Aneurysmal Bone Cyst of Mandible: A Case Report.

Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in the craniofacial skeleton about other structures like long bones or the spine. The rare jaw lesions encountered in the mandible and maxilla. On the other side, it is at the same time very exciting in terms of its differential diagnosis with other types of mandibular or maxillary bone lesions. We present the case of a 45-year-old female patient with an aneurysmatic cyst located at the left angle of the mandible describing the treatment for the same i.e. surgical excision and hemi mandibulectomy with reconstruction. We have focused on the differential diagnosis, mainly with the malignancies, which can be found at this location, along with therapeutic options classically described for these kinds of pathologies. In our patient, the surgical excision and hemi mandibulectomy allowed a complete removal of the lesion and recon plate was placed for rehabilitation.

Unicystic Ameloblastoma of The Mandible - A Case Report With Hemimandibulectomy.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. Its incidence, combined with its clinical behavior, makes ameloblastoma the most significant odontogenic neoplasm. Unicystic ameloblastoma refers to those cystic lesions that show clinical, radiographic or gross features of a jaw cyst but on histologic examination show a typical ameloblastomatous epithelium lining the cyst cavity, with or without luminal and/or mural tumor proliferation. As this tumor shows considerable similarities with dentigerous cysts, both clinically and radiographically the biologic behaviour of this tumor group was reviewed. Unicystic type has a considerably better overall prognosis and a much reduced incidence of recurrence compared with conventional ameloblastoma.

Manejo protésico-quirúrgico del paciente hemimandibulectomizado / Prosthetic and surgical treatment of patient previously subjected to hemi-mandibulectomy

Por lo general las mejores opciones de rehabilitación para el paciente hemimandibulectomizado quedan fuera del alcance del poder adquisitivo de la mayoría de ellos, esto hace que el abordaje reconstructivo protésico- quirúrgico para éstos se tenga que restringir al uso de materiales más accesibles tales como el clavo de Kirschner y las prótesis inmediatas de metilmetacrilato, siendo estas últimas las más recomendables por su bajo costo, fácil manejo, por evitar la rotación mandibular y por prevenir la atrofia de los tejidos blandos. Se reporta el caso clínico de un paciente masculino de 25 años de edad el cual ingreso al Servicio de Oncología del Hospital General de México debido a la presencia de un aumento de volumen en el área correspondiente al ángulo mandibular izquierdo, diagnosticándose microscópicamente como un tumor mixto maligno (diagnóstico histopatológico final). Se decidió hacer la hemimandibulectomía de la zona involucrada, con reconstrucción del segmento óseo perdido mediante la colocación de una prótesis inmediata implantada confeccionada con metilmetacrilato de metilo termocurable, la cual fue fijada con alambre para osteosínteis aproximadamente a 3 y 6 milímetros por arriba de la cortical inferior mandibular en ambos bordes de sección.

In general terms, the best rehabilitation options for patients previously subjected to hemi-mandibulectomy are far beyond their financial possibilities. For this reason surgical-prosthetic reconstructive approach is mainly restricted to the use of more affordable materials such as Kirschner wire and methyl-methacrylate immediate prostheses. The latter are widely recommended due to their low cost, ease of handling, and because they prevent soft tissue atrophy. A clinical case is reported in this article: 25 year old male patient seeking treatment at the Oncology Service of the Hospital General de Mexico (Mexico's General Hospital) due to the presence of a volume increase in the area of the left mandibular angle. Microscopic analysis revealed presence of mixed malign tumor ( final histopathological diagnosis). It was decided to perform hemi-mandibulectomy of involved area, with reconstruction of lost bone segment by means of positioning an immediate methyl methacrylate prosthesis (thermosetting methyl). The prosthesis was fixated with osteosynthesis wire at both resection margins, at 3 mm above the cortex.

Prosthetic Management of Edentulous Mandibulectomy Patient Using Twin Occlusion - A Case Report.

