A follow-up case of relapsing tuberculous spondylodiscitis, complicated with soft-tissues abscess and percutaneous fistula

CAD/CAM technology can enhance the dentistry application of ceramic materials that meet the more relevant biocompatibility and aesthetics demands. In implant-borne prosthesis rehabilitation, yttria-stabilized zirconia appeared to be a valid alternative to metal-alloys and titanium, with comparable mechanical properties and even better interaction with bone and soft tissues. The improvement of monolithic CAD/CAM manufacturing allows for a reliable, predictable, and rapid workflow that can correspond to a holistic treatment philosophy associated with zirconia fixtures. This reported clinical case highlights the advantages of this approach in resolving particularly functionally and aesthetically complex situations. A 40-year-old patient with permanent canine impaction and the persistence of a deciduous tooth compromised by caries was successfully rehabilitated with the surgical removal of the enclosed tooth, the seating of a mono-phase zirconia implant after the deciduous extraction and its loading with a zirconia single crown, without any clinical or radiographical alteration up to seven years follow-up.

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A Protocol for the Use of a Combined Microvascular Free Flap with Custom-Made 3D-Printed Total Temporomandibular Joint (TMJ) Prosthesis for Mandible Reconstruction in Children

Applied Sciences ◽

10.3390/app11052176 ◽

2021 ◽

Vol 11 (5) ◽

pp. 2176

Author(s):

Krzysztof Dowgierd ◽

Rafal Pokrowiecki ◽

Maciej Borowiec ◽

Marcin Kozakiewicz ◽

Dominika Smyczek ◽

...

Keyword(s):

Temporomandibular Joint ◽

Soft Tissues ◽

Total Joint Replacement ◽

Speech Development ◽

Functional Requirements ◽

Immediate Reconstruction ◽

Congenital Deformities ◽

Custom Made ◽

Masticatory System

Extended postoperative mandibular reconstructions due to orofacial disease involving the temporomandibular joint (TMJ) in immature patients remain a challenge as a result of ongoing growth, which is usually affected by the disease and treatment. Current reconstructive techniques based fully on alloplastic total joint replacement fail to meet fully the anatomical and functional requirements for the masticatory system and speech development. Fourteen children aged 12.6 ± 2.6 with tumors or congenital deformities affecting the mandible and TMJ were included in the study. Radical surgical treatment according to our own protocol was performed through microvascular anastomotic flap reconstruction of the soft tissues and bones, together with total TMJ custom replacements. Follow-up lasted 2–6 years. During the follow-up, increases in the mandible body (13% growth) and ramus (12% growth) were observed, both of which were related (p < 0.001). This is the first report concerning the immediate reconstruction of the mandible with ramus and total TMJ in children and adolescents that combines a free vascularized graft and total individual prosthesis of the TMJ. The presented technique enabled optimal function of the TMJ, growth of the mandible, and further rehabilitation of the patients. The technique was demonstrated to be safe, reliable, and provide good functional and cosmetic outcomes.

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Custom-Made 3D-Printed Implants as Novel Approach to Reconstructive Surgery after Oncologic Resection in Pediatric Patients

Journal of Clinical Medicine ◽

10.3390/jcm10051056 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1056

Author(s):

Giovanni Beltrami ◽

Gabriele Ristori ◽

Anna Maria Nucci ◽

Alberto Galeotti ◽

Angela Tamburini ◽

...

Keyword(s):

Pediatric Patients ◽

Soft Tissues ◽

Lower Limbs ◽

Host Bone ◽

Limb Salvage Surgery ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Custom Made ◽

3D Printed

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.

