Conservative enucleation for physiologic space closure in adenomatoid odontogenic tumor.

Adenomatoid odontogenic tumor (AOT) is a rare, asymptomatic, slow-growing benign tumor that can be divided into three variants: follicular, extrafollicular, and peripheral. By treating AOT using an enucleation and curettage approach, recurrence can be avoided. We report a case of a 24-year-old female who presented with a lump in the right mandibular premolar area along with diastema between displaced teeth #43 and #44 and was diagnosed with extrafollicular AOT. The patient was managed with enucleation-curettage surgery without additional bone graft procedure along with routine follow-up. A successful outcome without recurrence was achieved, and diastema closure with repositioning of the displaced teeth did not require orthodontic treatment. AOT should be managed via enucleation and curettage to obtain successful outcomes without recurrence. Spontaneous bone regeneration following enucleation can be achieved without guided bone regeneration. Also, diastema closure and repositioning of displaced teeth can occur without orthodontic interventions through physiologic drift.

Ultrastructural and immunohistochemical evaluation of hyperplastic soft tissues surrounding dental implants in fibular jaws.

In reconstructive surgery, complications post-fibula free flap (FFF) reconstruction, notably peri-implant hyperplasia, are significant yet understudied. This study analyzed peri-implant hyperplastic tissue surrounding FFF, alongside peri-implantitis and foreign body granulation (FBG) tissues from patients treated at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Using light microscopy, pseudoepitheliomatous hyperplasia, anucleate and pyknotic prickle cells, and excessive collagen deposition were observed in FFF hyperplastic tissue. Ultrastructural analyses revealed abnormal structures, including hemidesmosome dilation, bacterial invasion, and endoplasmic reticulum (ER) swelling. In immunohistochemical analysis, unfolded protein-response markers ATF6, PERK, XBP1, inflammatory marker NFκB, necroptosis marker MLKL, apoptosis marker GADD153, autophagy marker LC3, epithelial-mesenchymal transition, and angiogenesis markers were expressed variably in hyperplastic tissue surrounding FFF implants, peri-implantitis, and FBG tissues. NFκB expression was higher in peri-implantitis and FBG tissues compared to hyperplastic tissue surrounding FFF implants. PERK expression exceeded XBP1 significantly in FFF hyperplastic tissue, while expression levels of PERK, XBP1, and ATF6 were not significantly different in peri-implantitis and FBG tissues. These findings provide valuable insights into the interconnected roles of ER stress, necroptosis, apoptosis, and angiogenesis in the pathogenesis of oral pathologies, offering a foundation for innovative strategies in dental implant rehabilitation management and prevention.

Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale.

BACKGROUND: Immediate implant placement has gained popularity due to its several advantages. However, immediate placement has its challenges, including concerns about primary stability and bone formation around the implant. The aim of the present study is to evaluate the clinical outcomes of tapered, sand-blasted, and acid-etched internal submerged dental implants in various regions of the jaw bones and to provide a positional rationale for immediate implant placement. METHODS: Between 2009 and 2018, a single surgeon at Seoul National University Dental Hospital in Seoul, Korea, immediately inserted 49 dental implants with tapered bone-level design after extraction, in a total of 34 patients. The clinical outcomes were collected and evaluated, focusing on location of implant placement and marginal bone loss (MBL), with consideration of other parameters such as implant diameter and length. RESULTS: Of 49 immediately installed Luna® (Shinhung Co., Seoul, Korea) dental implants, 23 were placed in the mandible, and 26 were set in the maxilla. The mean age of patients at the time of installation was 65.91 years, ranging from 40 to 86 years. The average follow-up period was 7.43 years, with a range of 5 to 14 years. After a 5-year retrospective evaluation of tapered, sand-blasted, and acid-etched internal submerged dental implants for immediate implant placement, the cumulative survival rate was 93.88%, with 100% survival rate in the mandible and premolar region of both the maxilla and mandible. CONCLUSIONS: After a 5-year evaluation, tapered, sand-blasted, and acid-etched internal submerged dental implants demonstrated good efficacy for immediate placement in various locations within the dental arches, exhibiting effective clinical performance.

Elemental characteristics of sialoliths extracted from a patient with recurrent sialolithiasis.

