Calcifying odontogenic cyst: report of four cases from Nigeria, West Africa.
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The most common cystic lesion of the maxillary sinuses is the mucosal cyst. In reviewing a 5-years material of 5026 pathological X-ray examinations of the sinuses 12.2% of these were found to have mucosal cysts. These cysts usually do not give rise to symptoms and require no treatment, but are often erroneously diagnosed as polyps, compact maxillary sinuses, hypertrophy of the lining mucosa or tumors. As radiologic examination of the sinuses is a common procedure and the diagnosis of a mucosal cyst is possible other diagnoses may not be given in most cases.
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39,606 pathological reports issuing from the Department of Pathology, University of Vienna, during the years 1936, 1956 and 1976 were examined retrospectively. The Department of Maxillo-facial Surgery had referred 3.2% of the specimens. On analysis of the individual diagnoses, carcinoma was represented by 36.6% of the cases. Age, sex, distribution and tumour localization data are recorded in tabular form. In addition, data concerning in-patients treated for tumours at the Department of Maxillo-facial Surgery from 1974 to 1976 were stored in the Computer Centre of the University of Vienna. These data were subsequently analysed with regard to diagnosis, sex and average age of the patients.
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Computerized tomography has revolutionized the art of diagnosis by noninvasive techniques. Until recently, its use in oral and maxillofacial surgery has been limited. Basic principles include the production of a two-dimensional image representing an anatomically accurate slice of tissue. Advantages of computerized tomography are lack of image superimposition, preservation of detail of soft tissue, enhancement of vascular tumors, selective enlargement of areas of interest, tomographic capability, and the future possibility of the production of three-dimensional images. However, the presence of any metallic restoration produces artifacts, which limits the use of computerized tomography to areas excluding the dentition where restorations are present. Clinical application at our institution has been to use computerized tomography in the differential diagnosis of infections, midfacial trauma, vascular lesions, and lesions involving the mandibular ramus and maxilla.
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Three cases of benign osteoblastoma occurring in the jaws are presented along with radiographic and microscopic material. Pain was a consistent symptom reported in each case. It appears that there is no predilection for occurrence in either the mandible or maxilla.
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Odontomata of the jaw are relatively rare. They can be easily diagnosed by means of special x-ray techniques provided they are composite odontomata. Difficulties are created by ameloblastofibromes and complex odontomata. Complete excochleation predominates in surgical therapy, first importance being given to sparing vital neighbouring teeth and vasomotor nerve bundles.
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