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PubMed1995

Magnetic resonance imaging of osteomyelitis in the mandible. Comparative study with other radiologic modalities.

Magnetic resonance imaging of 14 histopathologically confirmed cases of osteomyelitis of the mandible was retrospectively reviewed. The findings of magnetic resonance imaging were compared with conventional radiography, computed tomography, bone scintigraphy, and histopathologic examinations. All lesions in bone marrow were shown as areas of low (64%) or low-to-intermediate (36%) signal intensity on T1-weighted images, and areas of high (29%), mixed (high and low, 21%; high and intermediate, 36%) or low (14%) signal intensity on T2-weighted images. Histopathologically, high T2-weighted signal intensity areas that showed enhancement after contrast injection corresponded to active infection. These were not collections of pus but were predominantly areas of granulation tissue. Magnetic resonance imaging showed larger areas of abnormality than plain radiography or computed tomography. Bone scintigraphy did not accurately reveal the locations of lesions but showed heterogeneous increased uptake in all patients. MRI was an extremely useful technique for assessing osteomyelitis of the mandible.

Acute Disease↗
PubMed1995

Antibody response in patients with osteomyelitis of the mandible.

Patients with mandibular osteomyelitis had quantification of 10 antibodies against certain bacterial proteins and polysaccharides. Sera from 31 patients with acute or chronic osteomyelitis of the mandible and from 17 healthy controls were analyzed. Some patients showed low levels of investigated antibodies in general and a lack of specific antiteichoic acid antibodies, as well as of different antipneumococcal antibodies particularly. Two patients with therapy-resistant osteomyelitis showed IgG2 and IgG3 subclass deficiency. They had replacement therapy with intravenous 10 or 15 gm immunoglobulin every 3 weeks for 6 months. Both patients showed considerable improvement in their clinical symptoms after treatment with immunoglobulin. This study indicates that impaired humoral immune response may be of importance in subgroups of patients with osteomyelitis of the mandible.

Acute Disease↗
PubMed1995

Ewing's sarcoma of the mandible: a case report.

Ewing's sarcoma is an uncommon malignancy that usually occurs in childhood and is rare in the mandible. A case of Ewing's sarcoma of the mandible is presented and discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Diagnosis of acute bone/bone marrow infarction of the mandible in sickle hemoglobinopathy. Report of a case.

Vasoocclusive involvement of bones is a common cause of acute morbidity in patients with sickle cell hemoglobinopathy. Although the literature contains only two reports of infarction of the mandible in sickle cell vasooccusive crisis, earlier authors were often limited to the clinical examination as their primary or only diagnostic method. This article presents a sickle cell patient in vasoocclusive crisis who subsequently developed infarction of the right mandible without an infectious or inflammatory cause and was ultimately diagnosed by nuclear bone imaging scans.

Adult↗
PubMed1997

Mucus escape reaction that involves the mandible: a case report and diagnostic imaging considerations.

We present a case of mucus escape reaction in which we encountered difficulty in interpreting the images acquired by plain radiography, computed tomography, and magnetic resonance imaging. The 48-year-old male Japanese patient was referred for evaluation of a gradual swelling subjacent to the inferior border of the left mandible. At the early imaging examinations, magnetic resonance imaging provided information crucial to resolving the issue of whether the lesion consisted of a central malignant disease process or a malignant disease in the submandibular space or both of these two separate disease entities. Magnetic resonance imaging demonstrated no evidence of tumorous lesion, but rather showed a fluid-containing cavity that was also confirmed by the subsequent intrasurgical inspection. On further consideration of these imaging findings, we concluded that the entity was mucus escape reaction with simultaneous occurrence of an intraconnective tissue hemorrhage adjacent to the left submandibular gland, concomitant extensive bony defect of the left mandible and lingual cortical defect, and chronic sialoadenitis of the left submandibular gland.

Diagnosis, Differential↗
PubMed1997

Primary Hodgkin's disease of the mandible: a case report and review of the literature.

Extranodal presentation in Hodgkin's disease is uncommon and bone involvement is rare at diagnosis. However, late in the course of this disease, bone involvement may occur in 9% to 35% of the cases. The mandible is very rarely involved even in advanced stages with only seven such cases reported in the literature. Of these only one had primary Hodgkin's disease of the mandible. A second case is described in this report.

Fatal Outcome↗
PubMed1998

Tubulopapillary hidradenoma-like tumor of the mandible: clinicopathologic and immunohistochemical features.

Tubulopapillary hidradenoma is a benign sweat gland tumor that appears as a well-defined, superficially located dermal nodule. It combines ductal as well as apocrine and eccrine glandular differentiation. Microscopically, the tumor is composed of tubular structures that characteristically show intraluminal non-villous papillary projections and a peripheral myoepithelial cell layer. A tumor that is histologically and immunohistochemically identical to tubulopapillary hidradenoma occurred in the mandible of a 73-year-old man and resulted in considerable diagnostic difficulty. The neoplasm developed in a mandibular cyst and recurred 5 years after initial enucleation. This is the first report of a central (intraosseous) sweat gland adenoma of the mandible. The differential diagnosis and possible histogenesis are discussed.

