Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a "three-step method" to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.
Bone Cements ; Bone Cysts ; surgery ; Bone Transplantation ; Curettage ; Humans ; Jaw Cysts

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Ameloblastoma ; Archives ; Biopsy ; Dentigerous Cyst ; Dentistry ; Diagnosis ; Fibroma, Ossifying ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Jaw Neoplasms ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral

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±20.1 years. 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.
Basal Cell Nevus Syndrome ; Biopsy ; Busan ; Clinical Study* ; Follow-Up Studies ; Humans ; Jaw ; Mandible ; Odontogenic Cysts* ; Odontogenic Tumors* ; Recurrence ; Retrospective Studies* ; Tooth, Impacted

OBJECTIVES: Ameloblastomas and keratocystic odontogenic tumors (KCOTs) are important odontogenic tumors of the jaw. While their radiological findings are similar, the behaviors of these two types of tumors are different. Precise preoperative diagnosis of these tumors can help oral and maxillofacial surgeons plan appropriate treatment. In this study, we created a convolutional neural network (CNN) for the detection of ameloblastomas and KCOTs. METHODS: Five hundred digital panoramic images of ameloblastomas and KCOTs were retrospectively collected from a hospital information system, whose patient information could not be identified, and preprocessed by inverse logarithm and histogram equalization. To overcome the imbalance of data entry, we focused our study on 2 tumors with equal distributions of input data. We implemented a transfer learning strategy to overcome the problem of limited patient data. Transfer learning used a 16-layer CNN (VGG-16) of the large sample dataset and was refined with our secondary training dataset comprising 400 images. A separate test dataset comprising 100 images was evaluated to compare the performance of CNN with diagnosis results produced by oral and maxillofacial specialists. RESULTS: The sensitivity, specificity, accuracy, and diagnostic time were 81.8%, 83.3%, 83.0%, and 38 seconds, respectively, for the CNN. These values for the oral and maxillofacial specialist were 81.1%, 83.2%, 82.9%, and 23.1 minutes, respectively. CONCLUSIONS: Ameloblastomas and KCOTs could be detected based on digital panoramic radiographic images using CNN with accuracy comparable to that of manual diagnosis by oral maxillofacial specialists. These results demonstrate that CNN may aid in screening for ameloblastomas and KCOTs in a substantially shorter time.
Ameloblastoma ; Artificial Intelligence ; Dataset ; Diagnosis* ; Hospital Information Systems ; Humans ; Jaw* ; Learning ; Mass Screening ; Odontogenic Cysts ; Odontogenic Tumors ; Oral and Maxillofacial Surgeons ; Radiography, Panoramic ; Retrospective Studies ; Sensitivity and Specificity ; Specialization

OBJECTIVES: The purpose of this study is to evaluate the treatment efficacy of enucleation after decompression. MATERIALS AND METHODS: A total of 17 patients with cystic lesion of the jaw were treated with decompression followed by enucleation. Pre- and postdecompression panoramic radiographs were analyzed. RESULTS: The mean percentage of reduction after decompression was 64%. The reaction was graded as good (>80%) in five patients (29.4%), moderate (50%-80%) in nine patients (52.9%), and poor (<50%) in three patients (17.6%). The reduction rate of larger cystic lesions was faster than that of smaller lesions. However, the reduction rate was not affected by age. The duration of follow-up ranged from one to eight years. There were no complications, and one case recurred. CONCLUSION: Decompression is an effective method for the initial treatment of jaw cysts.
Decompression* ; Follow-Up Studies ; Humans ; Jaw Cysts ; Jaw* ; Methods ; Odontogenic Cysts ; Retrospective Studies* ; Treatment Outcome

This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.
Ameloblastoma ; Ameloblasts ; Dentigerous Cyst ; Diagnosis ; Diagnosis, Differential ; Fibroma ; Jaw* ; Odontogenic Cyst, Calcifying ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Radiography ; Search Engine ; Tooth Diseases ; Tooth, Impacted*

Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is characterized by various embryological deformities and carcinoma formation. It is caused by PTCHI gene mutations and is autosomal dominantly inherited. Some of the main symptoms of NBCCS are multiple basal cell carcinomas, multiple keratocystic odontogenic tumors (KCOTs) of the mandible, hyperkeratosis of the palmar and plantar, skeletal deformity, calcification of the falx cerebri, and facial defomity. Recurrent KCOT is the main symptom of NBCCS and is present in approximately 90% of patients. In NBCCS, KCOTs typically occur in multiples. KCOTs can be detected in patients under the age of 10, and new and recurring cysts develop until approximately the age of 30. The postoperation recurrence rate is approximately 60%. This case report presents a 14-year-old female patient with a chief complaint of a cyst found in the maxilla and mandible. The patient was diagnosed with NBCCS, and following treatment of marsupialization and enucleation, the clinical results were satisfactory.
Adolescent ; Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell ; Congenital Abnormalities ; Female ; Humans ; Jaw Cysts ; Mandible ; Maxilla ; Odontogenic Cysts ; Odontogenic Tumors ; Recurrence ; Spinal Cord

OBJECTIVEThis study described the clinical, surgical, and radiographic findings of simple bone cysts.

METHODSA retrospective study was conducted for patients diagnosed with simple bone cysts in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanchang University from March 2005 to March 2015. Clinical, radio-graphic, surgical, and follow-up data were gathered. Results were statistically analyzed by central tendency and dispersionusing SPSS 20.0 software.

RESULTSEleven cases of simple bone cysts were collected, including three male and eight female patients. Ten cases (90.9%) were asymptomatic and one case developed symptoms of swelling. All of the cases had no history of trauma in the affected area, and all were solitary; ten cases (90.9%) were unilocular, and one (9.1%) was multilocular.The shape of each lesion could be assigned to four categories: cone (3 cases), round (2 cases), oval (4 cases), and irregular (2 cases). The treatment in 10 cases consisted of surgery to explore the cavity and curettage of the bone walls. During surgery,the bone cavity in seven cases (70%) was vacant, whereas serous fluid was found in two cases (20%) and serous-bloody fluid in one case (10%). Of the ten cases, three cases exhibited complete bone healing and seven cases showed new bone formation.

CONCLUSIONSimple bone cysts of the jaws are usually asymptomatic and appear incidentally on routine radiographies. The prevalence is higher in the mandible and young people. The patient usually has no history of trauma, and the bone cavity of lesion is mostly vacant. Curettage of the bone walls of the lesion is suggested for simple bone cysts. Systemic clinical and radiologic follow-up are necessary to ensure successful treatment.

Bone Cysts ; Dental Caries ; Female ; Hospitals ; Humans ; Jaw Cysts ; diagnosis ; pathology ; Male ; Mandible ; Mandibular Diseases ; Radiology ; Retrospective Studies ; Software

Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. Although marsupialization and decompression follow the same basic bone-regeneration principle, which is to say, by reducing the pressure within the cyst, the former leaves a large defect after healing due to the large fistula necessary to induce the conversion of the cyst-lining epithelia to oral epithelia; the latter leaves only a relatively small defect, because of the continuous washing carried out by means of a tube inserted into a small hole in the cyst. In the latter case too, a decompressor appropriate for the focal position is required, owing to the importance of maintaining the device and controlling for oral hygiene. We report herein decompression treatment with a patient-customized device for an extensive cyst in the anterior region of the mandible.
Decompression ; Fistula ; Jaw* ; Mandible ; Maxilla ; Odontogenic Cysts* ; Odontogenic Tumors* ; Oral Hygiene

Glandular odontogenic cyst (GOC) is a rare, potentially aggressive jaw lesion. The common radiographic features include a well-defined radiolucency with distinct borders, presenting a uni- or multilocular appearance. A cystic lesion in the posterior mandible of a 78-year-old female was incidentally found. Radiographs showed a unilocular lesion with a scalloped margin, external root resorption of the adjacent tooth, and cortical perforation. This lesion had changed from a small ovoid shape to a more expanded lesion in a period of four years. The small lesion showed unilocularity with a smooth margin and a well-defined border, but the expanded lesion produced cortical perforation and a lobulated margin. The provisional diagnosis was an ameloblastoma, whereas the histopathological examination revealed a GOC. This was a quite rare case, given that this radiographic change was observed in the posterior mandible of an elderly female. This case showed that a GOC can grow even in people in their seventies, changing from the unilocular form to an expanded, lobulated lesion. Here, we report a case of GOC with characteristic radiographic features.
Aged* ; Ameloblastoma* ; Diagnosis ; Female ; Humans ; Jaw ; Mandible ; Odontogenic Cysts* ; Pectinidae ; Root Resorption ; Tooth