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The Korean Journal of Pathology 1981;15(2): 100-109.
악골낭종의 병리조직학적 연구
Histopathological Study of the Jaw Cysts
Due to the facts that epithelial rests are frequently found in jaw bones and the jaw bones are vulnerable to trauma and infection which would stimulate to proliferate epithelial rest, occurrence of various types of cysts in jaw bones is not infrequently found. However, confusion exists in classification and terminology of the jaw cysts because of uncertainty of histogenesis of the cysts. Present study is, therefore, aimed to find the most rational classification of the jaw cysts with consideration of histopathologic features, clinical characteristics, and review of literatures. The material used in this stuffy consist of 70 cases of the jaw cysts examine at the Department of Pathology Yonsei University College of Medicine for ten year period from 1970 to 1980. All specimens were fixed in 10% neutral formalin. For histologic examination, paraffin embedded blocks were cut in 6 micron thickness and sections were stained by routine Hematoxylin-Eosin method. Classification recommended by World Health Organization in 1971 and description of Robinson in 1975 was applied. Each cases were analysed with clinical, radiological and histopathological findings. 1) Of the total 70 cases, 52(74.3%) were inflammatory periodontal cyst, and 18(25.7%) were developmental cysts. The developmental cyst consisted of 13 cases of dentigerous cysts (18.6%), 3 cases of odontogenic keratocyst, one case of Primordial cyst, and one case of nasopalatine cyst. 2) The peak age incidence of periodontal cysts was in the fourth decade of life with a wide age range, and developmental cysts were usually found in the second and third decades. There was a slight male predominance with the male to female ratio being 4:3. 3) The most common location of periodontal cysts was on the anterior aspects of the maxilla, and the majority of dentigerous cysts occurred in association with impacted supernumerary teeth in the maxilla. Multiple cysts were found in 2 cases of odontogenic keratocysts. 4) The most common complaints were swelling and pain. Other symptoms included pus discharge, trismus and delayed eruption of tooth. 5) Histologic type of epithlium lining cysts showed mainly stratified squamous epithelium, and ciliated cells were found only in the nasopalatine cyst. Inflamed fibrous wall was found predominantly in inflammatory periodontal cysts. 6) Heterogenous histological features of dentigerous cysts showed keratinization in 3 cases, hyaline bodies and calcification in 2 cases and adenoameloblastoma in one case. Metaplastic mucous cells were found focally on the lining epithelium in 2 cases of dentigerous and one case of periodontal cysts. 7) One case of odontogenic keratocysts showed microcyst formation in the fibrous wall. It is considered that this finding is the histologic evidence of high recurrence rate of odontogenic keratocyst.
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