scholarly journals Decompression: a first-intention treatment for “large” non-syndromic odontogenic keratocysts

2021 ◽  
Vol 27 (2) ◽  
pp. 29
Author(s):  
Marjorie Muret ◽  
Eve Malthiéry ◽  
Théo Casenave ◽  
Valérie Costes-Martineau ◽  
Jacques-Henri Torres
Keyword(s):  
Recurrence Rate ◽  
Dentigerous Cyst ◽  
Treatment Options ◽  
Inferior Alveolar Nerve ◽  
Final Diagnosis ◽  
High Recurrence Rate ◽  
Odontogenic Cysts ◽  
Complete Regression ◽  
Odontogenic Keratocysts ◽  
Long Term Follow Up

Though odontogenic keratocysts (OKCs) are benign lesions, they have a high recurrence rate. Because of their aggressive behavior, they have been classified as tumors by the WHO until 2017. Main differential diagnoses are amelobastoma and dentigerous cyst. Anatomopathological examination can reach a final diagnosis. Several treatments have been proposed: curettage, resection, enucleation (alone or together with peripheral ostectomy) and decompression. Decompression aims to decrease the volume of the lesion of “large” OKCs, in order to prevent surgery-related fractures and to preserve the surrounding important anatomical structures such as the inferior alveolar nerve. It could lead to a complete regression. If not, secondary enucleation can be performed in better conditions: a reduced volume to remove, a thicker epithelium to detach, a lower risk to damage neighboring anatomic structures and a lower recurrence rate. Long-term follow-up however remains necessary. Nowadays, minimally invasive surgery prevails. And since OKC was returned into the odontogenic cysts group in the WHO classification, decompression should be considered as the first intention treatment. The purpose of this paper is to provide an update about OKC features and biological mechanisms, to review the different treatment options and to provide a step-by-step protocol for decompression.

scholarly journals A clinicopathological study and management of odontogenic keratocyst

2019 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Mohammad Asifur Rahman ◽  
Tarin Rahman ◽  
Ismat Ara Haider
Keyword(s):  
Conservative Treatment ◽  
Recurrence Rate ◽  
Surgical Resection ◽  
Treatment Options ◽  
Anatomical Structure ◽  
Odontogenic Keratocyst ◽  
High Recurrence Rate ◽  
Odontogenic Cysts ◽  
Odontogenic Keratocysts ◽  
Surgical Methods

Odontogenic Keratocyst is an aggressive odontogenic cyst with a high recurrence rate. After radicular and follicular cysts, odontogenic keratocysts are the third most common cyst of the jaws and approximately 12-14% of all odontogenic cysts. It has been retermed to Keratocystic odontogenic tumour (KCOT) as it better reflects its neoplastic nature but recently it has been re classified and retermed into the cystic category. Various surgical methods have been proposed but comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. Objective: The aim of this study was to analyse the clinical, radiological and histopathological characteristics of Odontogenic Keratocyst and provide a proper management system affected by this type of lesions. Materials and methods: The prospective study was performed in Dhaka Dental College and Hospital from a period of January 2014 to January 2018. A total number of 75 patients were selected for this study based on clinical, radiological and histopathological confirmation of odontogenic keratocysts. The treatment options were enucleation, enucleation with curettage, enucleation with peripheral ostectomy, Dredging method and surgical resection. After treatment patients were followed up 1months, 3 months and 6 months in every year at least for 5 years. Results: Among 75 patient of odontogenic keratocyst; the mean age was 27.69±13.35 and age range was 11 to 66 years. Male were 53(71%) and 22 (29%) were female patients. 53 (70.67%) cases were found in the mandible, 15(20%) cases in the maxilla and in 7(9.33%) cases were involved in both maxilla and mandible; mandibular posterior region was the most specific region involved 37(69.81%).The most common clinical features revealed pain and swelling. Radiologically, 70.66% unilocular, 96% well defined and 94.66% radiolucent area were prominent. Bone expansion 37.38%, root resorption 30.00% and 36% were associated with an impacted tooth. Regarding treatment options enucleation with curatage 12%, enucleation, curettage & peripheral ostectomy 29.33%, Dredging 52% and surgical resection 6.6% was done. Recurrence occurred in 18 patients with recurrence rate of 24%. Conclusion: Odontogenic keratocyst is an aggressive cyst, male predominant, posterior mandible is the commonest site and well defined unilocular radiolucency are commonest radiological feature. Radical treatment options such as resection reduced the recurrences of the tumour but higher morbidity and jaw deformity. Comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. A long term follow up is paramount importance for the research and understanding the clinical pattern, behavior, treatment and recurrence of the lesion. Update Dent. Coll. j: 2019; 9 (1): 8-15

