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PubMed2004

[Interest of PET/CT scan fusion to assess mandible involvement in oral cavity and oro pharyngeal carcinomas].

UNLABELLED: The aim of the study is to assess mandible involvement in oral cavity and oropharyngeal carcinomas. OBJECTIVE: To evaluate interest of fusion of Positron Emission Tomography (PET) with Computed Tomography scan (CT scan). METHOD: Eight patients were included in this prospective study. Each patient underwent PET and CT scan of the head and neck before surgery including tumorectomy and mandibulectomy. We compared results of PET- CT fusion with histologic examinations. RESULTS: Oral cavity (6), oropharyngeal (2) carcinoma: Mandibular invasion was suspected by PET-CT in 3 cases, but was confirmed in histological examination in only 2 cases. In 5 cases, PET-CT did not find mandibular invasion; this was confirmed in histological examination in all cases. Sensibility of PET-CT fusion was 100%, specificity was 83%. Positive predictive value was 66% and negative predictive value was 100%. DISCUSSION: PET-CT fusion provided maximal sensitivity. Specificity was better than for MRI but less than CT-scan. There were no false negatives and the false positive rate was 33%. CONCLUSION: PET-CT fusion is interesting to predict mandible involvement. Further studies are necessary to confirm these preliminary results.

Aged↗
PubMed1999

Central hyalinizing clear cell carcinoma of the mandible and the maxilla a clinicopathologic study of two cases with an analysis of the literature.

We describe two cases of primary intraosseous hyalinizing clear cell carcinomas of the jaws. One tumor arose in the mandible, the other in the maxilla. Both patients were adult women. Histologically, both tumors were characterized by a population of clear, glycogen-rich cells arranged in solid nests, trabeculae, and occasional single files, surrounded by a markedly hyalinized fibrous stroma. In close admixture with the clear cells, a second component of smaller cells having eosinophilic cytoplasms was also noted. Focal areas of squamous metaplasia were seen in one of the tumors. Neither nuclear pleomorphism nor mitotic activity were conspicuous features. Mucicarmine stains were negative in both tumors. Immunohistochemically, the tumor cells expressed cytokeratins and epithelial membrane antigen. Stains for S100 protein, smooth muscle specific actin, and carcinoembryonic antigen were all negative. Both patients are alive and well 14 and 17 months respectively after the diagnosis without evidence of metastasis or recurrence. The major importance of recognizing the existence of this rare form of salivary gland-type adenocarcinoma arising as a primary lesion in the mandible or the maxilla lies in avoiding misdiagnosing it as other primary or metastatic clear cell neoplasms, including various odontogenic clear cell tumors, other primary intraosseous salivary gland tumors, and metastatic clear cell adenocarcinomas from other organs, particularly the kidney.

Adenocarcinoma, Clear Cell↗
PubMed1984

Degloving injury of the mandible.

A young boy fell off his bicycle, striking his face on the pavement. On arrival in the emergency department, his only apparent injuries were facial abrasions; however, further examination of his oral cavity revealed that the soft tissues overlying the mandible had been stripped from the bone. Oral Surgery was consulted and the patient was taken to the operating room, where debridement and primary closure of the wound was performed under general anesthesia. Soft tissue injuries that result from a shearing or stripping force are termed degloving injuries, which are described best in relation to injuries of the hand, although other body parts can be involved. We report the case of a degloving injury of the mandible, an injury that has not been reported previously.

Adolescent↗
PubMedDate not supplied

Desmoid-type infantile fibromatosis in the mandible: a case report.

A 3-year-old boy with desmoid-type infantile fibromatosis arose in the mandible was reported. He was referred to our hospital because of suspected malignant bone tumor of the mandible. Histological examination of an open biopsy specimen was performed followed by tumor resection with marginal mandibulectomy and reconstruction by iliac bone grafting, which caused no functional complications nor mandibular deformity. To treat tumors in the facial skeleton, the surgical procedure should be planned based on the histological diagnosis in order to determine the proper area of resection to prevent functional or cosmetic complications. Especially in children, attention should be taken for benign but clinically resembling malignant rare diseases such as desmoid-type infantile fibromatosis.

