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Orthokeratinized odontogenic cysts presenting as a periapical lesion: report of a case and literature review.

AbstractINTRODUCTION:
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.
AuthorsJoão Paulo Silva Servato, Sérgio Vitorino Cardoso, Marcelo Caetano Parreira da Silva, Mirna Scalon Cordeiro, Paulo Rogério de Faria, Adriano Mota Loyola
JournalJournal of endodontics (J Endod) Vol. 40 Issue 3 Pg. 455-8 (Mar 2014) ISSN: 1878-3554 [Electronic] United States
PMID24565671 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)
CopyrightCopyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Keratins
Topics
  • Adult
  • Connective Tissue (pathology)
  • Diagnosis, Differential
  • Epithelium (pathology)
  • Female
  • Follow-Up Studies
  • Humans
  • Keratins (analysis)
  • Odontogenic Cysts (diagnosis, pathology)
  • Periapical Diseases (diagnosis)
  • Radicular Cyst (diagnosis)
  • Tooth Extraction (methods)
  • Tooth, Nonvital (diagnosis)

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