Management and outcome of acute and recurrent pericarditis during pregnancy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lotan ◽  
Y Wasserstrum ◽  
E Itelman ◽  
M Nir-Simchen ◽  
M Arad ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Q Fever ◽  
Treatment Options ◽  
Subsequent Treatment ◽  
High Recurrence Rate ◽  
Recurrent Pericarditis ◽  
Long Term Follow Up

Abstract Background Pericarditis in pregnancy is uncommon. Treatment options, including NSAIDs and long term gluco-corticosteroids (CS) have extensive side-effects, while data on the use of Colchicine in pregnant women who suffer from pericarditis is limited. Objective To evaluate the management and outcome of active pericarditis during pregnancy in both acute (AP) and recurrent pericarditis (RP) patients. Methods and results Twelve pregnant women (14 pregnancies) with active pericarditis were followed prospectively in our cardiology-pregnancy clinic; 6 with AP and 8 with RP. Etiology: 11 idiopathic, 2 post-pericardiotomy syndrome and 1 Q fever. Maternal age on presentation was 27±4y vs. 33±3y in RP vs AP respectively. Average gestational age upon diagnosis was lower in RP than in AP (18 weeks, range 6–30 vs 26 weeks, range 5–35). In the RP group, 7/8 women (87%) were treated with CS compared with 2/6 women (33%) in the AP group; 3 women in RP group (37%) failed to respond to subsequent treatment with azathioprine and 1 patient was treated successfully with Anakinra. Colchicine was prescribed in 13/14 (93%) of pregnancies, average colchicine exposure during pregnancy was 25±15 weeks. Recurrence during pregnancy: 6/8 (75%) of RP; 2/6 (33%) of the AP, all of them on CS. All pregnancies culminated in a live birth with a mean gestational age on delivery of 37±1.4 weeks. Average birthweight was 3267±507 grams. There were no fetal anomalies or developmental delays after a mean follow-up of 2.7 years. All newborns and maternal outcomes were normal. On long term follow-up after delivery RP patients treated with colchicine developed less recurrences. Conclusion Active pericarditis is associated with a high recurrence rate during pregnancy despite treatment with CS. Colchicine use in pregnant women with active pericarditis appears to be safe. Funding Acknowledgement Type of funding source: None

Dentigerous Cyst Associated with a Misaligned Maxillary First Premolar: A Case Report

2021 ◽  
pp. 170-175
Author(s):  
Hassan Dib ◽  
Sarah Farhat ◽  
Antoine Berberi
Keyword(s):  
Case Report ◽  
Histological Examination ◽  
Dentigerous Cyst ◽  
Final Diagnosis ◽  
Tooth Eruption ◽  
Deciduous Teeth ◽  
Odontogenic Cysts ◽  
Dentigerous Cysts ◽  
Facial Swelling ◽  
Tissue Specimens

Aims: The main goal of the following case report was to shed the light on the importance of thorough clinical, radiological and histological examinations in order to elaborate a final diagnosis of asymptomatic dentigerous cysts detected in unusual locations. Presentation of Case: A case of dentigerous cyst was identified accidentally in the maxillary left premolar region of an asymptomatic 14-year-old female post an orthodontic consultation. Histological examination of the tissue specimens following enucleation confirmed the diagnosis of a dentigerous cyst. Discussion: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They involve impacted, un-erupted, permanent, supernumerary, odontomas and rarely deciduous teeth. Dentigerous cysts are usually painless but may cause facial swelling and delayed tooth eruption. Extensive maxillary involvement and childhood presentation are rare. Radio-graphic and histological examinations should be done to confirm the diagnosis of a dentigerous cyst. Conclusion: In our case, we showed the presence of a maxillary premolar dentigerous cyst that was removed by enucleation. The presence of dentigerous cyst is not always associated with a syndrome and its removal is very important to avoid future complications.