Child, Preschool↗
PubMed2003

Haemangioma of the body of the mandible: a case report.

We present a case of haemangioma of the mandible in a 46-year-old woman. The radiological appearance was of a unilocular radiolucency that looked similar to other more common lesions of the mandible. This case shows that a potentially life-threatening haemangioma can present as an apparently benign cyst-like unilocular radiolucency, and highlights the need to include haemangioma in many differential diagnoses, and the importance of taking all radiological features into account.

Diagnosis, Differential↗
PubMed1996

A three-dimensional study of loads across the fracture for different fracture sites of the mandible.

The loads across the fracture depend on variables such as position of the fracture and the bite point. Up to now, no study has described systematically the influence of these two variables on these loads. The aim of this study was to describe and compare value and direction of the loads across the fracture for different positions of fractures in the mandible. In a three-dimensional model, bending and torsion moments and shear forces were compared for five mandibular fractures. The fractures were located in, respectively, the angle, posterior body, anterior body, canine and symphysis region. Positive bending moments were defined to give compression at the border, negative bending moments to give compression at the alveolar side of the mandible. The angle and posterior body fracture have high positive bending moments, small torsion moments and high shear forces. The anterior body, canine and symphysis fracture have high negative bending moments and high torsion moments with similar maximum values. The number of bite points with negative bending moments were different for all fractures. These bite points were always located on the fractured side. It is concluded that mandibular fractures can be divided roughly into two groups with similar load patterns across the fracture. One group consists of angle and posterior body fractures, the other group consists of anterior body, canine and symphysis fractures.

Adult↗
PubMed1997

Osteomyelitis of the mandible in sickle cell disease.

We report 16 cases of osteomyelitis of the mandible in patients with sickle cell disease, an incidence of 5% of all patients who presented with osteomyelitis of the jaws. There was a striking predominance of men (13/16, 81%). The mean age at presentation was 23 years. The pathogens were predominantly mixed organisms and Staphylococcus aureus. Lesions were mainly in the posterior region of the mandible, and were usually operated on under general anaesthesia with adequate provision for the prevention of hypoxia.

Adolescent↗
PubMed1998

Reconstruction of the extremely resorbed mandible with interposed bone grafts and placement of endosseous implants. A preliminary report on outcome of treatment and patients' satisfaction.

During recent decades many surgical techniques have been developed to enlarge the denture-bearing area of the mandible. Most of these techniques improved retention and stability of the lower dentures only temporarily. Since the advent of endosseous implants to stabilize overdentures, combinations of augmentation procedures and placement of endosseous implants have been introduced to restore the severely resorbed mandible. In this study we describe the preliminary results of such a combined approach using sandwich osteotomy with an autogenous bone graft (iliac crest) followed by placement of four endosseous implants in the interforaminal region in 10 women. After a mean follow-up period of 31 months (range 19-57) several variables were measured including condition of the peri-implant tissues, radiographic bone changes and patient satisfaction. The first results indicate that the technique described offers a solid base for implant-stabilized overdentures: no implants were lost, the peri-implant tissues were in good condition, bone loss was limited, and patients were satisfied. Future studies will evaluate the permanence of these results.

Adult↗
PubMed1993

Evaluation of rigid internal fixation of mandible fractures performed in the teaching laboratory.

