• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.599-603
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• 2008

Calcifying odontogenic cyst(COC) is comparatively rare in occurrence. COC represents about 1% of jaw cysts, and although it may occur in soft tissue, it is most commonly found within bone. Both the intraosseous and extraosseous forms occur with about equal frequency in the maxilla and mandible, mainly in the incisor and canine areas The most notable features of this pathologic entity are histopathological and include a cyst lining demonstrating characteristic "ghost" epithelial cells with a propensity to calcify and the occasional association of this finding with certain odontogenic tumors including the odontoma and the ameloblastoma. In this case, COC was associated with anterior wall of the maxillary sinus which appeared in the anterior maxilla of 64-year-old woman, was reported. We report that the clinical experience of COC with review of literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권2호
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• pp.78-84
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• 2012

Objectives: Odontogenic keratocysts (OKCs) have a tendency to recur and possess an aggressive nature. the aim of the present study was to evaluate cytokeratin (CK) expression patterns as a method for the differentiation between dentigerous cysts (DCs) and OKCs, as their histomorphologic appearance are often indistinguishable. Materials and Methods: Formalin-fixed, paraffin-embedded tissue sections of 43 OKCs and 38 DCs were immunohistochemically analyzed with i-solution in a quantitative manner in order to evaluate the immunoreactivity of CK 10, 16 and 17. Results: CK 10 expression was evident in 79.1% of OKCs but found in only 18.4% of DCs (P<0.05), and CK 10 expression was observed to occur more frequently in OKCs (mean 25.45%) than in DCs (2.19%) (P<0.05). The expression of CK 16 was evident in 79.1% of OKCs but found in only 7.9% of the DCs (P<0.05) and CK 16 expression was observed to occur more frequently in OKCs (mean 4.33%) than in the DCs (0.61%) (P<0.05). The expression of CK 17 was evident in 88.4% of OKCs but seen in only 15.7% of the DCs (P<0.05) and CK 17 expression was observed to occur more frequently in OKCs (mean 31.11%) than in the DCs (2.37%) (P<0.05). Conclusion: The immunohistochemical detection of CK 10, 16 and 17 can be utilized as a valuable biomarker for use in distinguishing between OKCs and DCs, which have clinically significant differential diagnoses.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권3호
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• pp.161-168
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• 2011

Purpose: The odontogenic keratocysts demonstrated a high recurrence rate and a biologically aggressive nature. This might be due to unknown factors inherent in the epithelium or enzymatic activity in the fibrous wall. Bcl-2 protein is characterized by its ability to inhibit apoptosis. The aim of this study was to evaluate the expression and distribution of bcl-2 in the OKCs, its possible relationship with the tumorous characteristics, such as the aggressive nature and high recurrence rate, and its usefulness to differentiate OKCs from dentigerous cysts. Materials and Methods: Formalin fixed paraffin-embedded tissue sections of 53 OKCs, and 44 dentigerous cyst were immunohistochemically analyzed quantitatively for the immunoreactivity of the bcl-2 protein with i-solution. Results: More Bcl-2 expression was observed in the OKCs (mean34.387%) than dentigerous cyst (mean11.144%) with statistical significance (P<0.001). Seventeen and 15 of the 32 OKCs in this study showed positivity in the basal layer and basal/suprabasal layers, respectively. In dentigerous cyst, 2 of 3 showed positivity in the basal cell layer. Conclusion: Considering that bcl-2 over expression may lead to the increased survival of epithelial cells, this study demonstrated a possible relationship between the aggressive nature of OKC and the intrinsic growth potential of its lining epithelium. Furthermore, the basal/suprabasal distribution of bcl-2 positive cells was observed in some OKCs, which might have a significant impact on the behavior of cysts. The bcl-2 expression of OKCs can be useful for differentiating OKCs from dentigerous cysts.

• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.81-86
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• 2023

Purpose: To evaluate the clinical and radiologic findings of the postoperative maxillary cysts (POMCs) and investigate the relationship between lesion size and clinical symptoms depending on the time elapsed after radical maxillary sinus surgery. Methods: A total of 29 patients who were diagnosed with POMCs at Chonnam National University Dental Hospital were selected. Clinical and radiologic findings were investigated. POMC cases were divided into two groups: those with <24 years between maxillary sinus surgery and POMC diagnosis and those with >24 years. The chi-square test was used to compare the differences between the two groups. Results: The average period from surgery to POMC detection was 24.32 years; however, the period could not be confirmed in four patients. The average patient age was 52.75 years, and 12 (41.3%) patients were in their 50s. POMC-related clinical symptoms were as follows: buccal pain and swelling, dull pain, toothache, abscess, sensory abnormality, and asymptomatic. Twenty (69.0%) cases showed unilocular radiolucency and 9 (31.0%) revealed multilocular radiolucency. Seven cases (35.0%) were misdiagnosed as odontogenic lesions, resulting in the delayed treatment of POMCs. No statistical significance was found between the two groups with respect to symptoms, expansion to the surrounding area, presence of secondary cysts, and mesiodistal length of cyst on cone-beam computed tomography (CBCT) images. However, the buccopalatal length of the cyst on CBCT images was significantly different between the two groups. Conclusions: The buccopalatal length of POMCs observed on CBCT images was related to the time elapsed since surgery. The lack of awareness of POMCs may lead to misdiagnosis as an odontogenic infection and delayed treatment. Therefore, dentists must recognize the clinical and radiologic features of POMCs to differentiate it from dental infections.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.431-436
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• 2010

