The aims of this study were to determine the presence and distribution of
vascular endothelial growth factor (
VEGF) and
vascular endothelial growth factor receptor-2 (VEGFR2) in
dentigerous cysts compared with normal dental follicles as a control tissue and to evaluate endothelial cells and proliferating cells as indicators of angiogenic activity in these tissues.Twenty specimens histologically diagnosed as
dentigerous cysts and 20 dental follicle specimens were included. Immunohistochemistry (IHC) using anti-
VEGF and anti-VEGFR2
antibodies stained for the
growth factor and its receptor, while anti-CD34 and anti-CD146
antibodies were used to identify endothelial cells. Anti-
proliferating cell nuclear antigen (
PCNA) antibody detected proliferating cells within the specimens. Slides were examined microscopically and results evaluated using kappa statistics, negative binomial regression and ordinal logistic regression.The mean age for patients with
dentigerous cysts was 23 years and they were more common in males.
Proteins for
VEGF, VEGFR2,
PCNA, CD34, and CD146 were expressed in all
dentigerous cysts and dental follicles.
VEGF and VEGFR2 were expressed on several cell types within the tissues, however there was a significantly greater percentage of positive staining in
dentigerous cysts compared with dental follicles (odds ratio = 31.24, p < 0.001). CD34(+), CD146(+), and
PCNA(+) cells were observed in both
dentigerous cysts and dental follicles but for all markers there were significantly more positive cells in
dentigerous cysts (p < 0.001); this was especially evident in cases associated with
inflammation.
PCNA was seen in most endothelial cells lining small thin walled blood vessels suggesting endothelial proliferation. There was a high level of intra- and inter-examiner agreement (kappa 0.77 and 0.75, respectively).
VEGF and VEGFR2 and angiogenic activity are present in dental follicles and
dentigerous cysts and may contribute to local
bone resorption for tooth eruption or the development and progression of
dentigerous cysts.