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Influence of soft tissue and bone thickness on the dimensional change of peri-implant soft tissues: A clinical follow-up study

The Journal of the Korean Academy of Periodontology ◽

10.5051/jkape.2005.35.1.187 ◽

2005 ◽

Vol 35 (1) ◽

pp. 187

Author(s):

Moontaek Chang

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Dimensional Change ◽

Bone Thickness ◽

Follow Up Study

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Peripheral Ameloblastoma with Dystrophic Calcification: An Unusual Feature in Non-Calcifying Odontogenic Tumors

Brazilian Dental Journal ◽

10.1590/0103-6440201300024 ◽

2014 ◽

Vol 25 (3) ◽

pp. 253-256 ◽

Cited By ~ 5

Author(s):

Nelise Alexandre da Silva Lascane ◽

Bruno Tavares Sedassari ◽

Fábio de Abreu Alves ◽

Marina Helena Cury Gallottini ◽

Suzana Cantanhede Orsini Machado de Sousa

Keyword(s):

Soft Tissues ◽

Squamous Metaplasia ◽

Imaging Study ◽

Unusual Feature ◽

Bone Involvement ◽

Odontogenic Tumors ◽

Dystrophic Calcification ◽

Detailed Imaging

Peripheral ameloblastoma is a rare extraosseous counterpart of central ameloblastoma that occurs in soft tissues and may cause bone crest resorption. This study reports a peripheral ameloblastoma on the buccal gingiva of a 56-year-old man, which presented extensive squamous metaplasia areas, keratinization and dystrophic calcifications in the neoplastic islands. It is emphasized the need of a detailed imaging study and a long follow-up period to exclude bone involvement whenever peripheral ameloblastoma diagnosis is considered.

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A Conservative Approach to a Peripheral Ameloblastoma

Case Reports in Dentistry ◽

10.1155/2016/8254571 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Rocco Borrello ◽

Elia Bettio ◽

Christian Bacci ◽

Marialuisa Valente ◽

Stefano Sivolella ◽

...

Keyword(s):

Oral Cavity ◽

Soft Tissues ◽

Complete Removal ◽

The Other ◽

Conservative Approach ◽

Choice Of Treatment ◽

Long Term Follow Up ◽

One Year

Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion.

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PEComa of soft tissues can mimick lymph node relapse in patients with history of testicular seminoma

Canadian Urological Association Journal ◽

10.5489/cuaj.413 ◽

2013 ◽

Vol 7 (9-10) ◽

pp. 651 ◽

Cited By ~ 2

Author(s):

Gabriele Guglielmetti ◽

Paolo De Angelis ◽

Paolo Mondino ◽

Carlo Terrone ◽

Alessandro Volpe

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Soft Tissues ◽

Percutaneous Biopsy ◽

Surgical Excision ◽

Pelvic Lymphadenectomy ◽

Adjuvant Radiation ◽

Soft Tissue Neoplasm ◽

Testicular Seminoma

Perivascular Epithelioid Cell tumour (PEComa) is rare. We describe a 39-year-old man who underwent a left radical orchidectomy and adjuvant radiation therapy for a stage IA classical testicular seminoma. He was diagnosed with a mass lateral to the right common iliac artery that was considered suspicious for late lymph node relapse after 3 years of follow-up. Due to the unusual location of the mass and the equivocal findings of percutaneous biopsy, a laparoscopic pelvic lymphadenectomy was performed. Final pathology revealed PEComa of soft tissue. The patient is disease free after 38 months of follow-up without adjuvant treatment. The presence of rare soft-tissue neoplasm should be considered in differential diagnosis of retroperitoneal masses during follow-up of germ cell tumours. Suspicious isolated recurrences of these neoplasms in unusual locations can require surgical excision to confirm diagnosis and avoid inappropriate treatment.

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Posterior Ligamentous Reinforcement of the Upper Instrumented Vertebrae +1 Does Not Decrease Proximal Junctional Kyphosis in Adult Spinal Deformity

Global Spine Journal ◽

10.1177/2192568219868472 ◽

2019 ◽

Vol 10 (6) ◽

pp. 692-699

Author(s):

Sravisht Iyer ◽

Francis Lovecchio ◽

Jonathan Charles Elysée ◽

Renaud Lafage ◽

Michael Steinhaus ◽

...