The exact mechanism of sialolith formation has yet to be determined. Recurrence of sialolithiasis is rare, affecting only 1%-10% of patients. The current study presents a case of recurrent stones that occurred twice on the right submandibular gland 6 months postoperative and 7 months after reoperation in a 48-year-old female patient. The stones were analyzed using histology, scanning electron microscopy, energy dispersive spectroscopy, and transmission electron microscopy (TEM). The first stone showed a three-layered structure with a poorly mineralized peripheral multilayered zone, highly mineralized middle layer, and the central nidus. The stones were composed of Ca, C, O, Cu, F, N, P, Si, Zn, and Zr. In TEM, compact bi-layered bacterial cell membrane was found on the peripheral layer and the central nidus of the stone as well as exosomes in the central nidus. The results demonstrated the essential components of sialolith formation, including bacteria, inflammatory exosomes, and exfoliated salivary epithelial cells that cooperatively underwent the pathogenetic progresses of central nidus formation, induction of compact zone calcification of the middle layer, and repeated subsequent deposition in the peripheral multilayer zone. The rapid recurrence could have resulted from residual pieces of a sialolith acting as the nidus of bacterial infection.

A 10-year follow-up study on clinical outcomes of dental implant rehabilitation using surgical guide.

Objectives: The surgical guide is a static computer-assisted device used for implant surgery planning and guidance. By taking an impression and referring to the patients' three-dimensional computed tomography scan of the desired implant site, a surgical guide can be created. During surgery, the surgical guide aids in achieving the designed implant placement position and direction. We examined and evaluated the long-term clinical outcomes of implant surgery using surgical guides. Materials and Methods: This study investigated a total of 15 patients with 32 implants that were placed using surgical guides from 2009 to 2011 with a mean follow-up period extended beyond 10 years. Patient demographics and implant survival rates were recorded. We analyzed marginal bone loss (MBL) by assessing the radiographs acquired at installation, three months after installation, and one month, one, two, and five years after prosthesis delivery. Results: The mean patient age was 57.33 years at implant placement. Of the 32 implants, five implants were placed in the anterior region and 27 implants were in the posterior region. Six implants failed and three of them were replaced, resulting in an 81.25% survival rate. The mean follow-up period was 10 years and nine months. Mean MBL compared to post-installation was significantly higher than at three months after installation, and one month, one, two, and five years after prosthesis delivery. Mean MBL at three months after installation, and one month, one year, and two years were significantly higher compared to the previous visit (P<0.05). However, MBL at five years after prosthesis delivery did not differ significantly compared to at two years. Conclusion: In this study, implant rehabilitation assisted by surgical guides exhibited favorable survival rates. With the limitation of the sample amount in this study, further research and more samples are required to evaluate the long-term clinical effectiveness of surgical guides.

Long-term Follow-up of Implant Installation Following Multiple Distraction Osteogenesis in Maxillofacial Gunshot Wounds.

Distraction osteogenesis (DO) is a reconstruction technique developed in the fields of oral and maxillofacial surgery and plastic surgery, addressing both vertical and horizontal bone deficiencies and enhancing soft tissue volume to facilitate subsequent dental implant placement. In this treatment method, devices are placed to stretch the bone gradually to stimulate the formation of new bone, effectively filling the existing defect to treat maxillofacial deformities or repair posttraumatic injuries. This case report presents an almost 20-year long-term follow-up of jaw defect reconstruction resulting from a gunshot injury, using DO with multiple distractors. Details on the frequency, period of DO, and subsequent implant installation in the distracted anterior jaw area are outlined. This case exhibits DO treatments that reconstructed effectively severe bone defects in the jaws. The quality of bone generated during the DO process was both functionally and esthetically satisfactory for subsequent implant rehabilitation.

Clinical retrospective analysis of peri-implant oral malignancies.

PURPOSE: Complications of implant prostheses have direct correlation with the increased use of implants for dental rehabilitation. In this study, we present cases of peri-implant oral malignancies (PIOM) around dental implants and a retrospective analysis of patients treated for PIOM. METHODS: The retrospective analysis was performed with patients treated for PIOM at the Department of Oral and Maxillofacial Surgery of the Seoul National University Dental Hospital between 2006 and 2014. The patient records were thoroughly screened for previous medical issues, human papilloma virus infections, and other clinical data with a focus on relevant information such as localization, time from implant insertion to the development of the carcinoma, implant type and prosthetic rehabilitation. RESULTS: Twenty-one patients were diagnosed with PIOM. The male-to-female ratio was 1.625. The mean age of the patients was 60.42 ± 9.35 years old. Three patients reported ongoing alcohol/tobacco consumption. Five patients had a history of previous oral cancer surgery or exhibited mucosal lesions. The time from implant placement until carcinoma diagnosis was 49.13 ± 33.63 months on average. Most PIOM patients (95.2%) were diagnosed with SCC. All patients had previously been treated for peri-implantitis. In 85.7% of the patients, prostheses were observed on the opposing teeth where PIOM occurred. CONCLUSION: Based on the review of these cases, it can be deduced that there is a possibility that implant treatment and galvanic currents between prosthesis may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of malignant tumors. Patients at potential risk may benefit from individualized recall intervals and careful evaluations.

