Aneurysmal bone cyst of the ascending ramus mandible. A case report.

We report the clinical course of a 28-year old male patient with a large aneurysmal bone cyst of the ascending ramus of the left mandible. Surgical treatment was performed as radical resection of the ascending ramus of the mandible including the condyle with one-stage reconstruction with a free fibula flap. Aggressive growth, clinical symptoms and a high recurrence rate of aneurysmatic bone cysts were the reason for this surgical treatment. The free fibula flap offers a good quality of cortical bone, which is supposed to be the best choice for reconstruction of the condyle.

Periodontal regeneration employing gingival margin-derived stem/progenitor cells: an animal study.

AIM: This study investigated the periodontal regenerative potential of gingival margin-derived multipotent postnatal stem/progenitor cells. MATERIAL AND METHODS: Periodontal defects were induced at six sites in eight miniature pigs in the premolar/molar area (-4 weeks). Autologous cells isolated from the gingival margin were magnetically sorted using STRO-1 antibodies and characterized flow cytometrically for the expression of CD14, CD31, CD34, CD45, CD117 and STRO-1 surface markers. Colony formation and multilineage differentiation potential were tested. The cells were expanded and loaded on deproteinized bovine cancellous bone (DBCB) and Collagen scaffolds. Within every miniature pig, six periodontal defects were randomly treated with loaded-DBCB (test group 1), unloaded-DBCB (control group 1), loaded-Collagen scaffolds (test group 2), unloaded-Collagen scaffolds (control group 1), scaling and root planing (negative control 1) or left untreated (negative control 2). Differences in clinical attachment level (ΔCAL), probing depth (ΔPD), gingival recession (ΔGR) and radiographic defect volume (ΔRDV) between baseline and 12 weeks, as well as histological attachment level (HAL), junctional epithelium length (JE) and connective tissue adhesion (CTA) after 12 weeks were evaluated. RESULTS: Isolated cells showed stem/progenitor cell characteristics. Cell-loaded scaffolds showed higher ΔCAL, ΔPD, ΔGR, HAL and lower JE and CTA compared with unloaded scaffolds and negative controls. The sort of scaffold had no significant influence on the measured outcomes. CONCLUSION: Gingival margin-derived stem/progenitor cells show significant periodontal regenerative potential.

Iatrogenic transposition of the parotid duct into the maxillary sinus after tooth extraction and closure of an oroantral fistula. A case report.

CASE REPORT: We report the clinical course of a patient with a rare iatrogenic surgical complication of transposition of the Parotid duct into the maxillary sinus after tooth extraction. DISCUSSION: Oroantral fistula occurs most frequently following maxillary molar or premolar extraction. Closure of an oroantral fistula is frequently closed using the buccal mucoperiosteal flap first described by Rehrmann in 1936. Transposition of the Parotid duct is a rare surgical complication of this technique. CONCLUSION: Differential diagnosis of nonspecific discharge from the nose should take this rare cause into account as it is a common symptom of this complication. A careful and full patient history and the correlation of nasal secretion with food intake can lead to the diagnosis.

Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry.

Unilateral coronoid hyperplasia is a rare condition in the pediatric age. It may be an unrecognized cause of restricted mouth opening in children.The limited jaw movement is due to the enlargement of the coronoid process of the mandible that impinges on the zygomatic arch during mouth opening. This pathologic condition is still unknown and often misdiagnosed.Although in the past the term osteochondroma has been used to describe most of the unilateral and a few of the bilateral cases, there is no histologic evidence that the process has a neoplastic origin.Microscopic examination of the removed coronoid process has revealed hyperplastic compact bone covered with a thin layer of normal cartilage.There are multiple causes of mandibular hypomobility, each of them associated with different anatomic structures and etiologies, and a large number of cases, mostly bilateral, are idiopathic in nature.Several theories of pathogenesis have been proposed: temporomandibular joint dysfunctions, mandibular hypomobility, temporalis hyperactivity, hormonal stimulus, persistent cartilage growth center, genetic inheritance, and family factors.Unilateral coronoid hyperplasia is usually due to a trauma or a pathologic condition and is associated with facial asymmetry, being more frequently seen in women with histologic chondromatous or neoplastic changes. A thorough clinical history should include information about the onset and progression of pain and other subjective symptoms.In this study, we present a case of unilateral hyperplasia of the coronoid process in a 3 year-old female who, to the best of our knowledge, is the youngest patient so far reported with such anomaly.Our findings support the recommendation that early surgical treatment and aggressive postoperative physical therapy should be taken into account to allow for recovery of morphology and growth function in children.