An Atypical Bilateral Presentation of Fibrous Dysplasia (FD) in the Mandible: Clinical, imaging and therapeutic characterization.

INTRODUCTION AND IMPORTANCE: Fibrous Dysplasia (FD) is a benign fibro-osseous lesion, characterized by replacement with fibrous connective tissue instead of normal bone. The best treatment option for the condition has not yet been established, although several therapeutic approaches have been reported. The present case report describes the clinical, imaging and therapeutic aspects of an atypical bilateral presentation of FD in the mandible. CASE PRESENTATION: A 26-year-old afro-descendent woman, who had previously undergone surgery to remove FD in the right hemimandible, complained of asymptomatic swelling in the left hemimandible. Imaging analysis showed an ipsilateral extensive multilocular mandibular lesion, with thinning of the cortical bone. After diagnosis of FD, complete surgical removal was performed, associated with immediate local reconstruction with xenograft and covering membrane, with primary wound closure. CLINICAL DISCUSSION: Bilateral presentation of FD is uncommon, and its diagnosis by means of clinical data, imaging and histopathological analysis, is relevant in order to establish the correct therapy. CONCLUSION: Complete surgical removal associated with immediate local bone reconstruction, has shown satisfactory clinical results, when adequate follow-up is performed.

An atypical presentation of gigantiform torus palatinus: A case report: Atypical tori palatine and surgical management.

INTRODUCTION: Torus palatinus (TP) is a slow growing maxillary exostosis, commonly found in the in the hard palate on either side of the median raphe of the palatine bone. Its aetiology is still unclear, but it has been attributed to genetic events and environmental agents, with a slight predilection for the female gender. PRESENTATION OF CASE: The aim of this case report was to describe an unusual presentation of nodular TP in younger female patient, with medical history of hysterectomy when she was 25 years old. The TP manifested insidious progression that affected functional activities such as eating, swallowing and normal pronunciation. Furthermore, we describe our experience during pre-planning the surgery by using 3D-scan-printing, and the conservative surgical approach performed. DISCUSSION/CONCLUSION: TP may be associated with epidemiological, environmental and systemic disorders of patients suffering from this condition. Conservative surgical removal continues to be the first choice treatment when the TP must be removed. Further studies are considered necessary to elucidate the etiological factors.

Conservative management of odontogenic keratocyst with long-term 5-year follow-up: Case report and literature review.

INTRODUCTION: Odontogenic Keratocyst (OKC) is a benign lesion recently considered an odontogenic cyst in the present World Health Organization (WHO) classification of Head and Neck tumors (2017) mainly based on its clinical and histopathological features. Several studies, systematic reviews and meta-analyses have shown a multimodal approach to reducing the high recurrence rates inherently exhibited by this pathological condition after long-term periods of follow-up. PRESENTATION OF CASE: The patient, a 67-years-old woman, was submitted to conservative surgical management of an odontogenic keratocyst. Initially this consisted of decompression and subsequent enucleation, with a long-term period of follow-up to ensure that there was no recurrence. DISCUSSION: Conservative surgical management is the first choice and might be considered the gold standard, but combined therapy such as marsupialization, application of Carnoy's solution, enucleation of the remnant lesion and an extensive follow-up period would considerably reduce recurrence rates. CONCLUSION: Therefore, an appropriate long-term follow-up must be done after the treatment performed in order to ensure clinical success, which in this case was described as an absence of signs of recurrent disease.