Ultrastructure of odontogenic jaw cysts

The epithelial ultrastructure of six radicular cysts, four follicular cysts, and five keratocysts was studied with special attention to the epithelium-connective tissue junction, Inflammation was found to cause widened interepithelial cell spaces which often harbored inflammatory cells in the radicular and follicular cysts. The characteristic structures at the epithelium-connectivc tissue junction (plasma membrane, lamina lucida and basal lamina) were not affected by inflammation. Fibrous structures were seen to connect the basal lamina to the underlining collagenous connective tissue The keratocyst specimens, however, showed juxtaepithelial collagenolysis that was not associated with the degree of inflammation. Desmosomes were rare in the inflamed keratocysts' spinous layer but the cell-to-cell interactions still appeared close. Inflammatory cells were not detected within epithelium of the keratocyst specimens.     

Anaerobic bacteria in jaw cysts

The bacterial flora of the fluid content of 54 cysts of the jaws with a history suggestive of infection were studied. Forty-seven of these cysts were subsequently considered to be infected and from 78.6% of these, positive bacterial cultures were developed. Of the bacterial strains 89.2% were anaerobes and only 10.8% were pure aerobes or facultative anaerobes. Microorganisms isolated from each specimen ranged from 1 to 4 bacterial species. Gram positive anaerobic cocci revealed to be the most frequent bacterial group (36.9%), followed by Gram negative anaerobic rods (29.8%), Gram positive aerobic cocci being the third most common group of the isolates (19.0%). Antibiotic sensitivity tests of the isolated anaerobic cocci to a group of nine antibiotics revealed chloramphenicol and minocycline as the most effective. All anaerobic rods tested, were sensitive to metronidazole.     

Ultrastructure of odontogenic jaw cysts

The epithelial ultrastructure of six radicular cysts, four follicular cysts, and five keratocysts was studied with special attention to the epithelium-connective tissue junction. Inflammation was found to cause widened interepithelial cell spaces which often harbored inflammatory cells in the radicular and follicular cysts. The characteristic structures at the epithelium-connective tissue junction (plasma membrane, lamina lucida and basal lamina) were not affected by inflammation. Fibrous structures were seen to connect the basal lamina to the underlining collagenous connective tissue. The keratocyst specimens, however, showed juxtaepithelial collagenolysis that was not associated with the degree of inflammation. Desmosomes were rare in the inflamed keratocysts' spinous layer but the cell-to-cell interactions still appeared close. Inflammatory cells were not detected within epithelium of the keratocyst specimens.     

The nevoid basal cell carcinoma syndrome--Gorlin's syndrome. Multiple jaw cysts and skin cancer

The nevoid basal cell carcinoma (NBS) syndrome with its characteristic multiple cysts of the jaws and skin cancer is of great interest to the dentist, the dermatologist and the oncologist. The dentist may have the opportunity of making an early diagnosis as the multiple cysts appear mostly in the ramus of the lower jaw. There is a great risk of recurrence as surgical removal is often very complicated. The disease is hereditary and is transmitted through females. The skin cancer can in most cases be treated surgically. It is essential that the family with the syndrome is investigated regularly and at periods of about six months.     

Lipoproteins in fluid from non-keratinizing jaw cysts

abstract — Forty-seven cyst fluids and autologous sera were examined for lipoproteins (LP) by cellulose acetate membrane (GAM) electrophoresis, immunoelectrophoresis and quantitative analyses for β-lipoprotein and cholesterol. By CAM electrophoresis all cyst fluids showed β-LP and β-LP bands but no pre-β-LP band. Four cyst fluids exhibited an additional, well-defined lipid-staining band located within the y-globulin zone (post-β-band). The relative amount of β-LP was higher in cyst fluid than in serum. Single radial immunodiffusion showed that the content of β-LP was low. On an average, cyst fluid contained more cholesterol than did serum. Some cyst fluids were particularly rich in cholesterol. It is hypothesized that the cholesterol is derived partly from β-LP originating from plasma.     

