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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2020. Vol. 25, no. 6
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- Immediate post-extraction implants placed in acute periapical infected sites with immediate prosthetic provisionalization : a 1-year prospective cohort study(2020) Muñoz Camara, Daniel; Gilbel Del Aguila, Osmundo Eustaquio; Pardo Zamora, Guillermo; Camacho Alonso, FabioFew studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with immediate prosthetic provisionalization in sockets with or without acute periapical pathology. A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p>0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p=0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year.
- Comparative expression of cyclooxygenase 2 and Ki67 in amelanotic and conventional oral melanomas(2020) Soares, Ciro Dantas; Hernández Guerrero, Juan Carlos; Andrade, Bruno Augusto Benevenuto de; Romañach, Mário José; Mosqueda Taylor, Adalberto; Carlos, Román; Macedo, Madja Ruanna Soares; Almeida, Oslei Paes de; Jorge, JacksOral melanomas have some histopathological resemblance with its cutaneous counterpart; however, an aggressive behavior is more common in tumors that occur in the oral cavity. Several markers have been suggested as indicative of tumoral progression and aggressiveness, such as cyclooxygenase 2 (COX-2) and Ki67. In this study, we have compared the expression of COX-2 and Ki67 in a series of amelanotic (n=7) and melanotic oral melanomas (n=22). The cases were selected from 4 pathology laboratories and submitted to the immunohistochemical (IHC) reactions. We analyzed the IHC staining based on a qualitative ? using visual scores; and a computer-assisted method (quantitative) using scanned slides and software for digital analysis. COX-2 was expressed in all oral melanomas; however, its intensity was significantly higher in the amelanotic ones (P<0.001). Similarly, a high Ki67-positivity index was observed in the amelanotic than melanotic ones (P<0.001). Based on these results, we suggest that amelanotic oral melanomas have marked pro-inflammatory and high-proliferative phenotype, justifying their more aggressive behavior compared with the melanotic ones.
- Analyses of odontogenic tumours : the most recent classification proposed by the World Health Organization (2017)(2020) Barrios-Garay, Kevin; Agudelo-Sánchez, Luisa-Fernanda; Aguirre Urizar, José Manuel; Gay-Escoda, CosmeThe fourth edition of the ??WHO Classification of Head and Neck Tumours?? was published in January 2017 and includes a classification of odontogenic tumours. This review aims to examine the changes made in this new classification in comparison with the previous classification of 2005. An electronic search was conducted in the PubMed, Scopus and Cochrane databases with the keywords ?odontogenic tumor?, ?WHO classification? and ?update?. Studies published from January 2009 to April 2019 with a high level of scientific evidence were included, but studies not published in English, epidemiological studies and studies with a low level of evidence were excluded. The initial search found 457 articles and after eliminating duplicates, 8 studies were selected for full-text assessment. After excluding 3 epidemiological studies, 5 articles were finally included. These studies were stratified by their level of scientific evidence using SORT criteria (Strength of Recommendation Taxonomy). The new odontogenic tumour list has been simplified with the objective of improving its role as an international guide for diagnosis. Some changes have been possible thanks to the application of immunohistochemistry and molecular genetic techniques that allow better characterization of certain tumours. Further clinicopathological and molecular studies are needed so that this new classification can be consolidated and/or amended.
