ABSTRACT
Ameloblastic fibroma is a rare, slow-growing odontogenic mixed tumor with neoplastic epithelial and ectomesenchymal tissue, which does not show inductive changes to form enamel and dentin. It is frequently found in the first two decades of life. It is often confused with ameloblastoma and dentigerous cyst due to the presence of an impacted tooth and can be distinguished histologically. Ameloblastic fibroma can be differentiated from ameloblastoma by the presence of myxoid appearance of connective tissue. A case of an 11-year-old female with a slow-growing swelling on the left side of mandible in the molar ramus region has been presented which was diagnosed as ameloblastic fibroma postenucleation.
ABSTRACT
Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor with poor prognosis. It has an aggressive clinical course with extensive local destruction. It occurs primarily in the mandible. It may clinically present as a cystic lesion with benign clinical feature or as a large mass with ulceration, significant bone resorption and mobility of teeth in the affected region. Reliable evidence of it's biological activity along with extensive local destruction, direct extension of tumor, lymph node involvement and metastasis to various sites (frequently lung) have been reported. Wide local excision is the treatment of choice along with regional lymph node dissection. Because of recurrence close periodic assessment of the patient is advocated. The authors discussed a rare case of AC of mandible; with metastasis to regional lymph nodes in a 45 year old male along with a long-term follow up.
ABSTRACT
AIM: The present study attempted the evaluation of Primary and secondary closure techniques after removal of impacted third molars in terms of healing, post-operative pain and swelling. MATERIAL AND METHODS: 60 patients with impacted mandibular third molars were randomly divided into two groups of 30. Panoramic radiographs were taken to assess degree of eruption and to asses 3rd molar angulations to the long axis of 2nd molar. Teeth were extracted, and in Group 1 the socket was closed by hermetically suturing the flap. In group II a 5-6 mm wedge of mucosa distal to the second molar was removed & the flap was repositioned. Interrupted sutures were given, so as to form a triangular opening distal to second molar measuring about 5 × 5 mm. Swelling and pain were evaluated for 7 days after surgery with the VAS scale. RESULTS: Study results showed that post operative Sequale were comparatively less in secondary closure group than the primary closure group. Pain showed statistically significant difference between two groups. Pain was less in secondary closure group from day 1 to day 7. Swelling & trismus was also significantly less in secondary closure group. Evaluation of the complications of these two techniques showed that delayed wound healing occurred in 66.6% of cases (20 cases out of 30) in secondary closure group where as dehiscence of suture line occurred in 33.33% of cases (10 out of 30) in primary closure group. CONCLUSIONS: The results obtained in the present study enable us to conclude that, in cases of equal intra-operative difficulty, open healing of the surgical wound after removal of impacted third molars produces less post-operative swelling and pain than occurs with closed healing, by hermetically suturing the socket.
