João Paulo Silva Servato1, Sérgio Vitorino Cardoso1, Marcelo Caetano Parreira da Silva2, Mirna Scalon Cordeiro2, Paulo Rogério de Faria3, Adriano Mota Loyola4. 1. Oral and Maxillofacial Pathology Area, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil. 2. Department of Oral Surgery, UNITRI-Centro Universitário do Triângulo, Uberlândia, Brazil. 3. Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil. 4. Oral and Maxillofacial Pathology Area, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil. Electronic address: adrianol@hc.ufu.br.
Abstract
INTRODUCTION: Inflammatory cysts, granulomas, abscesses, and fibrous scars represent most periapical radiolucencies. However, other less common lesions, such as orthokeratinized odontogenic cysts (OOCs), can be found at this region, and they deserve to be discussed because the prognosis for an OOC is different from that expected for the ordinary inflammatory periapical diseases. METHODS: An interesting case of OOC associated with a nonvital tooth in a 40-year-old woman is described. After a previous clinical diagnosis of a radicular cyst, the tooth was extracted, and the lesion was enucleated and submitted to microscopy examination. RESULTS: Because of the detection of an orthokeratinized epithelium lining, a diagnosis of OOC was concluded. After 2 years of periodic follow-up, no signs of recurrence were detected. CONCLUSIONS: The presence of keratin in radicular lesions must be carefully evaluated to eliminate the diagnosis of lesions with more aggressive behavior, such as an OOC or even a keratocystic odontogenic tumor. Hence, histopathologic examination is mandatory to confirm the type of lesion and to differentiate other pathologic conditions, therefore establishing patients' prognoses precisely.
INTRODUCTION: Inflammatory cysts, granulomas, abscesses, and fibrous scars represent most periapical radiolucencies. However, other less common lesions, such as orthokeratinized odontogenic cysts (OOCs), can be found at this region, and they deserve to be discussed because the prognosis for an OOC is different from that expected for the ordinary inflammatory periapical diseases. METHODS: An interesting case of OOC associated with a nonvital tooth in a 40-year-old woman is described. After a previous clinical diagnosis of a radicular cyst, the tooth was extracted, and the lesion was enucleated and submitted to microscopy examination. RESULTS: Because of the detection of an orthokeratinized epithelium lining, a diagnosis of OOC was concluded. After 2 years of periodic follow-up, no signs of recurrence were detected. CONCLUSIONS: The presence of keratin in radicular lesions must be carefully evaluated to eliminate the diagnosis of lesions with more aggressive behavior, such as an OOC or even a keratocystic odontogenic tumor. Hence, histopathologic examination is mandatory to confirm the type of lesion and to differentiate other pathologic conditions, therefore establishing patients' prognoses precisely.
Authors: Beatriz Vera-Sirera; Luis Rubio-Martínez; Leopoldo Forner-Navarro; Francisco Vera-Sempere Journal: Head Face Med Date: 2018-07-13 Impact factor: 2.151