• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.408-413
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• 2009

Odontogenic keratocyst (OKC) is a epithelial developmental cyst which were first described by Phillipsen in 1956. The frequency of OKC has been reported to vary from 3% to 11% of odontogenic cysts. The most characteristic clinical aspect of OKC is the high frequency of recurrence. The mechanism of recurrence is thought to be related to residues of cyst epithelium and an intrinsic growth potential following excision. And since the lining of the OKC is thin and friable, removal of the cyst in one piece may sometimes be difficult. Complete removal of the cyst lining without leaving behind remnants attached to the soft tissue or bone is necessary to avoid recurrence. Therapeutic approaches vary in different studies from marsupialization and enucleation, which may be combined with adjuvant therapy such as cryotherapy or Carnoy's solution, to marginal or radical resection. The recurrent rate varies from approximately 20% to 62%. And OKC in the angle-ramus region of the mandible had a higher tendency to recur, because of the difficulty in accessing and removing OKC from the ramus. By employing a sagittal splitting of the mandible a good surgical access was provided and cyst could be removed completely. We present an illustrative case of a small, lobulated OKC that involved ramus on mandible, and a review of the contemporary literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.68-72
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• 2006

Mucoepidermoid carcinoma is one of the most common malignant salivary gland neoplasm. It occurs over a wide age range, and is most common in the parotid gland and usually appears as an asymptomatic swelling. Pain or facial nerve palsy may develop. Minor salivary gland tumors also typically appear as asymptomatic swellings, which are sometimes fluctuant and have blue or red color that can be mistaken clinically for a mucocele. Histopathologically the mucoepidermoid carcinoma is composed of a mixture of mucous-producing cells and squamous (epidermoid) cells. Low-grade tumors show prominent cyst formation, minimal cellular atypia, and relatively high proportion of mucous cells. Mucoepidermoid carcinoma of the minor salivary glands are treated usually by assured surgical excision. For low-grade neoplasm, only a modest margin of surrounding normal tissue may need to be removed, but high-grade or large tumors warrant wider resection. Postoperative radiation therapy also may be used for more aggressive tumors. Mucoepidermoid carcinoma of the oral minor salivary glands generally have a good prognosis, because they are mostly low-to intermediate grade tumors. We present a case of mucoepidermoid carcinoma managed with surgical enucleation and postoperative irradiation and a good clinical result with review of literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.520-523
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• 2011

A keratoameloblastoma is a histologically variant of the ameloblastoma group, which varies in size and contains keratin material in the fibrous connective tissue among cystic lesions. A keratoameloblastoma is a rare disease with only 13 cases reported in the literature since Pindborg's first report in 1970. A 41-year-old man visited, complaining of pus discharged from the right maxilla. He had been diagnosed with an odontogenic keratocyst and was treated with cyst enucleation in the past. The clinical and radiology examination found evidence of recurrence and finally diagnosed him with keratoameloblastoma after enucleation and biopsy. This report discusses the clinical, radiological and histological characteristics of keratoameloblastoma and its treatment. In addition, we report another case of keratoameloblastoma that had transformed from an odontogenic keratocyst.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.485-489
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• 2008

Basal cell nevus syndrome is a hereditary disease of an autosomal dominant trait with variable conditions such as basal cell carcinomas of the skin, deformity of rib, fusion of vertebrae, mental retardation, hypertelorism, and multiple odontogenic keratocysts. A 32 years old man with pus discharge from fistula on the vestibule of left upper 1st molar visited to Chosun University Dental Hospital. Radiographic evaluation revealed multiple maxillary and mandibular cysts that had multilocular radiolucency on left mandibular body area, thining of inferior border of left border of ramus and well defined unilocular radiolucency above right upper 1st and 2nd molar and from left upper 1st premolar to 2nd molar. In chest PA view, he had a forked rib in the left 4th rib and in skull PA view the calcification of falx cerebri was observed. There was not any skin lesion. After the preliminary evaluation, the patient was diagnosed with basal cell nevus syndrome and he underwent marsupialization for decreasing the size of cystic lesion and came to hospital for dressing 3days a week. As time goes by, the size of lesion decreased. So, one and half year after marsupialization, he underwent cyst enucleation and iliac bone graft for the mandibular lesion and buccal fat pad grafts for the maxillary lesions. After the surgery, the patient experienced normal healing without any complications and he is on long-term follow-up.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.108-115
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• 2017

Numerous therapeutic approaches are available for impacted teeth, including orthodontic retraction, implantation, and autogenous tooth transplantation. Autotransplantation is a promising method, especially for juvenile patients, as it enables preservation of the function of the periodontal tissues, as well as continued alveolar bone growth. This report describes autotransplantation in two cases in which the tooth was fully-ectopically impacted. With case 1, an ectopically impacted premolar was extracted and transplanted in an upright position, and regenerative endodontic treatment was performed using a platelet-rich fibrin clot and mineral trioxide aggregate (MTA). With case 2, a calcifying odontogenic cyst with an impacted left mandibular second molar was treated by enucleation. The tooth was transplanted into the proper position 3 months after enucleation, and endodontic treatment was performed using MTA. In both cases, autotransplantation appeared to provide a simple and rapid treatment option for patients with ectopically impacted teeth. These cases demonstrate that autotransplantation of ectopically impacted teeth is a viable treatment option rather than implant placement or prosthesis, especially in juvenile patients.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.483-488
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• 2003

