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1.
BMC Oral Health ; 24(1): 1084, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39272104

RESUMEN

BACKGROUND: Ameloblastoma and odontogenic keratocyst (OKC) are odontogenic tumors that develop from remnants of odontogenic epithelium. Both display locally invasive growth characteristics and high predilection for recurrence after surgical removal. Most ameloblastomas harbor BRAFV600E mutation while OKCs are associated with PATCH1 gene mutation but distinctive indicators of ameloblastoma growth characteristics relative to OKC are still unclear. The aim of this study was to assess hub genes that underlie ameloblastoma growth characteristics using bioinformatic analysis, ameloblastoma samples and mouse xenografts of human epithelial-derived ameloblastoma cells. METHODS: RNA expression profiles were extracted from GSE186489 gene expression dataset acquired from Gene Expression Ominibus (GEO) database. Galaxy and iDEP online analysis tools were used to identify differentially expressed genes that were further characterized by gene ontology (GO) and pathway analysis using ShineyGO. The protein-protein interaction (PPI) network was constructed for significantly upregulated differentially expressed genes using online database STRING. The PPI network visualization was performed using Cytoscape and hub gene identification with cytoHubba. Top ten nodes were selected using maximum neighborhood component, degree and closeness algorithms and analysis of overlap was performed to confirm the hub genes. Epithelial-derived ameloblastoma cells from conventional ameloblastoma were transplanted into immunocompromised mice to recreate ameloblastoma in vivo based on the mouse xenograft model. The top 3 hub genes FN1, COL I and IGF-1 were validated by immunostaining and quantitative analysis of staining intensities to ameloblastoma, OKC samples and mouse ameloblastoma xenografts tissues. RESULTS: Seven hub genes were identified among which FN1, COL1A1/COL1A2 and IGF-1 are associated with extracellular matrix organization, collagen binding, cell adhesion and cell surface interaction. These were further validated by positive immunoreactivity within the stroma of ameloblastoma samples but both ameloblastoma xenograft and OKC displayed only FN1 and IGF-1 immunoreactivity while COL 1 was unreactive. The expression levels of both FN1 and IGF-1 were much lower in OKC relative to ameloblastoma. CONCLUSION: This study further validates a differentially upregulated expression of matrix proteins FN1, COL I and IGF-1 in ameloblastoma relative to OKC. It suggests that differential stromal architecture and growth characteristics of ameloblastoma relative to OKC could be an interplay of differentially upregulated genes in ameloblastoma.


Asunto(s)
Ameloblastoma , Quistes Odontogénicos , Ameloblastoma/genética , Ameloblastoma/patología , Humanos , Quistes Odontogénicos/genética , Quistes Odontogénicos/patología , Ratones , Animales , Matriz Extracelular/genética , Matriz Extracelular/metabolismo , Mapas de Interacción de Proteínas/genética , Neoplasias Maxilomandibulares/genética , Neoplasias Maxilomandibulares/patología
2.
J Clin Med ; 13(17)2024 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-39274556

RESUMEN

Ameloblastoma is a rare, benign, but locally aggressive odontogenic tumor that originates from the epithelial cells involved in tooth development. The surgical approach to treating an ameloblastoma depends on the type, size, location, and extent of the tumor, as well as the patient's age and overall health. This umbrella review's aim is to summarize the findings from systematic reviews (SRs) and meta-analyses on the effect of radical or conservative treatment of ameloblastoma on the recurrence rate and quality of life, to evaluate the methodological quality of the included SRs and discuss the clinical management. Three electronic databases (PubMed, Scopus, The Cochrane Library) were checked. The primary outcome was the recurrence rate after surgical treatment, while the secondary outcomes were the post-operative complications, quality of life, esthetic, and functional impairment. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Eighteen SRs were included. The quality of the included reviews ranged from critically low (three studies) to high (eight studies). Four studies were included in meta-analysis, and they revealed that the recurrence rate is about three-times more likely in the conservative treatment group compared to the radical treatment group, and this result is statistically significant. Despite the high recurrence rate, the latter was more appropriate in the case of smaller lesions and younger patients, due to better post-operative quality of life and reduced functional and esthetic impairments. Based on the results of this overview, conservative treatment may be recommended as the first-line approach for intraosseous ameloblastoma not involving soft tissue. However, given the expectation of a higher recurrence rate, it is advisable to reduce the interval between follow-up visits. However, further prospective studies are needed to establish the best treatment choice and follow-up period.

