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A case report is presented describing bilateral dens invaginatus of the maxillary lateral incisors. Pulpal disease of the lateral incisors resulted in radicular cysts with the right cyst expanding to cause the eventual loss of four teeth. Removal of the cysts was followed by normal healing. Early detection of the bilateral dens invaginatus might well have resulted in successful interceptive care.
AIM: As CD57 antigen is an important modulator of the immune system, the purpose of the present study was to compare the expression of this antigen on radicular cysts (RC) with hyperplastic or atrophic epithelium. METHODOLOGY: Twenty cases of RC were retrieved and classified as atrophic or hyperplastic. A biotin-streptavidin amplified system was used for identification of the CD57 receptor. RESULTS: The results demonstrated a greater percentage of CD57+ cells in RC with atrophic epithelium compared to hyperplastic epithelium. CONCLUSION: As the expression of CD57 is indicative of immunosuppression, it may constitute a negative immunomodulator of RC's epithelium growth. Further studies are necessary to understand the importance of this cell to the biological activity or inactivity of RC's epithelium development.
The purpose of this investigation was to study periapical lesions by means of computerized tomography to ascertain if this noninvasive method could be of value in distinguishing between radicular cysts and granulomas. Periapical radiographs were taken of the teeth of 60 human cadavers. Periapical radiolucencies were seen in conjunction with 33 teeth. Based on the periapical radiographs, an oral radiologist (J.P.) attempted to select 4 granulomas and 4 cysts from the 33 radiolucencies. Computerized tomography was performed on the root tips and the periapical lesions of these 8 teeth. The roots and periapical lesions were then surgically removed and prepared histologically for microscopic examination. In the tomographs, 7 of the periapical lesions had a cloudy appearance with a density similar to each other and to the surrounding soft tissue. In the eighth lesion a homogeneous dark area with a distinctly lower density could be distinguished from surrounding cloudy areas. Histologically, the dark area was shown to be an epithelialized cyst cavity. The other 7 lesions were granulomas. Thus, a cyst could be differentiated from periapical granulomas by computerized tomography because of a marked difference in density between the content of the cyst cavity and granulomatous tissue.
Cytokines released by immune system cells play an important role in cyst enlargement. This study aimed to determine, by ELISA, the levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin 3 (IL-3), and IL-6 in fluid and tissue from human radicular cysts. GM-CSF was found in 42.8% of the fluid samples (164.3 pg/mL) and IL-6 in 92.8% (641.4 pg/mL). No IL-3 was detected in any fluid samples. In the tissue samples, 28.6% were positive for IL-3 (369.2 pg/mL), 86.4% for IL-6 (92.4 pg/mL), and 95.8% for GM-CSF (200.5 pg/mL). It can be concluded that GM-CSF and IL-6 were widely found in the fluid and tissue samples. In contrast, IL-3 was found only in the cystic tissue, even though in few lesions. These cytokines may contribute to the inflammation, cystic growth, and bone resorption that characterize cystic lesions.
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