Purpose: It is estimated that the odontogenic keratocyst (OKC) makes up 10% to 12% of all developmen-tal odontogenic cysts. The lesion has been of particular interest because of its specific histopathologic fea-ture, high recurrence rate, and aggressive behavior. Materials and Methods: We investigated 266 OKCs of Korean patients for the sex of patient, the age of the patient, the location of OKC, the recurrence rate related to radiographic impression. Results: The male-to-female ratio was 1.47:1, showing a slight male predilection. Odontogenic keratocysts had a peak of occurrence in the third decade of life. The mandibular angle and ascending ramus area (49.6%) is the most frequent site of OKCs in the jaws. Fourteen cases of unilocular (12%) and 5 cases of multilocular (20%) OKCs recurred. Thirteen cases of smooth (12.9%) and 6 cases of lobulated (14.6%) OKCs recurred. Seventeen cases of OKCs without perforation of cortical bone (12.5%) and 2 cases of OKCs with perforation of cortical bone (33.3%) recurred. Fifteen people of patients with single lesion (12.2%) and 4 people of patients with multiple lesions (66.7%) recurred. Conclusion: In this resul, we consider multiple odontogenic keratocysts can recur more easily. So we have to treat them more carefully and need long-time follow-ups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권3호
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• pp.107-111
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• 2018

Objectives: A keratocystic odontogenic tumor (KOT) is a type of odontogenic tumor that mainly occurs in the posterior mandible. Most KOTs appear as solitary lesions; however, they sometimes occur as multiple cysts. This study analyzed the clinical features of multiple KOTs. Materials and Methods: The participants were diagnosed with KOT by biopsy with multiple surgical sites, and were patients at the Pusan National University Hospital and the Pusan National University Dental Hospital from January 1, 2005 to March 31, 2016. Charts, records, images and other findings were reviewed. Results: A total of 31 operations were conducted in 17 patients. The mean patient age was $28.4{\pm}20.1years$. Multiple KOTs were found to occur at a young age (P<0.01). The predominant sites were in the posterior mandible (28.6%). Most cases of multiple lesions appeared in both the upper and lower jaw, and 40.3% of lesions were associated with unerupted and impacted teeth. The overall recurrence rate measured by operation site was 10.4% (8/77 sites). No patients were associated with nevoid basal cell carcinoma syndrome. Conclusion: The pure recurrence rate was lower than estimated, but there was a higher possibility of secondary lesions regardless of the previous operation site; therefore, long-term follow-up is necessary.

• 대한소아치과학회지
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• 제38권4호
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• pp.421-426
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• 2011

구강내 대부분의 감염은 치성 기원으로 치성 감염은 초기 감염부위로부터 저항이 제일 적은 경로를 따라 확산된다. 상악에서 치근단과 피질골 사이의 두께가 구개측보다 협측에서 더 얇기 때문에 감염이 구개측 보다는 협측으로 더 쉽게 확산되며, 구개 치근보다 협측 치근이 좁아서 근관치료의 실패가 협측 치근에서 많이 발생한다. 따라서 구개 농양의 발생은 협측 농양에 비해 흔치 않다. 구개 농양은 구개부에 발생하는 비치성 기원의 양성 또는 악성 타액선 신생물, 양성 신경 종양, 낭종 등과 감별진단이 어렵다. 따라서 소아에서 구개종창이 관찰될 경우 치성 기원의 구개 농양을 조기에 진단해 감염이 전신적으로 확산되는 것을 방지 해야 한다. 본 증례에서는 유치의 통증과 구개부 종창을 주소로 내원한 환아에서 치성 기원의 구개 농양이라고 진단하여 해당치아를 발치하고 항생제를 처방하였다. 치료 후 구개 종창이 해소되어 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.250-254
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• 2007

Dentigerous cysts are the most common type of developmental odontogenic cysts. They form as a result of a separation of the follicle from around the crown of an unerupted tooth. Usually this lesion can be asymptomatic. Such cysts are often discovered accidently on inspection of x-rays. In other advanced cases, cortical bone expansion, displacement of teeth, secondary infection can be observed. The treatment of dentigerous cyst is enucleation. And according to size, location of lesion and environmental structure marsupialization can be considered. However, Marsupialization takes long treatment time and, cystic tissues are remained so secondary surgery may be needed for total removal., Risks of oroantral fistula, damage on maxillary sinus wall and infraorbital nerve can be considered as complications of conventional surgical treatment of cysts located in maxillary sinus. We treated third molar origin dentogerous cyst located in maxillary sinus removing endoscopically both the tooth and an associated dentigerous cyst. We report our clinical experience with literature review.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.201-205
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• 2015

급성 상악동염의 원인으로는 급성 상기도 감염이 가장 흔하며 함치성 낭종 등의 치성원인에 의한 경우는 상악동염의 10-12%를 차지한다. 함치성 낭종은 주로 치과에서 우연한 방사선학적 검사에 의해 발견되며 소아에서는 드물게 보고되고 있다. 함치성 낭종이 과잉치와 동반되었을 때 주위 상악골의 파괴와 치근의 흡수를 야기하거나 침범된 치아의 변위를 유발할 수 있으므로, 조기 진단과 적절한 치료가 중요하다. 본 증례에서 콧물과 코막힘으로 부비동염으로 진단받았던 9세 남자 환아가 2개월 뒤 좌측안면부 연부조직염으로 내원하여 시행한 방사선학적 검사에서 좌측 상악동에 과잉치와 동반된 함기성 낭종이 관찰되었으며, 치료로 외과적 절제술을 시행하였다. 저자들은 소아에서 부비동염의 원인으로 과잉치를 동반한 감염된 함치성 낭종을 경험하였으며, 부비동염의 진단과 치료에 있어 항생제 치료로 호전되지 않거나 증상이 지속될 시 단순 상기도감염 합병증 외에 다른 질환의 감별을 고려할 것을 당부하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권3호
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• pp.140-145
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• 2024

Objectives: The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts. Materials and Methods: This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location. Results: A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment. Conclusion: The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.