Abstrak
This article reports 3 cases of melanin pigmented lesions among 75 histologically diagnosed periradicular lesions of extracted teeth.
Case 1 was a 25-year old male who presented with one week history of toothache involving a tender carious left mandibular second molar tooth (37), with periapical radiolucency and diagnosed clinically as acute apical periodontitis. The lesion was diagnosed histologically (using Haematoxylin and Eosin) as periapical granuloma, while histochemical examination (using Masson-Fontana technique) showed the presence of round/oval shaped melanin pigmented macrophages (melanophage) in the lesion.
Case 2 was a 54-year old male with one week history of toothache associated with tender carious right maxillary first molar tooth (16) with periapical radiolucency. A clinical diagnosis of acute apical periodontitis was made, but histological and histochemical examination showed a melanin pigmented periapical granuloma with spindle shaped melanophage.
Case 3 was a 28-year old female who presented with 4 days history of toothache, involving the tender left mandibular first molar tooth (36). The lesion had periapical radiolucency and a clinical diagnosis of acute apical periodontitis. On examination histologically and histochemically, the lesion was diagnosed as an intraosseous melanocytic naevi with dark-brown nests of round naevus cells. In conclusion, this article shows the rarity of melanin pigmented periradicular lesions in the jaws. The cases reported suggest that the trigger for formation of melanin-pigmented cells in the periradicular lesions may be related to the acute phase of the lesions. Further study is recommended to determine if the remnants of the migratory neural crest cells are the precursors of melanin-pigmented cells in the periradicular region.
Key words: Melanin pigment; periradicular lesion; extracted-teeth
Résumé
Cet article rapport trois cas de lésions pigmentées de mélanine parmi 75 lésions periradiculaires histologiquement diagnostiquées des dents extraits. Le premier cas était un homme de 25 ans qui se présentait avec une histoire d’une semaine de douleur dentaire due à une légère carie sur le second molaire de la mandibule gauche(37), avec une radiolucence periapicale et cliniquement étant une périodontie apicale aigue. La lésion était diagnostiqué histologiquement en utilisant l’hématoxyline et l’éosine comme granulome periapicale, tan disque l’examen histochimique utilisant la technique de Masson-Fontana montrait la présence des macrophages (melanophages) rondes /ovales pigmentées de mélanine dans la lésion. Le deuxième cas était de 54 ans ayant une histoire d’une semaine de douleur dentaire associée a une carie de la première molaire du maxillaire droit (16) avec une radiolucence periapicale’. Le diagnostic clinique de la périodontie apicale aigu était fait mais les examens histologiques et histochimique démontraient un granulome perapicale pigmentée de mélanine avec de melanophage en forme de fibre. Le troisième cas était une femme de 28 ans qui se présentait avec quatre jours d’histoire de douleur dentaire du a une légère douleur au premier molaire du mandibule gauche (36). La lésion avait une radiolucence periapicale et un diagnostic clinique de la périodontie apicale aigue. L’examen histologique et histochimique de la lésion montre une intra osseuse melanocytique de naevi avec des mèches marron foncées sur les rondes cellules de Naevius. En conclusion, cet article démontre la rareté des lésions pigmentées de mélanine periradiculaire dans la bouche. Ces cas rapportaient suggère la stimulation de formation des cellules pigmentées de mélanine dans les lésions periradiculaires peuvent être lié a la phase acute des lésions. Une étude approfondie est recommande pour déterminer si les restes migratoires des cellules neurales qui sont des précurseurs des cellules pigmentées de mélanine dans la région periradiculaire.
Correspondence: Dr. F.O. Omoregie, Department of Oral and Maxillofacial Surgery and Pathology, School of Dentistry, College of Medical Sciences, University of Benin, Benin City, E-mail: omoregiefo@yahoo.com
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