Solitary fibrous tumor of the masticator space - Report of a rare case.

The solitary fibrous tumor (SFT) is a potentially malignant spindle cell neoplasm of the mesenchymal origin that was originally described as a thoracic lesion originating from the pleural tissue. Recently, numerous extrapleural sites of origin have been described, also affecting the head and neck region. SFTs are benign in most cases, but 10%-15% of extrapleural SFTs show malignant behavior in the form of recurrent or metastatic disease. We present the case of a 25-year-old female who presented with an asymptomatic left-sided facial swelling of over three years. She had a diffuse swelling in the left preauricular region, extending to the temporal region deep to the zygomatic arch. On magnetic resonance imaging, the vascular lobulated mass occupied the masticator space, infratemporal fossa, and parapharyngeal space, eroding the mandible. An ultrasound-guided fine-needle aspiration cytology was suggestive of SFT, positive for signal transducer and activator of transcription 6 and negative for TLE1. After preoperative embolization, the tumor was excised through a midline lip split approach with posterior segmental mandibulectomy and reconstruction with a titanium plate. Histopathological report was consistent with SFT. Due to high-risk features, she was advised adjuvant radiation therapy. SFTs of the head and neck are exceedingly rare and those with aggressive behavior even more so. To our knowledge, this is the only case of SFT arising in the masticator space. Diagnosis is often difficult and not definitive without immunohistochemistry. In most cases, complete surgical excision is the only treatment necessary. Regardless, all patients require close clinical follow-up for several years.

Assessing perceptions of oral health related quality of life in dental implant patients. Experience of a tertiary care center in India.

BACKGROUND: Patients perception of treatment outcomes are invaluable assessment tools and are effective indicators for future prognosis. Various tools of measurement have been used to assess the same. The oral health impact profile questionnaire (OHIP 14) has been effectively used to evaluate the oral health-related quality of life (OHRQoL) with regards to individual perceptions. This study was conducted to assess OHRQoL in patients who have had dental implants to replace missing teeth in the Department of Dental Surgery, Unit 1, Christian Medical College and Hospital, Vellore, TN, India by using the OHIP 14 questionnaire. MATERIALS AND METHODS: A total of 107 patients who had treatment with dental implants were sent a modified form of the OHIP 14 questionnaire. An attempt was made to draw an inference by correlating scores of the OHIP 14 with data pertaining to key independent variables. Gamma regression was applied to the results as the outcome score distribution was skewed. All statistical analyses were performed using SPSS Version 21.0. RESULTS: The mean score for the OHIP 14 was 16.82 with the highest score of 30 for a total score of 70. OHIP 14 scores were higher in patients with implant-supported fixed dental prosthesis as compared to patients with single implant supported crowns (P = 0.0069). Patients with no complaints scored 9% lesser than those who reported complaints (P = 0.0438). CONCLUSION: Assessing quality of life with regards to specific treatment interventions may help to draw critical inferences that determine overall success. Results from the study enabled us to delineate and appreciate the success imparted by esthetics and function from the general well being imparted by treatment with dental implants. Social media could be used to positively improve responses in questionnaire based studies. Future studies using implant specific OHRQoL questionnaire may help to elicit unbiased patient perception in dental implant patients.

A review of clinical and radiological features of cleidocranial dysplasia with a report of two cases and a dental treatment protocol.

Cleidocranial dysplasia (CCD) is a rare autosomal dominant condition with generalized dysplasia of bone characterized by delayed closure of cranial sutures, hypoplastic or aplastic clavicles, short stature, dental abnormalities and a variety of other skeletal abnormalities. We report two cases presenting with classical features of CCD because of its rarity.

Management of severe sleep apnea secondary to juvenile arthritis with temporomandibular joint replacement and mandibular advancement.

Variations affecting the growth centers can severely affect the normal formation and subsequent function of vital musculoskeletal structures. We report a case of bilateral condylar atrophy with a history of juvenile arthritis (JA) resulting in progressive obstructive sleep apnea (OSA) in adulthood. In addition to this, the case report emphasizes the role of temporomandibular joint replacement and advancement of the mandible to correct progressive OSA secondary to idiopathic JA. Computed tomography revealed micrognathia, condylar hypoplasia, and decreased pharyngeal airway space. The resultant increase in the retrolingual-pharyngeal airway space following the surgery, helped to completely resolve the presenting symptoms. It is hoped that the described technique could be used in similar cases with a predictable outcome.

Audit on titanium reconstruction of mandibular defects for jaw lesions.

AIMS: The aim of the study is to audit the titanium reconstruction of jaw defects in benign conditions in Christian Medical College and Hospital, Vellore. METHODS AND MATERIAL: A retrospective study of titanium reconstruction of mandibular defects due to jaw lesions at Christian Medical College and Hospital, Vellore, India, between May 2008 and May 2011. RESULTS: Mouth opening, facial symmetry, occlusion, chewing ability, plate exposure and patient satisfaction were used as outcome measures. CONCLUSIONS: The three-dimensional titanium plate is a reasonable material for immediate mandible reconstruction after surgical resection of benign jaw pathologies.