3.
BMC Oral Health ; 24(1): 1102, 2024 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-39289711

RESUMEN

BACKGROUND/PURPOSE: This retrospective immunohistological pilot study aimed to investigate the influence of natural killer group 2, member D (NKG2D) ligand expression on ameloblastoma recurrence after surgical resection. It also aimed to elucidate additional clinical factors that could serve as predictors of ameloblastoma recurrence. MATERIALS AND METHODS: This study included 96 patients who were histologically diagnosed with ameloblastoma after surgical resection. The expression of NKG2D ligands, including UL16-binding proteins (ULBPs) 1-3 and major histocompatibility complex class I chain-related molecule (MIC) A/B, was evaluated in formalin-fixed paraffin-embedded tumor tissues via immunohistochemistry assays. Furthermore, the patients' electronic medical records were reviewed. Multivariate Cox regression analysis was conducted, and data were expressed as adjusted hazard ratios [HRs] with 95% confidence intervals [95% CIs]. RESULTS: Multivariate analysis revealed that recurrent tumors (ref.: primary; adjusted HR [95% CI]: 2.780 [1.136, 6.803], p = 0.025) and positive MICA/B expression (ref.: negative; adjusted HR [95% CI]: 0.223 [0.050, 0.989], p = 0.048) independently affected recurrence-free survival in ameloblastoma. CONCLUSION: This study identified recurrent cases and loss of MICA/B expression as independent predictors of early ameloblastoma recurrence following surgical resection. The findings suggest that decreased MICA/B expression might undermine NKG2D-mediated tumor immunosurveillance, thereby influencing early recurrence.


Asunto(s)
Ameloblastoma , Recurrencia Local de Neoplasia , Humanos , Estudios Retrospectivos , Masculino , Femenino , Recurrencia Local de Neoplasia/patología , Proyectos Piloto , Persona de Mediana Edad , Ameloblastoma/patología , Ameloblastoma/metabolismo , Ameloblastoma/cirugía , Adulto , Subfamilia K de Receptores Similares a Lectina de Células NK/metabolismo , Anciano , Inmunohistoquímica , Adolescente , Neoplasias Maxilomandibulares/patología , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/cirugía , Adulto Joven
4.
J Stomatol Oral Maxillofac Surg ; : 102001, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39164189

RESUMEN

INTRODUCTION: Ameloblastoma is the most common odontogenic tumor (OT) accounting for about 1- 3 % of all tumors and tumor-like lesions of the head and neck region. Contrasting reports from documented studies have observed that the relative frequency of ameloblastomas is higher in the black population as compared to Caucasians. This is a systematic review and meta-analysis of Sub-Sahara African prevalence of Ameloblastoma. METHODS: The MEDLINE, SCOPUS, and AJOL databases were searched for relevant studies published from 1980 till date. Papers selected for full-text review were included in the systematic review if they provided a hospital or population-based prevalence of Ameloblastoma. Manual searching of selected articles' reference list was also performed to include additional studies. Two individuals independently performed abstract and full-text reviews, data extraction, and quality assessment of the papers. Random-effects models and/or meta-regression were used to generate pooled estimates by country, sex, and year of data collection. RESULTS: Of 264 abstracts screened, 166 articles were selected for full-text review. A total of 22 studies met the inclusion criteria and all articles were hospital-based. The pooled prevalence for Ameloblastoma was 12 % (CI 95 %: 9 % - 15 %). Increasing participant age was not associated with a higher Ameloblastoma prevalence. Prevalence was higher in Nigeria (13 %, CI 95 %: 10 % - 17 %) than in other sub-Saharan countries (9 %, CI 95 %: 6 % - 14 %). Sex, country, and year of data collection were not associated with statistically significant different estimates of prevalence. CONCLUSION: Significant gaps in data collection and overall knowledge about its epidemiology were identified, particularly about the population-based incidence of Ameloblastoma in sub-Saharan countries. Accurate estimates of the prevalence and incidence of Ameloblastoma are needed to plan for the health and social services that will be required to deal with this enigmatic lesion.

