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Archives of Iranian Medicine Nov 2022
Topics: Humans; Odontogenic Tumors; Immunohistochemistry; Carcinoma; Mandibular Neoplasms
PubMed: 37543901
DOI: 10.34172/aim.2022.119 -
Journal of Stomatology, Oral and... Jun 2020
Topics: Humans; Palatal Neoplasms; Postoperative Complications; Surgical Flaps
PubMed: 31491562
DOI: 10.1016/j.jormas.2019.08.011 -
The Journal of Craniofacial Surgery May 2022Aggressive benign mandibular tumors are uncommon in the pediatric population, and there is few publishing in the literature specifically dealing with them. Aggressive...
INTRODUCTION
Aggressive benign mandibular tumors are uncommon in the pediatric population, and there is few publishing in the literature specifically dealing with them. Aggressive tumors can be defined based on known biologic behavior and/or histologic type and/or clinical characteristics.
AIM OF THE STUDY
To review the clinical features and management of lower jaw pediatric aggressive benign tumor.
PATIENTS AND METHODS
Medical records review of pediatric patients presented with aggressive benign mandibular tumors to the Maxillofacial and Plastic Surgery Department, University of Alexandria, Egypt between 2011 and 2019.
RESULTS
Fifty-eight patients were included in this study, aged between 2 and 16 years (average = 11.8). Ameloblastoma was the commonest pathological diagnosis (n = 18) followed by central giant cell granuloma (n = 11) and juvenile ossifying fibroma (n = 10). Patients with central giant cell granuloma were treated by en-block resection (n = 4) or curettage after interferon alfa injection (n = 7). All other benign tumors were treated by en-block resection. The length of follow-up ranged from 1 to 8 years. Successful reconstruction was accomplished in 45 patients (88.2%).
CONCLUSIONS
Aggressive lesion should be treated in an aggressive manner and immediate reconstruction is advocated. However, pharmacotherapy combined with enucleation is a more conservative approach for management of aggressive central giant cell tumors.
Topics: Adolescent; Ameloblastoma; Child; Child, Preschool; Curettage; Granuloma, Giant Cell; Humans; Mandible; Mandibular Neoplasms
PubMed: 34387270
DOI: 10.1097/SCS.0000000000008085 -
European Archives of... Aug 2022The maxillectomy defect is complex and the best means to achieve optimal reconstruction, and dental rehabilitation is a source of debate. The refinements in zygomatic...
PURPOSE
The maxillectomy defect is complex and the best means to achieve optimal reconstruction, and dental rehabilitation is a source of debate. The refinements in zygomatic implant techniques have altered the means and speed by which rehabilitation can be achieved and has also influenced the choice regarding ideal flap reconstruction. The aim of this study is to report on how the method of reconstruction and oral rehabilitation of the maxilla has changed since 1994 in our Institution, and to reflect on case mix and survival.
METHODS
Consecutive head and neck oncology cases involving maxillary resections over a 27-year period between January 1994 and November 2020 were identified from hospital records and previous studies. Case note review focussed on clinical characteristics, reconstruction, prosthetic rehabilitation, and survival.
RESULTS
There were 186 patients and the tumour sites were: alveolus for 56% (104), hard palate for 19% (35), maxillary sinus for 18% (34) and nasal for 7% (13). 52% (97) were Brown class 2 defects. Forty-five patients were managed by obturation and 78% (142/183) had free tissue transfer. The main flaps used were radial (52), anterolateral thigh (27), DCIA (22), scapula (13) and fibula (11). There were significant changes over time regarding reconstruction type, use of primary implants, type of dental restoration, and length of hospital stay. Overall survival after 24 months was 64% (SE 4%) and after 60 months was 42% (SE 4%).
CONCLUSION
These data reflect a shift in the reconstruction of the maxillary defect afforded by the utilisation of zygomatic implants.
Topics: Humans; Maxilla; Maxillary Neoplasms; Neoplasms; Plastic Surgery Procedures; Surgical Flaps
PubMed: 35106619
DOI: 10.1007/s00405-022-07277-y -
The Journal of Craniofacial Surgery May 2022Guidelines for pediatric mandibular reconstruction (PMR) are not well-established. One must consider the growing craniofacial skeleton, mixed dentition, long-term dental...
