53 A Rare Malignant Lesion of the Jaws

Abstract Introduction Primary intraosseous carcinoma (PIOC) of the jaw is an incredibly rare lesion with approximately 200 cases reported in the literature. PIOC are mostly asymptomatic incidental radiographic findings and present as poorly-defined, non-corticated radiolucencies often with root resorption and cortical perforation. Prognosis is considered poor and best predicted by histological grade. Case report A gentleman in his 50s presented to his dentist with a draining sinus from his LR6 tooth. A radiograph revealed a non-corticated radiolucency localised to the distal root of the LR6. 7 months later, he returned with pain and mobility of the LR7. Another radiograph revealed a non-corticated radiolucency from around the distal root of the LR6 extending to the LR8. Urgent biopsy of the mandibular bone was arranged by the oral and maxillofacial surgery team. Histopathology revealed the lesion was likely a benign squamous odontogenic tumour. However, it was not possible to exclude a well-differentiated squamous cell carcinoma. Correlation of clinical findings, imaging and multidisciplinary team discussion was recommended. Following the MDT meeting, excision of the bony lesion was undertaken. Histopathology this time returned as primary intraosseous carcinoma NOS T4N0M0, thought to have arisen from a radicular cyst associated with the LR6/7. The treatment was right segmental mandibulectomy, fibular free flap, selective neck dissection (I-III) and adjuvant radiotherapy. Conclusions This case highlights how subtle radiographic features can represent malignancy in lesions appearing cystic at first. Although rare, clinicians should be aware of PIOC as a differential diagnosis when presented with radiographic features which could represent malignancy.

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Bioactive-glass in Oral and Maxillofacial Surgery

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0035-1551543 ◽

2016 ◽

Vol 9 (1) ◽

pp. 001-014 ◽

Cited By ~ 9

Author(s):

AndreaCorrado Profeta ◽

Christoph Huppa

Keyword(s):

Bioactive Glass ◽

Maxillofacial Surgery ◽

Neck Region ◽

Bone Substitutes ◽

Clinical Findings ◽

Oral And Maxillofacial Surgery ◽

Head And Neck Region ◽

Synthetic Materials ◽

Composition And Structure ◽

Craniofacial Defects

The use of synthetic materials to repair craniofacial defects is increasing today and will increase further in the future. Because of the complexity of the anatomy in the head and neck region, reconstruction and augmentation of this area pose a challenge to the surgeon. This review discusses key facts and applications of traditional reconstruction bone substitutes, also offering comparative information. It then describes the properties and clinical applications of bioactive-glass (B-G) and its variants in oral and maxillofacial surgery, and provides clinical findings. The discussion of each compound includes a description of its composition and structure, the advantages and shortcomings of the material, and its current uses in the field of osteoplastic and reconstructive surgery. With a better understanding of the available alloplastic implants, the surgeon can make a more informed decision as to which implant would be most suitable in a particular patient.

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Síndrome de Gardner – relato de caso

Full Dentistry in Science ◽

10.24077/2021;1246-6469 ◽

2021 ◽

Vol 12 (46) ◽

pp. 64-69

Author(s):

Tamile Sousa Silva ◽

Luciano Cincurá Silva Santos ◽

Adna Barros Ismerim ◽

Bráulio Carneiro Junior

Keyword(s):

Maxillofacial Surgery ◽

Clinical Findings ◽

Body Region ◽

Bone Lesions ◽

Oral And Maxillofacial Surgery ◽

Gardner's Syndrome ◽

Adenomatous Polyposis ◽

Gardner’S Syndrome ◽

Mandibular Body ◽

The Right

The Gardner’s syndrome is described as a rare genetic disease resulting from mutations of the Adenomatous Polyposis Coli (APC) gene located in chromosome 5q21. This syndrome is a variant of familial adenomatous polyposis associated with intestinal polyps, mandible osteomas, epidermoid cysts, impacted teeth, and supernumerary among other clinical findings. The aim of this study is to report a clinical case of a 12-year-old female patient diagnosed with the Gardner’s syndrome who searched the Oral and Maxillofacial Surgery and Traumatology Service of Vitoria da Conquista General Hospital complaining of aesthetic alteration in the face. Clinically, there was a hardened mass in the mandibular body region in the right side, painless to palpation. Through computed tomography it was possible to identify the presence of bone lesions, the largest one located in the right mandibular body. With a diagnostic hypothesis of osteoma, the patient was submitted to surgery for mandible tumors resection with subsequent follow-up by the surgeon. The case highlights the importance of knowledge and proper management of the oral and maxillofacial alterations involved in this pathology.