- Effectiveness of salivary stimulation using xylitol-malic acid tablets as coadjuvant treatment in patients with gastro-oesophageal reflux disease : early findings(2020) Sánchez Blanco, Irene; Rodríguez Téllez, Manuel; Corcuera Flores, José Ramón; González-Blanco, Carolina; Torres Lagares, Daniel; Serrera Figallo, María Angeles; Machuca-Portillo, GuillermoBesides dental erosion syndrome, other oral syndromes could benefit from the stimulation of salivary secretion, in patients with gastro-oesophageal reflux disease (GORD). Our aims is evaluate the improvement of oral extra-oesophageal manifestations in patients with GORD using xylitol?malic acid tablets to stimulate salivary secretion. The effectiveness of salivary stimulation using xylitol?malic acid tablets (as a supplement to omeprazole 40 mg/day) was assessed in a clinical trial (n = 14) lasting six months with patients with prior positive pH-metry, through GORD extra-oesophageal clinical signs, GerdQ and RDQ questionnaires, odontological variables, basal salivary secretion, stimulated salivary secretion, pH and buffer capacity, mucosal erythema index and dental wear. Statistics: chi-square (Haberman post-hoc), ANOVA, and Mann-Whitney U; variables between visits were evaluated with McNemar?s Student?s t and Wilcoxon tests; p < 0.05. 100% of patients not taking xylitol?malic acid presented xerostomia, but only 14.3% of patients taking xylitol?malic acid (p < 0.01) did. The mean saliva-buffer capacity at the last visit for patients not taking xylitol?malic acid was 2.14 ± 0.38, versus 2.71 ± 0.49 for patients taking xylitol?malic acid (p < 0.05). Retro-sternal burning (p < 0.05), heartburn (p < 0.05) and regurgitation (p < 0.05) were also reduced. Xylitol?malic acid tablets improve quality of life among patients with GORD, by reducing dry mouth, increasing saliva buffering and reducing heartburn, retro-sternal burning and regurgitation.
- Influence factors of dental anxiety in patients with impacted third molar extractions and its correlation with postoperative pain : a prospective study(2020) Xu, Ji Liang; Xia, RongTo explore the prevalence of dental anxiety (DA) in patients with third molar extractions and its influence factors and the correlation between DA levels and postoperative pain. A prospective and descriptive clinical study was performed. All patients who underwent the impacted third molar extraction from October 2017 to February 2019 were enrolled. DA levels were assessed by virtue of the modified dental anxiety scale (MDAS) and pain was assessed with a visual analog scale (VAS). A total of 150 patients were investigated and 136 valid questionnaires were retrieved, with an effective rate of 90.7%. The independent sample t-test and ANOVA results showed that the anxiety level of patients with the third molar extractions was statistically different in gender, teeth extraction experience and self-assessment oral health status. Multiple linear regression analysis with DA as a dependent variable showed that gender and teeth extraction experience were independent factors influencing DA in patients with third molar extractions. Pearson's test showed that there was a significant correlation between DA level in patients and the postoperative pain on the first day (r=0.542, p=0.000). For patients (females, poor oral hygiene and no teeth extraction experience), surgeon should pay more attention to DA of such patients and take measures to reduce the anxiety when removing the third molars. Furthermore, surgeon can recommend oral administration ibuprofen sustained release capsules after surgery.
- A novel mobile application to determine mandibular and tongue laterality discrimination in women with chronic temporomandibular disorder(2020) Diaz-Saez, Marta Carlota; Gil Martínez, Alfonso; Iglesias González, Irene; Kim Lee, Jesús; Castillo Pardo de Vera, José Luis del; Cebrián Carretero, José Luis; Beltrán Alacreu, H.Chronic pain from temporomandibular disorders (TMDs) is caused by a somatosensory disturbance due to sustained activation of central nervous system nociceptive pathways, which can induce changes in neuroplasticity in the thalamus, basal ganglia and limbic system, as well as disturbances in the somatosensory, prefrontal and orbitofrontal cortex and cognitive impairment. The main objective of this study was to determine the discrimination capacity of mandibular and tongue laterality between women with chronic TMDs and asymptomatic women. This descriptive-comparative study examined 2 groups with a total of 30 women. All participants were between the ages of 23 and 66 years and were assigned to the chronic TMD group or the asymptomatic group according to the inclusion criteria. We employed a mobile application developed specifically for this study to measure the accuracy and reaction time (RT) of mandibular and tongue laterality discrimination. The chronic TMD group had a lower success rate in laterality discrimination (mean mandibular accuracy of 40% and mean tongue accuracy of 67%) than the asymptomatic group (mean mandibular accuracy of 61% and mean tongue accuracy of 90%). These results showed statistically significant differences between the groups for mandibular laterality discrimination (d, 1.14; p<0.01) and tongue laterality discrimination (d, 0.79; p=0.03). The asymptomatic group had faster RTs than the chronic TMD group. The data revealed statistically significant differences for the right mandibular RT (d, 0.89; p=0.02) and right tongue RT (d, 0.83; p=0.03). However, there were no significant differences for left mandibular and left tongue RT. We found that the women with chronic TMDs had a lower success rate and slower RTs in the discrimination of mandibular laterality when compared with the asymptomatic women.
