• 치과방사선
• /
• 제29권1호
• /
• pp.241-254
• /
• 1999

The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst & periapical granuloma. The obtained results were as follows; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas. 2. The equivalent circular diameter was over 6.3mm, there was significant difference between periapical cyst and periapical granuloma. 3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile. sensitivity. specificity and accuracy were considerably high(0.83. 0.86. 0.86) respectively. 4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.

• Restorative Dentistry and Endodontics
• /
• 제17권1호
• /
• pp.83-94
• /
• 1992

This study was executed to measure the biosynthesis of arachidonic acid metabolic products in chronic periapical lesions, to compare the products among periapical granuloma, periapical cyst and chronic periapical abscess, and to understand the pathogensis of chronic periapical lesions. Tissues from 33 chronic periapical lesions of human teeth were enucleated during endodontic surgery. large part of each tissue was contained in liquid nitrogen immediately and the other was examined histologically. In histologically diagnosed 8 cases of periapical granuloma, 9 cases of periapical cyst and 8 cases of chronic periapical abscess. the tissues were homogenatecl and incubated with $_{14}C$-arachidonic acid. Lipid solvent extracts were separated by thin layer chromatography to be analyzed by autoradiography and TLC analyzer. 1. $TXB_2$, 6-keto-$PGF_1{\alpha}$ and $PGE_2$, $LTB_4$, HETEs, and unidentified product which are metabolic products of arachidonic acid were measured in the tissues of chronic peripaical lesions. 2. In all of periapical granuloma, cyst and abscess, the conversion rate of HETEs among all products was the highest(P<0.05), and the percentage of HETEs in total converted products was also the highest(P<0.05). 3. The concentration of each arachidonic acid product was higher in chronic periapical absecss than in periapical granuloma and cyst(P<0.05). The concentration of $TXB_2$ and HETEs in periapical cyst were hight than in periapical granuloma. 4. The relative amounts of total products from lipoxygenase pathway to those from cyclo-oxygenase pathway were about 7 fold in chronic periapical lesions. There was no difference among periapical granuloma, cyst and abscess(P<0.05). The total amount of products from each pathway were higher in chronic periapical abscess than in periapical cyst and granuloma.

• 대한치과의사협회지
• /
• 제51권1호
• /
• pp.33-38
• /
• 2013

Traumatic bone cyst is known as a symptomless, radiolucent bony les ion incidentally found during routine radiographic examinations. The main characters of traumatic bone cyst are asymptomatic and unicystic radiolucent bony lesion with vital tooth. This case is a confusing case of a traumatic bone cyst with sudden gingival swelling and appearance like a periapical abscess. After surgical exploration and drainage, clinical and radiographic examination showed bony healing with pulpal vitality preserved after 7 months postoperatively.

• Restorative Dentistry and Endodontics
• /
• 제20권1호
• /
• pp.55-70
• /
• 1995

Periapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce he31ing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nonspecific inflammation, fibrosis and periapical Cyst were evaluated for the distribution of immunoglobulin containing cells. The influence of the state of root canal treatment on the distribution of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with Vitapex(calcium hydroxide). The distribution of immunoglobulin-containing cells according to the presence of pain and fistula was also evaluated. The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<0.05) The number of immunoglobulin-containing cells in fibrosis was remarkably lower than that of periapical abscess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig-containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distribution of immunoglobulin containing cells in periapical lesions.(t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

• Restorative Dentistry and Endodontics
• /
• 제24권1호
• /
• pp.200-211
• /
• 1999

The periapical response to injury is a complex interaction of inflammatory, immune, neural, vascular and synthetic activity. TGF-${\beta}$ is a potent modulator of proliferation and differentiation in various tissue, seems to lead to an increase in extracellular matrix. MMP are a family of proteolytic enzyme that mediate the degradation of extracellular matric macromolecules, but little is known about theirs possible role in periapical tissue. The purpose of this study is to investigate the differential expression of TGF-${\beta}$ and MMP-1 in tooth follicle, periapical abscess, granuloma and cyst. The expression of TGF-${\beta}$ and MMP-1 in Periapical tissue was evaluated by immunohistochemical staining and Western blot analysis. Correlationship among the periapical lesions were stastically analyzed. The degree of MMP-1 expression in periapical abscess was higher than in any other periapical lesion, and stastically significant. TGF-${\beta}$ expression is the prominent in granuloma than other periapical lesion, which was stastically significant. The increased expression of MMP and TGF-${\beta}$ was not co-related with inflammatory cell infiltration degree of the periapical cyst. The expression degree of MMP and TGF-${\beta}$ was not co-related with periapical abscess and cyst, but expression of MMP and TGF-${\beta}$ showed strong positive co-relationship with periapical granuloma, which was stastically significant. TGF-${\beta}$ expression by Western blot analysis was prominent in granuloma and cyst, and similar to the results by imunohistochemistry. MMP-1 expression is less than TGF-${\beta}$, but there is not extreme difference between periapical lesion. These results suggest that TGF-${\beta}$ and MMP may be involved in tissue remodeling and has an important role in progress or mediation of periapical lesions.