Layered structure of sialoliths compared with tonsilloliths and antroliths.

Objectives: The aim of this study was to perform a comparative analysis of the ultrastructural and chemical composition of sialoliths, tonsilloliths, and antroliths and to describe their growth pattern. Materials and Methods: We obtained 19 specimens from 18 patients and classified the specimens into three groups: sialolith (A), tonsillolith (B), and antrolith (C). The peripheral, middle, and core regions of the specimens were examined in detail by histology, micro-computed tomography (micro- CT), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy, and transmission electron microscopy (TEM). Results: In the micro-CT, group A showed alternating radiodense and radiolucent layers, while group B had a homogeneous structure. Group C specimens revealed a compact homogeneous structure. Histopathologically, group A showed a laminated, teardrop-shaped, globular structure. Group B demonstrated degrees of immature calcification of organic and inorganic materials. In group C, the lesion was not encapsulated and showed a homogeneous lamellar bone structure. SEM revealed that group A showed distinct three layers: a peripheral multilayer zone, intermediate compact zone, and the central nidus area; groups B and C did not show these layers. The main elemental components of sialoliths were O, C, Ca, N, Cu, P, Zn, Si, Zr, F, Na, and Mg. In group B, a small amount of Fe was found in the peripheral region. Group C had a shorter component list: Ca, C, O, P, F, N, Si, Na, and Mg. TEM analysis of group A showed globular structures undergoing intra-vesicular calcification. In group B, bacteria were present in the middle layer. In the outer layer of the group C antrolith, an osteoblastic rimming was observed. Conclusion: Sialoliths had distinct three layers: a peripheral multilayer zone, an intermediate compact zone and the central nidus area, while the tonsillolith and antrolith specimens lacked distinct layers and a core.

Morphometric Assessment of Alveolar Antral Artery Using Medical Computed Tomography.

This study aimed to investigate the prevalence, diameter, and position of the alveolar antral artery (AAA) in paranasal sinus computed tomography (CT) images and to correlate the location of the AAA with tooth position, the presence of teeth, and residual alveolar bone height (ABH). A retrospective study was conducted at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, from November 2016 to October 2021. CT images of 100 maxillary sinuses from 50 patients managed for modified endoscopic sinus surgery and sinus lifting by a single surgeon were selected and obtained from the Infinitt picture archiving and communication system radiology system (Infinitt Healthcare Co., Seoul, Korea). The location of the AAA in the lateral wall of the maxillary sinus was evaluated in correlation with the area of the first and second molars (M1 and M2), the presence of teeth, and the residual ABH. In this study, we found that the intraosseous type is the most common type of AAA. Furthermore, the location and distance of the AAA are significantly affected by tooth position, an edentulous state in the case of the first molar, and residual ABH. Pre-evaluation of the diameter, position, and distance to the AAA using CT images is essential to help prevent hemorrhage. The existence and wide range of the AAA distances based on the tooth position, edentulous state, and residual ABH should be considered even if CT imaging cannot locate the AAA.

Review of two immunosuppressants: tacrolimus and cyclosporine.

Immunosuppressants are vital in organ transplantation including facial transplantation (FT) but are associated with persistent side effects. This review article was prepared to compare the two most used immunosuppressants, cyclosporine and tacrolimus, in terms of mechanism of action, efficacy, and safety and to assess recent trials to mitigate their side effects. PubMed and Google Scholar queries were conducted using combinations of the following search terms: "transplantation immunosuppressant," "cyclosporine," "tacrolimus," "calcineurin inhibitor (CNI)," "efficacy," "safety," "induction therapy," "maintenance therapy," and "conversion therapy." Both immunosuppressants inhibit calcineurin and effectively down-regulate cytokines. Tacrolimus may be more advantageous since it lowers the likelihood of acute rejection, has the ability to reverse allograft rejection following cyclosporine treatment, and has the potential to reinnervate nerves. Meanwhile, graft survival rates seem to be comparable for the CNIs. To avoid nephrotoxicity, various immunosuppressants other than CNIs have been studied. Despite averting nephrotoxicity, these medications show increases in acute rejection or other types of adverse effects compared to CNIs. FT has been a topic of interest for oral and maxillofacial surgeons, and the postoperative usage of immunosuppressants is crucial for the long-term prognosis of FT. As contemporary transplantation regimens incorporate novel medications along with CNIs, further research is required.