Actins↗
PubMed1999

Malignant spindle cell tumor arising in the mandible of a patient with florid osseous dysplasia.

Florid osseous dysplasia is a non-neoplastic condition of the alveolar processes of the jaws characterized by the replacement of multiple foci of bone by fibrous connective tissue, accompanied by gradual deposition of cementum, bone, or both. The lesions are not associated with inflammatory diseases of the dental pulp or periodontal tissues. In fully developed florid osseous dysplasia, there are multiple lobulated masses in the alveolar bone bilaterally in the mandible and sometimes in the maxilla. This is the first report of a malignancy originating within the jaws of a patient with florid osseous dysplasia. A spindle cell malignancy was diagnosed in the mandible of a 54-year-old black woman whose jaw was affected by florid osseous dysplasia bilaterally. Despite extensive surgery and radiotherapy, the patient died 20 months after diagnosis of the malignancy.

Fatal Outcome↗
PubMed1999

A unique case of desmoplastic ameloblastoma of the mandible: report of a case and brief review of the English language literature.

A unique case of desmoplastic ameloblastoma is reported from the clinical, radiographic, and histologic viewpoints. The patient was a 56-year-old man who complained of a painless swelling on the buccal aspect of the left mandible. Periapical and panoramic radiographs revealed a rounded, slightly radiolucent area with blurred osteosclerotic margins. Occlusal radiograph and computed tomography images disclosed buccal bone expansion outlined by thinned cortices. Computed tomography images exhibited an enhanced area in the anterior portion of the lesion. Interestingly, the coronal computed tomography images revealed a close relationship between the periodontal membrane of the left mandibular second premolar and the enhanced area. Biopsy specimens from the anterior portion of the lesion displayed typical histologic features of the desmoplastic variant of ameloblastoma. However, those from the posterior portion disclosed a large cystic formation. Oxytalan fibers were identified in the stromal tissue of the tumor, which suggested that the tumor arose from the epithelial rests of Malassez in the periodontal membrane of the related tooth. We also reviewed previously reported 41 cases. In 36 of 38 cases in which the location was specified, the tumor was found in the anterior to premolar region of the maxilla or mandible. A radiographic description was given in only 29 previous cases, 28 of which involved multilocular lesions. No cyst as large as the one in the present case was found among the previously reported desmoplastic ameloblastomas. Although the present case deviates from the usual desmoplastic variant of ameloblastoma in terms of locus, radiologic appearance, and cyst formation, it still meets the histologic criteria for this variant in both the stromal and epithelial components.

Ameloblastoma↗
PubMed2004

Central odontogenic fibroma of mandible: a case report and review of the literature.

Central odontogenic fibroma is an extremely rare benign tumor, accounting for less than 0.1% of all odontogenic tumors. The most recent literature review revealed that only 69 cases have so far been reported in the English literature, and only 1 of these cases showed radiologic appearance of a dentigerous cyst and this involved impacted maxillary incisors. A case of central odontogenic fibroma occurring in the mandible of a 30-year old female with radiological appearance of a dentigerous cyst involving an impacted lower first molar, presented here, appears to be the first reported case of central odontogenic fibroma of mandible with radiological appearance of dentigerous cyst in the English-language literature.

Adult↗
PubMed2000

Primary intraosseous carcinoma of the mandible: a case report.

A case of primary intraosseous carcinoma of the mandible in a 75-year-old man is reported. This tumor is an uncommon lesion arising from odontogenic rests. This tumor affects men more than women and is more frequent in the sixth and seventh decades of age. Most tumors occur in the posterior mandible as painful, non-ulcerated lesions, even if several cases have shown complete absence of subjective symptoms in early phases; often they are detected first on routine radiographs. Radiographically the lesion usually shows a fully enclosed, irregular pattern of bone destruction, even if sometimes the margins are well defined. The accepted treatment is radical surgery; but metastases could occur in lymph nodes.

Aged↗
PubMed2001

Curative treatment of central hemangioma in the mandible by direct puncture and embolisation with n-butyl-cyanoacrylate (NBCA).

Management of central hemangioma in the mandible is difficult because of the abundant vascular network in this region. One of the most common signs of these patients, especially in the mixed dentition period, is hypermobility of the teeth with spontaneous hemorrhage from the surrounding gingival sulcus. Various therapeutic modalities have been considered, but surgery is the most frequently used. In cases of a large extensive lesion, however, intralesional injections of sclerosing agents have often been successful. A case of central hemangioma of the mandible with arteriovenous malformations in a 10-year-old girl is reported. She was treated with direct injection of an embolic material, n-butyl-cyanoacrylate, which brought satisfactory results. Preoperative embolisation of feeder vessels with Gelfoam and Avitene soaked in thrombin together with this direct injection is a safe treatment modality that is as effective as surgery.