- Professional diagnostic delay in osteosarcomas of the jaws(2020) Waal, Isaäc Van derA series of 20 consecutive patients with an osteosarcoma of the jaws has been evaluated with regard to possible professional diagnostic delay. When set at an arbitrarily chosen period beyond three months, professional delay occurred in 15 patients, the mean being 21 months and the median 11 months. In five of the 15 patients a wrong diagnosis has been rendered on the biopsy specimen, being fibrous dysplasia (2x), osteoma (2x) and, in case of palatomaxillary swelling, pleomorphic adenoma (1x). In the other ten patients the initial clinicoradiographic features were misleading and apparently not indicative of a malignancy, except for one patient in whom a distinct widening of the periodontal ligament, as expressed on a periapical film, has been overlooked or not properly interpreted. It has not been possible to assess the possible influence of the delayed diagnosis on the prognosis.
- Validation of the oral health impact profile - 14 in patients with head and neck cancer(2020) Tesic, Milan; Cankovic, Milos; Jevtic, Marija; Stevanovic, DejanThe Oral Health Impact Profile-14 (OHIP-14) was designed to assess patients? perception of the impact of oral disorders on their quality of life (QoL). Although the OHIP-14 is now frequently used in patients with head and neck cancer, data related to its measurement properties in this population are scarce. The aim of the present study was to evaluate the reliability and validity of the OHIP-14 in a sample of Serbian patients with head and neck cancer. Data were available for 345 patients (257 [74.5%] males; aged 30-92 years), with head and neck cancer. All patients completed the OHIP-14 and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35. Factor analyses, internal consistency reliability (i.e., Cronbach?s ? coefficient), and construct validity were analyzed. The factor analyses confirmed that 14 OHIP items were measuring a single underlying factor. Cronbach?s ? coefficient was 0.98 and corrected item-total correlations ranged 0.77-0.93. Lower OHIP-14 scores (i.e., lower impacts on oral health) were more frequently present among patients who had only surgery as a therapeutic procedure compared to those who had surgery accompanied with radio- and chemotherapy (p< 0.01). Patients with a tumor stage 0-II also had lower OHIP-14 scores compared to those who had a tumor stage III-IV (p< 0.01). The OHIP-14 correlated significantly with the QLQ-C30 and QLQ-H&N35 scales. As a unidimensional instrument, the OHIP-14 provides oral QoL assessments with sound internal consistency reliability and construct validity among patients with head and neck cancer.
- Bacteria associated with periodontal disease are also increased in health(2020) López-Martínez, Jesús; Chueca, Natalia; Padial Molina, Miguel; Fernandez Caballero Rico, Jose Angel; García Sabán, Francisco; O'valle Ravassa, Francisco Javier; Galindo Moreno, PabloThe objective of this cross-sectional clinical study was to analyze the differences in the microbiome in gingival sulci of adult patients in the presence or absence of chronic periodontitis. Patients with or without periodontal disease were included in this cross-sectional study. Subgingival biofilm samples were collected and analyzed by 16S massive pyrosequencing. Functional analyses were also performed. A total of 15 phyla, 154 genera and 351 species were detected globally. Differences between disease and non-disease samples were observed in all taxonomical levels which suggest functional profile changes in the community. It was found that the main species associated with non-disease samples were reduced in disease but not completely suppressed. Analysis of the functional potential of the biofilms revealed a significantly higher activity related to endocytosis and phosphatidylinositol signaling in the disease group but lower cell adhesion molecules. Specific differences between health and disease suggest functional profile changes in the community, although bacteria associated with periodontal disease are also increased in health. Transcriptome studies should be conducted to confirm and deepen metabolic dysfunctions.
