Osteochondromatosis and the coronoid- zygomatic pseudojoint [Jacob's disease] as an unusual cause of midfacial asymmetry and jaw restriction

A young male presenting with a history of progressive midfacial symmetry and limitation of mouth opening was found to have a unilateral coronoid hyperplasia forming an osteochondromatous pseudojoint with the expanded zygomatic arch [Jacob's disease]. This paper reviews the differential diagnoses of problems, especially in developing countries, that can cause restricted mouth opening, highlighting problems with conventional radiography and the role of CT assessment in the diagnosis of this rare condition

Oral fibro-histiocytic lesions: immuno-histological investigation and review of an unusual presentation in the tongue

A right sided mid-tongue growth in a 14-year-old boy diagnosed initially as Pyogenic Granuloma was found subsequently to be a Benign Fibrous Histiocytoma. This lesion had three seeming recurrences with divergent histologic and clinical appearances within a short period of time. Although there was eventual consensus on the morphogenesis and benign histologic nature of the lesion this caused diagnostic and management problems and a potential prognostic dilemma. This report on a unique and aggressive head and neck lesion, possibly the third documented case ill the tongue, reviews the bewildering spectrum of clinical and immuno- histologic manifestations of fibrous histiocytic lesions. Wide excision with close follow up is recommended

Esthetic and functional outcomes of a post-ankylosed case - an interdisciplinary approach: use of stainless steel surgical screws for orthodontic anchorage control in an adult patient

The use of stainless steel [SS] surgical screws as a suitable alternative to titanium implants for anchorage control in the orthodontic treatment of a 17 year old female patient has been reported. The patient gave history of trauma related bilateral TMJ ankylosis that had been released earlier. She had the stigmata of the ankylotic face presenting as bimaxillary proclination on a skeletal Class II jaw base with retrognathic mandible, typical bird face, increased over bite and overjet and multiple missing teeth resulting in disturbed occlusion and poor esthetics. The rigid anchorage obtained allowed for dental correction. Esthetics and function was improved after active orthodontics; by genial augmentation and prosthetic replacement of missing teeth. Our results suggest that SS mini screws which are extremely cost-effective and readily available can successfully be used as an alternative to expensive titanium mini implants for orthodontic anchorage. This could have significant implications in other developing countries