5.
J Oral Pathol Med ; 2024 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-39192690

RESUMEN

BACKGROUND: Ameloblastoma is a locally destructive benign odontogenic tumor. While the neoplastic cells of conventional ameloblastoma can infiltrate the connective tissue and bone, in unicystic ameloblastoma the epithelium is encapsulated. The mechanisms driving ameloblastoma's bone resorption remains unclear. METHODS: RNA sequencing (RNA-seq) was performed in a discovery cohort of conventional ameloblastoma, and pathway enrichment analysis was carried out. mRNA levels of MMP13, a gene associated with bone resorption, were assessed using RT-qPCR in a larger cohort of conventional ameloblastoma and in unicystic ameloblastoma. Zymogram gels and the immunoexpression profile of collagenase 3 (encoded by MMP13 gene) were evaluated as well. RESULTS: Enriched pathways related to bone mineralization and upregulation of MMP13 were observed in ameloblastomas. Collagenolytic activity of collagenase 3 was detected in the tumor lysates. Collagenase 3 immunopositivity was observed in ameloblastomatous epithelium infiltrating the fibrous capsule of unicystic ameloblastoma. At the tumor-bone interface, collagenase 3 expression was detected in stromal cells, osteoblasts, and osteocytes. CONCLUSION: The results indicate a potential involvement of MMP13 in ameloblastoma-related bone resorption and progression.

6.
J Plast Reconstr Aesthet Surg ; 97: 296-301, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39181059

RESUMEN

Unicystic ameloblastoma is a distinct entity of ameloblastoma characterized by slow growth and locally aggressive behavior. This retrospective study aimed to assess the efficacy of different treatment modalities of unicystic ameloblastoma, focusing on clinico-radiological and histopathological features. Data from patients diagnosed with unicystic ameloblastoma were retrospectively analyzed. Patients were categorized into luminal and intraluminal (Group A) and mural (Group B) variants based on the Ackermann classification, which has a significant influence on their biological behavior, treatment approaches, and prognosis. Patients in Group A underwent enucleation with chemical cauterization, peripheral ostectomy, and iodoform packing, whereas those in Group B were treated with resection and reconstruction. Post-operatively, the patients were subjected to radiographic assessments via digital orthopantomogram at regular intervals. Because of the rarity of unicystic ameloblastoma, only 17 patients were included in the study (Group A: 9 patients; Group B: 8 patients), with a mean follow-up of 4.9 years (range: 1.4-11.8 years). The primary outcome measure was the absence of recurrence, which indicated treatment success. No patient in either group experienced recurrence within the follow-up period. This study provides evidence supporting the successful treatment of luminal and intraluminal variants of unicystic ameloblastoma in young individuals using a conservative approach. However, the more aggressive mural variant demonstrated favorable outcomes with radical treatment. These findings emphasize the importance of the Ackermann classification in guiding treatment decisions for unicystic ameloblastoma and contribute valuable insights into optimizing therapeutic strategies based on clinico-radiological and histopathological findings.


