• Title/Summary/Keyword: Surgical enucleation

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Incidentally detected odontoma within a dentigerous cyst

  • Kim, Kwang Seog;Lee, Han Gyeol;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.62-65
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    • 2019
  • Odontoma is an asymptomatic slow-growing odontogenic tumor. It is usually found by chance in the maxilla or mandible on radiography, or when it deforms the adjacent teeth. It is commonly found in patients who are 30 years of age or younger. We report our encounter with an odontoma within a dentigerous cyst found incidentally in a 56-year-old man. He presented with abnormal fullness in the right infraorbital area of the cheek. During the evaluation of the mass, we incidentally detected the odontogenic tumor within a dentigerous cyst in the patient's maxilla. Under general anesthesia, complete surgical drainage of the infraorbital cystic mass was performed. Enucleation of the odontogenic tumor and a bone grafting from the iliac bone were also performed. The final diagnosis was odontoma. After 2 years of follow-up, there was no sign of recurrence of the tumor. In case of odontogenic tumors, even in old patients, it is important to suspect an odontoma. When odontoma accompanies a dentigerous cyst, surgical excisional biopsy should be performed to rule out malignancy. In case of a large bony defect after enucleation, autogenous bone grafting is essential for reconstruction.

Clinical Study of Jaw Cysts (악골낭종에 대한 임상적 연구)

  • Moon, Cheol;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Kim, Tae-Seong
    • 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.

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Conservative Surgical Treatment of Keratocystic Odontogenic Tumor : A Case Report (각화낭성 치성 종양의 보존적 외과적 치료 : 증례보고)

  • Shin, Seyoung;Yang, Yeonmi;Kim, Jaegon;Baik, Byeongju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.328-334
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    • 2013
  • The keratocystic odontogenic tumor (KCOT) is a unique cyst because of its locally aggressive behavior, high recurrence rate and characteristic histological appearance. Various options are available for treatment. While some clinicians advocate aggressive forms of dental treatment, others prefer more conservative therapy. In this study, two types of conservative surgical procedures were performed to treat the tumor; marsupialization and cyst enucleation. The patients showed healing process on conservative surgical treatment and teeth erupted without recurrence. Conservative surgical treatment can be an effective treatment option for young children because of their efforts to preserve teeth and other anatomical structures.

Extensive Adenomatoid Odontogenic Tumor of the Maxilla: A Case Report of Conservative Surgical Excision and Orthodontic Alignment of Impacted Canine

  • Moon, Jee-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.173-177
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    • 2014
  • The present report describe the surgical therapy, clinical course, orthodontic treatment and morphological characteristics of an adenomatoid odontogenic tumor in the maxilla of an 11-year-old patient. The cystic tumor filled the maxillary sinus and involved a tooth. Marsupialization was accompanied by partial enucleation and applied traction to the affected tooth by a fixed orthodontic appliance. Healing was uneventful and no local recurrence was observed during a 1-year period of follow-up control.

SURGICAL TREATMENT OF JAW CYSTS IN CHILDREN (소아의 악골내 발생한 낭종의 외과적 처치)

  • Kim, Jae-Gon;Kim, Young-Jin;Kim, Mi-Ra;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.1-7
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    • 2001
  • The Dentigerous cyst is reported to be one of the most common lesions of the jaw. It is derived from reduced enamel epithelium that surrounds the crown of an unerupted tooth. Dentigerous cysts usually remains asymptomatic and presents as well-circumscribed radiolucencies surrounding the crown of a tooth. Most dentigerous cysts are treated by surgical enucleation or marsupialization of the cyst to allow eruption of the permanent tooth. The nasopalatine duct cysts derived from the islands of epithelium remaining after closure of the embryonic nasopalatine duct. The cyst presents as a well-circumscribed oval or heart-shaped radiolucency located in the midline of the anterior maxilla between the roots of the central incisors. Treatment is by surgical enucleation, employing a palatal approach. This report present two cases. One case was diagnosed with dentigerous cyst and treated by enucleation. 12 Months later, affected second premolar was erupted normally. The other case was diagnosed with nasopalation duct cyst. Histological examination of the enucleated cyst confirmed a nasopalatine duct cyst. There was no recurrence during follow up period.