Electron microscopic analysis of necrotic bone and failed implant surface in a patient with medication-related osteonecrosis of the jaw.

BACKGROUND: Bisphosphonates (BP), a commonly used medication for various bone diseases, have been known to have severe complications such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). Failure of dental implants has also been found in patients with medication-related osteonecrosis of the jaw (MRONJ). In this study, we analyzed the necrotic bone tissues and the surface of the failed implants removed from the jaw in patients treated with BPs and antiresorptive agents. RESULTS: Chronic inflammatory cells with collagen and fibrous tissues and bone sequestrum were shown at 5.0 × , 10.0 × , 20.0 × , and 40.0 × magnified histologic sections in the bone and fibrotic scar tissues removed from patients with MRONJ due to osteonecrosis. Hardened bone tissues with microcracked bony resorbed lacunae were observed in SEM. Unlike the previously published comparative data where immune cells, such as dendritic cells, were found in the failed implant surface, these immune cells were not identified in the BRONJ-related peri-implantitis tissues through the TEM investigations. Furthermore, EDS revealed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, silicon, and sulfur elements were found. CONCLUSION: Hardened bone tissues with microcracked bony resorbed lacunae were observed in the SEM findings, which were considered as the main characteristic of the osteonecrosis of the jaw. Immune cells, such as dendritic cells were not identified in the TEM. EDS showed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, and silicon elements were found. Furthermore, it was revealed that sulfur was found, which was considered to be one of the complicated causes of implant failure in patients with BRONJ.

Late side effects of bleomycin injection into the lower lip mucosa of a nine-year-old patient with venous malformation.

Venous malformation (VM) is a benign lesion of blood vessels caused by an error in vascular morphogenesis during the embryologic phase. This entity mostly affects the head and neck region, including the lips, tongue, buccal mucosa, gingiva, or palate. VM may cause functional and aesthetic impairments. The anatomical structure and shape of the lips provide an important aesthetic accent for an individual. Therefore, management of VM in the lip area without postoperative defects or scarring is challenging. In this brief communication article, we present a conservative approach to lip VM in a nine-year-old boy using a bleomycin injection that had good aesthetic and functional outcomes. Injection of 2 mL of 1/10 of 15 mg bleomycin in a saline dilution into the lip mucosa may present a drug reaction as a white plaque and reddish owl eye lesion that takes up to three weeks to resolve without a scar. It is important to recognize the characteristics and self-limiting nature of postoperative bleomycin complications to avoid unnecessary treatment.

A 10-year survival rate of tapered self-tapping bone-level implants from medically compromised Korean patients at a maxillofacial surgical unit.

BACKGROUND: The 10-year survival rate of dental implants in healthy subjects is 90-95%. While in healthy individuals, dental implants have become commonplace to solve problems of edentulism, whether dental implant treatment is optimal in patients with systemic disease remains unclear. The purpose of this study is to investigate the clinical outcomes of tapered, sand-blasted, and acid-etched internal submerged dental implants installed in medically compromised patients in our maxillofacial surgical unit. METHODS: A total of 1019 Luna® dental implants were placed in 333 patients at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Kaplan-Meier survival estimates after 10 years of follow-up were computed for healthy vs. medically compromised patients. RESULTS: The 10-year follow-up survival rate of 1019 Luna® dental implants in the Korean maxillofacial surgical unit was 97.0% with a mean follow-up of 41.13 ± 35.13 months (0-120 months). The survival rate was 97.0%, in which 31 implants were failed during the follow-up. Cumulative 10-year implant survival rates were 99.4% in healthy individuals without systemic disease and 95.9% in patients with systemic disease. CONCLUSIONS: Comparable success and survival rates were achieved with those of implants in healthy patients. Preoperative general health assessments including laboratory test results and checking the previous medication records are essential in diagnosing any unrecognized conditions for improved implant success rates in medically compromised patients.

Oral galvanism related to dental implants.

