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由于颌骨内的成牙组织常可作为囊肿和肿瘤的组织来源,因此颌骨是人类骨骼中最好发上皮性囊肿和肿瘤的部位。这类牙源性病损好发于年轻人,可造成颌骨及邻近组织的破坏,导致口腔颌面部外形改变,某些侵袭性病损具有较高的复发倾向,可对患者的生存质量及心理健康造成严重影响。本文着重讨论几种常见的牙源性囊肿与牙源性肿瘤的病理学诊断。     

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牙源性囊肿与牙源性肿瘤是口腔颌面部较为常见的疾病。由于临床表现的多样性,易与其他类型的颌面部囊肿或肿瘤相混淆,而且不同类型的牙源性囊肿和肿瘤其治疗方案也有所区别,所以牙源性囊肿及肿瘤的术前诊断对于其治疗方案的选择起着关键的作用,而在其诊治的过程中,影像学检查起到了非常重要的作用;不同类型的牙源性囊肿及肿瘤的影像学表现也各具特征。本文对常见的牙源性囊肿(牙源性角化囊肿等)及肿瘤(成釉细胞瘤、恶性成釉细胞瘤等)的影像学表现结合实际的影像学图片作简单的介绍,比较各种影像学检查在上述疾病诊断中所具有的优点,以期望能将CT、MRI及全景片等影像学检查手段更好的运用于上述疾病的诊治中。     

Developmental odontogenic cysts. An update1

This review paper reports recent advances in the subject of developmental odontogenic cysts, essentially those of the past decade, starting with reference to the new WHO classification (1). On keratocysts, the latest reported recurrence rates are assessed as are their mode of growth, immunocytochemistry, immunology, genetic studies, and work on specific keratocyst antigens. There is a critical account of the group of lesions which includes the gingival cyst of adults, lateral periodontal cyst, hotryoid odontogenic cyst and glandular odontogenic cyst, and their possible relationship to one another. On dentigerous cysts, reference is made to the relationship between them and deciduous teeth, as well as to their immunocytochemistry and immunology. Recent work on the unicystic ameloblastomas. their classification and prognosis, is assessed, as is the calcifying odontogenic cyst and its relationship with solid odontogenic tumours.     

囊肿塞在颌骨囊肿开窗减压术中的应用

囊肿塞是颌骨囊肿进行开窗减压术治疗中常用的辅助治疗器具,近年来,随着材料和技术的发展,不同形式的囊肿塞层出不穷。本文回顾了目前临床常见囊肿塞的种类、制作方法及其适应证,探讨了各类囊肿塞在制作及应用过程中的优缺点。     

Histochemical studies on cholesterol formation in odontogenic cysts and granulomas

abstract — A histologic and histochemical study was made of 45 odontogenic periapical cysts and granulomas with cholesterol formation. The specimens were transported in Histocon® solution and sectioned by cold microtome. This technique permits the preservation of the lipids and rertains the enzyme activities in the cells. Cholesterol crystals seemed to be formed in disintegrating clots of red blood corpuscles in congested capillaries of the inflammatory areas. The pericytes of the vessel walls changed their enzyme activities, indicating increased lysosomal functions, and eventually formed giant cells with tissue degrading properties.     

Mast cells in human odontogenic cysts

Mast cells have been shown to be present in substantial numbers in both nonkeratinizing and keratinizing odontogenic cysts and could be seen in the connective tissue capsule and the epithelial lining. Within the cyst capsule, mast cells were more prevalent just beneath the epithelium than in deeper areas. This distribution pattern for mast cells is in accord with the histochemical picture for heparin staining in odontogenic cysts. In the non-keratinizing cysts, there appeared to be some trend towards mast cells being associated with increasing inflammation but not in the odontogenic keratocyst. No evidence could be found for distinct mast cell subpopulations in odontogenic cysts. The presence of mast cells in odontogenic cyst could contribute to their pathogenesis in several ways.     

Expression of transforming growth factor-beta 1 (TGF-beta 1) in odontogenic cysts

AIM: To evaluate the positivity to transforming growth factor-beta 1 (TGF-beta 1) in different types of odontogenic cysts. METHODOLOGY: A total of 30 radicular cysts (RCs), 27 follicular cysts (FCs) and 28 odontogenic keratocysts (OKCs) were evaluated for immunohistochemical analysis of TGF-beta 1. TGF-beta 1 was evaluated in blood vessels, stromal cells (fibroblasts) and pluristratified squamous epithelium. TGF-beta 1 expression was determined by evaluating the number of positive elements. TGF-beta 1 expression was determined by evaluating 1000 cells in the pluristratified squamous epithelium (500 in the basal and parabasal layers, and 500 in the superficial layer) and 500 cells (the fibroblasts in the stroma) for each specimen, and counting the number of positive cells. The number of positive vessels was evaluated in 10 high power fields (HPF). The Chi-square test was used to evaluate differences between the two groups (RC + FC and OKC). A P-value <0.05 was considered to indicate statistical significance. RESULTS: A higher and statistically significant positivity was found in the basal-suprabasal epithelial layers (P=0.0011), superficial epithelium (P=0.053) and stromal cells (P=0.0002) of orthokeratotic and parakeratotic OKC as compared with RC and FC. CONCLUSIONS: These differences suggest that control of the cell cycle may be abnormal in orthokeratotic OKCs. These OKCs may have an intrinsic growth potential not present in other cyst types.     

开窗减压配合囊肿塞治疗青少年颌骨囊肿的疗效分析

目的 分析开窗减压术配合囊肿塞治疗青少年颌骨囊肿的疗效。方法 收集整理2009年8月—2011年8月于我院口腔颌面外科行开窗减压术的青少年（13~20岁）颌骨囊肿患者（15例26个囊肿）病例资料,统计分析疗效。结果 15例患者中8例患者（53.3%）开窗效果良好,6例患者（40.0%）效果中等,1例患者（6.7%）效果不佳。93颗受累恒牙,70颗（75.3%）得以保存。结论 开窗减压术配合囊肿塞是一种有效的保守治疗青少年颌骨囊肿的方法。     

Epidermal growth factor receptor in odontogenic cysts and tumors

The expression of epidermal growth factor receptor (EGFR) was investigated in 67 cases of odontogenic cysts and 35 cases of odontogenic tumors using monoclonal antibody to EGFR (Biomarker, Israel) to determine the presence and significance of this transmembrane growth factor receptor. The cystic epithelial cells of odontogenic cystic lesions (keratocyst 60%; primordial cyst 75%; radicular cyst 35%; and follicular cyst 47.4%) were positive to EGFR staining. Cytochemical characterization of EGFR in those cystic epithelium was cell membrane positive type as in the normal epithelium. No expression of EGFR was found in the odontogenic tumors. This diversity of EGFR represents no binding activity of EGF, or loss of EGFR in the tumor cell upon EGFR mediated growth in odontogenic tumors was suggested a different tumor cell growth factor status or microenvironment in cell proliferation mechanism at the cellular level in cysts and tumors of odontogenic origin.