Asunto(s)
Ameloblastoma , Radiografía Panorámica , Humanos , Ameloblastoma/patología , Ameloblastoma/cirugía , Ameloblastoma/diagnóstico por imagen , Masculino , Femenino , Estudios Retrospectivos , Adulto , Adolescente , Neoplasias Mandibulares/patología , Neoplasias Mandibulares/cirugía , Neoplasias Mandibulares/diagnóstico por imagen , Adulto Joven , Niño , Resultado del Tratamiento , Neoplasias Maxilomandibulares/patología , Neoplasias Maxilomandibulares/diagnóstico por imagen , Neoplasias Maxilomandibulares/cirugía
7.
Int J Surg Case Rep ; 123: 110156, 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39186909

RESUMEN

INTRODUCTION: Marsupialization is a dependable choice for mandibular unicystic ameloblastoma (UA) management. However, investigations regarding its speed of shrinkage (SS) and reduction rate (RR) are lacking. This case report highlights the treatment of a huge mandibular UA with high SS and RR using marsupialization before secondary surgery. PRESENTATION OF CASE: A 45-year-old male patient presented with severe swelling of the right side of the mandible, resulting in prominent facial asymmetry. Panoramic radiograph revealed a unilocular, radiolucent lesion extending from the mandibular midline to the right ramus. Computed tomography (CT) revealed a large radiolucent lesion that expanded in the buccolingual direction. Incisional biopsy showed that the lesion was UA. After 1.5 years of marsupialization, an SS of 0.183 % per day was reached, leading to an impressive RR of 98.7 %. Treatment was followed by enucleation and peripheral osteotomy. No recurrence was observed at 1 year post-surgery. DISCUSSION: The treatment of mandibular UA remains controversial, ranging from conservative approaches to aggressive interventions. In the current case, marsupialization was highly effective in reducing the volume of the lesion, thereby facilitating a minimally invasive secondary surgery to preserve function. The intact periosteum, which has the potential to differentiate into various cell types, may be associated with the regeneration of new bone after marsupialization. CONCLUSION: Marsupialization remains a successful strategy for managing mandibular UA. Even the huge lesions causing facial deformity can be treated with marsupialization combined with secondary surgery, avoiding the aesthetic and functional disruptions associated with radical treatment.

8.
Onco Targets Ther ; 17: 643-653, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39131904

RESUMEN

Ameloblastoma (AB) is a common odontogenic tumor that develops in the mouth. Despite its benign nature, AB exhibits significant invasiveness leading to tumor metastasis and high postoperative recurrence rates. Studies have shown a relationship between the occurrence and development of various tumors and non-coding RNA (ncRNA). NcRNA, transcribed from the genomes of mammals and other complex organisms, are often products of alternative splicing and processing into smaller products. MicroRNA (miRNA), circular RNA (circRNA), and long non-coding RNA (lncRNA) are the main types of ncRNA. NcRNA play increasingly significant roles in the pathogenesis of human cancers, regulating their occurrence and progression as oncogenes or tumor suppressors. They are involved in tumor development and progression through alternative splicing of pre-mRNA, transcriptional regulation, mRNA stability, protein translation, and chromatin remodeling and modification. The importance of ncRNA in AB has received significant attention in recent years. However, the biological functions and mechanisms of ncRNA in AB remain largely unknown. In this review, we not only explore the functions and roles of ncRNA in AB, but also describe and envision their potential functional roles as biomarkers in AB diagnosis. In particular, we highlight the potential of miR-29a as a molecular marker for diagnosis and therapy. As promising novel therapeutic targets, the biological functions of ncRNA need further study, which is indispensable.

