Primary malignant tumors of orofacial region at Benghazi, Libya: a 17 years review.

The aim of this study was to systematically analyze the clinical presentations of orofacial malignant tumors in a Libyan population over a period of 17 years and compare the results with the reports from other countries. During the study period, tumors of epithelial origin were found in 160 patients (82%), followed by tumors of immune system, 22 (11%) and tumors of mesenchymal origin, 14 (7%). Of the total malignant tumors, 115 were men and 81 were women and the male to female ratio was 1.41:1. Malignant non-odontogenic tumors were seen in 194 patients (99%) and malignant odontogenic tumors were seen in 2 patients (1%). Among the epithelial tumors, squamous cell carcinoma (50.6%) was the most common neoplasm, followed by mucoepidermoid carcinoma (15%) and adenoid cystic carcinoma (8.7%). The incidence of oral malignancy is impressively low with respect to the corresponding levels in other countries in Africa and some European countries.

A study on the impact of mandibular third molars on angle fractures.

PURPOSE: This study evaluated the relationship between the status and position of mandibular third molars and angle fractures. MATERIALS AND METHODS: In a total of 2,033 patients with a mandibular fracture, 532 (26%) had angle fractures, and 1,466 (72%) had retained their lower third molars. The most frequent cause for mandibular fracture was road traffic accident (64%), followed by assault (19%). RESULTS: Of 341 patients with an unerupted third molar, mandibular angle fracture was evident in 249 patients (73%). Only 62 patients (9.4%) with a completely erupted third molar had angle fractures, whereas 83 patients (17.6%) with partially erupted third molars had angle fractures. CONCLUSIONS: Our study confirmed an increased risk of angle fractures in the presence of a lower third molar, as well as a variable risk for angle fracture, depending on the third molar's position.

Awareness of management of dental trauma among medical professionals in Pondicherry, India.

The aim of the study was to establish the level of knowledge on the management of dental trauma among physicians at Pondicherry, India. A questionnaire was designed and was given to physicians working in medical colleges or as residents in advanced training programs in medicine in Pondicherry, India. The questionnaire contained a clinical situation of tooth avulsion and various treatment options. Only 5.5% of the medical professionals knew about reimplantation and none knew that the patients' mouth was the best transport medium. 90% of them accepted that they had no knowledge on dental trauma management. As the physicians get an opportunity to attend a case of dental trauma in emergency or private practice, it is vital that they possess sufficient knowledge on primary management of tooth avulsion, before referring to dentists.

Ancient schwannoma arising from mental nerve. A case report and review

Schwannoma is an intraoral rare, benign neoplasm derived from the nerve sheath of peripheral nerves. “Ancient schwannoma”shows histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused withmalignant neoplasms. Ancient schwannoma of the head and neck region is relatively uncommon and very few cases hadbeen reported in the oral cavity. We present a case of ancient schwannoma arising from the mental nerve in a 19 year oldmale which was of eight months duration. Examination revealed a 30 x 25 mm firm, strawberry-like mass in the periapicalregion of the left lower first premolar, extending anteriorly to the canine and posteriorly to the first molar, obliterating thebuccal vestibule, with an intact overlying mucosa. Ultrasonography showed that the tumor was closely associated withthe mental nerve on the left side, suggestive of a peripheral neural sheath tumor. Complete excision of the lesion was doneunder local anesthesia, preserving the mental nerve. The histological picture was strongly suggestive of ancient schwannoma(Antoni A type). There was no evidence of recurrence 18 months after excision. The clinicopathological aspects ofthis special case are discussed, and the literature regarding this entity is reviewed (AU)

Ancient schwannoma arising from mental nerve. A case report and review.

Schwannoma is an intraoral rare, benign neoplasm derived from the nerve sheath of peripheral nerves. "Ancient schwannoma" shows histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. Ancient schwannoma of the head and neck region is relatively uncommon and very few cases had been reported in the oral cavity. We present a case of ancient schwannoma arising from the mental nerve in a 19 year old male which was of eight months duration. Examination revealed a 30 x 25 mm firm, strawberry-like mass in the periapical region of the left lower first premolar, extending anteriorly to the canine and posteriorly to the first molar, obliterating the buccal vestibule, with an intact overlying mucosa. Ultrasonography showed that the tumor was closely associated with the mental nerve on the left side, suggestive of a peripheral neural sheath tumor. Complete excision of the lesion was done under local anesthesia, preserving the mental nerve. The histological picture was strongly suggestive of ancient schwannoma (Antoni A type). There was no evidence of recurrence 18 months after excision. The clinicopathological aspects of this special case are discussed, and the literature regarding this entity is reviewed.