Proteins in fluid from non-keratinizing jaw cysts

Abstract. Contents of IgG, IgA and IgM in the fluids from 45 non-keratinizing jaw cysts, and of albumin, α₁-acid glycoprotein (orosomucoid), α₁-antitrypsin, α₂-macroglobulin, ceruloplasmin, C3 (C3/C3c-globulin), and transferrin in 15 of these cyst fluids have been determined by single radial immunodiffusion. In addition, cystic "fibrinogen" was measured in 37 cyst fluids. The mean ratios of IgG:IgA:IgM were for cyst fluid 20.1:4.8:1 and for the autologous serum 14.6:2.5:1. On the average, cyst fluid contained IgG, IgA and IgM in concentrations 1.2, 1.7 and 0.9 times, respectively, that of autologous serum. These ratios as well as data obtained from other calculations indicate partly local synthesis of cyst fluid immunoglobulins, mainly IgA and IgG. Remarkably high IgA levels were found in some cyst fluids. In apical periodontal cyst fluid there was a highly statistically significant positive correlation ( P <0.001) between the concentrations of IgG and IgA. No statistically significant differences were found between the Ig quantities in fluid from apical periodontal, follicular and residual cysts. The non-immunoglobulin proteins other than fibrinogen, which is structurally altered when present in cyst fluid, occurred in lower concentrations than in autologous serum. Cyst fluid to autologous serum concentration ratios (C_CF/C_S ratios) for the different proteins have been calculated. Considerably higher C_CF/C_S ratios were found for immunoglobulins than for non-immunoglobulin proteins with similar molecular weights. The implications of the findings for cyst wall permeability and clearance of proteins in cyst fluid arc discussed.     

Glycoproteins in fluid from non-keratinizing jaw cysts

abstract – Fluid from 47 non-keratinizing jaw cysts and autologous serum were separated by electrophoresis on cellulose acetate membranes and stained for glycoproteins. All cyst fluids contained glycoproteins, but the separation patterns differed from those of serum. The major carbohydrate-bearing fractions of cyst fluid migrated with a₂- and γ-globulins, while in serum a₂- and β-glycoproteins contained most bound carbohydrates. The appearance of the γ-globulin patterns indicated local synthesis and accumulation of cyst fluid γ-globulins. The other glycoproteins most likely had escaped from plasma. Electrophoretograms of cyst fluid stained for glycosaminoglycans revealed that cystic glycoproteins often were complexed with glycosaminoglycans, causing more or less distorted separation patterns.     

Proteins in fluid from non-keratinizing jaw cysts

Abstract. Fluid from 41 non-keratinizing jaw cysts was examined by cellulose acetate membrane (CAM) electrophoresis. Improved separation with more regular protein profiles was obtained after digestion with bovine testicular hyaluronidase of two cyst contents exhibiting pronounced viscosity. CAM electrophoretograms of cyst fluid and serum contained the same protein fractions, with the exception of the β₂globulin band which was clearly demonstrated in only one cyst fluid, that from a median palatine cyst. Quantitation by scanning of the CAM eleclrophorelograms yielded contents of albumin, α₁-, and α₂-globulins which usually were proportionately lower in cyst fluid than in autologous serum while the β₁-globulin fraction was roughly similar. Relative concentrations of γ-globulins were significantly higher in cyst fluid than in autologous scrum, rising to as much as 56% of the total cyst fluid protein content. The γ-globulin band of cyst fluid generally was broad-based ("polyclonal" pattern). Within these broad γ-zones discrete, narrow, but well demarcated bands were occasionally seen ("oligoclonal" pattern). One cyst fluid exhibited a narrow-based γ-globulin band ("monoclonal" pattern). The electrophoretic patterns as well as other observations provide indirect evidence for the view that the bulk of the cyst fluid proteins are derived from the plasma and indicate that the γ-globulin fraction is a mixture of extravasated arid locally produced immunoglobulins.     

Proteins in fluid from non-keratinizing jaw cysts

Abstract. Fluids from 32 non-keratinizing jaw cysts were examined by polyacrylamide gel disc electrophoresis, and by immunoelectrophoresis and double diffusion in agar against rabbit anti-human serum and rabbit antisera monospecific for six different plasma proteins. Albumin, α₁-antitrypsin, α₁-acid glycoprotein (orosomucoid), transferrin, IgG, IgA, and IgM were invariably recognized. Most cyst fluids also reacted with antiserum to α₁-lipoprotein, α₂-macroglobulin, β₁ C/β₁A-globulin (C3/C3c), and fibrinogen. Cyst fluid "fibrinogen" which showed somewhat slower electrophoretic migration than plasma fibrinogen, appeared as two precipitin bands or as one line with an apparently split cathodic end. Two cyst fluids exhibited one additional "fibrinogen" line located in the α₁-globulin region. C3, which was not detected in all cyst fluids, displayed an electrophoretic mobility between that of β₁C- and β₁A-globulin of serum. In two cases an even faster C3 subtraction appeared. Double diffusion gave a "reaction of identity" between albumin and the α- and β-globulins of cyst fluid and autologous scrum. Cystic "fibrinogen" and fibrinogen of human plasma gave a "reaction of partial identity". These findings indicate that albumin and the main α- and A-globulins of fluid from non-keratinizing jaw cysts are derived from plasma and that breakdown products of fibrinogen or fibrin are also present. High levels of IgG and IgA, but decreased amounts of α₂-macroglobulin and C3 as compared to autologous serum are also suggested.