Retrospective analysis of 31 cases of nasopalatine duct cyst

OBJECTIVE: To perform a retrospective analysis of patients with nasopalatine duct cysts (NPDC) in Brazil and compare with previous analyses. MATERIALS AND METHODS: The files of the Laboratory of Oral Pathology (Minas Gerais Federal University) from 1966 to 1997 were reviewed. Demographic, clinical and histologic data of patients with nasopalatine duct cysts were collected. RESULTS: The mean age of patients with nasopalatine duct cysts at the time of diagnosis was 37.4 years and with a predilection for males. The majority of cases were asymptomatic. Histologically, non-keratinized stratified squamous epithelium alone or in combination with other epithelia was observed in 93% of the cases. Recurrence was not recorded. CONCLUSION: The demographic, histopathological, radiographic, and clinical data of the NPDC in our series are similar to previous studies in other populations.     

Extensive nasopalatine duct cyst causing nasolabial protrusion

In this report, we show a case of the extensive nasopalatine duct cyst showing remarkable nasolabial protrusion. CT and MR examinations showed remarkable expansion of the extraosseous part of the lesion toward anterior and lateral sides, and this finding is considered to show the rather aggressive nature of this common cystic lesion after penetration of the maxillary cortex.     

细胞角蛋白(CK)13在鼻腭囊肿衬里上皮中的表达及其意义

目的 研究细胞角蛋白(CK)13在鼻腭囊肿衬里上皮中变化的规律和其表达的意义.方法 对经临床和病理诊断的36例鼻腭囊肿的衬里上皮进行常规HE染色和免疫组化染色,检测CK13在鼻腭囊肿上皮中的表达.结果 CK13在鼻腭囊肿的纤毛上皮表达呈阴性;在纤毛柱状与鳞状上皮细胞的混合型上皮的中间层表达呈弱阳性;CK13在部分鳞状上皮的基底层、中间层或表层表达为阳性;鳞状上皮的全层呈强阳性.结论 在纤毛柱状上皮细胞中出现化生鳞状上皮细胞时,同时表达CK13;CK13随着纤毛柱状上皮向鳞状上皮化生程度的逐渐增强而逐渐增多;CK13可作为判断鼻腭囊肿上皮鳞状化生的标志和检测化生程度.根据纤毛柱状上皮向鳞状上皮化生过程中细胞形态的变化和CK13的表达,推测鳞状上皮细胞是由纤毛柱状上皮化生而来.     

Pigmented nasopalatine duct cyst. Report of 2 cases

Dendritic cells containing melanin pigment have been demonstrated in the epithelial lining of 2 pigmented nasopalatine duct cysts. The significance of this observation is discussed.     

Differential diagnosis of apical periodontitis and nasopalatine duct cyst

Introduction

An accurate differential diagnosis of apical periodontitis (AP) and nasopalatine duct cyst (NPDC) should be established to define the best treatment for endodontically treated maxillary anterior teeth with apical periodontitis. Three-dimensional cone beam computed tomography (CBCT) images help to plan treatment and to define an initial diagnostic hypothesis. However, endodontic treatment or retreatment may be unnecessarily prescribed when radiographs show a superimposition of the incisor foramen over the apex of maxillary central incisors, mimicking AP. Diseases of nonendodontic origin that affect the tooth apex, such as NPDC, should be included in the differential diagnosis.

Methods and Results

Four clinical cases of patients with large periapical radiolucencies and similar radiographic features are described. AP is usually a consequence of endodontic infection; in cases of NPDC, however, spontaneous epithelial proliferation, in addition to bacterial infection and trauma, may also contribute to cyst formation. The frequency and recurrence rates of NPDC are low, and its behavior is less aggressive. Surgical enucleation of the periapical lesion is recommended after nonsurgical treatment does not heal AP.

Conclusions

The use of new diagnostic tools, such as CBCT imaging, may provide detailed high-resolution images of oral structures, which help to make an initial diagnostic hypothesis and to plan surgery. Histopathology is mandatory for the differential diagnosis.     

Immediate dental implant failure associated with nasopalatine duct cyst

This case report presents an analysis of the clinical, radiographic, and histological features of a peri-implant lesion around an implant placed immediately after extraction of a tooth with a periapical lesion. A 52-year-old man received an immediate implant (3.75 x 11.5 mm2) placed in the anterior region of the maxilla. Three years after implant placement, the patient presented with swelling in the anterior portion of the maxilla. Radiographic examination showed a well-circumscribed radiolucency around the implant. The implant and the lesion were removed and fixed in 10% buffered formalin and processed. Histological analysis showed 3 types of epithelium: respiratory, cuboidal, and non-keratinized stratified squamous. In the cyst wall peripheral nerves, arteries, veins, and chronic inflammation were present. The diagnosis was nasopalatine duct cyst. We concluded that the nasopalatine duct cyst can develop in association with dental implants. Clinically, the lesion is similar to the classical nasopalatine duct cyst. Histological analysis should be mandatory in all cases of peri-implant lesions and in all dental periapical lesions before immediate implant placement.     

Diagnostic dilemma: an unusual presentation of an infected nasopalatine duct cyst

The pertinent literature on nasopalatine duct cysts is reviewed. A case is reported in which a nasopalatine duct cyst infected by Actinomyces presented clinically with unusual features. The clinical findings could have been confused with an early acute periapical abscess arising from an incisor tooth. The relevant aspects of diagnosis are discussed.     

