Botryoid odontogenic cyst

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Botryoid odontogenic cyst
Specialty Dentistry

Botryoid odontogenic cyst (BOC) is a type of developmental odontogenic cyst that is extremely rare. [1] It is thought to be a lateral periodontal cyst (LPC) variant with a higher risk of recurrence. [2] Weathers and Waldron coined the term BOC in 1973. [3] Adults over the age of 50 are the most affected. [4] BOC appears as a slow-growing lesion that is symptomatic in approximately 70% of cases. [5]

Contents

Signs and symptoms

BOC patients frequently complain of swelling, as well as pain and paraesthesia. BOCs are larger cysts that range in size from 4 mm to 45 mm and can be unilocular or multilocular. [1]

Diagnosis

The BOC has a thin epithelial cyst lining composed of flattened squamous or cuboidal cells with focal plaque-like thickenings under the microscope. Clear cells may be seen in the cyst lining or among the epithelial rests dispersed among the fibrous connective-tissue wall on rare occasions. [6]

In terms of appearance, BOC shares similarities with some odontogenic tumors such as ameloblastoma, odontogenic myxoma, adenomatoid odontogenic tumor, and others. Incisional biopsy can be used to perform preoperative differential diagnosis. [6]

See also

Related Research Articles

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<span class="mw-page-title-main">Odontogenic keratocyst</span> Medical condition

An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. It most often affects the posterior mandible and most commonly presents in the third decade of life. Odontogenic keratocysts make up around 19% of jaw cysts.

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Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. It may contain air, fluids, or semi-solid material. Intra-bony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. That odontogenic epithelium is critical in normal tooth development. However, epithelial rests may be the origin for the cyst lining later. Not all oral cysts are odontogenic cysts. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.

A cyst is a pathological epithelial lined cavity that fills with fluid or soft material and usually grows from internal pressure generated by fluid being drawn into the cavity from osmosis. The bones of the jaws, the mandible and maxilla, are the bones with the highest prevalence of cysts in the human body. This is due to the abundant amount of epithelial remnants that can be left in the bones of the jaws. The enamel of teeth is formed from ectoderm, and so remnants of epithelium can be left in the bone during odontogenesis. The bones of the jaws develop from embryologic processes which fuse, and ectodermal tissue may be trapped along the lines of this fusion. This "resting" epithelium is usually dormant or undergoes atrophy, but, when stimulated, may form a cyst. The reasons why resting epithelium may proliferate and undergo cystic transformation are generally unknown, but inflammation is thought to be a major factor. The high prevalence of tooth impactions and dental infections that occur in the bones of the jaws is also significant to explain why cysts are more common at these sites.

A median mandibular cyst is a type of cyst that occurs in the midline of the mandible, thought to be created by proliferation and cystic degeneration of resting epithelial tissue that is left trapped within the substance of the bone during embryologic fusion of the two halves of the mandible, along the plane of fusion later termed the symphysis menti. A true median mandibular cyst would therefore be classified as a non-odontogenic, fissural cyst. The existence of this lesion as a unique clinical entity is controversial, and some reported cases may have represented misdiagnosed odontogenic cysts, which are by far the most common type of intrabony cyst occurring in the jaws. It has also been suggested that the mandible develops as a bilobed proliferation of mesenchyme connected with a central isthmus. Therefore, it is unlikely that epithelial tissue would become trapped as there is no ectoderm separating the lobes in the first instance.

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<span class="mw-page-title-main">Gingival cyst</span> Medical condition

Gingival cyst, also known as Epstein's pearl, is a type of cysts of the jaws that originates from the dental lamina and is found in the mouth parts. It is a superficial cyst in the alveolar mucosa. It can be seen inside the mouth as small and whitish bulge. Depending on the ages in which they develop, the cysts are classified into gingival cyst of newborn and gingival cyst of adult. Structurally, the cyst is lined by thin epithelium and shows a lumen usually filled with desquamated keratin, occasionally containing inflammatory cells. The nodes are formed as a result of cystic degeneration of epithelial rests of the dental lamina.

The ameloblastic fibro-odontoma (AFO) is essentially a benign tumor with the features characteristic of ameloblastic fibroma along with enamel and dentin. Though it is generally regarded as benign, there have been cases of its malignant transformation into ameloblastic fibrosarcoma and odontogenic sarcoma. Cahn LR and Blum T, believed in "maturation theory", which suggested that AFO was an intermediate stage and eventually developed during the period of tooth formation to a complex odontoma thus, being a hamartoma.

References

  1. 1 2 Arora, Piyush; Bishen, KundenduA; Gupta, Nishant; Jamdade, Anshuman; Kumar, GopaR (2012). "Botryoid odontogenic cyst developing from lateral periodontal cyst: A rare case and review on pathogenesis". Contemporary Clinical Dentistry. Medknow. 3 (3): 326. doi: 10.4103/0976-237x.103629 . ISSN   0976-237X. PMC   3532799 .
  2. Méndez, Pedro; Junquera, Luis; Gallego, Lorena; Baladrón, Jaime (December 1, 2007). "Botryoid odontogenic cyst: clinical and pathological analysis in relation to recurrence" (PDF). Medicina oral, patología oral y cirugía bucal. Spain: Valencia, España : Medicina Oral S.L. 12 (8): E594–E598. ISSN   1698-6946. PMID   18059246 . Retrieved 17 November 2023.
  3. Weathers, Dwight R.; Waldron, Charles A. (1973). "Unusual multilocular cysts of the jaws (botryoid odontogenic cysts)". Oral Surgery, Oral Medicine, Oral Pathology. Elsevier BV. 36 (2): 235–241. doi:10.1016/0030-4220(73)90244-2. ISSN   0030-4220.
  4. Üçok, Ö.; Yaman, Z.; Günhan, Ö.; Üçok, C.; Doğan, N.; Baykul, T. (2005). "Botryoid odontogenic cyst: report of a case with extensive epithelial proliferation". International Journal of Oral and Maxillofacial Surgery. Elsevier BV. 34 (6): 693–695. doi:10.1016/j.ijom.2005.01.005. ISSN   0901-5027.
  5. de Andrade Santos, Pedro Paulo; Freitas, Valéria Souza; de Almeida Freitas, Roseana; Pinto, Leão Pereira; de Souza, Lélia Batista (2011). "Botryoid odontogenic cyst: A clinicopathologic study of 10 cases". Annals of Diagnostic Pathology. Elsevier BV. 15 (4): 221–224. doi:10.1016/j.anndiagpath.2010.03.008. ISSN   1092-9134.
  6. 1 2 Yildirim, Benay; Baris, Emre (July 19, 2019). "Botryoid Odontogenic Cyst with Extensive Clear Cells". Biomedical Journal of Scientific & Technical Research. Biomedical Research Network+, LLC. 19 (5): 14589–14591. Retrieved November 18, 2023.

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