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A Comparative Evaluation of Gustafson’s Formula and New Formula for Age Estimation in India – A Forensic Study

Prague Medical Report ◽

10.14712/23362936.2015.59 ◽

2015 ◽

Vol 116 (3) ◽

pp. 203-209 ◽

Cited By ~ 3

Author(s):

Manas Bajpai ◽

Nilesh Pardhe ◽

Manish Kumar ◽

Shyam Agrawal

Keyword(s):

Age Estimation ◽

Root Resorption ◽

Maxillofacial Surgery ◽

Age Determination ◽

Longitudinal Section ◽

Oral And Maxillofacial Surgery ◽

Dental Fillings ◽

Correlation And Regression Analysis ◽

Periodontal Bone Loss ◽

New Formula

The choice to use teeth for age determination is well accepted due to their longevity ability of being resilient to change. The total of 228 extracted teeth collected from the patients visited to the Department of Oral and Maxillofacial Surgery, NIMS Dental College, Jaipur, the teeth were without dental fillings and without and/or cavity selected. The known age was from 21 to 70 years with the average age of 43.46 years. For age estimation the method according to Gustafson was used. Every tooth was subject to longitudinal section of the midpulpal area. The following dental parameters were studied in each case: attrition, periodontal bone loss, root translucency, secondary dentin deposition, cementum apposition and root resorption. Total scores of different parameters plotted against the chronological age and regression formula was obtained. Using this formula ages were estimated, Gustafson formula was also applied in the same scores and ages estimated. The results of the chronological and estimated age by both formulae have been statistically compared using Pearson’s correlation and regression analysis. The results showed strong correlation (0.92; p<0.001) between chronological and estimated age by using both formulae. We found the mean error of ± 5.47 by using newly derived and formula and ± 6.35 by Gustafson’s formula. As a result of our study it was found that newly derived formula provides better results in comparison with Gustafson’s formula in Indian population. A positive correlation between age and total scores of physiological changes also revealed.

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Harmonic Scalpel over Electrocautery, Evaluation of Peroperative Blood Loss in Selective Neck Dissection: A Comparative Study

Birat Journal of Health Sciences ◽

10.3126/bjhs.v3i2.20964 ◽

2018 ◽

Vol 3 (2) ◽

pp. 475-479

Author(s):

Manish Agrawal ◽

Sanjeev Kumar Thakur ◽

Quazi Billur Rahman ◽

Atul Kumar Agrawal ◽

Nancy Bansal Agrawal

Keyword(s):

Blood Loss ◽

Neck Dissection ◽

Harmonic Scalpel ◽

Maxillofacial Surgery ◽

Standard Of Care ◽

Oral And Maxillofacial Surgery ◽

Selective Neck Dissection ◽

Medical College ◽

Number Of Patients ◽

Test Of Significance

Introduction: The use of Harmonic Scalpel (HS) over Electrocautery (EC) in neck dissection has become standard of care in recent years. However, both the devices are presently widely used in practice and still serve large number of patients globally according to surgeon's choice and cost effectiveness.Objective: To evaluate the amount of peroperative blood loss in cancer patient undergoing selective neck dissection (Levels I, II and III) with Harmonic Scalpel (HS) and Electrocautery (EC).Methodology: The study was performed in the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biratnagar Hospital PVT LTD and Birat Medical College and Teaching Hospital, Nepal from June 2012 to February 2018. A total of 40 patients, 27 male and 13 female, aged 45 to 70 years diagnosed with oral cavity cancer were included in this prospective study. Two groups were formed, 20 patients in each group based on the surgical instrument used; Harmonic Scalpel (HS) and Electrocautery (EC). Data for age and sex of the patients were collected preoperatively. The surgery was performed under general anesthesia with endotracheal intubation and standard protocol was maintained during surgery. Amount of peroperative blood loss was measured and recorded. Data was processed and analyzed using SPSS and was compiled and test of significance was done using unpaired't' test.Results: The amount of peroperative blood loss was significantly lower in Harmonic Scalpel (HS) group then in Electrocautery (EC) group.Conclusion: Results from this study suggests that the Harmonic Scalpel (HS) is an effective device to reduce peroperative blood loss during selective neck dissection. BJHS 2018;3(2)6: 475-479

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CORRELATION OF PANORAMIC RADIOGRAPHIC FINDINGS AND CLINICAL FINDINGS OF DENTAL PATIENTS AT MOI TEACHING AND REFERRAL HOSPITAL, KENYA

