase before and after enucleation of jaw cysts combined with bone grafting, and to evaluate biochemically the effectiveness of the early detection of bone healing and infection as a prognostic marker. Eighteen patients (13 males, 5 females) with cystic lesions of the jaws were divided into two groups. The bone graft group underwent enucleation and bone graft. The control group underwent only enucleation. Both groups were measured levels of ALP before surgery, and plus-minus 4 weeks postoperatively. The more discriminating results were obtained in the bone graft group. The results were as follows : 1. Levels of ALP after enucleation of jaw cysts were decreased in all patients with and without bone graft. 2. The bone graft group showed more marked decrease in variation of levels of ALP than the control group.(p=0.008) This should be considered as a result of increased osteoblastic activity and new bone formation. 3. Such variation could be used as a prognostic marker for bone healing after cyst operation. In the cost/benefit ratio, measurement of ALP activity could be useful as a convenient procedure in routine clinical practice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.108-115
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• 2020

Objectives: Kinesiology tape (KT) creates a pulling force on the skin, thus improving blood and lymph flow by alleviating hemorrhage and congestion of lymphatic fluid. The authors hypothesized that the use of KT could be beneficial for the management of complications after head and neck surgery and designed this study to evaluate the effects of KT on swelling, pain, and trismus after enucleation of mandibular dentigerous cysts with third molar extraction. Materials and Methods: Forty patients who underwent enucleation of a dentigerous cyst with extraction of the mandibular third molar were selected. The patients were randomized into two groups (n=20 each): a KT group, where KT was applied after surgery in addition to basic postoperative care, and a control group, where patients received basic postoperative care without KT application. Swelling, pain, and trismus were evaluated before surgery (T0) and on postoperative days 1 (T1), 2 (T2), and 3 (T3). Cyst volume, gauze weight for assessing bleeding, and operation time were recorded. Results: There was a significant difference between the two groups in the change in swelling up to T1 and the change in swelling between T1 and T2. The maximum swelling in the KT group was significantly less than that in the No-KT group and maximum swelling appeared faster in the KT group than in the No-KT group. Both groups showed a mild pain response but there was no significant difference between the two groups. There was no significant difference on interincisal distance change between the two groups. There were no correlations between cyst volume, bleeding, operation time, and maximum swelling. Conclusion: KT can effectively manage facial swelling after oral and maxillofacial surgeries such as cyst enucleation and third molar extraction, thus improving postoperative patient satisfaction levels and quality of life.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.4 no.1
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• pp.45-57
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• 1974

This report based on 300 cases of serious diseases in maxillofacial region by radiograms seen at the department of dental radiodontics, infirmary school of dentistry, Kyung Hee University from October 1971 to August 1974. The maxillofacial diseases were analysed upon the following items, such as 1) the frequency of dominant diseases, 2) sex-ratio of male to female, 3) predominant region of diseases, 4) comparison with the age, 5) the incidence of diseases in relative to the individual teeth. The results were obtained as follows. 1) Among the total of 300 cases of the patients, the frequency of dominant diseases of patients were fractures of facial bone (44.3±2.87%), inflammatory diseases (22.7±2.39%), cysts (11.1±1.62%), tumors (10.7±1.77%), maxillary sinusitis (7.9±1.56%), temporomandibular joint disorders(3.3±1.05%) in the order. 2) The ex-ratio of male to female in occurence of jaw fractures were 7.3:1, temporomandibular joint disorders were 2.1:1, inflammatory diseases were 1.8:1, maxillary sinusitis were 1.7:1, but tumors were equal to 1:1, while cysts were 1:1.2 in sex difference. 3) The predominant region of mandibular fractures were symphysis(17.3±3.27%), canine region (15.0±3.09%), and angle region (14.3:±3.04%) in the order. Inflammatory diseases were occured frequently in mandible and it's left side were a little dominant. Odontogenic cysts were observed frequently in maxilla, but regardless of right and left. Carcinomas were involved most frequently in maxilla, while sarcomas and ameloblastomas in mandible. Frequency of the maxillary sinusitis were dominant right side and molar area, also temporomandibular joint disorders were right side. 4) To study comparison with the age jaw fractures showed the highest ratio at the 2nd decade(32.3±4.06%), and 3rd decade (27.8±3.89%), 4th decade (19.6±3.44%), 6th decade (9.0±2.47%), 5th decade(6.0±2.06%), 1st decade (5.3±1.95%) in the order. But 7th decade were not involved entirely. Frequency of the inflammatory diseases were the highest in the age group of 3rd decade (28.0±5.44%), and those of cysts were 5th decade (24.2±7.22%), temporomandibular joint disorders were 3rd decade (60.0±15.49%). Tumors were occured frequently over the 4th decade especially malignint tumors over the 5th decade, but maxillary sinusitis were rearless of age except for 2nd decade. 5) About the incidence of diseases in relative to individual teeth, fractures of facial bone were most frequently involved the maxillary and mandibular anterior teeth, and mandibular 3rd molar region. Cysts were maxillary anterior region inflammatory diseases were mandibular molar region maxillary sinusitis were maxillary 1st molar, region but tumors were regardless of individual teeth.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.12 no.1
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• pp.7-13
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• 1982