Keyword(s):

Cohort Study ◽

Spinal Deformity ◽

Soft Tissues ◽

Sagittal Alignment ◽

Adult Spinal Deformity ◽

Proximal Junctional Kyphosis ◽

Propensity Matching ◽

Surgical Data ◽

Junctional Kyphosis

Study Design: Retrospective cohort study. Objectives: Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Biomechanical and clinical studies suggest that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK. The purpose of this study was to evaluate the effect of PLS augmentation on the rate of PJK at 1 year. Methods: A retrospective single-surgeon cohort study was performed of 108 adult spinal deformity patients who underwent 5 level fusions to the pelvis. Patients were divided into 2 groups: PLS+ patients had reconstruction of the PLS between upper instrumented vertebrae +1 (UIV+1) and UIV−1 with a surgical nylon tape while PLS− patients did not. Demographics, surgical data, and sagittal alignment parameters were compared between the cohorts. The primary outcome of interest was the development of PJK at final follow-up. A subgroup propensity match and logistic regression model were utilized to control for differences in the cohorts. Results: A total of 108 patients met final criteria, 31 patients (28.7%) were PLS+. There were no differences with regard to preoperative or final sagittal alignment parameters, number of levels fused, rates of 3-column osteotomies, and body mass index ( P > .05), though the PLS+ cohort was older and had larger initial sagittal corrections ( P < .05). The rates of PJK for PLS+ (27.3%) and PLS− (28.6%) were similar ( P = .827). After controlling for sagittal correction via propensity matching, PLS+ had no impact on PJK (29% vs 38.7%, P = .367). In our multivariate analysis, only increased sagittal malalignment and failure to restore sagittal balance were retained as significant predictors of PJK. Conclusion: Even after controlling for extent of correction and preoperative sagittal alignment, PLS reinforcement at UIV+1 using a hand-tensioned nylon tape does not reduce the incidence of PJK at 1 year.

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Primary orbital extraskeletal osteosarcoma and review of literature

BMC Ophthalmology ◽

10.1186/s12886-020-01690-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jingwen Hui ◽

Yun Zhao ◽

Lei Zhang ◽

Jinyong Lin ◽

Hong Zhao

Keyword(s):

Soft Tissues ◽

Malignant Tumour ◽

Extraskeletal Osteosarcoma ◽

Complete Excision ◽

Case Presentation ◽

Left Orbit ◽

Orbital Wall ◽

Previous Trauma ◽

History Of

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

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Langerhans cell histiocytosis of the rib presenting with pathological fracture: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01368-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Tao Zuo ◽

Ping Jiang ◽

Junjie Yu ◽

Ke Zhao ◽

Yong Liu ◽

...

Keyword(s):

Langerhans Cell Histiocytosis ◽

Pathological Fracture ◽

Soft Tissues ◽

Langerhans Cell ◽

Rib Fracture ◽

Unknown Etiology ◽

Case Presentation ◽

Left Chest ◽

Rib Tumor

Abstract Introduction Langerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology. It is clinically rare for patients with solitary rib lesion and pathological fracture; moreover, its diagnosis and treatment are quite difficult. The purpose of this study is to present a case for the pathogenesis, clinical features, imaging, and treatment of this disease. Case presentation A 52-year-old female patient complained of left chest pain for one week. CT showed a fracture in the left 5th rib. The rib tumor was then resected and the surrounding muscles and soft tissues were accordingly resected. The patient was diagnosed with pathological rib fracture, and the patient was pathologically diagnosed with LCH. After surgery, no local recurrence or distant metastasis was reported during the two-year follow-up. Conclusions LCH should be treated by observation, chemotherapy, radiotherapy, or surgery, or using a combination of several methods. Moreover, primary tumor should be considered when rib fracture without trauma and tumor metastasis.

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