- Prevalence of ulcerative stomatitis in arbovirus infections in a Brazilian Northeast population(2020) Barros, Ana Maria Ipólito; Martins-de-Barros, Allan Vinícius; Costa, Moan Jéfter Fernandes; Sette de Souza, Pedro Enrique; Lucena, Eudes Euler de Souza; Araújo, Fábio Andrey da CostaAlthough there are no population-based studies that support an association, there are reports in the literature of mucocutaneous, vesiculobullous and ulcerated lesions in the oral mucosa in cases of arbovirus infection. The aim of this study is to analyze the prevalence of ulcerative stomatitis in individuals affected by arboviruses in a population of the municipality of Arcoverde, Pernambuco, Brazil. 1,003 people living in an area assigned to a Primary Health Care Unit were interviewed. A structured questionnaire was used for data collection, with questions about sociodemographic variables, residence conditions, general health information, as well as information about the general signs and symptoms of arboviruses and specifically about oral lesions. Of the 1,003 individuals interviewed, 815 (81.25%) were infected by one or more arboviruses. Of these, 147 (18%) reported ulcerated oral lesions during arbovirus infections. The association between arbovirus infections and the presence of ulcerated oral lesions was statistically significant (p = 0.000). In these cases, the ulcerated lesions on the oral mucosa appear to be associated with arbovirus infection, especially Chikungunya, although the pathophysiological mechanisms are not defined, and the studies are not sufficient to confirm this association.
- Volume and effectiveness assessment of articain 4% versus mepivacaine 2% used in third molar surgery : randomized, double-blind, split-mouth controlled clinical trial(2020) de Almeida, Paula Carolina; Raldi, Fernando Vagner; Sato, Fábio Ricardo Loureiro; Nascimento, Rodrigo; Moraes, Michelle deThe different indications for extraction of the lower third molars, require resources to manage pain and discomfort, such as, for example, adequate anesthetic techniques, and the type of anesthetic used can influence the management of pain in tooth extractions. Few studies in the literature compare the anesthetics 4% articaine hydrochloride and 2% mepivacaine hydrochloride showing evidence that both allow for successful pain management. This study sought to compare the volume, efficacy and safety of these two anesthetic drugs, both associated with epinephrine at a ratio of 1:100,000, used in the extraction of lower third molars. A controlled, clinical, split-mouth compared these both local anesthetics in a sample of 20 patients requiring bilateral extraction of teeth. Pain was the main parameter to be assessed by means of the visual analogue scale (VAS) applied during and immediately after the surgery. Hemodynamic parameters, adverse events, presence of paresthesia and satisfaction of patients and surgeon were also analysed. Pain management was more effective with mepivacaine up to two hours after surgery (p=0.014), whereas the surgeon was more satisfied with the use of articaine during divulsion and suture (p<0.05). However no statistically significant differences were found between both anesthetics regarding pain perception. It was observed that both anesthetics are efficient and safe in the management of pain for extraction of third molars, in which less amount of mepivacaine is needed. The satisfaction of patients and surgeon was the same for both anesthetics, with articaine being highlighted during divulsion and suture.
- Effect of zinc on oropharyngeal mucositis in children with acute leukemia undergoing chemotherapy(2020) Gutiérrez-Vargas, Rosaura; Villasís-Keever, Miguel Angel; Portilla Robertson, Javier; Ascencio-Montiel, Ivan De Jesús; Zapata-Tarrés, MartaOropharyngeal mucositis (OM) is one of the main side-effects of oncological therapy. There is no treatment to prevent its occurrence, but some zinc-based therapies have been proven to help in decreasing its intensity. The objective of this study was to determine the effect of zinc in OM in children with acute leukemia in the early stages of oncological treatment. This quasi-experimental study evaluated OM in 2 groups (control group: conventional hospital management, and experimental group: administration of 50 mg of zinc gluconate daily plus conventional hospital management). OM severity was recorded at a two-month follow-up. Forty-nine patients (26 in the control group and 23 in the experimental group) were included. The mean age of the patients was 11.1 ± 2.7 years; 65.3% had a diagnosis of pre-B acute lymphoblastic leukemia. The incidences of OM in the control group and the experimental group were 46.2% and 26.1%, respectively, but the difference was not significant. Based on a negative binomial regression model, females had, on average, 1.5 more days with OM (p = 0.002), and patients assigned to the experimental group had, on average, 2 less days with OM than the control group (p = 0.001). The pain score was higher in the control group (p = 0.0009), as was the mean score on the WHO scale (p = 0.0012). Zinc facilitated a reduction in the severity and duration of OM; further studies focusing on children are needed to confirm the effects of this trace element.