Child↗
PubMed2003

Acute psychotic state due to hyperthyroidism following excision of a mandible bone tumor: a case report.

The etiology of psychotic symptoms that emerge following surgery needs to be sought to allow physicians to provide effective treatment. We present the case of a patient who developed hyperthyroidism shortly after excision of a mandible bone tumor and discuss its clinical features, course, and management. A 48-year-old female without previous thyroid disease accidentally found a tumor over her left mandible bone and underwent excision of the tumor. Soon after surgery, she suffered from anxiety, mood swings, insomnia, and even auditory hallucinations. Through careful differential diagnosis and a series of examinations, she was shown to be in a hyperthyroid state. Her condition improved after short-term use of haloperidol, lithium, and methimazole. Her thyroid function recovered and she was free from any psychiatric symptoms during the 1-year follow-up. Hyperthyroidism following surgery is not uncommon and its possibility should be considered when making differential diagnoses.

Acute Disease↗
PubMed1985

Haemangioma of the mandible. Diagnosis and management.

A case of haemangioma of the mandible is presented. The clinical and radiological features, including the use of angiography, are discussed. An approach to the surgical management of haemangioma of the mandible is given.

Angiography↗
PubMed2006

Ossifying fibroma of the mandible with primary hyperparathyroidism due to non-familial parathyroid adenoma.

Ossifying fibroma is an uncommon benign osteogenic neoplasm arising from cells of the periodontal ligament, typically with a slowly progressive enlargement of the affected bone. The neoplasm sometimes presents with hyperparathyroidism, most of which cases are due to familial parathyroid tumours. We report a rare case of ossifying fibroma of the mandible which showed very rapid growth and presented with primary hyperparathyroidism due to non-familial parathyroid adenoma. Despite improvement of parathyroid dysfunction after removal of the parathyroid adenoma, the tumour continued to grow very aggressively. The case required partial mandibular resection for complete resection of the tumour, and fixation of the remaining mandible with a titanium plate.

Adenoma↗
PubMed2000

Effectiveness of three treatment modalities for the edentulous mandible. A five-year randomized clinical trial.

Currently, 3 treatment options are available for patients with denture complaints and an edentulous mandible with a height of at least 15 mm: meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), and construction of an implant-retained mandibular overdenture (IRO). The aim of this study was to evaluate patient satisfaction and subjective chewing ability of edentulous patients treated with one of these treatment modalities. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 mm) were randomly assigned to receive 1 of these 3 groups. Denture satisfaction and chewing ability were assessed using questionnaires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after treatment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. At 5-year evaluation the "complaints of the lower denture" showed a significantly better score in the IRO group when compared to the PPS and CD groups. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are therefore a satisfactory treatment modality for edentulous patients with problems with their lower denture, even in cases of not severely resorbed mandibles.

Analysis of Variance↗
PubMed2002

Clear cell odontogenic carcinoma of the mandible.

This article describes a case of clear cell odontogenic carcinoma (CCOC) in a 55-year-old woman who presented such a tumor extending from the midline of the mandible to the right first molar. The tumor was surgically excised and has not recurred or metastasized 6 months after surgery. To date, only 33 well-documented cases have been reported (including the present case) in the English literature. Twenty-eight (84.8%) have developed in the mandible and five (15.2%) in the maxilla. Eighteen (54.5%) occurred anterior to the first molar. The vast majority have been diagnosed in patients older than 40 years (30/33), and the mean age at diagnosis is 57.4 years (range: 17-89), with a male/female ratio: 1/2. Recurrences have been described in 17 cases (51.5%) and metastasis in 10 (30.3%). Based on its morphologic, histochemical and immunophenotypic features, CCOC should be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial regions.

Adenocarcinoma, Clear Cell↗
PubMed2002

Clear cell odontogenic carcinoma with ghost cells and inductive dentin formation - report of a case in the mandible.

An atypical case of clear cell odontogenic carcinoma occurred in the mandible of a 50-year-old Japanese man. Microscopically, the tumor mainly consisted of clear, glycogen-rich epithelial cell nests, aggressively proliferated in the mandible and invading into the surrounding soft tissues. Within the tumor cell nests, clusters of ghost cells were observed in addition to occasional foci of microcystic degeneration. Hyaline, osteoid or dentinoid-like deposits were also demonstrated adjacent to the tumor cell nests. Dentinal tubules were clearly revealed in some of these structures. Hence, this tumor was regarded as an epithelial neoplasm with odontogenic ectomesenchyme induction.

Dentin, Secondary↗