Nasopalatine duct cyst(NPDC) is the most common non-odontogenic cyst in the oral area and is thought to be originated from the epithelial remnants of the nasopalatine duct. Many etiologic factors have been proposed for the NPDC; trauma to the region during mastication or from ill fitting dentures, bacterial infection, and spontaneous proliferation of tissue. The majority of cases are seen between the ages of 40th and 60th and it is rare in children. Surgical enucleation is the recommended treatment for NPDC, usually under general anaesthesia. A 9-year-old boy was refered to the chosun university pedodontics clinic that this child who has anterior palatal swelling is in routine check. In this case, swelling was presented at the bottom of the anterior nasal cavity as well as in the labial aspect of the upper alveolar ridge. It was so large that we treated it by marsupialization and obturator was put. This patient is on the continuous observation. We treated the child who had NPDC by marsupialization, and got the successful results such as rapid bone regeneration and the consistency of incisor vitality.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.49-54
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• 1999

Ko, Lim found some differences in the concentrations of bone resorptive cytokines, especially IL-$1{\alpha}$ and IL-$1{\beta}$ in periapical lesions and inflamed pulps. And they suppose that these differences may be due to the type of cells which produce each cytokine. The purpose of this study was to analyze the human odontogenic cysts & cystic fluid for their contents of IL-$1{\alpha}$, IL-$1{\beta}$ and TNF-$1{\alpha}$ and to compare the concentrations of each cytokine according to the cytokine producing cells. The cystic tissues used in this experiment, were obtained from periapical surgery or cyst enucleation surgery. Cystic fluid was obtained from root canal during routine endodontic therapy(n=5). Cystic tissues were subdivided into two groups, inflammatory radicular cyst group(n=15) and developmental odontogenic keratocyst group(n=3). Normal periapical tissues of extracted third molar(n=5) were also obtained to be used as control group. Each specimen was incubated in 0.5ml homogenizing buffer (0.1mol/L potassium chloride, 0.02mol/L TRIS;pH=7.6) for two hours and then homogenized with glass homogenizer. Each specimen was centrifuged in a microcentrifuge for 3 minutes, and supernatants were extracted. The concentrations of cytokines were measured with R&D ELISA kit. The data were analyzed by Mann-Whitney U test for the differences among the diseases and t test for the correlations among each cytokine. Following results were obtained ; 1. For IL-$1{\alpha}$ and IL-$1{\beta}$, all experimental groups showed significantly higher concentrations of each cytokine than the control group (p<0.05). 2. In radicular cysts, the concentrations of IL-$1{\alpha}$ were higher than IL-$1{\beta}$, but not stastically significant (p>0.05). In odontogenic keratocysts, the concentrations of IL-$1{\alpha}$ were significantly higher than IL-$1{\beta}$ (p<0.05). In cystic fluid, the concentration of IL-$1{\beta}$ was significantly higher than IL-$1{\alpha}$ (p<0.05). 3. Between odontogenic keratocysts and radicular cysts, the concentrations of IL-$1{\alpha}$ were significantly higher in odontogenic keratocysts than in radicular cysts (p<0.05). 4. For TNF-${\alpha}$, only cystic fluid group showed significantly higher concentrations than the control group (p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.3
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• pp.280-288
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• 2017

The aim of the present study was to identify the clinical characteristics and treatment outcomes associated with maxillary anterior dentigerous cysts in children. Among 55 patients who had been diagnosed with maxillary anterior dentigerous cysts, 33 patients had cysts located in the incisor region and 22 had cysts located in the canine region. Cysts in the incisor region were 7.2-fold more prevalent in male patients, while cysts in the canine region were 1.75-fold more prevalent in female patients. For cysts in the incisor region, marsupialization was performed in 21 cases and enucleation in 12 cases. In the canine region, marsupialization was performed in 20 cases and enucleation in 2 cases. Spontaneous eruptions of the displaced teeth in the incisor and canine region were 90% and 54.5%, respectively. Among patients which spontaneous eruption occurred, patients with cysts in the incisor region underwent orthodontic treatment more often due to malocclusion. This study is expected to be used as fundamental data for establishing future treatment plans by providing the analyzed results of distribution and characteristics of dentigerous cysts involving the maxillary anterior tooth.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.313-323
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• 2023

Purpose: This study aimed to investigate the potential factors that could affect the reduction rate of odontogenic cysts following decompression using cone-beam computed tomography (CBCT) for 3-dimensional volumetric analysis. Materials and Methods: The study sample consisted of CBCT images of 41 individuals who underwent decompression of odontogenic cysts at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, between 2010 and 2022. Preoperative and postoperative CBCT results were collected, and a volumetric analysis was conducted to evaluate the differences in the reduction rate and the percentage of volume reduction of cystic lesions based on different parameters. Correlations between these parameters were analyzed to determine associations. Results: In this study, the average time of decompression for odontogenic cysts was 316 days. Males demonstrated a higher reduction rate than females (P<0.05). The reduction rate was directly proportional to initial cyst volume, with higher reduction rates for cysts with large initial volume than those with small initial volume (P<0.05). Spearman's rank correlation coefficient indicated a weak positive correlation between the initial cyst volume and the duration of decompression. Additionally, a strong positive correlation was observed between the initial volume and the reduction rate. Conclusion: Knowledge of the reduction rate of odontogenic cysts is vital for surgeons to evaluate the duration of decompression before enucleation and to determine a definitive treatment plan. Sex and initial lesion volume had significant effects on the reduction rate.