Numerous prosthetic methods are employed to minimize deviation and improve masticatory efficiency of hemimandibulectomy patient, who has undergone resection without reconstruction which include implant supported prosthesis, mandibular guide flange prosthesis and palatal based guidance restoration .this article describes an another method twinned occlusion which is simple and effective method for prosthetic management of mandibulectomy edentulous patient

Three-dimensional finite element analysis of implant-supported crown in fibula bone model

PURPOSE: The purpose of this study was to compare stress distributions of implant-supported crown placed in fibula bone model with those in intact mandible model using three-dimensional finite element analysis. MATERIALS AND METHODS: Two three-dimensional finite element models were created to analyze biomechanical behaviors of implant-supported crowns placed in intact mandible and fibula model. The finite element models were generated from patient's computed tomography data. The model for grafted fibula was composed of fibula block, dental implant system, and implant-supported crown. In the mandible model, same components with identical geometries with the fibula model were used except that the mandible replaced the fibula. Vertical and oblique loadings were applied on the crowns. The highest von Mises stresses were investigated and stress distributions of the two models were analyzed. RESULTS: Overall stress distributions in the two models were similar. The highest von Mises stress values were higher in the mandible model than in the fibula model. In the individual prosthodontic components there was no prominent difference between models. The stress concentrations occurred in cortical bones in both models and the effect of bicortical anchorage could be found in the fibula model. CONCLUSION: Using finite element analysis it was shown that the implant-supported crown placed in free fibula graft might function successfully in terms of biomechanical behavior.

Solitary Plasmacytoma of Mandible: A rare case report.

Solitary plasmacytoma is a rare condition affecting the jaws which manifests itself as a single osteolytic lesion without plasmocytosis of bone marrow and constitutes approximately 3% of all plasma containing tumors. It is different from multiple myeloma in terms of its clinical behaviour and prognosis. The most common clinical presentation is local bone pain and lesion on alveolar ridge and affects mandible frequently than maxilla. We report a rare case of solitary plasmacytoma of mandible, diagnosed on the basis of distinct radiological and histopathological findings, that has been treated by subtotal hemimandibulectomy. The review of literature concerning clinical, histological and radiological features, as well as the proper management concerning this tumour is included.

Post Resection Physiotherapy And Rehabilitation; Using Functionally Moulded Maxillary Guide Ramp.

Often the loss of the continuity of the mandible hampers the balance and the symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the surgical side. Successful intercuspal position with the antagonist in the remainder arch was accomplished through the use of functionally moulded palatal guidance appliance in a patient who underwent hemisection and postsurgical radiation of the mandible, subsequent to treatment for a squamous cell carcinoma of right side of the ramus of mandible. This article describes the fabrication and function of a maxillary palatally positioned, functionally moulded guide flange to assist post resection physiotherapy and rehabilitation.

Hemimandibulectomia como tratamiento de ameloblastoma multiquístico / Hemimandibulectomy as multicystic ameloblastoma treatment

Ameloblastoma es un tumor de origen odontogénica que presenta crecimiento lento como una de las características principales, localmente invasivo y raramente causa metástasis. Pueden alcanzar grandes dimensiones si no tratado precozmente, convirtiéndose en un desafío su exéresis y reconstrucción en fases más avanzadas. El actual artículo tiene como objetivo relatar un caso clínico de un ameloblastoma multiquístico que afecta toda la región de la mandíbula derecha, en la cual fue realizado hemimandibulectomia, seguido de una reconstrucción con placa de 2.4mm y prótesis de cóndilo mandibular confeccionada en resina acrílica termopolimerizada, cubierta por el colgajo del músculo esternocleidomastoideo

The ameloblastoma is a tumor of odontogenic origin that present as main characteristics slow growth, locally invasive and they rarely cause metastasis. They can reach great dimensions if relegated the precocious treatment, turning his it complete removal and reconstruction in more advanced phases. The present article has as objective tells the clinical case of an ameloblastoma multicístico involving every area right mandibular, in which hemimandibulectomy was accomplished, following by reconstruction with plate 2.4mm and prosthesis of mandibular condylar made in resin acrylic thermopolimerizate, associated to shred of the muscle externocleidomastoideo