BACKGROUND: A range of different chemical interactions can generate an unexpected electronic current in a process called galvanism. Oral galvanism (OG) can also be generated by different chemical actions from diverse intraoral rehabilitated metals, including gold, copper, mercury, titanium, and titanium alloy. The main aim of this manuscript is to review OG, particularly focusing on titanium implants and related metallic materials. We searched the MEDLINE (PubMed), Embase, Scopus, and Google Scholar databases for relevant literature published through December 2019. The keywords included "galvanic current", "galvanism", "galvanic corrosion", "oral galvanism", combined with "oral", "oral cavity", "implant", and "saliva." RESULTS: Out of 343 articles, 126 articles that met the inclusion criteria were reviewed. We examined and summarized research on OG through a division into four categories: definition and symptoms, diagnosis with testing methods, galvanic corrosion, and oral precancerous lesions with OG. CONCLUSIONS: Patients with OG have high oral energy and current, and although this phenomenon may be due to the patient's mental illness, OG due to amalgam or mercury occurs. It is evident that the difference in electron potential caused by different elemental components such as titanium alloy and pure titanium, which are essential for manufacturing the implant fixture and the abutment, and chrome and nickel, which are essential for manufacturing the upper crown, causes OG. Since the oral cavity is equipped with an environment in which electric current can be transmitted easily due to saliva, it is imperative that clinicians review the systemic and local effects of salivation.

Functional rehabilitation of the maxillary sinus after modified endoscopic sinus surgery for displaced dental implants.

PURPOSE: Dental implants may become displaced into the maxillary sinus due to insufficient primary stability, changes in nasal air pressure, or surrounding bone resorption and should be removed as soon as possible. The aim of this study was to evaluate the efficacy of the modified endoscopic sinus surgery (MESS) approach for removal of displaced dental implants. METHODS: From September 2010 to November 2021, we studied 15 cases with displaced implants in the maxillary sinus. The patient characteristics, medical history, clinical and imaging results, and post-removal outcomes were retrospectively assessed. RESULTS: The symptoms included sinusitis (100%), pain (26.6%), postnasal drip (6.6%), nasal obstruction (26.6%), and oroantral communication (26.6%). Two cases were managed through the crestal approach (13.3%), while two cases were treated with the Caldwell-Luc procedure (13.3%). One case was addressed using functional endoscopic sinus surgery (6.7%), while 10 cases were managed with the MESS approach (66.7%). MESS allows functional rehabilitation of mucociliary clearance by the cilia in the sinus membrane. Implant displacement into the maxillary sinus can be classified as early, late, or delayed displacement. CONCLUSIONS: MESS is a reliable treatment option that can identify migrated dental implants in any part of the sinus with endoscopic assistance for functional rehabilitation of the maxillary sinus without postoperative sequelae.

Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic.

INTRODUCTION: The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana. METHODS: The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana. RESULTS: From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH's current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation. CONCLUSIONS: The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.

Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication.

Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review.

BACKGROUND: Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ. METHODS: Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed. RESULTS: The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%). CONCLUSIONS: For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.

Craniofacial Epidermoid and Dermoid Cysts.

BACKGROUND: Epidermoid and dermoid cysts are benign developmental anomalies that can form anywhere in the body. Despite the rarity of incidence in the head and neck, they can arise at a variety of craniofacial locations. The purpose of this study was to analyze the clinical features of epidermoid and dermoid cysts arising in the craniofacial region with a literature review. METHODS: A retrospective study was designed, and clinical features and surgical considerations were investigated from a literature review. Cases of epidermoid cysts in the scalp, temporal area, glabellar area, mouth floor, and buccal mucosa were described. RESULTS: Dermoid cysts in more lateral regions of the scalp are rarely associated with intracranial extension. Because temporal dermoid cysts have a high rate of intracranial extension, radiological evaluation of the lesions in the temporal area is imperative. Epidermoid cysts in the glabellar area are usually superficial. Consideration of the surgical approach for an epidermoid cyst of the mouth floor is important. Because epidermoid cysts in the buccal mucosa are extremely rare, differential diagnosis was emphasized. Epidermoid cysts in the scalp, in the temporal intradiploic area, on the glabellar area in the periorbital region, in the mouth floor, and in the buccal mucosa were surgically excised considering the depth and location. Ten cases of epidermoid cysts in the buccal mucosa were retrieved from the literature review. CONCLUSIONS: Consideration of the anatomic locations of epidermoid and dermoid cysts in the craniofacial region might help facilitate accurate diagnosis and treatment.