Gingival odontogenic keratocyst presenting as pseudoinfection: Inclusion of demonstrative case report and review.

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
John K Brooks, Sami Abu Alhuda, Pareesa Malik, Jeffery B Price, Camille E Alexander, Ahmed S Sultan
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引用次数: 0

Abstract

Background: The peripheral odontogenic keratocyst (POKC) is a rare developmental odontogenic cyst and represents the soft tissue counterpart of the more common intraosseous variant. Although the majority of POKCs have been discovered on the gingiva, scant information is available in the periodontal literature.

Methods: A 69-year-old man presented with a painless, red fluctuant-like papular lesion on the maxillary anterior labial gingiva. The adjacent teeth had vital pulpal responses and normal gingival probing depths. A subtle radiolucency with corticated borders was evident overlying the apical third of the roots. The patient recalled receiving local anesthesia in this site 3 months ago in conjunction with dental restorative treatment.

Results: An excisional biopsy was performed and pus-like material extruded from the surgical specimen. The histopathologic diagnosis was POKC.

Conclusion: With the inclusion of this report, at least 31% (14/45) of cases of gingival OKC have mimicked infection by exhibition of a fluctuant consistency and/or extrusion of thick luminal fluid that contains keratin and resembles purulence. Due to the high recurrence rate, affected patients should be followed for at least 5-7 years.

Plain language summary: This article features a rare example of the peripheral odontogenic keratocyst (POKC) on the gingiva. The lesion was initially suspected to be an infection and appeared as a painless, red compressible growth on the maxillary anterior labial gingiva of an older adult male. A dental radiograph revealed a subtle radiolucency with corticated borders. A biopsy was performed to determine the diagnosis. Affected patients must continue to be monitored for lesional recurrence.

Key points: The gingival odontogenic keratocysts may be adherent to the overlying mucosa and warrant supraperiosteal dissection during excisional biopsy to reduce lesional recurrence. At least 31% of published cases of gingival odontogenic keratocysts have featured an infection-like clinical presentation. Due to the high rate of lesional recurrence, affected patients should undergo yearly follow-up clinical assessments for at least 5 years, as informed by the current evidence.

牙龈牙源性角化囊肿表现为假性感染:纳入示范病例报告和综述。
背景:外周牙源性角化囊肿(POKC)是一种罕见的发育性牙源性囊肿,代表了更常见的骨内变异的软组织对应。虽然大多数POKCs是在牙龈上发现的,但在牙周文献中缺乏相关信息。方法:一名69岁男性在上颌前唇龈出现无痛、红色波动样丘疹病变。邻近牙齿牙髓反应正常,牙龈探探深度正常。在根尖的三分之一处明显可见细微的带皮质边缘的透光性。患者回忆3个月前在该部位接受局部麻醉并进行牙齿修复治疗。结果:行切除活检,从手术标本中挤出脓样物质。组织病理学诊断为POKC。结论:纳入本报告后,至少有31%(14/45)的牙龈OKC病例通过表现出波动的稠度和/或含有角蛋白的粘稠腔液挤压而模拟感染。由于复发率高,患者应至少随访5-7年。摘要:本文报道一例罕见的牙龈外周牙源性角化囊肿(POKC)。病变最初被怀疑是感染,表现为上颌前唇牙龈无痛,红色可压缩生长。牙科x光片显示细微的放射透光,边缘呈皮质状。进行活检以确定诊断。受影响的患者必须继续监测病灶复发。重点:牙龈牙源性角化囊肿可能附着在上覆粘膜上,需要在切除活检时进行骨上剥离,以减少病变复发。在已发表的牙龈牙源性角化囊肿病例中,至少有31%具有感染样临床表现。由于病变复发率高,根据目前的证据,受影响的患者应每年接受至少5年的随访临床评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Advances in Periodontics
Clinical Advances in Periodontics DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.60
自引率
0.00%
发文量
40
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