• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.23.2008.tde-19012009-160646
Document
Author
Full name
Ophir Ribeiro Junior
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Guimaraes Junior, Jayro (President)
Queiroz, Eliane dos Anjos
Sugaya, Norberto Nobuo
Title in Portuguese
Estudo retrospectivo de 24 tumores odontogênicos queratocísticos, com correlações clínico-imaginológicas, histopatológicas e cirúrgicas
Keywords in Portuguese
Cistos odontogênicos
Diagnóstico bucal
Neoplasias bucais
Recidiva
Tumores odontogênicos
Abstract in Portuguese
O tumor odontogênico queratocístico (TOQ) é uma neoplasia cística benigna, que apresenta controvérsias no seu diagnóstico e no tratamento. Propôs-se analisar 24 TOQs, correlacionando seus aspectos clínico-imaginológicos, histopatológicos e cirúrgicos, para aplicação no diagnóstico, prognóstico e tratamento racional. As análises foram submetidas ao teste do qui-quadrado (2) de Yates, com nível de significância de 5%. O abaulamento lingual foi presente em 100% dos casos no ramo mandibular. O padrão radiográfico unilocular e o deslocamento dental tiveram prevalências de 79,2% e 70%, respectivamente. A ocorrência de fluido queratinóide foi de 50% e mostrou correlação significativa com a síndrome do carcinoma nevóide de células basais (SCNCB). Nos demais fluidos (translúcido, citrino, sanguinolento e turvo), 63,6% apresentaram precipitado queratinóide. Fenestrações ósseas chegaram a 80% no ramo mandibular e 100% na tuberosidade maxilar. Inflamação ocorreu em 85,7% dos casos, com alterações epiteliais em 88,9% deles. A prevalência de microcistos satélites foi de 66,6%, com maior freqüência na SCNCB, no contorno festonado e no padrão multilocular. Dois casos submetidos à excisão tegumentar evidenciaram microcistos na mucosa. Num período médio de 25,5 meses, apenas um caso (4,2%) recorreu. A exérese por curetagem ocorreu em 17,4% dos casos, sem nenhuma correlação com infecção secundária, atrofia epitelial e inflamação. Todos os casos marsupializados apresentaram microcistos na lesão residual. As deiscências relacionadas à solução de Carnoy ocorreram em 75% dos casos marsupializados e em 11,1% dos demais. Parestesias relacionadas à aplicação da substância na área posterior da mandíbula ocorreram em 30,8%, com diferença significativa nos casos com e sem exposição nervosa. Conclui-se que: 1) o abaulamento lingual é característico no ramo mandibular; 2) a unilocularidade e o deslocamento dental são freqüentes; 3) o fluido queratinóide é freqüente na SCNCB e o precipitado é aplicável no diagnóstico diferencial; 4) as fenestrações corticais são prevalentes na tuberosidade maxilar e no ramo mandibular; 5) a inflamação interfere no diagnóstico histopatológico; 6) os microcistos satélites são prevalentes na SCNCB, relacionados à multilocularidade e presentes nos tecidos moles; 7) a curetagem é determinada por fatores técnicos; 8) a exérese é recomendável depois da marsupialização; 9) as deiscências são influenciadas pela marsupialização; e 10) as parestesias dependem do contato da solução de Carnoy com o epineuro.
Title in English
Retrospective study of 24 keratocystic odontogenic tumors, with clinical, image, histopathological and surgical correlation
Keywords in English
Diagnosis
Mouth neoplasms
Odontogenic cysts
Odontogenic tumors
Oral
Recurrence
Abstract in English
The keratocystic odontogenic tumor (KOT) is a cystic benign neoplasm, which presents controversies about its diagnosis and treatment. It was proposed to analyze 24 KOTs, correlating their clinical, image, histological and surgical aspects with application to diagnosis, prognosis and rational treatment. The data were submitted to the chi-square test (2) from Yates, with significance level of 5%. The lingual cortical expansion was present in 100% of the cases in the mandibular ramus. The unilocular radiograph pattern and the dental displacement had prevalence of 79.2% and 70%, respectively. The occurrence of keratin-like fluid was 50% and this was significantly correlated with the nevoid basal cell carcinoma syndrome (NBSCS). For the other fluids (translucid, citrin, bloody and cloudy), 63.6% presented keratin-like precipitation. Bone fenestrations achieved 80% of the mandibular ramus and 100% at the maxillary tuberosity. Inflammation occurred in 85.7% of the cases, with epithelial alterations in 89% of them. The satellite microcysts prevalence was 66.6%, with higher frequency in the NBSCS, at the fenestrated contour and at the multilocular pattern. Two cases submitted to tegument excision showed microcysts in the mucosa. In a mean period of 25.5 months, only one case (4.2%) recurred. The excision by curettage occurred in 17.4% of cases, without any specific correlation to the secondary infection, epithelial atrophy or inflammation. All marsupialized cases displayed microcysts in the residual lesion. The dehiscence related to the use of Carnoy solution occurred in 75% of the marsupialized cases and 11.1% of the others. Paresthesia related to the use of this solution in the posterior region of the mandible occurred in 30.8% of the cases, with significant difference among cases with and without nerve exposure. It can be concluded that: 1) the lingual cortical expansion is characteristic in the mandibular ramus; 2) the unilocular aspect and dental displacement are frequent; 3) the keratin-like fluid is frequent in the NBSCS and the precipitation in appliable for differential diagnosis; 4) the cortical fenestrations are prevalent in the maxillary tuberosity and at the mandibular ramus; 5) the inflammation interferes in the histopathologic diagnosis; 6) the satellite microcysts are prevalent in the NBSCS, related to multilocular aspect and present in soft tissues; 7) the curettage is determined by technical facts; 8) the exeresis is recommended after marsupialization; 9) the dehiscence is influenced by marsupialization; and 10) the paresthesia depends of the contact of Carnoy solution with the epineurium.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2009-03-16
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.