9.
Head Neck Pathol ; 18(1): 82, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39177897

RESUMEN

PURPOSE: This scoping review aimed to identify factors associated with the recurrence of ameloblastoma. METHODS: Systematic searches were conducted in PubMed, Scopus, and EMBASE, based on the board research question: "What factors are related to the recurrence of ameloblastoma?". English-language observational studies addressing the risk and preventive factors associated with recurrent ameloblastoma were included and data were extracted. RESULTS: Eighty-three retrospective observational studies met the inclusion criteria. The identified prognostic factors for recurrence included: (1) Tumor size/diameter/volume, (2) cortical bone perforation/ soft tissue invasion, (3) multilocular radiolucency, (4) impacted tooth-involving lesions, (5) root resorption, (6) WHO classification - conventional (solid/multicystic) ameloblastoma, (7) histological subtype - mural invasion of unicystic ameloblastoma, (8) conservative treatment modalities - simple enucleation, curettage, and marsupialization, and (9) non-extraction/preservation of involved teeth. No strong evidence linked immunohistochemical expression to recurrence. Interestingly, BRAF p.V600E remained controversial in terms of recurrence, despite being a frequent finding in ameloblastoma. CONCLUSION: Certain clinical characteristics, radiographic findings, histological subtypes, and treatment choices of ameloblastoma can help identify patients at high risk of recurrence. Further prospective studies to evaluate the prognostic factor model and research on immunohistochemistry are required.


Asunto(s)
Ameloblastoma , Neoplasias Maxilomandibulares , Recurrencia Local de Neoplasia , Humanos , Ameloblastoma/epidemiología , Ameloblastoma/patología , Neoplasias Maxilomandibulares/epidemiología , Neoplasias Maxilomandibulares/patología , Recurrencia Local de Neoplasia/epidemiología , Estudios Observacionales como Asunto
10.
Oral Maxillofac Surg ; 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39210202

RESUMEN

PURPOSE: This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023. METHODS: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS. RESULTS: Of the 34,225 biopsies over the 15-year period, 1.8% were identified as OTs, COC and OKCs and accounted for 47%, 1.5% and 51.5% respectively. The most prevalent OT types were odontoma (43.7%), ameloblastoma (27%) and cemento-ossifying fibroma (7.5%). Malignant OT, ameloblastic carcinoma, constituted 1.4% of OT. The average age at diagnosis for OKC, COC and OT patients were 48.2 ± 20.9, 33.7 ± 23.3 and 28.9 ± 19.3 years. Overall, male and mandibular site predilections were observed. Recurrence of OKC and ameloblastoma occurred in 15.2% and 13.7% of patients. The time for recurrence for OKC and Ameloblastoma were 61.7 ± 56.5 months and 122 ± 152 months respectively. CONCLUSION: The demographic features and range of OT, COC and OKC in New Zealand align with those of other western countries. The study also confirms need for long term follow up for patient with OKC and ameloblastoma.

11.
Sci Rep ; 14(1): 15492, 2024 07 05.
Artículo en Inglés | MEDLINE | ID: mdl-38969711

RESUMEN

Unicystic ameloblastoma (UAM) of the jaw can be effectively reduced in volume through decompression, which promotes bone regeneration and restores jaw symmetry. This study quantitatively evaluated changes in mandible volume and symmetry following decompression of mandibular UAM. This study included 17 patients who underwent surgical decompression followed by second-stage curettage for mandibular UAM. Preoperative and postoperative three-dimensional computed tomography (CT) images were collected. Bone volume and the area of cortical perforation were measured to assess bone growth during decompression. Mandibular volumetric symmetry was analyzed by calculating the volumetric ratio of the two sides of the mandible. Twelve pairs of landmarks were identified on the surface of the lesion regions, and their coordinates were used to calculate the mean asymmetry index (AI) of the mandible. Paired t-tests and the Mann-Whitney U test were used for statistical analysis, with p < 0.05 considered indicative of statistical significance. The mean duration of decompression was 9.41 ± 3.28 months. The mean bone volume increased by 8.07 ± 2.41%, and cortical perforation recovery was 71.97 ± 14.99%. The volumetric symmetry of the mandible improved significantly (p < 0.05), and a statistically significant decrease in AI was observed (p < 0.05). In conclusion, UAM decompression enhances bone growth and symmetry recovery of the mandible. The present evaluation technique is clinically useful for quantitatively assessing mandibular asymmetry.


