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Experience with anti-angiogenic therapy of giant cell granuloma of the facial bones.

Interferon alfa-2a inhibits angiogenesis and was discovered through a series of laboratory experiments that began in 1980. It was first used in 1989 in the management of a child with pulmonary haemangiomatosis. Interferon alfa A was then subsequently use to treat life threatening haemangiomas and other vascular tumours in various organs. Kaban reported on anti-angiogenic therapy of a recurrent giant cell tumour of the mandible in a 5 year old girl with interferon alfa-2a reasoning that as it was a rapidly proliferating vascular lesion it could be treated as an haemangioma. This paper reviews the history and role of interferon alfa-2a as an angiogenesis inhibitor in the treatment of complex haemangiomas and presents its use in the successful management of a rapidly growing central giant cell granuloma in a 4 year old boy in Australia.

Angiogenesis Inhibitors↗

Response of patients and families to lengthening of the facial bones by extraoral distraction osteogenesis: a review of 14 patients.

Fourteen patients or their immediate family were interviewed about their experiences of having either unilateral or bilateral external distraction osteogenesis of the mandible. The patients showed a high level of co-operation with treatment. Six of the 14 patients required repeat distractions, and had been informed and accepted that this was a possibility before the initial distraction. However, patients or their parents expressed some reservations about the extraoral distractors, which prevented them from practising their favourite sport and made them vulnerable to bullying by their friends and colleagues. Patients had moderate pain when the appliances were removed. They all expressed their satisfaction with the results and would recommend this treatment to others. Problems, including speech, eating, pain, and sleeping difficulties, were encountered by patients at all stages of treatment. Of considerable concern was the disruption of education when the child was treated during the school term.

Absenteeism↗

Immediate replacement of a maxillary central incisor associated with severe facial bone loss: use of Bio-Oss collagen--case report.

The loss and replacement of anterior maxillary teeth pose several challenges. Treatment must successfully address immediate tooth replacement, esthetics, patient comfort, and psychologic acceptance. The purpose of this case report is to present a prosthetic and surgical technique for immediate tooth replacement following extraction in an area of severe localized bone loss. Combined full- and partial-thickness flaps associated with the use of Bio-Oss collagen grafting material and a Bio-Gide membrane were used for alveolar ridge reconstruction. To improve the final esthetic result, a connective tissue graft was used to increase ridge volume and papillary height.

Adult↗

[Fibrous dysplasia of jaw and facial bones:A combined analysis of clinic,radiologic and histopathologic diagnosis of 117 cases]

A clinical-radiologic-histopathologic review of 106 cases of fibrous dysplasia involving the jaws is presented. Ninety eight patients onset in the first and second decades.Fifteen cases were polyostotic and the remaining cases were were monstotic.Radiologicaly,the lesions showed and extending growth pattern,poor definite border and slight pattern,poor definite border and slight involvement of teeth.The radiographic features were classified into four types:ground grass (52.0%),sclerotic(8.0%),cystic-like(8.0%) and mixed type (32.0%).Histologically the lesions were characterized by a cellular fibrous stroma that contain varying amounts of mineralized substance,represented by woven bone(63.0%),lamellar bone(30.0%) and cementum-like structure(7.0%).The final definitive diagnosis requires the combined evaluation of clinic,radiologic and histopathologic findings.

Journal Article↗

Dental and facial bone abnormalities in pyknodysostosis: CT findings.

Pyknodysostosis is an autosomal-recessive disorder of osteoclast dysfunction causing osteosclerosis, with associated maxillofacial anomalies. Multidetector CT with multiplanar and 3D reconstruction illustrated the pathologic findings in this case. Abnormalities included multiple retained deciduous teeth, unerupted teeth with associated follicles, an irregularly expanded alveolus and body of the mandible, and an obtuse mandibular angle. Volume-rendered imaging better delineated the irregular dentition, with crowding and retention of deciduous teeth.

Adult↗

[Evaluation of the results of the treatment of infections in newborn infants with developmental anomalies of the facial bones].

A clinical course and the results of treatment of infections in 53 neonates with visceral cranium defects are discussed. The analysis included the type of defect, immunity and the causes of therapeutical failures. Developmental defects of other organs coexisted with visceral Cranium defects in 45% of the neonates. High incidence of aspiration pneumonia (in 57%) with unfavourable prognosis (40%) was observed despite an intensive respiratory therapy including assisted ventilation. Therapeutical failures were caused by the coexistence of other developmental anomalies (found in 80% od deceased neonates) and low body weight at birth (35% of deaths). No immunological disorders were found except sporadic deficit of immunoglobulins and T-cells. Prophylaxis is of utmost importance. It includes: early orthodontic correction and introduction of the appropriate feeding technique at the neonatal wards.

Cleft Palate↗