Bilateral Maxillary Langerhans Cell Histiocytosis in a Six-Month-Old Infant.

Langerhans cell histiocytosis (LCH) is a rare proliferative disease of myeloid cells that can affect multiple organs and present with diverse clinical manifestations. The skeleton, skin and lymph nodes are commonly affected sites, while oral involvement is rare. LCH is currently classified by disease extent into single system and multisystem forms, and further categorized by risk organs. The purpose of this report is to describe the case of a six-month-old girl who presented with a chief complaint of feeding difficulties, premature eruption of the primary left maxillary second molar, expansion of the maxillary alveolar ridges and ulceration of the posterior maxillary oral mucosa. The diverse presentations of pediatric LCH in the literature are reviewed and the role of pediatric dentists and oral surgeons in helping to diagnose LCH is highlighted.

Systematic review of the use of pentoxifylline and tocopherol for the treatment of medication-related osteonecrosis of the jaw.

OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) is a pathologic process resulting in progressive destruction of the jaws. There are no established guidelines for the medical management of MRONJ. Interest in pentoxifylline and tocopherol is growing because these agents have been shown to be effective in treating osteoradionecrosis of the jaw. This review evaluates the clinical usefulness of pentoxifylline and tocopherol in treating MRONJ. STUDY DESIGN: Literature databases were searched for relevant reports of pentoxifylline and tocopherol in treating MRONJ. Only English-language reports and human studies were considered. RESULTS: There were 3 published observational studies and 2 abstracts relevant to this topic. The combination of pentoxifylline and tocopherol is associated with subjective and objective improvements and no major adverse outcomes. CONCLUSIONS: Pentoxifylline and tocopherol has been demonstrated to be effective for managing MRONJ nonsurgically, and, thus, this treatment modality holds promise. However, larger clinical studies are needed to optimize dose and duration.