Solitary Plasmacytoma of the Mandible: An Uncommon Entity.

INTRODUCTION: Plasma cell dyscrasias are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary bone plasmacytoma (SBP) is a local form of the disease with the vertebrae and long bones being the most frequently encountered sites. Its prevalence in the maxillofacial area is extremely rare. CASE PRESENTATION: A 70-year-old Caucasian male patient was referred for the extraction of his mobile premolar tooth with a poorly-defined radiolucent lesion. Histopathological analysis revealed an SBP and no distant lesion or serum M protein was noted on radiological and hematological examinations. The patient was under follow-up care with no recurrence at 2 years of follow up. CONCLUSIONS: Diagnosis of an SBP is based on local radiological and neurological symptoms and similar systemic manifestations of multiple myeloma that are also distinctive for SBP. Skeletal radiological analysis including CT and PET-CT, bone marrow biopsy, and serum protein electrophoresis are essential for confirmation of the diagnosis. Although surgery, chemotherapy, and radiation, or a combination of these modalities, have been successfully used in the treatment of SBP, it should be managed in relation to its possible long-term evolution.

Effects of osteoformin in the rapid distraction osteogenesis of rabbit mandibles.

OBJECTIVE: To evaluate the effects of osteoformin on mineralisation and quality of the new bone formation during rapid distraction osteogenesis. METHODS: This multi-centre study was conducted at the Karadeniz Technical University, Middle East Technical University and Selcuk University. The experimental study was conducted from January 2010 to September 2012 and comprised New-Zealand rabbits that were randomly divided into three groups. In group I distraction rate was 1 mm/day while in groups II and III distraction rates were 2mm/day and 1 mm/day. In groups I and II 100µg/kg osteoformin was injected after the latency period. Distraction region was evaluated by radiological, histomorphometrical and dual energy X-ray absorptiometry analyses. SPSS 17 was used for statistical analysis. RESULTS: There were 18 rabbits with each of three groups having 6(33.3%). Accelerated bone healing was noted in groups I and II compared with group III (p<0.05). No significant differences were indicated between groups I and II (p>0.05). CONCLUSIONS: Local injection of osteoformin was effective in the craniomaxillofacial distraction osteogenesis in rabbits. Further experimental studies are recommended before using osteoformin on humans.

Comparative treatment outcomes of menopausal and nonmenopausal women after arthrocentesis.

OBJECTIVES: Most of the patients treated for temporomandibular joint disorders constituted from the female population, and this situation is generally hypothesized and demonstrated in several studies. Arthrocentesis of the temporomandibular joint is a minimally invasive and effective treatment method in the management of patients with stage III and stage IV Wilkes syndrome. This study was aimed at assessing the effectiveness of this method between menopausal and nonmenopausal female patients. STUDY DESIGN: A total of 59 patients (25 menopausal and 34 nonmenopausal) were evaluated according to the visual analog scale for pain and chewing function scores, joint sound, and maximum mouth opening. RESULTS: In both groups, the parameters were detected statistically significant according to follow-up periods. The menopausal group showed better results than the nonmenopausal group at 6-month controls. CONCLUSION: In conclusion, arthrocentesis is a satisfactory treatment modality in the management of temporomandibular joint derangements. Female reproductive hormone levels may affect the success of this procedure.

Cholesterol granuloma of the jaws: report of two cases.

Cholesterol granuloma (CG) is a foreign body reaction to the deposition and inadequate drainage of cholesterol crystals that are frequently found in association with chronic middle ear diseases but an uncommon entity in maxillary sinuses. The clinical symptoms are non-specific and depend on the localization and extent in each individual case. Bone erosion may be seen in cholesterol granuloma showing expansive growth. The differential diagnosis of CG includes cysts, mucocoeles and neoplasms. Radiological and histopathological findings are essential for diagnosis of CG. In this report it is aimed to introduce two new CG cases with its clinical, histopathological and radiological findings

Short-term results of prolotherapy in the management of temporomandibular joint dislocation.