Asunto(s)
Ameloblastoma , Descompresión Quirúrgica , Imagenología Tridimensional , Mandíbula , Tomografía Computarizada por Rayos X , Humanos , Ameloblastoma/cirugía , Ameloblastoma/diagnóstico por imagen , Femenino , Masculino , Mandíbula/cirugía , Mandíbula/diagnóstico por imagen , Adulto , Descompresión Quirúrgica/métodos , Imagenología Tridimensional/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto Joven , Adolescente , Persona de Mediana Edad , Neoplasias Mandibulares/cirugía , Neoplasias Mandibulares/diagnóstico por imagen , Desarrollo Óseo , Regeneración Ósea
12.
Cureus ; 16(6): e63233, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39070377

RESUMEN

Maxillary ameloblastoma is one of the rarest odontogenic epithelial tumors encountered, as 80% of ameloblastomas are seen within the mandible. Ameloblastoma is usually incidentally detected in the third to fourth decades of life, as most patients remain asymptomatic; yet some patients may complain of a slowly growing, painless swelling. We present a case of maxillary ameloblastoma with pulmonary metastasis along with a brief literature review. A 17-year-old male initially presented with painless right facial swelling, which, on examination, was non-tender, immobile, irregular, pink in color, with a high tendency to bleed, and located in the mucogingival sulcus with a size of around 3x2.5 cm. Following comprehensive radiological and histopathological evaluation, the diagnosis of ameloblastoma characterized by the coexistence of plexiform and follicular patterns was confirmed. The patient underwent a partial right maxillectomy with an obturator sealing the hard palate. Unfortunately, multiple local recurrences were identified afterward, and eventually, pulmonary metastasis was detected. Early and adequate surgical resection of the primary tumor is crucial to prevent further recurrences in patients with ameloblastoma. This could be achieved by providing a tight postoperative follow-up schedule while paying special attention to the lungs, neck, and other suspicious areas to detect metastasis as early as possible.

13.
Cureus ; 16(6): e61686, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38975386

RESUMEN

Ameloblastoma is an epithelial odontogenic tumor with a benign nature and demonstrates local aggressiveness. It frequently occurs between the third and fifth decades of life, showing significant gender predilection. While typically displaying a benign growth pattern, it tends to invade and sporadically metastasize locally. Ameloblastoma is predominantly found in the posterior regions. Periodic recur commonly follows insufficient treatment. Hence, conducting thorough identification of tumors and management is crucial to prevent relapse. Complications and improved prognosis are associated with meticulous surgical techniques, regular follow-up care, and early detection of recurrence. This study presented a report of a 19-year-old male with swelling in the left lower jaw, detailing its area of complaint, radiographic findings, histopathologic characteristics, and different treatment approaches. The uniqueness of the case is the hybrid histopathology of ameloblastoma composed of plexiform and desmoplastic variants.

14.
Int J Surg Case Rep ; 121: 110023, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38991367

RESUMEN

INTRODUCTION AND IMPORTANCE: Ameloblastoma is a benign but locally aggressive odontogenic tumor mostly occurring in the jaws. Ameloblastoma can be difficult to diagnose because it mimics other benign lesions. Its diagnosis requires a combination of imaging data, histopathological analysis, and molecular tests. Its treatment modality diverges from simple enucleation with bone curettage up to wide surgical resections. CASE PRESENTATION: A 25-year-old female presented with a right-sided mandibular mass for five years. Histopathology and radiology tests confirmed it to be an ameloblastoma. A hemimandibulectomy was done, followed by immediate reconstruction using an autogenously inserted iliac crest bone and a costochondral graft as an interposition graft for the lost part. The patient had a satisfactory clinical outcome, and no sign of recurrence after a follow-up of six months. CLINICAL DISCUSSION: The ideal management of ameloblastoma should minimize recurrence, restore function and appearance, and present minimal donor site morbidity. While the removal of a wide part of the bone and soft tissue leads to defects that may cause functional and aesthetic concerns, conservative management is associated with minimal downtime but high recurrence rates. Reconstructive surgery is of paramount importance for the recovery of the lost parts in these patients. CONCLUSION: Radical surgery is the treatment of choice for large tumors to minimize recurrence, and immediate reconstruction utilizing grafting techniques is essential to restoring function and appearance. The autologous bone graft technique is satisfactory for immediate mandibular reconstruction as it represents a simple, easy, less costly, and reliable method for restoring mandibular continuity defects.