Journal of Health, Medicine and Nursing ◽

10.47604/jhmn.1440 ◽

2021 ◽

Vol 7 (4) ◽

pp. 28-44

Author(s):

Abdullatif Badru ◽

Elias Onditi ◽

Kenneth Okemwa

Keyword(s):

Clinical Examination ◽

Panoramic Radiograph ◽

Clinical Findings ◽

Referral Hospital ◽

Categorical Variables ◽

Unique Contribution ◽

Radiographic Findings ◽

Panoramic Radiographs ◽

Radiographic Features ◽

Dental Patients

Purpose: The purpose of this study was to determine the correlation of panoramic radiographic findings and clinical findings among dental patients at Moi Teaching and Referral Hospital (MTRH), Kenya. Materials and Methods: This was a hospital based cross sectional study conducted at the Radiology and Imaging department and dental department at Moi Teaching and Referral Hospital from September, 2019 to June, 2020. A total of 93 consenting patients were enrolled using systematic random sampling. Standard chart review forms were administered, and clinical examination findings documented. Panoramic radiograph findings were then discussed with a consultant radiologists and findings recorded. Descriptive statistics were carried out. Categorical variables were summarized as frequencies and proportions, and reported in tables. Numerical variables were summarized as median and interquartile ranges. Cross tabulation was done to compare clinical examination and panoramic radiograph findings where total raw agreement was reported as proportions. Results: 93 patients whose ages ranged from 5-73 years with a mean of 29 years were included into the study. Radiographic features of dental caries were present in 54% of panoramic radiographs compared to clinical examination (50.5%) while 23.7% of radiographs revealed impacted teeth compared to clinical examination (19.4%). Radiographic features of periodontitis were observed in 14% compared to clinical examination (16.1%). Fractures (12.9%) were observed radiographically compared to (10.7%) clinically. Periapical lesions (8.6%) were observed radiographically compared to clinical examination (6.4%). Temporo-mandibular disorder (6.5%) were observed both on radiographs and clinical examination. Radiographic features of missing teeth (3.2%) were observed compared to clinical examination (1.1%) while only 1.1% of malpositioned teeth were observed radiographically compared to clinical examination (2.2%). Notably, mandibular lesions (3.2%) and nasal congestion (14%) were only discovered radiographically. The overall raw agreement between panoramic radiograph and clinical examination was 75.3% (70/93) with a p value of less than 0.001. Unique contribution to theory, practice and policy: The study recommends that all patients presenting with dental conditions should be done panoramic radiograph to improve diagnosis. Moi Teaching and Referral Hospital and the Ministry of Health to consider routine panoramic radiographs in the guidelines for the assessment of dental patients in all the hospitals offering, dental health services

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Dentinal Dysplasia Type I: A Case Report with a 6-Year Followup

Case Reports in Dentistry ◽

10.1155/2013/659084 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Sezin Ozer ◽

Bora Ozden ◽

Feyza Otan Ozden ◽

Kaan Gunduz

Keyword(s):

Unusual Case ◽

Maxillofacial Surgery ◽

Permanent Teeth ◽

Radiographic Examination ◽

Oral And Maxillofacial Surgery ◽

Type I ◽

Radiographic Findings ◽

Case Presentation ◽

Surgery Department ◽

Dentin Formation

Introduction. Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pulpal morphology that is inherited as an autosomal pulpal morphology.Case Presentation. A 7-year-old female who had problems in chewing function was referred to Oral and Maxillofacial Surgery Department at the Faculty of Dentistry in Ondokuz Mayıs University. In the radiographic examination, it was determined that some of the unerupted permanent teeth of the patient had short, blunted, and malformed roots with obliterated pulp chambers, although the bone below the teeth showed well-defined margins. This unusual case of generalized short roots presents a case demonstrating both classic and atypical features of dentinal dysplasia type I (DDI) in the mixed and permanent dentitions.Conclusion. There are still many issues in the diagnosis and management of patients with dentin dysplasia. Early diagnosis, clinical and radiographic findings, as well as treatment of this condition and the initiation of effective preventive strategies may help prevent or delay loss of dentition.

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Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

Nuklearmedizin ◽

10.1055/s-0038-1629824 ◽

1996 ◽

Vol 35 (04) ◽

pp. 116-121 ◽

Cited By ~ 4

Author(s):

G. E Fueger ◽

M. Vejda ◽

R. M. Aigner

Keyword(s):

Bone Scintigraphy ◽

Antibiotic Treatment ◽

Diagnostic Value ◽

Clinical Findings ◽

Laboratory Findings ◽

Radiographic Findings ◽

Serum Parameters ◽

Wbc Count ◽

Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

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