Cases reported "Mandibular Diseases"

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1/14. Glandular odontogenic cyst: absence of PTCH gene mutation.

    Glandular odontogenic cyst (GOC) is a rare jawbone cyst of odontogenic origin. Human patched (PTCH) is a tumour suppressor gene that has been recently associated with signalling pathways during odontogenesis. Recently alterations of this gene were found on sporadic odontogenic keratocysts. This evidence, together with the biological behaviour similarities of both lesions, and the absence of reports on molecular analysis of GOC, led us to hypothesize that PTCH gene mutations may underlie the tumorigenesis of GOC. Therefore the aim of this study was to report one additional case of GOC and investigate the PTCH gene of the cyst. No mutations were found in the splicing and coding regions of the PTCH gene. In conclusion, the PTCH gene does not seem to be involved in GOC pathogenesis.
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keywords = behaviour
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2/14. Longitudinal in vivo observations on odontogenic keratocyst over a period of 4 years.

    A case is presented of simultaneous adjacent odontogenic keratocyst and dentigerous cyst occurring in the same quadrant. Their in vivo behaviour, influence and effect on each other, surrounding tissues and on tooth development over a period of 4 years are described. This unique case may further advance the understanding of the behaviour of the odontogenic keratocyst in vivo.
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keywords = behaviour
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3/14. Unusual jaw lesions in the paediatric and adolescent patient: a management challenge.

    While major maxillofacial pathology in the young patient is relatively uncommon, non-malignant conditions may pose a significant treatment dilemma due to their aggressive or unpredictable behaviour. Several such diseases managed by the Oral and Maxillofacial Surgery Unit at the Royal Children's Hospital of Melbourne have been selected for review. Illustrative case reports to highlight the principles of management are presented.
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keywords = behaviour
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4/14. Radiological features of glandular odontogenic cyst.

    OBJECTIVES: To present five new cases of glandular odontogenic cyst (GOC) and to review the radiological features at presentation as reported in the English literature. methods: From 1993 to 2002, five patients in our department were diagnosed with GOC based on histopathological findings and supported by radiography and CT. The radiographic features of the new GOC cases were analysed in addition to 51 literature cases. RESULTS: There were 31 male and 25 female patients, aged 14-90 years (mean 50 years). The mandible was involved in 80% and the maxilla in 20%; most of the lesions were located in the anterior jaw. Radiographically, 52% of the lesions were unilocular and 48% were multilocular; 94.5% showed well defined borders, which were sclerotic in 7.7% and scalloped in 13%. Information on cortical plate integrity was available in only 24 cases: 50% showed perforation, 8.3% erosion of the cortical plates and 8.3% thinning of the cortical plates. root resorption was reported in 22% of patients and tooth displacement in 24.4%. CONCLUSIONS: Data collected indicate that GOC has potentially aggressive behaviour, with expansion and perforation in a significant number of cases. We recommend the use of multiple plane radiographs, with CT reserved for large lesions, especially those that are multilocular or involve extragnathic structures.
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keywords = behaviour
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5/14. Case report of dentigerous cyst of lower incisor.

    This paper reviews the pathogenesis, clinical features and the behaviour of dentigerous cyst. A case of mandibular dentigerous cyst involving the incisor tooth (an unusual site) is presented to illustrate this pattern of behaviour. A recurrent pyogenic granuloma in the region of the lower incisors prevented the eruption of the lower left incisor with subsequent cystic formation around the tooth. The histological and radiological presentation is consistent with that of a dentigerous cyst. The significance of the potential of the cyst lining is stressed. The cyst was enucleated with the associated tooth as the latter was not in a favourable position to erupt. There was no recurrence after one year of treatment.
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ranking = 2
keywords = behaviour
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6/14. Aggressive behaviour of cherubism in a teenager: 4-years of clinical follow-up associated with radiographic and histological features.

    cherubism is a rare hereditary fibro-osseous childhood disease characterized by bone degradation and fibrous tissue replacement at the angles of the mandible and at the tuberosity areas of the maxilla that leads to prominence of the lower face and an appearance reminiscent of the cherub's portrayal in Renaissance art. This disease has an autosomal dominant hereditary characteristic. The purpose of this report is to analyse laboratory tests, clinicopathological and radiographic features of cherubism and its intraoral manifestations in a patient during 4-years of follow-up, correlating the features observed in this case with those of the literature. Also discussed is the atypical and aggressive behaviour of this case during puberty.
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ranking = 5
keywords = behaviour
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7/14. Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy: a report of 2 cases.

    Central giant cell granuloma (CGCG) is a benign lesion of the jaws with a sometimes locally aggressive behaviour. The most common therapy is surgical curettage which has a high recurrence rate, especially in lesions with aggressive signs and symptoms (i.e. pain, paresthesia, root-resorption and rapid growth). Alternative therapies such as interferon alpha (INFalpha) or calcitonin are described in the literature. In this study 2 patients with an aggressive CGCG are presented who were treated with INF mono-therapy. INF mono-therapy was capable of terminating the rapid growth of the lesion in both patients and induced a partial reduction. Total resolution, however, was not obtained and alternative treatment is still necessary.
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keywords = behaviour
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8/14. Botryoid odontogenic cyst: report of a case with clinical and histogenetic considerations.

    A case of a botryoid odontogenic cyst is reported. Some considerations regarding histogenetic and biologic behaviour of the lesion are discussed.
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keywords = behaviour
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9/14. Primary bone cyst of the mandibular condyle.

    cysts of the mandibular condyle are rare and their diagnosis and treatment can be difficult. A case in a young girl is described where the histology was that of a solitary bone cyst but the presentation and behaviour more closely resembled an aneurysmal bone cyst.
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keywords = behaviour
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10/14. Proliferation kinetics-study of the growth of keratocysts. Morpho-functional explanation for recurrences.

    The mode of growth of the odontogenic keratocyst is of decisive importance in the strategy and radicality of its surgical removal. The high rate of recurrence reported in the literature is striking. Staining with haematoxylin-eosin for histological examination provides only limited information on growth. Serial sections of a keratocyst obtained by fractionated curettage were prepared and the proliferation patterns of epithelium and connective tissue were studied by means of autoradiography and dna cytophotometry and compared with those of an odontogenic reference cyst of the radicular type. The epithelium of the keratocyst examined clearly showed a higher rate of proliferation than that of the radicular cyst. The connective tissue was also growing very actively with a high rate of proliferation and this growth behaviour is at least partly responsible for the invasive and destructive growth of the keratocyst. In contrast to the radicular cyst, proliferation of the epithelium of the keratocyst is multicentric being simultaneous within the growth centres. As a result the epithelium "buds" with formation of satellite cysts in the alveolar bone and peripheral epithelial islands located in the connective tissue. A case is reported of a keratocyst treated by radical curettage with subsequent freshening of adjacent bone with a bur. Our morphological findings are an important contribution to the present discussion of the various methods of treating keratocysts.
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keywords = behaviour
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