INTRODUCTION
Guidelines for pediatric mandibular reconstruction (PMR) are not well-established. One must consider the growing craniofacial skeleton, mixed dentition, long-term dental occlusion, need for secondary reconstruction, and speech development. The traditional guideline (bone defect > 5 cm) for use of vascularized bone grafts (VBG) is not applicable given the variation of pediatric mandibular size and growth. We seek to propose a novel algorithm for PMR.
MATERIALS AND METHODS
An Institutional Review Board approved retrospective review of patients who underwent PMR for tumor resections between 2005 and 2019 evaluated patients' demographics, complications, resection index (RI) (resection length to mandibular length), and surgical outcomes. Outcomes based on RI were analyzed to establish guidelines for VBG utilization.
RESULTS
Twenty-four patients underwent PMR at a mean age of 9.1 years (range: 1 - 18). The mandibular defect (mean± standard deviation) fornon-VBG (n = 18) and VBG (n = 6) was 6.6 ± 3.0 cm and 12.8 ± 4.3 cm, respectively. The VBG group had fewer return trips to the operating room (P = 0.028) and fewer major complications (P = 0.028). When non-VBG with RI > 32% were compared to <32%, there was statistically less returns to the operating room for complications and a lower rate of early (< 30 days) major complications.
DISCUSSION
Our algorithm proposes an RI cutoff of 32% for VBG use for PMR. Patients with a sizable soft tissue defect, previous chemotherapy and/or radiation, planned adjuvant chemotherapy and/or radiation therapy, or a history of failed non-VBG should undergo reconstruction using VBG.
Topics: Algorithms; Bone Transplantation; Child; Humans; Mandible; Mandibular Neoplasms; Mandibular Reconstruction; Retrospective Studies; Treatment Outcome
PubMed: 34636762
DOI: 10.1097/SCS.0000000000008116 -
International Journal of Oral and... Nov 2019The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to... (Review)
Review
The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to collect available reports, searching for 'clear cell odontogenic carcinoma', 'CCOC', or 'clear cell ameloblastoma'. The search resulted in 75 reports detailing 107 cases between 1985 and 2018. Clinically the tumor manifests as a swelling in the posterior mandible (n=46), anterior mandible (n=33), and maxilla (n=28). Radiological analysis of 85 cases typically showed a poorly defined expansive radiolucency (n=83). Of the 70 patients with symptoms reported, 44 specified a swelling, 11 tooth mobility, seven gingival/periodontal issues, five numbness, and three decreased jaw opening. One patient presented with a neck mass. The duration of symptoms prior to seeking care was specified for 52 patients: 2 months to 1 year for 34 patients, 1-2 years for seven, 2-4 years for two, 4-7 years for six, and 7-12 years for three. The incidence of recurrence appeared to be 38 of the 88 cases where recurrence was reported. CCOC can be distinguished from other oral cancers by its distinctive histology and immunohistochemical characteristics and less aggressive behavior. Currently, treatment should be early and aggressive resection with clear surgical margins and long-term follow-up. The overall goal is to collect a cohort of patients.
Topics: Adenocarcinoma, Clear Cell; Humans; Jaw Neoplasms; Mandibular Neoplasms; Neoplasm Recurrence, Local; Odontogenic Tumors
PubMed: 31227275
DOI: 10.1016/j.ijom.2019.05.006 -
Journal of Comparative Pathology Oct 2022Neoplastic masses were evaluated in the rostral region of the mandible of three young adult cattle. In all three cases, the masses were macroscopically large, firm,...