Rigid internal fixation of mandible fractures is advocated as an effective means of providing undisturbed healing and immediate function. However, its application in the clinical setting has resulted in many technique-related failures. To determine the reasons for clinical failure and to help develop improved means of providing successful fixation, the results of plate application in the teaching laboratory were evaluated. Seventy-four surgeons taking the AO/Association for the Study of Internal Fixation (AO/ASIF) maxillofacial course in Davos, Switzerland and 56 surgeons taking the advanced AO/ASIF course in Naples, FL applied rigid internal fixation devices to a mandibular fracture model. Treatment was evaluated for anatomic morbidity and effectiveness. In Davos, 92 of 121 subcondylar, body, symphysis, and ramus fractures (76%) were treated effectively. This included 22 of 34 symphysis fractures (65%). In Naples, 11 of 28 symphyseal fractures (39%) were fixed effectively with lag screws without anatomic morbidity. Technique failure is a frequent event in the application of rigid internal fixation devices to mandible fractures. Lag screw fixation of symphyseal fractures had a particularly high rate of technique-related failure.

Bone Plates↗
PubMed1980

Masticatory muscle function in patients treated for condylar fractures of the mandible.

The activity of the temporal and masseter muscles and of the upper lip was examined by electromyography in five adults and in five children who had sustained uni- and bilateral fractures of the mandibular condyle. Electromyographic recordings were done in the postural position of the mandible, during maximal bite in the intercuspal and retruded mandibular positions, during chewing and swallowing of peanuts and during swallowing of water. In the children, who were examined on three occasions after the trauma, a reduced muscle activity was found shortly after the trauma, but it had normalized at follow-up examination 1 year after the injury. The adults, who were examined 4-6 years after the trauma, had, in general, normal muscle function. In subjects with a unilateral fracture, no difference in muscle activity was found between the two sides. An enlarged distance between the retruded and intercuspal positions of the mandible did not, in these subjects, seem to influence the muscle activity during the functions studied.

Adolescent↗
PubMed1983

A pseudo-tumour of the mandible in a haemophiliac patient. A case report.

The presence of a rare pseudo-tumour of the mandible in a haemophiliac justifies the presentation of this case in which the history and the clinical and radiological examinations were sufficient for a presumptive diagnosis. The authors present a case of pseudo-tumour of the mandible in a boy, with a history of haemophilia following a traumatic injury. They comment on the clinical and radiological aspects and surgical technique employed. The patient underwent the surgical treatment after the administration of 1000 U. of factor VIII. The whole pseudo-tumour was removed. The postoperative follow up one year after surgery was normal both clinically and radiologically.

Child↗
PubMed1999

Long-term application of chincup force alters the morphology of the dolichofacial Class III mandible.

The conventional orthopedic Milwaukee brace exerts a large and continuous force that induces malocclusion and a significant deformation of the mandible. Our previous chincup study examined its use in moderately severe mandibular prognathism without retrusion of the maxilla. The orthopedic force was approximately 500 g at the center of chin and was applied during sleep for 6 to 24 months. For mandibular prognathism subjects (means, 1.0 degrees and -1.3 degrees of ANB angle in the prepubertal and pubertal subjects), the resultant changes were maintained after retention. However, research reported that the changes obtained during chincup treatment (average, 4 (1/2) years' use) were often not maintained in severe skeletal Class III malocclusion. The aim of this clinical study was to investigate the immediate and long-term effects of prolonged use (mean, 7 years 2 months) of chincup appliances in subjects with dolichofacial Class III mandibles. Thirty-six female subjects with severe skeletal Class III malocclusions, associated with large gonial angles, were selected from the dental records of a private clinic. At posttreatment (T1, 65 months' duration) and postretention (T2, 56 months after T1), Ar-Me and Wits appraisal cephalometric parameters were significantly different (P <.01) between patients and control subjects (n = 230). Furthermore, the Go-Me parameter in treated subjects was longer than that of the controls at T0 but became significantly shorter at T2 (P <.01). Treatment was associated with a finding that the Ar-Go parameter increased less than the controls at T2. Our results indicate that long-term use of the chincup appliance (>5 years) is effective in subjects with severe skeletal Class III abnormality.

Case-Control Studies↗
PubMed1994

Chronic sclerosing osteomyelitis of the mandible in monozygotic twins.

