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  3. Vol. 44 No. 1 (2026): Continuous
  4. Original Article

Vol. 44 No. 1 (2026)

December 2025

Impact of COX2, SOX2, and Nestin Expression on Behavior of Dentigerous Cysts, Odontogenic Keratocysts, and Dental Follicles: An Immunohistochemical Study

  • Fatemeh Mashhadiabbas
  • Mohammadreza Kashefi Baher
  • Sanaz Gholami Toghchi

Journal of Dental School, Vol. 44 No. 1 (2026), 29 December 2025 , Page e11
https://doi.org/10.22037/jds.v44i1.50158 Published: 2026-05-03

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Abstract

Objective(s): Odontogenic Keratocyst (OKC) and Dentigerous Cyst (DC) are two common developmental odontogenic cysts affecting jaws. The role of cyclooxygenase-2 (COX2), SRY-related HMG-box gene 2 (SOX2), and Nestin in the invasion and progression of cysts and tumors has been studied. This study aimed to compare the expression of COX2, SOX2, and Nestin markers in DC and OKC. Methods: In this descriptive-analytical study, samples, including 80 paraffin blocks (32 DC, 32 OKC, and 16 cases of Dental follicle (DF)), were selected, and Immunohistochemical (IHC) staining using the antibodies for COX2, SOX2, and Nestin markers was performed using the envisioned method. Data was analyzed using the Kruskal-Wallis test at p<0.05. Results: The highest mean percentage of COX2, SOX2, and Nestin expression was observed in the DC, OKC, and DF, respectively. The only significant difference in COX2 expression was observed between the DF and DC (P = 0.001). The differences in SOX2 expression among the DC, OKC, and DF groups were all significant (P < 0.05). The only non-significant difference in Nestin expression was between the DF and DC (P = 0.157). Conclusion: COX2, SOX2, and Nestin can assist in diagnosing different inflammed types of DC and OKC. COX2 may be effective in explaining OKC's aggressive behavior. The expression of COX2 and SOX2 in DC may indicate the potential for tumoral behavior, while in OKC, it might suggest an increased epithelial proliferation rate. The findings related to Nestin expression in OKC suggest that the connective tissue of the cyst wall does not contribute to tumoral behavior and is not associated with odontogenic ectomesenchyme. Assessing molecular marker expression in IHC evaluation can help identify lesion aggressiveness and guide treatment plans to reduce future complications.

Keywords:
  • Odontogenic Keratocyst
  • Dentigerous Cyst
  • Dental Follicle
  • Cyclooxygenase-2 (COX2)
  • SOX2
  • Nestin
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How to Cite

Mashhadiabbas, F., Kashefi Baher, M., & Gholami Toghchi, S. (2026). Impact of COX2, SOX2, and Nestin Expression on Behavior of Dentigerous Cysts, Odontogenic Keratocysts, and Dental Follicles: An Immunohistochemical Study. Journal of Dental School, 44(1), e11. https://doi.org/10.22037/jds.v44i1.50158
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