牙源性角化囊肿的生长与行为

牙源性角化囊肿(ｏｄｏｎｔｏｇｅｎｉｃｋｅｒａｔｏｃｙｓｔ,ＯＫＣ)由Ｐｈｉｌｉｐｓｅｎ[1]于1956年最先报道,是一种好发于下颌磨牙升支部的颌骨囊肿。纤维囊壁内衬较薄的角化复层鳞状上皮,常由5～8层细胞组成,表层一般为皱折状不全角化,基底细胞呈柱状或立方状,胞核呈栅栏状排列且远离基底膜[1]。与其他类型的牙源性囊肿不同,ＯＫＣ的生长缺乏自限性,具有某些肿瘤的特征;术后有较高的复发倾向;内衬上皮可发生瘤变、甚至癌变;还可与痣样基底细胞癌综合征(ｎａｅｖｏｉｄｂａｓａｌｃｅｌｌｃａｒｃｉｎｏｍａｓｙｎｄｒｏｍｅ,ＮＢＣＣ…     

角化囊肿癌变临床病理特征

目的 研究和探讨角化囊肿（ＯＫＣ）癌变的临床与组织病学特征。方法 对２２６例ＯＫＣ临床病理资料进行研究分析,采用增殖细胞核抗原ＰＣＮＡ单克隆抗体对单囊和多囊性ＯＫＣ进行免疫组化反应。结果 ２２６你ＯＫＣ中,６例（２．６５％）ＯＫＣ发生癌变。癌变病例临床特征是：①骨腔充满病变组织,类似实体肿瘤。②癌变病例全部为多囊性,单囊ＯＫＣ未见癌变。③囊壁衬里上皮异常增生,侵袭性生长,可见异常核分裂,呈典型鳞癌     

A comparative immunohistochemical analysis of cortactin in orthokeratinized odontogenic cyst (OOC), sporadic odontogenic keratocyst (OKC), and syndromic OKC

ObjectivesTo evaluate and compare the immunohistochemical expression of cortactin in the epithelial lining of orthokeratinized odontogenic cyst (OOC), sporadic odontogenic keratocyst (OKC), and syndromic OKC.MethodsFormalin-fixed paraffin-embedded tissue blocks of histopathologically diagnosed cases of OOC, OKC, syndromic OKC, normal buccal mucosa (NBM), and oral squamous cell carcinoma (OSCC) were examined for immunohistochemical expression of cortactin. Clear brown cytoplasmic and membranous staining was considered positive.ResultsA statistically significant difference was observed between OOC and syndromic OKC (p < 0.001), as well as between sporadic OKC and syndromic OKC (p < 0.001). Although not statistically significant, the expression of cortactin was slightly higher in the basal layer of NBM (mean = 0.47), OOC (mean = 0.27), sporadic OKC (mean = 0.47) syndromic OKC (mean = 1.53), and OSCC (mean = 0.67) than in the parabasal layers of NBM (mean = 0.27), OOC (mean = 0.20), sporadic OKC (mean = 0.47), syndromic OKC (mean = 1.27), and OSCC (mean = 0.60).ConclusionThe expression of cortactin in the basal layer may suggest the formation of invadopodia in the basal layer where the invasion mechanism occurs. This finding is further supported by the higher localization of cortactin in areas of epithelial budding and daughter cysts in syndromic OKC, thereby reaffirming its possible association with recurrence.     

快速上颌扩展对颌骨和牙齿的影响

快速上颌扩展是一种常用的矫治上颌横向宽度不调的方法。本文结合近年来的国内外文献就快速上颌扩展对颌骨和牙齿影响方面的研究进展进行了回顾和总结,以期为快速上颌扩展的临床应用和研究提供参考。     

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.

Clinical and histopathological study of simus lift procedure

Sixteen sinuses of 11 patients performed by sinus lift procedure were retrospectively discussed clinically and histopathological investigations from grafted materials. Grafted materials were 10 autogenous bones harvested from 1 iliac crest and 9 chin bones, 1 non-resorbable hydroxyapatite plus mandibular alveolar ridge bone, and 1 mixed of resorbable hydroxyapatite plus human freezed dry bone. Histopathological investigation on several small speciemens taken from grafts of these different materials was performed. New bone formation, small amount of bone resorption and fibrous encapsuling tissue were observed for autogenous bone graft, but new bone formation was delayed around non-resorbable hydroxyapatite particles, and most of all grafted specimens of human freezed dry bone was replaced and encapsulated by fibrous tissues. These results showed that autogenous bone is highly recommended as graft material for sinus lift procedure. Endosseous implants were placed for 8 patients in the first group after an average period of 9.2 months of elevation, and for 2 patients in the second group at the time of elevation. One patient in the third group received a second sinus elevation to prevent maxillary sinusitis by perforating through maxillary sinus membrane following the installation. The survival rate of dental implants with sinus lift procedure was 94.1% after fabrication of prosthesis without any complication.