scholarly journals Odontogenic myxofibroma- Report of a rare entity

2016 ◽  
Vol 6 (12) ◽  
pp. 1043-1045
Author(s):  
P Poudel ◽  
B Bajracharya ◽  
S Bhattacharya ◽  
D Bajracharya ◽  
S Singh ◽  
...  
Keyword(s):  
Female Patient ◽  
Recurrence Rate ◽  
Rare Case ◽  
Benign Tumor ◽  
Final Diagnosis ◽  
High Recurrence Rate ◽  
Rare Entity ◽  
Odontogenic Myxoma ◽  
Immunohistochemical Examination ◽  
Rare Benign Tumor

Odontogenic myxofibroma is a rare, benign tumor, which is considered to be the variant of odontogenic myxoma. It is locally infiltrative, aggressive and has high recurrence rate. Only 24 specific cases of myxofibroma have been reported since 1950 and only two cases have been reported with excessive calcifications till 2012. Here, we report a rare case of Odontogenic myxofibroma with calcifications in 53 years old female patient who presented with the chief complain of swelling. The final diagnosis of Odontogenic myxofibroma was established after histopathological and immunohistochemical examination.

scholarly journals Multiple Odontogenic Keratocysts in a Non-syndromic Young Patient: An Unusual Case Report

2021 ◽  
Vol 9 (01) ◽  
pp. 87-90
Author(s):  
Ravish Mishra ◽  
Laxmi Kandel ◽  
Deepak Yadav ◽  
Shashank Tripathi ◽  
Bijay Karki ◽  
...  
Keyword(s):  
High Recurrence Rate ◽  
Jaw Cysts ◽  
Dental Lamina ◽  
Odontogenic Keratocysts ◽  
Goltz Syndrome ◽  
Long Term Follow Up ◽  
Intraosseous Lesion ◽  
Unusual Case Report

Odontogenic keratocyst (OKC) is a benign intraosseous lesion with invasive and aggressive behavior. It comprises approximately 2-21.8% of all jaw cysts. Odontogenic keratocysts (OKCs) are believed to arise from remnants of the dental lamina most common site in the molar ramus area. OKCs have a specific histopathologic appearance and are found to be locally aggressive and have a high recurrence rate, thus requires close long-term follow-up. OKCs are one component of the Gorlin-Goltz syndrome and all patients with multiple OKCs should be evaluated for this syndrome. In this paper, we present a case of a 13-year old non-syndromic female patient with multiple OKCs located at symphysis and bilateral mandibular angle region who was treated surgically with no obvious post-operative complications during follow-up period.

Aggressive angiomyxoma of left buttock

2021 ◽  
Vol 14 (6) ◽  
pp. e241550
Author(s):  
Hassan Akram ◽  
Deanna Tran ◽  
Rafey Rehman ◽  
Zaid Al-Wahab
Keyword(s):  
Recurrence Rate ◽  
Hormonal Treatment ◽  
Final Diagnosis ◽  
Surrounding Tissue ◽  
High Recurrence Rate ◽  
Surgical Removal ◽  
Aggressive Angiomyxoma ◽  
Left Buttock ◽  
Pelvic Pressure

Aggressive angiomyxoma (AA) is a rare mesenchymal tumour that is characterised by increased incidence in women compared with men, local invasion to the surrounding tissue and high recurrence rate. A premenopausal woman presented to clinic with pelvic pressure, intermittent tingling in the thigh and pressure emptying the bladder. CT scan, vaginal and gluteal biopsies, and MRI scan were performed to conclude a final diagnosis of AA. The patient underwent complete resection of the mass. The mass tested positive for oestrogen receptor and progesterone receptor. The patient received leuprolide postoperatively to prevent recurrence. AA should be considered as a differential diagnosis for a pelvic and perineal mass. Patients should be warned of high recurrence rate, necessity of surgical removal and long-term hormonal treatment.