Cysts of the nasopalatine duct

Nasopalatine duct cysts in 70 patients were reexamined clinically and radiographically. 50 of them were also reexamined histopathologically. 20 specimens of normal duct tissue were likewise examined. More than half of the cysts showed clinical symptoms. The form on the radiograph was usually spherical or oval. Only 1 of 5 cysts was heart-shaped; 1 of 10 was unilateral. The mesiodistal width of the cysts ranged from 4-40 mm, with 75% from 6-12 mm. 3 of 4 showed pronounced radiolucency. Every 2nd cyst was completely surrounded by a thin radiopaque border. The histopathological investigation showed small cysts to be present in 1 of 4 clinically and radiographically normal nasopalatine ducts. More than 1 of 4 clinically and radiographically diagnosed cysts lacked histopathological characteristics of a cystic cavity. The type of epithelium in the cysts was independent of the vertical position in the duct.     

Patent nasopalatine duct: a diagnostic pitfall

We describe a patient in whom the combination of excessive air in the maxillary sinus and the presence of a patent nasopalatine duct led to misdiagnosis and subsequent treatment of a non-existent oroantral perforation. When a radiograph indicates that antral involvement during removal of a maxillary molar is unlikely, and yet a routine postoperative nose-blowing test contradicts this, the possible presence of a pre-existent oronasal communication such as a patent nasopalatine duct should be considered.     

切牙管应用解剖研究

目的 :测量切牙管及邻近骨性结构 ,为切牙区种植体植入提供参考依据。方法 :以游标卡尺等测量工具对 73例上颌骨标本的切牙管进行实体定量测量。结果 :(1)切牙管前壁与鼻底平面交角 :114 .80°±11.0 0° ;(2 )上前牙槽骨前壁与鼻底平面交角 :10 7.2 8°± 10 .75° ;(3 )切牙管长度 :男性为 (15 .63± 2 .18)mm ,女性为 (14 .5 9± 1.96)mm ;(4 )切牙管鼻腔开口宽径 :男性为 (4 .92± 1.46)mm ,女性为 (5 .73± 1.5 0 )mm ;切牙管口腔开口宽径 :男性为 (3 .2 3± 0 .60 )mm ,女性为 (3 .83± 0 .92 )mm。 (5 )在鼻底平面 ,切牙管前壁与上前牙槽骨前壁距离 :(6.15± 1.90 )mm。结论 :切牙管区种植体植入方向应与切牙管平行 ,与鼻底平面成约 115°角 ;切牙管前部牙槽骨较薄 ,宜植入直径为 4mm以下的种植体。     

Use of gutta percha cores in CT scan imaging for patent nasopalatine duct

Gutta percha cores were inserted in nasopalatine ducts to improve their visualization on CT scans. This simple method enhances the diagnostic quality of these images so that surgery can be performed more precisely.     

Endodontic considerations of the nasopalatine duct region

Although rare, anomalies of the nasopalatine region have been reported in the literature mimicking pathoses of endodontic origin. The purpose of this article is to present a case of a patent nasopalatine duct that was originally diagnosed as a sinus tract and referred for endodontic therapy. A review of the anatomy of the nasopalatine region is also discussed.     

38例切牙管囊肿的X线三维影像学分析

目的利用螺旋CT和锥形束CT分析上颌切牙管囊肿的三维影像学特点。方法收集2012年12月至2018年1月于我院就诊的有完整临床资料、病理诊断及螺旋CT或锥形束CT影像的上颌切牙管囊肿患者38例,分析其影像学特点。结果 38例中男性28例,女性10例,年龄13～77岁。26例(68.4%)囊肿位置居中,12例偏左或偏右。囊肿矢状面形态包括轻度扩张型(8例)、全程膨隆型(17例)、区段膨隆型(12例)和移位扩张型(1例)。30例(78.9%)腭侧骨板膨隆,27例(71.1%)累及牙根周围骨质,11例(28.9%)存在根吸收。结论切牙管囊肿以位于切牙管走形范围内的典型低密度形态常见,少数可偏侧发展,甚至主体偏离切牙管。多数病变腭侧骨板膨隆,累及邻牙根周。     

Diagnosis and surgical management of nasopalatine duct cysts

ABSTRACT: Nasopalatine duct cyst also known as nasopalatine cyst is a developmental, epithelial, non-neoplastic cyst that is considered to be the most common nonodontogenic cyst in the maxillofacial region. It is one of the many pathologic processes that may occur within the jaw bones, but it is unique in that it develops in only a single location-in the midline anterior maxilla. Nasopalatine cysts are usually asymptomatic and may be discovered during routine clinical and/or radiologic examination. The current study reports 18 cases of nasopalatine duct cyst that were diagnosed and treated at the Department of Oral and Maxillofacial Surgery at Ramadi Teaching Hospital, Anbar Province, Iraq. A correct diagnosis can only be made after proper clinical, radiographic, and histopathologic examination.     

A nasopalatine cyst in an 8-year-old child

The nasopalatine cyst (NPC) was first described in 1914 and it is considered the most common non-odontogenic cyst. Most studies show a higher incidence of NPC among males than females, with a male/female ratio of 1·7:1. The majority of the cases described in people in their fifth decade involve Afro-Caribbeans, while those in their sixth decade are mainly caucasians. These cysts are normally asymptomatic, unless they are infected. The most commonly reported clinical symptom is swelling in the anterior part of the palate. The treatment of choice is enucleation.
  Even though it has been stated that NPCs may occur at any age no reports have been made on children less than 9 years old. Some reports support a predisposition in young Afro-Caribbeans, where NPCs appear to be more aggressive, larger and symptomatic. We present a case of a NPC in an 8-year-old caucasian female.     

Clinical and histopathological features of nasopalatine duct cyst: A 47-year retrospective study and review of current concepts

Purpose

To evaluate the clinical and histopathological features of nasopalatine duct cysts (NDCs) stored in the archives of a referred Oral Pathology Service over a 47-year-period, and to review current concepts about these cysts.