OBJECTIVE: Prolotherapy, the rehabilitation of ligaments or tendons by induced proliferation of cells by using dextrose, is a noninvasive and effective method for the treatment of temporomandibular joint (TMJ) dislocation. The aim of this study was to evaluate the efficacy of prolotherapy method for the management of acute or chronic dislocation of TMJ. MATERIALS AND METHODS: In this study, 10 patients with TMJ dislocation (2 acute, 8 chronic) were examined retrospectively. All patients consisted of female patients, with a mean age of 28.4, who were treated with prolotherapy procedure. Differences of visual analog scale scores in quality of life, pain on function, and chewing function efficacy between sessions were investigated using the Wilcoxon t test and median values of sessions were evaluated using the Kruskal-Wallis H test. The amount of change at the maximum mouth opening occurring between the preoperative and postoperative values and the frequency of locking episodes were calculated, with results considered statistically significant at P < 0.05. RESULTS: Pain on function scores were significantly decreased in all patients, and TMJ locking were not observed during the follow-up period. Maximum mouth opening exhibited a tendency to decrease, but it was not statistically significant. Also, clicking sound on function presented no significant change (P > 0.05). On the other hand, the visual analog scale scores for quality of life showed significant improvement in all patients (P < 0.05). CONCLUSIONS: The results of this study show that prolotherapy can be used as an efficient, simple, and conservative method to treat TMJ dislocation.

The effect of chronic temporomandibular joint dislocation: frequency on the success of autologous blood injection.

Autologous blood injection (ABI) is a conservative, non-surgical method of treating chronic temporomandibular joint (TMJ) dislocation. Although many clinicians have reported positive results, procedural success has not been evaluated according to dislocation type. This study investigated the success of ABI on chronic TMJ dislocation with respect to dislocation frequency. ABI was used to treat 27 joints in 17 patients. The patients were divided into two groups based on dislocation frequency: (A) at least twice a week on different days and (B) at least twice a day. The procedure was successful in 13 of the 15 injected joints (86.6 %) in group A and six of the 12 injected joints (50 %) in group B. This difference was statistically significant (p = 0.03814). Autologous blood injection had limited success in patients with very frequent dislocation, while it was useful for treating less frequently dislocated TMJs.

Evaluation of sedation in oral and maxillofacial surgery in ambulatory patients: failure and complications.

OBJECTIVES: This study evaluated the failure and complication rates of sedation in ambulatory patients undergoing oral and maxillofacial surgery. MATERIALS AND METHODS: This retrospective cohort study was carried out among 619 patients who had undergone maxillofacial surgical procedures under intravenous sedation with midazolam and fentanyl. Each patient's age, American Society of Anesthesiologists (ASA) classification, systemic condition, surgical procedure, complications, and failures were recorded for evaluation. RESULTS: A total of 400 patients with ASA I, 199 with ASA II, and 20 with ASA III between the ages of 9 months and 84 years were included in the study. The most common systemic disorders in our patients were mental retardation (35%), hypertension (19%), and epilepsy (15%). Evaluation of the cases revealed 9 complications (1.4%) and 9 sedation failures (1.4%). The complications were bradycardia, postoperative agitation and hallucination, drug reaction, vomiting and nausea, desaturation, and hypotension. CONCLUSIONS: Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates.

Intra-mandibular canalicular adenoma: report of a rare case.

Canalicular adenomas are uncommon benign salivary gland neoplasms of the oral cavity. They are typically located on the upper lip, buccal mucosa and infrequently found on the palate and derived from minor salivary glands. Intra-mandibular localization of canalicular adenoma is extremely rare. Due to benign character of the tumour, canalicular adenomas rarely present with bone erosion. Histologically, trabecular type of basal cell adenoma, pleomorphic adenoma and polymorphous low-grade adenocarcinoma should be discriminated from canalicular adenomas. A-56- year old female patient with asymptomatic intra-mandibular canalicular adenoma was presented. The lesion was managed surgically under local anesthesia and 2 year's follow up was uneventful. Only two other intra-mandibular canalicular adenoma cases have been reported up till now. This case report describes the third intra-mandibular canalicular adenoma, and reviews the literature.