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A CASE REPORT OF DENTIGEROUS CYST WITH FACIAL SWELLING (안면부 종창을 동반한 함치성 낭종의 치험례)

  • Hur, Sun;Kim, Jae-Gon;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.587-592
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    • 1994
  • The dentigerous cyst originates through alteration of the reduced enamel epithelium after amelogenesis is completed, with accumulation of fluid between the layers of the enamel epithelium or between this epithelium and the tooth crown. It is always associated with unerupted teeth. There are two methods of treament which are generally accepted. One is the enucleation of the cystic sac in its entirety, the other is the Partch operation, or the marsupialization, by which the cyst is uncovered or "deroofed" and the cystic lining made continuous with the oral avity or surrounding structures. The present case report showed that in instance of dentigerous cyst & odontogenic keratocyst surgical enucleation followed by careful excision of all cyst wall was successfully carried out and recovery and healing were rapid and uncomplicated.

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A Long-term Follow-Up Case of Enucleation of Dentigerous Cyst in the Maxilla: Case Report (상악골에 발생한 거대 함치성낭종의 적출술 후 장기치료 결과: 증례보고)

  • Lee, Eun-Young;Kim, Kyoung-Won
    • 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.

Warthin's Tumor of the Parotid Gland (이하선의 Warthin씨 종양)

  • Lee Kang-Young;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.177-180
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    • 1996
  • Warthin's tumor is a benign and slow growing tumor found exclusively in the parotid gland or the periparotid lymph nodes. It mostly affects males between the age of forty to seventy years and is closely related with smoking history. Between January 1981 and June 1996, 42 patients underwent surgical excision of Warthin's tumor of the parotid gland; which made up 10.6% of all parotid gland surgeries(398 cases) during the same period. Their ages ranged from 36 to 75 years with a mean age of 56 years. There were 33 male and 9 female patients with a 4.3 : 1 male to female ratio. The majority of the tumors were situated in the parotid tail whereas one was in the deep lobe. Bilateral simultaneous involvements of the parotid gland were found in 4 patients(9.5%) ; therefore total of 46 parotid glands were involved. Four(8.7%) of the 46 parotid glands had multifocal tumors ranginging from two to three lumps. Tumor sizes varied from 1.5 to 6.0cm with mean diameter of 3.lcm. Of the 42 patients, 26(61.9%) were diagnosed preoperatively or peroperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 46 tumors, 30 underwent a superficial(n=29) or total(n=1) parotidectomy and for 16 cases with tumors suspected preoperatively or peroperatively of being single Warthin's tumor, only enucleation was performed. No cases of recurrence were identified during the follow up period regardless of type of operation performed, however the postoperative complication rate was much higher in the parotidectomy group(33.3%) than in the enucleation only group(12.5%). We feel that an enucleation procedure may be appropriate for the patients with single Warthin's tumor.

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RADICULAR CYST ENUCLEATION ON MANDIBULAR ANTERIOR REGION (하악 전치부에 발생한 치근낭종의 치험례)

  • Kim, Sun-Ha;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.84-89
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    • 2012
  • The radicular cyst is the most common odontogenic cyst which is caused by pulpal inflammation, pulp death, and secondary to trauma or dental caries. Usually, the radicular cyst is asymptomatic, but a secondary inflammation can cause pain, swelling and redness. Getting larger, the radicular cyst can cause facial asymmetry and paresthesia by pressure on nerves. It requires conservative endodontic treatment or surgical approach. When the size of cyst is large or invasion of the adjacent tissue is not expected, cyst enucleation is carried out. And most of the case can be completely cured and shows low recurrence. In these radicular cysts cases, by cyst enucleation or apicoectomy after root canal treatment simultaneously, the infected teeth can be preserved successfully.

Conservative surgical approach to aggressive benign odontogenic neoplasm: a report of three cases

  • Kumar, Vijay
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.37-42
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    • 2015
  • Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often invade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, management (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefits of conservative management. Three patients with different complaints and final histopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.