Rehabilitation After Hamstring-Strain Injury Emphasizing Eccentric Strengthening at Long Muscle Lengths: Results of Long-Term Follow-Up

2017 ◽  
Vol 26 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Timothy F. Tyler ◽  
Brandon M. Schmitt ◽  
Stephen J. Nicholas ◽  
Malachy P. McHugh
Keyword(s):  
Recurrence Rate ◽  
Outcome Measures ◽  
Sports Medicine ◽  
Return To Sport ◽  
High Recurrence Rate ◽  
Hamstring Strain ◽  
Long Term Follow Up ◽  
Recurrent Injuries

Context:Hamstring-strain injuries have a high recurrence rate.Objective:To determine if a protocol emphasizing eccentric strength training with the hamstrings in a lengthened position resulted in a low recurrence rate.Design:Longitudinal cohort study.Setting:Sports-medicine physical therapy clinic.Participants:Fifty athletes with hamstring-strain injury (age 36 ± 16 y; 30 men, 20 women; 3 G1, 43 G2, 4 G3; 25 recurrent injuries) followed a 3-phase rehabilitation protocol emphasizing eccentric strengthening with the hamstrings in a lengthened position.Main Outcome Measures:Injury recurrence; isometric hamstring strength at 80°, 60°, 40°, and 20° knee flexion in sitting with the thigh flexed to 40° above the horizontal and the seat back at 90° to the horizontal (strength tested before return to sport).Results:Four of the 50 athletes sustained reinjuries between 3 and 12 mo after return to sport (8% recurrence rate). The other 42 athletes had not sustained a reinjury at an average of 24 ± 12 mo after return to sport. Eight noncompliant athletes did not complete the rehabilitation and returned to sport before initiating eccentric strengthening in the lengthened state. All 4 reinjuries occurred in these noncompliant athletes. At time of return to sport, compliant athletes had full restoration of strength while noncompliant athletes had significant hamstring weakness, which was progressively worse at longer muscle lengths (compliance × side × angle P = .006; involved vs noninvolved at 20°, compliant 7% stronger, noncompliant 43% weaker).Conclusion:Compliance with rehabilitation emphasizing eccentric strengthening with the hamstrings in a lengthened position resulted in no reinjuries.

scholarly journals Complete Surgical Excision with Keeping Drain Tube in Situ for 2 to 3 Weeks in the Treatment of Cystic Hygroma: A study of 5 years

2016 ◽  
Vol 10 (1) ◽  
pp. 26-28 ◽  
Author(s):  
Swapan Kumar Paul ◽  
Suprotim Howlader ◽  
Diponker Kumar Saha ◽  
Abdur Rahed Khan
Keyword(s):  
Recurrence Rate ◽  
Surgical Resection ◽  
Treatment Options ◽  
Surgical Excision ◽  
Cystic Hygroma ◽  
The Body ◽  
High Recurrence Rate ◽  
Drain Tube ◽  
Complete Surgical Excision

Lymphangiomas are benign hamartomatous lymphatic tumours characterized by multiple communicating lymphatic channels and cystic spaces. Cystic lyphangiomas may be seen anywhere in the body but are common in neck, axilla, mediastinum and groin. Treatment options are surgical resection, radiation, sclerotherapy etc but have got high recurrence rate and complications. In the present study we hypothesized that complete surgical resection along with keeping a drain for 2-3 wks, may reduce recurrence rate. This prospective study was performed from July 2008 to June 2013. Total 21 children treated during this period by the technique of complete surgical excision with keeping drain tube in situ for 2 to 3 weeks. Ultrasound performed in all patients, CT scan and Duplex study performed in some patients, histopathology done in all patients. Patients with intra-abdominal lymphangioma not included in this study. Twenty one patients were operated during the study period and average duration of keeping drain tube was 18.57 days. Among the 21 cases 2 (9.52%) patients developed mild infection, 1 (4.76%) patient developed infection with pus formation and 1 (4.76%) patient developed recurrence. Our success in the treatment warrants further verification of potential benefits of keeping drain tube in situ for 2-3 weeks after surgical excision of lymphangiomas.Faridpur Med. Coll. J. Jan 2015;10(1): 26-28

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