• Restorative Dentistry and Endodontics
• /
• 제17권1호
• /
• pp.222-234
• /
• 1992

The purpose of this study was to evaluate the systemic and local production of immunoglobulins and their levels in patients with periapical cysts using Enzyme - Linked Immunosorbent Assay. Streptococcus sanguis, Bacteroides gingivalis, and Bacteroides intermedius were grown for use as antigen and they were harvested by centrifugation. The patients were divided into two groups: patients of periapical cysts and normal control. 5 patients of each group were selected and their blood were obtained via intravenous puncture prior to surgical operation. Sera were prepared by centrifugation of each blood samples. Cyst fluid were aspirated from cystic cavity and cyst wall were excised at operation. Control tissue were also excised at extraction site of impacted wisdom teeth from normal control. Each tissue was prepared by homogenization and centrifugation. Then antibodies of each sample were measured by modified ELISA. The following results were obtained: 1. Serum IgG and IgM levels were not significantly different between patients with periapical cyst and normal control. 2. IgG and IgM levels of cyst fluid to Bacteroides gingivalis and Bacteroides intermedius were significantly higher than those of serum of patients with periapical cyst, but there was no significant difference to Streptococcus sanguis. 3. IgG and IgM levels of cyst wall to Bacteroides gingivalis and Bacteroides intermedius were significantly higher than those of control tissue, but there was no significant difference to Streptococcus sanguis. 4. IgG and IgM levels in cyst fluid and IgG levels in cyst wall were highest to Bacteroides gingivalis, and IgM levels in cyst wall were highest to Bacteroides intermedius.

• 치과방사선
• /
• 제21권1호
• /
• pp.109-118
• /
• 1991

The author studied the age distribution, etiology, affected site and several radiographic features of periapical granulomas, cysts, and abscesses. The material consisted of 928 films obtained from the patients who were diagnosed and treated under the diagnosis of periapical granulomas, cysts, and abscesses during the past 8 years (1979-1986) at the Infirmary of Dental School, Chosun University. The obtained results were as follows: 1. The order of incidence was as follows: periapical abscess (67.2%), granuloma, and cyst. 2. The age distribution revealed the highest incidence around the age of 30 and relatively higher incidence over the age of 60 in the case of periapical abscess and granuloma. 3. In the frequency of location: Periapical abscesses occured most frequently in the mandibular molars. Granulomas showed relatively higher incidence in maxilla than in mandible. Cysts were most common in the maxillary anterior teeth. 4. The mean diameter of dental granuloma was 5.9㎜, however, all dental granulomas were less than 9.3㎜ in diameter. The mean diameter of periapical cyst was l3.8㎜. 5. Periapical cyst revealed well circumscribed radiolucent lesions and 77.8% of the lesion showed white line. 86.0% of dental granuloma showed well circumscribed border, 54.5% sclerosis on surrounding bone and 38.5% partial white line. Periapical abscess revealed diffuse radiolucent lesion, 89.6% of the lesions had sclerosis on surrounding bone, and 38.0% sinus tract.

• 구강회복응용과학지
• /
• 제32권3호
• /
• pp.209-213
• /
• 2016

Stafne 골낭종은 악하선의 발생 시 생긴 하악골의 결손부로 주로 하악골의 후방부나 하악 우각부에 발생한다. 대부분 하치조 신경관 하방에 발생하며 하악골 전방부에 발생하거나 하악 치아와 연관된 경우는 드물다. 또한 하악골의 천공을 일으키는 경우는 더욱 드물다. 본 증례는 하악골 전방부에 발생하여 하악골 천공을 일으킨 치근단낭과 유사한 병소가 stafne 골낭종으로 진단된 희귀한 증례로, 이와 유사하게 하악골에 발생 가능한 병소의 감별 진단과 함께 보고하고자 한다.

• 대한치과의사협회지
• /
• 제55권7호
• /
• pp.489-496
• /
• 2017

Oral and maxillofacial cyst is defined as an pathogenic cavity with an lining epithelium and connective tissue wall. Cysts of the jaws and periapical regions vary in histogenesis, treatment and prognosis. Cysts with similar clinical and radiographic can be shown different histopathologic features. Cysts are classified into odontogenic cysts and nonodontogenic cysts. Cysts are also divied into true cysts and pseudocyst. True cysts are lined with an epithelium, however pseudocysts are not lined with epithelium. A periapical cyst, dentigerous cyst and odontogenic keratocyst is clinically common and important lesions at dental clinic.

• Restorative Dentistry and Endodontics
• /
• 제42권2호
• /
• pp.111-117
• /
• 2017

Objectives: Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope. Materials and Methods: The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls. Results: Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall. Conclusions: In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.