The purpose of this study is to delineate the nature of the occurrence of benign mucosal cysts in a Seoul National University Hospital population by use of orthopantomographs and to help their differentiation from more serious antral diseases. 2143 orthopantomographs were scrutinized for evidence of benign mucosal cyst, and following results were obtained from the study. 1. An incidence of 3.3% was found. 2. The lesions were found in all age groups and their mean age was 35.2 years of age. 3. The incidence was higer in males as compared to females. 4. The majority of lesions were single, unilateral and situated on the floor of the antrum. 5. The size of the lesions varied. from 7.2㎜ × 16.0㎜ to 40.0㎜ × 49.5㎜ and the mean size was 22.9㎜ × 26.5㎜. 6. There was no significant relationship between the occurrence of benign mucosal cyst and odontogenic factors.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.167-173
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• 2002

Purpose : To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. Materials and Methods: 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (LIS) ratio of the lesion, and expansion angle of the cortex. Results: Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1 %), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The LIS ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8°) and OKC (31.5°). Conclusion : The numeric morphology (LIS ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

• Imaging Science in Dentistry
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• v.34 no.2
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• pp.75-79
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• 2004

Purpose: To compare the proliferation potential of the epithelial cells between unicystic ameloblastoma (UA), dentigerous cyst (DC), and odontogenic keratocyst (OKC) and to correlate this proliferation potential with the radiographic features of these three pathoses. Materials and Methods: Immunohistochemical expression of PCNA, Ki-67, and cytokeratin as a proliferation marker were assessed for 15 cases of UA, 15 cases of DC, and 15 cases of OKC. The degree of immunochemical expression of three proliferation markers were correlated with the radiographic features, especially cortical expansion (negative and positive) and shape of border (scalloped and round). Results: Using PCNA and Ki-67, OKC showed the highest proliferation potential and UA the lowest. Statistically significant differences were found between the OKC and the UA (p < 0.05). However, no statistically significant difference was present according to the radiographic features in all pathoses. Using cytokeratin, there was no significant differences of proliferation potential among three pathoses. Conclusions : OKC epithelium has the most intense proliferation potential, followed by the dentigeous cyst and then unicystic ameloblastoma. There is no significant relation between the radiographic features and the proliferation potential of epithelium of these three pathoses.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.15-21
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• 2000

Ameloblasotma is slowly growing, locally invasive neoplasm with a potentially destructive behavior. The epithelium of ameloblastoma is thought to have an intrinsic growth potential and has been shown to present a higher rate of proliferation as compared to odontogenic cysts with low local recurrence rate. The molecular mechanisms that regulate the cell growth and invasion of ameloblastoma cells are unknown. Bcl-2 protein, which prevent apoptosis, is expressed in immortalized ameloblastoma cell line(AM-1)(Harada et al 1998). Expression of bcl-2 protein occurs in tooth germs, whose epithelial component may act as the histogenic precursor of ameloblastoma. Bax is considered as a main effector of apoptosis. Bax forms homodimers and also heterodimers with bcl-2. p53 tumor supressor gene participates not only in cell proliferation control but also in induction of apoptosis. The objective of the present study was to evaluate the apoptosis related protein expression in odontogenic cyst and ameloblastoma. A total of 10 dentigerous cysts and 16 ameloblastomas were used in the present study. Dentigerous cyst showed negative or slight positive for p53 and bcl-2 but strongly positive for bax, ameloblastoma, on the other hand, strongly positive for p53 and bcl-2 but weekly positive for bax. Bcl-2 was expressed for ameloblastoma mainly in outer layer or whole layer of epithelium and for dentigerous cyst mainly in basal layer. The difference in expression of apoptosis related protein in dentigerous cyst and ameloblastoma might explain the peculiar aggressive growth pattern of ameloblastoma.