Identical female twins with chronic sclerosing osteomyelitis of the mandible are presented. The diagnoses of both at the age of 12 years were based on typical history, and on clinical, radiographic, and histologic findings. High concentrations of IgA and IgG were detected in the serum of both patients, but deviations were not observed in other immunologic variables. The normally commensal organism, Propionibacterium acnes grew from a bone biopsy specimen from the mandible of one twin. No oral focus of the disease was confirmed in either case. We suggest that hereditary factors must have played a role in the pathogenesis of these cases of chronic osteomyelitis.

Child↗
PubMed1988

Treatment of osteoradionecrosis combined with pathologic fracture and osteomyelitis of the mandible with electromagnetic stimulation.

Osteoradionecrosis, complicated by pathologic fracture and osteomyelitis, is difficult to treat. Electromagnetic stimulation therapy may present a solution to this problem. A case of a 66-year old woman, suffering from osteoradionecrosis, pathologic fracture and osteomyelitis of the mandible, 6 years after irradiation therapy and partial resection of the mandible for squamous cell carcinoma of the gingiva, treated by electromagnetic stimulation, is presented. After 9 months of treatment, the patient was asymptomatic. Radiographic examination and bone scintigraphy carried out upon termination of the treatment, proved that healing of osteoradionecrosis and osteomyelitis had occurred. As far as we know, no previous reports have been published regarding this type of treatment.

Aged↗
PubMed1992

Carcinoma of the male breast metastatic to the mandible.

A case is reported of male breast carcinoma which, among other bony sites, metastasized to the mandible. This case and the review of the literature illustrate the need to include the mandible in bone scans for metastatic disease in breast cancer.

Adenocarcinoma, Scirrhous↗
PubMed1988

Lower lip carcinoma. Infiltration of the mandible along the mental nerve.

In general, carcinoma of the lower lip has a good prognosis after radical surgery. In rare cases, however, recurrences may be seen because of spread of the tumour along the mental nerve into the mandible. The earliest symptom of this is pain in the mandible and radiological evidence of widening of the mental foramen. Large resections and reconstructive procedures will be necessary. Three cases are presented.

Aged↗
PubMed1988

Chondrosarcoma of the mandible. Report of case and a survey of 23 cases in the Japanese literature.

A huge chondrosarcoma of the mandible (80 X 95 X 100 mm in size) with extension into the infratemporal fossa is described. The tumour was successfully treated by surgical removal and postoperative irradiation. A survey of the Japanese literature revealed 23 cases of chondrosarcoma with involvement of the mandible. The tumours occurred equally in males and females whose mean age was 38 years. The molar region was the site of predilection. The most common symptom was swelling and it was accompanied by pain in 7 cases and paraesthesia in 5 cases. Radiographically, the lesions were quite variable and with the exception of 3 cases in which information was not available, they consisted of a combination of irregular radiopacity and radiolucency in 9 cases, whereas the predominant feature was radiopacity in 6 cases and radiolucency in 4 cases. There was no radiographical abnormality in 2 cases. Root resorption of adjacent teeth was noted in 3 of 6 cases where information existed. Computed tomography was thought to be quite valuable in determining the nature and extent of the tumour. Although an elevation of serum alkaline phosphatase was observed in our case, results of laboratory tests were mostly of no diagnostic significance. Surgical removal was employed in 22 cases alone or in conjunction with irradiation and/or chemotherapy. Of 14 cases on whom information was available, local recurrence occurred in 6 cases in which radiotherapy was not given and distant metastasis in 2 of 10 cases on whom information was available. Of 20 patients on whom information was available on the postoperative course, 7 patients died 5 months to 6 years after the primary treatment.

Adult↗
PubMed2003

Intraosseous schwannoma of the mandible: a case report and review of the literature.

Schwannomas are benign neoplasms originating from the neural sheath and occurring most often in the soft tissues of the head and neck. Intraosseous schwannomas, however, are rare. The most common site of occurrence for these unusual lesions is the mandible. This article documents a case of an intramandibular schwannoma and provides a review of the literature on intraosseous schwannomas, with special attention to cases arising in the mandible and the maxilla.

Adolescent↗