Neoplastic masses were evaluated in the rostral region of the mandible of three young adult cattle. In all three cases, the masses were macroscopically large, firm, ulcerated, infiltrative, whitish and solid, and led to tooth displacement and loss. Radiographically, the neoplastic masses were intraosseous and radiolucent with foci of radiopacity. Loss of radiopacity due to bone necrosis was seen in the mandibular bone adjacent to the neoplasms. Histologically, well-differentiated, infiltrative non-encapsulated mesenchymal neoplastic proliferation replaced the mandibular bone and extended to the oral mucosa in all three cases. The neoplastic cells had scant cytoplasm and fusiform or oval hyperchromatic nuclei with loose chromatin, and were arranged in bundles in various directions. Within the neoplastic tissue, there were mineralized bone trabeculae and unmineralized osteoid, lined by a layer of osteoblasts and osteocytes within the lacunae. The pre-existing bone tissue adjacent to the neoplasm had areas of necrosis and osteoclasis of variable extent and intensity. Based on the macroscopic, radiographic and microscopic findings, a diagnosis of mandibular ossifying fibroma was established in all three cattle.
Topics: Animals; Cattle; Cattle Diseases; Chromatin; Fibroma, Ossifying; Mandible; Mandibular Neoplasms; Soft Tissue Neoplasms
PubMed: 36116887
DOI: 10.1016/j.jcpa.2022.07.006 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Feb 2023Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of...
Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.
Topics: Humans; Fibroma, Ossifying; Diagnosis, Differential; Cementoma; Jaw Neoplasms; Facial Bones
PubMed: 36746445
DOI: 10.3760/cma.j.cn112144-20220905-00477 -
The Pan African Medical Journal 2022Maxillary myxomas are rare benign odontogenic tumors with a high potential for infiltration and destruction. Clinical and radiological manifestations are variable and...
Maxillary myxomas are rare benign odontogenic tumors with a high potential for infiltration and destruction. Clinical and radiological manifestations are variable and non-specific and often lead to confusion with other benign and malignant lesions. We present here two cases of odontogenic myxoma of different localization (maxilla and mandible). In both cases, the patient presented with a progressively enlarging facial swelling without any neurologic disturbance or lymph nodes. On computed tomography, the lesions appeared as a large unilocular, homogeneous image causing a cortical thinning and rupture along with repression of surrounding tissues. The clinical and radiological features were poorly suggestive of precise nature, and only histological examination of biopsy specimen was able to reveal the diagnosis of myxoma. Given the large size of the tumors and the locally aggressive pattern, we have opted for large maxillecetomy and marginal mandibulectomy. In conclusion, myxoma is a slow growing but locally aggressive tumor that the clinician should keep in mind. As there is a lack of consensus regarding their treatment, we can suggest a conservative treatment for small non-extensive lesions, which consists of enucleation and curettage of the tumor; and a radical excision in case of large tumors given the high risk of recurrence.
Topics: Humans; Mandible; Maxilla; Maxillary Neoplasms; Myxoma; Odontogenic Tumors
PubMed: 36034028
DOI: 10.11604/pamj.2022.42.103.34690 -
Oral Radiology Jan 2020The radiology of the most important and/or frequent lesions affecting the bones of the face and jaws has been set out in this review and pictorial essay. (Review)
Review
INTRODUCTION
The radiology of the most important and/or frequent lesions affecting the bones of the face and jaws has been set out in this review and pictorial essay.
METHODS
The latter is composed of multiple images displaying one or more key radiological features derived from almost every one of the most important and/ or frequent lesion affecting the face and the jaws. These images have been grouped together in 18 figures, each served by a detailed and free-standing legend. These lesions are outlined in a flowchart, which focuses on one or at most two radiological features in turn.
RESULTS
It begins with those lesions that could indicate systemic disease, such as multiple lesions, and then proceeds onward to single lesions. The first of these single lesions are the neoplasms which need not only an early diagnosis, but also complete ablation in the majority of cases. Cystic lesions are then next, including consideration of the frequently occurring non-cysts such as simple bone cysts and lingual bone defects which require no treatment. Finally, it ends with the periapical radiolucency of inflammatory origin.
CONCLUSION
The most important and/or frequent lesions affecting the bones of the face and jaws that present to the oral and maxillofacial clinician can be considered systematically en route to the 'periapical radiolucency of inflammatory origin,' which is one of the most usually encountered lesions in clinical dentistry.
Topics: Diagnosis, Differential; Face; Humans; Jaw; Jaw Neoplasms
PubMed: 30758774
DOI: 10.1007/s11282-019-00367-4