Document Type : Original Article
University of Misan, College of Medicine, Amarah, Iraq
Forty eight cases of epithelial jaws cysts in Iraqi patients were diagnosed, and biopsy records of the Al Sader general hospital in Missan city. The cases were analyzed for prevalence in sex, jaws site, and cyst type. The retrospective study was conducted from May 2020 to May 2021 in Missan city; 48 patients were diagnosed with jaws cyst within one year. The histopathology department made these diagnoses at the Sader general Hospital.
The odontogenic cysts (89.6%) were more common than non-odontogenic cysts (10.4%). A radicular cyst (56.25%) was the most common epithelial jaw cyst, followed by residual cyst (12.5%). The prevalence of jaws cysts in males (60.4%) and maxilla (66.6%) were more than in females (39.6%) and mandible (33.4%). The study concluded that radicular cyst was the most common odontogenic cyst. Males are affected more than females, and maxillas are more than the mandible.
Cysts of the jaws are sack-like pouches that fill with fluid and form within the tissues of the jaw. Odontogenic cysts are defined as those cysts that arise from dental epithelium in the tooth-bearing area of the jaws. It is usually considered that this epithelium’s proliferation and/or degeneration leads to odontogenic cyst formation . Jaw cysts are generally benign in nature and non-cancerous growths but may rarely present with malignant degeneration. Cystic jaw lesions are classified as odontogenic cysts, either inflammatory or developmental or non-odontogenic in origin .
In pediatrics, many developmental change processes occur in the maxillofacial region. These include the development of the maxillofacial skeleton and the formation of the deciduous and permanent dentition, all of which may be associated with cyst formation. In adulthood, the fixed dentition is damaged from tooth decay and injury. Both of these may be associated with cyst formation. Most jaw cysts are odontogenic in origin. Inflammatory cysts is the most common type seen in both jaws .
Cysts seldom cause any symptoms unless ended up by infection. The signs depend primarily upon the size and location of the cyst. Most cysts are found as a chance finding on schedule dental radiography. They are frequently asymptomatic unless there has been a long-standing apparent enlargement of secondary infection .
The diagnosis of jaw lesions is established from the different clinical and radiological features though the final diagnosis is based on a histopathological examination of the lesion. On an x-ray, cysts appear as radiolucent areas with radiopaque borders. Cysts are usually unilocular but may also be multilocular. Occasionally aspiration (puncture aspiration) is used to aid the diagnosis of a cystic lesion; e.g., fluid aspirated from an inflammatory cyst may appear straw-colored and display shimmering due to cholesterol content . After surgical resection, the cyst wall is continuously sent to a pathologist for histopathologic examination .
The treatment methods were: marsupialization, enucleation. The prevalence and features of jaw cysts in children are different from those in adults. In general, in children, developing cysts are relatively high, whereas in adults, inflammatory cysts are more common .
Aims of study
This study aimed to investigate the prevalence of jaws cysts diagnosed in Misan city/ southern Iraq concerning gender and anatomic site.
Materials and Methods
The retrospective study was conducted from May 2020 to May 2021 in Missan city, 48 patients were diagnosed with jaws cyst within one year. These diagnoses were made by the histopathology department of the Al-Sader general hospital. In all cases, histological preparations were reviewed, and clinical reports were analyzed, along with the complementary means of diagnosis, conventional radiography (panoramic, periapical, and occlusal views). Some of them were referred to compute tomography (CT). Demographic data (age and sex) and cyst type were recorded. Depending on the case, surgery was performed under local or general anesthesia and included one of the following treatment modalities: marsupialization, enucleation was used.
Throughout the period of study, 48 cases were diagnosed as cysts. Among 48 jaw cysts, 43 cases (89.6%) were diagnosed with odontogenic cysts, and 5 cases (10.4%) were non-odontogenic cysts Table (1). The majority of jaw cysts were diagnosed predominantly in males 29 (60.4 %), 18 case was a radicular cyst, 1 dentigerous case cyst, 3 cases odontogenic Keratocyst (OKC), 2 cases gingival cyst, 4 cases residual cyst and 4 cases non-odontogenic nasolabial cyst, while females the total diagnostic cases were 19 (39.6%) 9 cases were radicular cyst, 1 dentigerous case cyst, no keratocyst was diagnosed during the period of study, 3 cases eruption cyst, 2 cases residual cyst and 4 cases nasolabial cyst (Table 1). The patients’ mean age was 35.7 years at the diagnosis, ranging from 6 to 68 years.
Table 1: The distribution in terms of the gender of jaw cysts