16.
Saudi Dent J ; 36(7): 990-994, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39035567

RESUMEN

Background: The current study aims at investigating gap junctions which allow cells to connect with one another. Such process is essential for cell differentiation and the preservation of diverse cell functions. It is noticeable that connexin 43 (Cnx43) was differentially expressed in ameloblasts and odontoblasts in the processes of odontogenesis. Moreover, in carcinoma in situ (CIS) and oral squamous cell carcinoma (SCC), Cnx43 expression apparently thought to be a defining feature of the neoplastic state of squamous epithelial cells. Aim: Therefore, the study has postulated that Cnx43 may be involved in the pathophysiology of ameloblastoma and certain odontogenic cysts whose epithelial constituents exhibit squamous cells. Materials and methods: In order to prove the foregoing hypothesis, the study explored the immunohistochemical profiles of Cnx43 in ameloblastoma as well as some odontogenic cysts to assess Cnx43 trafficking and its relation with characteristic tissue architectures of odontogenic lesions. Results: The study has concluded that Cnx43 was down regulated significantly in follicular ameloblastoma with obvious ameloblasts-like cell components as well as in odontogenic keratocyst with palisaded basal cells. Additionally, other patterns of ameloblastoma (plexiform and desmoplastic) and different types of odontogenic cysts manifest heavy trafficking for Cnx43. Conclusion: Finally, altered Cnx43 expression between various patterns of ameloblastoma and odontogenic cysts might be related to their pathogenesis and is responsible for their morphological diversity.

17.
Oral Maxillofac Surg ; 2024 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-39060850

RESUMEN

BACKGROUND: This research aimed to investigate the concordance between clinical impressions and histopathologic diagnoses made by clinicians and artificial intelligence tools for odontogenic keratocyst (OKC) and Odontogenic tumours (OT) in a New Zealand population from 2008 to 2023. METHODS: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OKCs and OT. Specimen referral details, histopathologic reports, and clinician differential diagnoses, as well as those provided by ORAD and Chat-GPT4, were documented. Data were analyzed using SPSS, and concordance between provisional and histopathologic diagnoses was ascertained. RESULTS: Of the 34,225 biopsies, 302 and 321 samples were identified as OTs and OKCs. Concordance rates were 43.2% for clinicians, 45.6% for ORAD, and 41.4% for Chat-GPT4. Corresponding Kappa value against histological diagnosis were 0.23, 0.13 and 0.14. Surgeons achieved a higher concordance rate (47.7%) compared to non-surgeons (29.82%). Odds ratio of having concordant diagnosis using Chat-GPT4 and ORAD were between 1.4 and 2.8 (p < 0.05). ROC-AUC and PR-AUC were similar between the groups (Clinician 0.62/0.42, ORAD 0.58/0.28, Char-GPT4 0.63/0.37) for ameloblastoma and for OKC (Clinician 0.64/0.78, ORAD 0.66/0.77, Char-GPT4 0.60/0.71). CONCLUSION: Clinicians with surgical training achieved higher concordance rate when it comes to OT and OKC. Chat-GPT4 and Bayesian approach (ORAD) have shown potential in enhancing diagnostic capabilities.

