[Introsseous schwannoma of the mandible]. / Intraosser schwannoma a mandibulában.

Schwannoma is a benign neoplasm originating from the neural sheath and occuring most often in the soft tissues of the head and neck. Intraosseous schwannoma (IS) is extremely rare, most commonly occurring in the mandible. This paper documents a case of IS and the histopathology, karyotyping, CT, and MRI in the diagnostic work-up. Histologically it was a classic schwannoma. The karyotype was normal. CT demonstrated destruction of the mandibular canal while MRI detected encasement of the inferior alveolar nerve by the tumor, and consequently the need to resect the nerve together with the tumor. Using CT and MRI, the morbidity associated with the anticipated surgery can precisely be determined preoperatively.

Solitary fibrous tumor of the buccal vestibule: report of two cases.

Solitary fibrous tumor (SFT) is a rare benign tumor that occurs most frequently in the pleura. It is considered rare in the maxillofacial area. Two new cases of SFT of the buccal vestibule are reported. The previously reported cases of oral SFT are reviewed. The tumors were composed of spindle-shaped cells that were arranged haphazardly and were positive for CD-34, BCL-2, CD-99 and vimentin. Although rare, SFT should be included in the differential diagnosis of oral soft tissue tumors. The clinical presentation and imaging can provide the clinician a better tool for preoperative diagnosis.

Mandibular fractures in children: analysis of 61 cases and review of the literature.

OBJECTIVE: The purpose was to evaluate the incidence, etiology, site and patterns, management and treatment methods, and outcome of pediatric patients with mandibular fractures. METHODS: Pediatric patients (1.5-16 years old) with mandibular fractures, treated at the Soroka University Medical Center were included in the study. Age, gender, etiology, site and type of fracture, associated injuries, mode of treatment, outcome, complications, and follow up were evaluated. The cases were divided into 3 age groups: Group A: 1.5-5 years, Group B: 6-11 years, and Group C: 12-16 years. RESULTS: Sixty one patients were included in the study. The male to female ratio was 2:1. Motor vehicle accident was the most common cause. Associated trauma was more common in young children. The condyle was involved in 54% of the fractures. Closed reduction and intermaxillary fixation was the most common treatment used. Complications were rare. CONCLUSION: Management of mandibular fracture in the pediatric age group is a challenge. The anatomical complexity of the developing mandible and teeth strongly suggest the use of surgical techniques that are different from those routinely used in adults. The conservative approach is recommended. Whenever possible closed reduction should be the treatment of choice.

Iatrogenic mandibular fracture associated with third molar removal. Can it be prevented?

Removal of third molars is the most common procedure in oral surgery. It may be associated with complications, such as sensory damage , dry socket, infection and iatrogenic damage. A case of mandibular angle fracture during third molar extraction in a 37-year-old female is reported. Literature review on the possible etiologies and ways of prevention were recorded. The reason is believed to be multifactorial and include: age, gender, degree of impaction, relative volume of the tooth in the jaw, preexisting infection or bone lesions, failure to maintain a soft diet in the early postoperative period and the surgical technique. It is possible to reduce the risk of this complication by adoption of preventive measures.

Iatrogenic mandibular fracture associated with third molar removal. Can it be prevented?

No disponible

Removal of third molars is the most common procedure in oral surgery. It may be associated with complications, such as sensory damage, dry socket, infection and iatrogenic damage. A case of mandibular angle fracture during third molar extraction in a 37–year-old female is reported. Literature review on the possible etiologies and ways of prevention were recorded. The reason is believed to be multifactorial and include: age, gender, degree of impaction, relative volume of the tooth in the jaw, preexisting infection or bone lesions, failure to maintain a soft diet in the early postoperative period and the surgical technique. It is possible to reduce the risk of this complication by adoption of preventive measures

Peripheral osteoma of the maxillofacial region. Diagnosis and management: a study of 14 cases.

PURPOSE: The purpose of the article was to present 14 new cases of peripheral osteoma and to evaluate the diagnosis and management of peripheral osteoma of the maxillofacial region with an analysis of the literature. PATIENTS AND METHODS: The records of 14 consecutive patients (6 males and 8 females) referred for the management of peripheral osteoma the maxillofacial region were reviewed. Demographic data, location, presenting symptoms, radiographic findings, bone scan, colonoscopy results and surgical management were analyzed. The criteria used to diagnose peripheral osteoma included radiographic and histologic features. RESULTS: The 14 patients, ranged in age from 13 to 79 years with a mean age of 40.5 years. The lesions were located in the mandible (64%), maxilla (7%), temporal bone (22%) and maxillary sinus (7%). Colonoscopy results performed in 10 subjects were negative. Surgical excision was the treatment of choice with good results. There were no complications or recurrences. CONCLUSIONS: Peripheral osteoma of the jaw bones is uncommon. The post surgical follow-up should include periodic clinical and radiographic studies. Patients with osteoma associated with impacted or supernumerary teeth, should be evaluated for the possible Gardner's syndrome.

Radiographic features of large cystic lesions of the jaws in children.

BACKGROUND: The surgical approach to cystic lesions of the jaws is either marsupialisation or enucleation. The treatment of choice is dependent on the size of the lesion, the bony integrity of the cyst and its proximity to anatomical structures. OBJECTIVES: To assess large (>2.0 cm) cystic lesions of the jaws using plain film radiography (PFR), CT, multiplanar reconstruction program (MPR) and three-dimensional CT (3D-CT). PATIENTS AND METHODS: Twelve children aged 7-14 years. RESULTS: The classic radiological feature was a unilocular radiolucent area surrounded by a well-defined radio-opaque margin adjacent to the root of a non-viable tooth or associated with the crown of an unerupted tooth. Malposition of teeth and root resorption were more common in dentigerous cysts. The features seen on CT were clear and more precise than those seen on PFR. MPR, by the three-dimensional visualisation of the jaw (axial, panoramic, and bucco-lingual), provided useful information for determining the outline of the cyst and its proximity to adjacent anatomical structures, such as teeth, nerves or maxillary sinus. 3-D CT further and more clearly demonstrated discontinuity in the buccal or palatal/lingual cortices of the jaw bone. PFR was very accurate in determining root resorption. CONCLUSIONS: CT with MPR and, ideally, 3-D CT should be used for the comprehensive diagnostic work-up and meticulous surgical management of large cystic lesions of the jaws in children.

Orofacial manifestations of congenital insensitivity to pain with anhidrosis: a report of 24 cases.

PURPOSE: To report the incidence and severity of the oral and dental manifestations associated with congenital insensitivity to pain with anhidrosis (CIPA). METHODS: Young children with CIPA underwent orofacial examination. The tongue, lips, and buccal mucosa were examined for soft tissue disorder. Missing and luxated teeth were recorded. RESULTS: Twenty four patients (14 males and 10 females, mean age 60 months, range 9-144 months) with CIPA showed moderate to severe self-mutilation. Oral self-mutilation, such as biting injuries and scarring of soft tissues (tongue, lip, and buccal mucosa) were found in all patients. Fingertip biting was also found in most patients. Among infant patients, the mutilation was typically characterized by decubital ulcers of the tongue. Many edentulous areas due to previously extracted teeth were also found. CONCLUSIONS: Early diagnosis and specific dental care for patients with CIPA can be helpful in prevention of the fingertip biting and orofacial manifestations seen in this disorder.