Cervical necrotizing fasciitis: an unusual sequel of odontogenic infection.

Cervical necrotizing fasciitis is a rare infection of the fascial planes, which is less common in head and neck, because of the rarity and higher vascularity in the region. We reviewed five patients with cervical necrotizing fasciitis of odontogenic infection managed at a teaching hospital at Chennai, India. There were four men and one woman, of whom four patients were diabetic and hypertensive, with a mean age of 53 years. Mandibular molars (periapical or pericoronal abscess) were found to be the source of infection in all of the cases. The treatment involved incision and drainage and debridement. Anti-microbial drugs were given for all the patients, which included cephalosporins, metronidazole and gentamycin. In four patients the wound healed by contracture and one patient required split skin grafting. Due to the smaller extent of the necrosis, better control of the systemic disease and small size of the sample, there was neither a major complication nor death. This paper reminds us that cervicofacial necrotizing fasciitis (CNF) remains one of the potential complications of long standing odontogenic infections in patients with immune-compromised status, particularly in lower dentition.

Cervical necrotizing fasciitis: An unusual sequel of odontogenic infection

Cervical necrotizing fasciitis is a rare infection of the fascial planes, which is less common in head and neck, becauseof the rarity and higher vascularity in the region. We reviewed five patients with cervical necrotizing fasciitisof odontogenic infection managed at a teaching hospital at Chennai, India. There were four men and one woman,of whom four patients were diabetic and hypertensive, with a mean age of 53 years. Mandibular molars (periapicalor pericoronal abscess) were found to be the source of infection in all of the cases. The treatment involved incisionand drainage and debridement. Anti-microbial drugs were given for all the patients, which included cephalosporins,metronidazole and gentamycin. In four patients the wound healed by contracture and one patient required split skingrafting. Due to the smaller extent of the necrosis, better control of the systemic disease and small size of the sample,there was neither a major complication nor death. This paper reminds us that cervicofacial necrotizing fasciitis(CNF) remains one of the potential complications of long standing odontogenic infections in patients with immunecompromisedstatus, particularly in lower dentition (AU)

Awareness of the specialty of oral and maxillofacial surgery among health care professionals in Pondicherry, India.

PURPOSE: The aim of this study is to establish the level of knowledge among dental, medical, and paramedical professionals of the hospital, regarding the role of oral and maxillofacial surgery in health care. This study also aims to highlight the perception of the medical professionals and what they think an oral and maxillofacial surgeon does. MATERIALS AND METHODS: A survey was done at Jawaharlal Institute of Postgraduate Medical and Research Institute, Pondicherry, India, in 2006. RESULTS: The result showed that out of 100, only 41% of the medical students, 76% of the medical practitioners, and 58% of the paramedical workers have heard of the name of the specialty. CONCLUSION: While the dental professionals realize the scope of the specialty to a larger extent, medical professionals are not fully aware of the expertise the specialty has to offer.

Salivary gland tumors: a single institution experience in India.

Between 1991 and 2006, 684 cases of salivary gland tumours were analysed retrospectively, of which 422 (62%) were benign and 262 (38%) malignant. Sixty-one percent of tumours were in the parotid gland, 22% in the minor salivary glands, and 17% in the submandibular glands. The most common benign tumour was pleomorphic adenoma (86%), and the most common malignant tumours were adenoid cystic carcinoma (25%) and mucoepidermoid carcinoma (18%). Among the minor salivary gland tumours, most were seen in the palate (68%). We analyse the incidence and distribution of all types of salivary gland tumours in an Indian series, and provide data for comparison with other epidemiological studies from different geographical sites and races. Demographic data from these studies should help us to a better understanding of the biological and clinical characteristics of the disease.

Cystic changes in dental follicle associated with radiographically normal impacted mandibular third molar.

The aim of the study was to find out the incidence of histological abnormalities in soft tissues that are associated with impacted lower third molars with no pericoronal lytic lesion. We studied 100 patients who had a radiographically normal asymptomatic impacted lower third molar (<2.4mm radiolucency). The incidence of cystic changes in the dental follicle was 46%. There was a high incidence in the right side and in men. We recommend histopathological evaluation and radiographic diagnosis in the management of impacted third molars.