18.
Oman Med J ; 39(2): e607, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38988797

RESUMEN

Objectives: Ameloblastoma, comprising approximately 11% of all odontogenic tumors, is a locally aggressive tumor with a high recurrence rate. This study aimed to assess the immunohistochemical expression of Ki-67 and p53 and their association with clinical and pathological factors among patients with ameloblastoma. Methods: Retrospective follow-up data of patients histologically confirmed with ameloblastoma at Makerere College of Health Sciences in Kampala, Uganda from January 2012 to December 2018 were retrieved. Factors associated with Ki-67 and p53 immunohistochemical expression were determined using one-way one-way analysis of variance. Chi-square and Fisher's exact statistical tests were used to assess factors associated with recurrence. A two-tailed p < 0.05 was considered statistically significant. Results: A total of 40 patients confirmed histologically with ameloblastoma were included in the analysis. The majority (62.5%) of cases were of the conventional type of ameloblastoma. The expressions of Ki-67 and p53 were 52.5% and 85.0%, respectively. Recurrence was found in 47.5% of patients and it was associated with conventional histological type (p=0.042), segmental resection (p < 0.001), tumor size (p < 0.001), and high p53 expression (p=0.041). Conclusions: Almost half the cases in this study had recurrence. The immunohistochemical expression of p53 was significantly higher than that of Ki-67.

19.
J Dent (Shiraz) ; 25(2): 125-131, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38962075

RESUMEN

Statement of the Problem: Paxillin (PXN) is one of the proteins involved in cell adhesion. PXN and integrins constitute a key site for the focal adhesion between the cell and extracellular matrix. Several studies have shown that PXN is a factor in tumor formation, progression, invasion, and metastasis. Purpose: This study evaluated PXN expression in four types of odontogenic lesions with different aggressive behaviors. Materials and Method: In this retrospective cross-sectional study, PXN expression was immunohistochemically assessed in 68 paraffin-embedded tissue samples from patients with the confirmed diagnosis of four types of odontogenic lesions, including 14 dentigerous cysts (DC), 20 odontogenic keratocyst (OKC), 16 unicystic ameloblastoma, and 18 solid ameloblastoma. The PXN expression in these samples were scored based on the percentage and intensity of immunoreactivity, and compared among the groups by Chi-square test. Results: The PXN marker was detected in the cytoplasm of tumor cells (unicystic and solid ameloblastoma) and the epithelial layer of cysts (DC and OKC). The intensively stained marker of PXN was observed in 9 cases (64.3%) of the DC, 14 cases (70%) of OKC, 12 cases (75%) of unicystic ameloblastoma, and 13 cases (72.2%) of solid ameloblastoma. However, there was not statistical difference of PXN protein expression between DC and OKC (p Value = 0.51) and unicystic and solid ameloblastoma (p = 0.58), also the same was true for cysts and tumors (p = 0.37). Conclusion: The expression of PXN is not related to the biological behaviors of odontogenic lesions.

20.
Head Neck Pathol ; 18(1): 65, 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39073499

RESUMEN

Adenoid ameloblastoma is a newly recognized epithelial odontogenic tumor. Herein, we present the case of a 24-year-old male patient who exhibited swelling in the anterior region and right hemi-mandible. Computed tomography demonstrated the presence of a hypodense osteolytic lesion associated with an impacted tooth. Based on the clinical hypotheses of the dentigerous cyst, odontogenic keratocyst, and ameloblastoma, an incisional biopsy was performed, and the diagnosis of ameloblastoma was rendered. A surgical resection of the tumor was performed. Histopathological examination of the specimen revealed typical areas of ameloblastoma associated with ductiform structures and cell proliferation in a solid storiform pattern, features resembling those found in adenomatoid odontogenic tumor. Based on these findings, the diagnosis of adenoid ameloblastoma was rendered. The accurate diagnosis of this locally infiltrative tumor is essential due to its similarity to other odontogenic neoplasms.


Asunto(s)
Ameloblastoma , Neoplasias Mandibulares , Humanos , Masculino , Ameloblastoma/patología , Adulto Joven , Neoplasias Mandibulares/patología , Tumores Odontogénicos/patología
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