- Clinical retrospective study of dental implant removal : do patients who require implant removal desire implant prosthesis again?(2020) Sukegawa, Shintaro; Saika, Masato; Tamamura, Ryo; Nakano, Keisuke; Takabatake, Kiyofumi; Kawai, Hotaka; Nagatsuka, Hitoshi; Furuki, YoshihikoThis study investigated the causes of dental implant removal due to complications, and examined whether patients who had dental implant removal desired re-implant prosthesis treatments. A retrospective case?control study was conducted on patients who had their dental implants removed. We investigated whether the removed dental implant was replaced with other implant prostheses. Age, sex, diabetes, smoking, implant site distribution, reason for implant removal, and blade and root-form implants were categorized as predictive variables. The outcome variable was desire for re-implantation or use of other prosthetic methods after implant removal. A logistic regression model was created to identify patient factors that could predict the re-implantation of dental prostheses after implant removal. A total of 215 dental implants were removed from 143 patients. The most common reason for implant removal was peri-implantitis that was identified in 165 implants. After implant removal, re-implantation was performed in 98 implants (45.6%). Bivariate analyses showed that age, diabetes, implant type, and reason for implant removal were associated with the desire for re-implanted prostheses. The multiple regression model revealed that age, implant type, and reason for implant removal were associated with an increased desire for re-implant prostheses after implant removal. Re-implantation of prostheses after the removal of dental implants was desired by patients who were younger, had implants placed in the root form, and had implants removed due to prosthetic-related complications.
- The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil(2020) Zavarez, Larissa Balbo; Stramandinoli, Roberta-Targa; Sassi, Laurindo-Moacir; Ramos, Gyl-Henrique; Schussel, Juliana Lucena; Torres-Pereira, Cassius CarvalhoThe aim was to examine the interval since first symptoms until final diagnosis of squamous cell carcinoma (SCC) in the head and neck region in southern Brazil. The individuals were prospectively selected and underwent anamnesis, physical examination and interview in the first medical consultation at a Cancer Hospital from south of Brazil. From 488 patients who underwent clinical examination, 105 were included in the study with diagnosis of SCC. Patients average interval from first symptoms to final diagnosis was 152 days (median 86; max:1105; min: 1), the average professional interval was 108 days (median: 97; max:525; min: 1) , and the average total period interval was 258 days (median: 186; max:1177; min: 45). Factors statistically associated with patient and diagnosis itinerary intervals were smoking and poorly adapted dentures and distance from home to hospital, respectively. The identification of the itinerary characteristics of this specific population may reflect in more effective public policies, such as primary and secondary prevention programs, aiming to increase the survival of oncological patient. Furthermore, the knowledge of the variables that influence the late diagnosis minimizes patient's journey in search of care to cancer centers through health programs.
- Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy : a randomized clinical trial(2020) Palma, Luiz Felipe; Marcucci, Marcelo; Remondes, Cíntia Maria; Chambrone, LeandroOne of the most important complications of radiotherapy (RT) for head and neck cancer (HNC) is osteoradionecrosis (ORN) of the jaws, arising mainly from tooth extractions. Thus, the present study aimed to evaluate the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in preventing ORN following tooth extraction in post-irradiated HNC patients, as well as other postoperative complications. 23 patients previously submitted to conventionally fractionated 3D-conformational RT for HNC underwent atraumatic tooth extractions with perioperative antibiotic therapy. Besides, they were randomly assigned to receive L-PRF clots to fill and cover the extraction sockets (n=11, Test Group) or not (n=12, Control Group). A visual analog scale was used to quantify postoperative pain on the 3rd and 7th days. For ORN diagnosis, patients were clinically assessed for up to 180 days. Other postoperative complications (edema, alveolitis, suture dehiscence, continuous bleeding, and oroantral communication) were also evaluated within this period. No case of ORN or another surgical complication was observed and there were no differences in the postoperative pain scores between the groups on the 3rd and 7th days. L-PRF did not seem to provide any additional benefits than those achieved by the combination of the surgical and drug protocols used for tooth extractions in the post-irradiated HNC patients.
