Brazilian Oral Research - Analysis of 153 cases of odontogenic cysts in a South Indian sample population: a retrospective study over a decade

Brazilian Oral Research - Analysis of 153 cases of odontogenic cysts in a South Indian sample population: a retrospective study over a decade

Manickam Selvamani; Mandana Donoghue; Praveen Shivappa Basandi
Department of Oral and Maxillofacial Pathology & Microbiology, College of Dental Sciences & Hospital, Davangere, Karnataka, India

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ABSTRACT
The purpose of this study was to determine the prevalence of odontogenic cysts and to identify their clinico-pathological features among patients by studying biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 10 years. Data for the study were retrieved from the case records of patients fitting the histological classification of the World Health Organization (1992). Analyzed clinical variables included age, gender, anatomical location, and histological diagnosis. Of the 2275 biopsy reports analyzed, 194 cases (8.5%) were jaw cysts, including odontogenic (6.7%) and nonodontogenic cysts (0.25%). Odontogenic cysts included 69.3% radicular, 20.3% dentigerous, 5.2% keratinizing odontogenic, 3.3% residual, and 1.9% other cysts, such as lateral periodontal, botryoid odontogenic, and gingival cysts. The most frequent clinical manifestation was swelling, followed by a combination of pain and swelling. Age, gender, and location were related to the etiopathologic characteristics of the cyst type. A definitive diagnosis can be made on the basis of clinical, radiological, and histological findings, which makes a good interdepartmental relationship between the clinicians and pathologists essential. Knowledge of the biological and histological behavior of the odontogenic cysts is required for their early detection and treatment.
Descriptors: World Health Organization; Odontogenic Cysts; Nonodontogenic Cysts.

To read the article go to....
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-83242012000400008&lng=en&nrm=iso&tlng=en

The XII National PG Convention IAOMP- Highlights of the Scientific Proceedings

The XII National PG Convention IAOMP- Highlights of the Scientific Proceedings 

from left: Dr. Suchitra Gosavi, Dr.Mandana Donoghue, Dr. Sindhu Ganvir 

The XII National PG Convention of IAOMP concluded on 15^th July 2012 at the Le Meridien Pune. The convention provided an interesting mix of Guest lectures by renowned speakers and poster presentations by students and faculty.

*Prof Diane Stern presented many interesting ideas based on her vast experience with odontogenic cysts and tumors in a lecture on “Advanced Diagnostics and Treatment Modalities of Odontogenic Cysts and Tumors”– Some key points of her lecture included:

• Keratinization may be seen in any odontogenic cyst and such a cyst does not need to show the typical features of an OKC and can be called Keratinizing odontogenic cyst.
• Adenomatoid odontogenic tumor,which exists in a cystic cavity, is better considered as adenomatoid odontogenic cyst with luminal proliferation.
• Calcifying odontogenic cyst is also best considered as a cyst and not as a tumor.

*Dr. ShubhaChiplunkar’s lecture on “Immune Dysfunction in Oral Cancer” highlighted:

• the role of chronic inflammation and infection in cancer development with a contribution in about  25% of cancers; in oral cancer such a contributory role  may be played by oral lichenplanus, HPV infection, periodontitis & tobacco associated carcinogens.

• The three Es of cancer immunology were discussed as elimination, equilibrium and escape.

*The Dr.  A.T. Biviji Oration by Dr. SuchitraGosavi  on “Metastatic Tumors to the Jaws” highlighted

• “the possibility of metastatic spread of tumors from different sites to the jaws, the necessity of keeping in mind a possibility of an unknown primary and the need to view the patient as a whole and not just a disease”

*Dr. Rohini Kelkar lecture on “Molecular Diagnosis for Infectious disease” emphasized “the need for appropriate sample collection and using standardized tests and centers”.

*The Slide discussion by Dr. Shubhada Kane presented many interesting cases. An interesting diagnostic hint was that nests in squamous cell carcinoma have an uneven or even jagged outline.

The last event on the first day of the convention was the poster presentations which had a large participation,and we assume very good scientific content… however, only the participants and the judges will be able to comment on the actual content, since there was no time for others to see the posters…

*The second day started with Dr. Stern’s lecture on “Advanced Diagnostic and Treatment Modalities of Fibro-Osseous diseases and Bone Pathologies” that was immediately followed by a video presentation onthe same topic by Dr Robert Marx. Both were informative lectures highlighting salient points of fibro- osseous diseases;

• Fibrous dysplasia (FD) is caused by a Gene mutation that is it is developmental but not hereditary. The cortices of the normal bone are involved in the dysplastic process and are therefore not visible on radiographs. The osteoid/ osseous tissue shows continuity with the fibrous tissue - Dr Stern
• Ossifying fibroma (OF) shows a rounded contour as it expands like a balloon with in the affected bone and therefor it does not follow normal bone contours as seen in FD-Dr.Stern
• FD is not encapsulated in bone,but the section extending into soft tissue may be encapsulated – Dr Marx
• “FD is a lesion of bone while OF is a lesion in bone” a statement that can help in visualizing and understanding the inherent differences between the lesions.
• Highlighting the three types of cherubism and the Syndromic variety (Ramon Syndrome); the lectures emphasized the need of being updated with the importance of genetic and hereditary diseases. Cherubism is hereditary and, therefore, affected parents need counseling.  Dr-Marx
• Cherubism should not be treated by bony re-contouring before the age of 18. This allows the disease to pass its active stage and the tissue vascularity to reduce by fibrosis – Dr Marx
• Zoledronate 5 mg in a single dose treats Paget’s disease   and may even be curative- Dr Stern

 

* The lecture by Dr. Shashi Apte Titled “Blood investigation…. A Reflection of Disease”- interesting points of the lecture included the beginning of dentistry traced to 7000 BC and Hem-Pathology to more than 300 years.

• Most commonly hematological diseases  manifest as : Bleeding, gums, Mandible (pain & numbness- Bennett’s Sign) and teeth
• The hematological disorders that can affect the oral cavity and orofacial structures include: Malignancy, hemoglobinopathies and bleeding disorders.
• Among the various malignancies of blood forming elements, Leukemia (especially monocytic leukemia) is the most likely cause of gingival enlargement and permeation.
• The most common causes of anemia in India are hemoglobinopathies, aplastic anemia and Lead poisoning.

*Dr. Anil D’cruz delivered an interesting lecture on “Synoptic histopathology reporting… Its clinical implication”….. Which highlighted the differences between narrative reporting and synoptic reporting of cancer specimens… concluding that synoptic reporting is much more effective in treatment planning and follow-up.

Additional interesting points included:

• Need to complete examination and grossing of tissues as early as possible since tissue shrinks 15-46% post resection and fixation.
• A clear margin of minimum 5 mm (not showing frank malignancy, dysplasia, ca- insitu) is   necessary to consider any margin clear.
• In T1 & T2 tumors, it is essential to report on the tumor thickness, measuring the actual depth from the normal mucosal level, intravascular, perineural and muscular involvement.

* The slide discussion by Dr SindhuGanvir presented many interesting cases and emphasized the importance of adequately examining the gross specimens and obtaining its  x-ray image.

ORAMPS 2012

The Scientific registration for ORAMPS 2012 is now officially closed. Registration for the convention is however open and progressing at full speed.