- Overexpression of ALDH1 and EMT marker profile are linked with unfavorable outcome in head and neck cancer(2020) Vieira, Rúbia Rocha; Campos, Laura Hildebrand; Jesus, Luciano Henrique; Klabunde, Caroline; Gamba, Thiago de Oliveira; Flores, Isadora Luana; Oliveira, Márcia Gaiger de; Rados, Pantelis VarvakiThe aim of this research was to assess the expression of aldehyde dehydrogenase 1 (ALDH1) and epithelial-mesenchymal transition (EMT) markers in head and neck squamous cell carcinoma (HNSCC), and to correlate them with the clinical and histopathological parameters of a patient cohort with follow-up over an 8-year period. For this, seventeen HNSCC and non-neoplastic adjacent epithelium (AE) samples were subjected to laser microdissection and real-time PCR to evaluate the mRNA expression of ALDH1, E-cadherin (E-CAD), N-cadherin (N-CAD), and vimentin (VIM). Also, immunohistochemistry was performed for ALDH1, E-CAD, N-CAD, and VIM in the tumor center (TC), invasion front (IF), and AE of the seventeen samples. Mann-Whitney, Kruskal-Wallis and Chi-square tests were used to correlate the mRNA and immunohistochemical expression with different variables, considering p<0.05. Kaplan-Meier curves were produced for local recurrence, regional metastasis and treatment. A mRNA overexpression of ALDH1 in primary tumors was associated with regional metastasis and a high ALDH1 immunostaining was related to metastasis and a worse patient outcome. Additionally, a favorable outcome was associated with the transition phase and an unfavorable outcome was associated with EMT event. An overall 26.9 months was observed with longer survival associated with surgery and radiotherapy. However, due to the intense variability inherent to the indicator proteins in the EMT process, the complete profile markers related to this biological process should be continuous investigated.
- Clinical presentation of burning mouth syndrome in patients with oral lichenoid disease(2020) Alberdi Navarro, Javier; Aguirre Urizar, José Manuel; Ginestal Gómez, EduardoTo analyze the presence of burning mouth syndrome (BMS) in a group of patients diagnosed with oral lichenoid disease (OLD). A retrospective study of 217 patients diagnosed with OLD; 158 (72,8%) women and 59 (27,2%) men, with an average age upon diagnosis of 56,4 years (SD 11,88). We carried out a detailed and complete characterization of symptoms, with special emphasis on BMS diagnostic data specified by the International Headache Society. Four patients (1.8%) presented with long-term clinical symptoms of burning mouth, indicative of BMS and they fulfilled the IHS 2018 criteria, except for criterion D, i.e.?Oral mucosa is of normal appearance?. The observed lichenoid mucosal lesions were not considered to be able to account for the reported intraoral pain in any of our patients. Thus neither diagnosis was considered to be exclusive. Patients diagnosed with OLD, and who simultaneously present clinical characteristics of BMS should be studied in detail, in order to evaluate the possibility of both diagnoses concurring.
- Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enucleation(2020) Consolo, Ugo; Setti, Giacomo; Tognacci, Sara; Cavatorta, Chiara; Cassi, Diana; Bellini, PierantonioThe purpose of this study was to evaluate whether marsupialization treatment induces changes in the histology of odontogenic keratocyst epithelium and to compare our experience with the literature. A retrospective revision of histological samples was performed. 5 patients with odontogenic keratocyst treated with marsupialization follow by enucleation were selected. Histologic evaluation analyzed the changes in the keratocyst epithelium after marsupialization in terms of type of keratinization, thickness of the epithelium and connective tissue, the presence of acanthosis, the presence and grade of fibrosis, the type and grade of inflammation and the presence and number of mitotic figures and daughter cysts. In our case series, a variation of para-keratinized into ortho-keratinized keratocyst was found in one case, and no significant increases were observed in the epithelium and capsule thickness, or even in the level of inflammation. However, we observed an increase in fibrosis and qualitative changes in inflammation type. Minor and major histological changes were associated with reduction in cyst volume, which resulted in a simpler and less invasive cystic enucleation after marsupialization.
