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PubMed1985

Periodontal bone loss in dry mandibles of South African blacks: a biometric study.

Periodontal bone loss associated with periodontitis results in increase in the distance between the cemento-enamel junction (CEJ) and the alveolar bone crest (ABC). This study analyzed periodontal bone loss in 100 mandibles of South African blacks who were never exposed to preventive or restorative dental treatment. Specimens were equally distributed over the third to the seventh decade of adult life. CEJ-to-ABC (CA) distances were measured along 4904 surfaces of 1076 teeth. Analysis of the measurements showed that, generally, CA distances increased with age; differences were substantial between the first and fifth age groups. The incisors were most severely affected in all age groups, and bone loss was less severe around posterior teeth. Pre-molars and second molars lost the least bone. No significant differences between measurements on the buccal, lingual, mesial, or distal surfaces for these teeth were found. Measurements on the right and left sides of the mandible did not differ significantly. These observations may, in part, have been influenced by mid-life loss of teeth caused by severe periodontitis; their absence from the sample may have masked the true extent of periodontal bone loss. The difference in age of eruption and, therefore, the difference in period of exposure to the oral environment may account for the more severe bone loss in the anterior teeth, especially in specimens from younger individuals (21-30 years).

Adult↗
PubMed1994

Gunshot wounds to the mandible and midface: evaluation, treatment, and avoidance of complications.

As American society becomes progressively violent, an ever-increasing number of gunshot wounds are being seen across the United States. Particularly challenging are injuries that involve the mandible and midface, not only because of problems with reconstructing bone and soft-tissue defects but also because of emergent problems with airway obstruction and neurovascular compromise. We present 40 cases of gunshot wounds to the mouth, mandible, and maxilla treated at Wake Forest University Medical Center during the past 7 years. The focus of this retrospective analysis is on emergency evaluation and treatment, complications encountered, and operative techniques used for reconstruction. Special emphasis is placed on recognizing and avoiding the complications of these injuries.

Adolescent↗
PubMed2006

Malignant fibrous histiocytoma of the mandible.

We report a case of malignant fibrous histiocytoma (MFH) primary within the mandible of a 32-year-old female. The mandible is a rare location of MFH, accounting for only 3% of all tumours of this type occurring within bone. The clinical, pathological and radiographic features are discussed with special emphasis on the radiographic features of this lesion.

Adult↗
PubMed2004

Ameloblastomatous calcifying odontogenic cyst in the mandible.

Ameloblastoma is one of the well-known odontogenic tumours that can be associated with calcifying odontogenic cysts (COCs), but only a few reports include detailed clinical and radiographic features. In this paper we demonstrate a case of large ameloblastomatous COC in the mandible. The radiographic examination revealed the presence of a multilocular cystic lesion in the right posterior part of the mandible containing the impacted lower second molar with remarkable expansion toward both lingual and buccal side. This feature was different from the general findings of COC and rather resembled that of ameloblastomas.

Adolescent↗
PubMed2005

Metastatic retinoblastoma of the maxilla and mandible.

Metastatic retinoblastoma of the jaws is very rare. We present a 4-year-old boy with metastatic retinoblastoma that involved both the maxilla and mandible simultaneously. Enhanced CT indicated bone-destructive masses with partially non-enhanced area and enhanced margin in the right maxilla and left mandible. MRI showed well-delineated masses that were isointense on T(1) weighted images and hyperintense on T(2) weighted images. Four weeks after chemotherapy and bone marrow transplantation, the size of lesions remarkably decreased. The patient died 19 months later with extensive tumour metastases despite additional chemotherapy. In this case, the dental crypt of a permanent tooth was considered the potential target through which retinoblastoma metastasized to the jaws.

Child, Preschool↗
PubMed2006

Osteoporosis and mandibles.

OBJECTIVES: The purpose of this study was to find out whether mandibular bone tissues on dental panoramic tomograms (DPTs) are statistically significantly different between osteoporotic and non-osteoporotic women. We wanted to develop a simple method of common DPT analysis that could represent a simple, inexpensive and readily available screening tool for osteoporosis. METHODS: DPT images of 36 women with primary osteoporosis were compared with 20 DPT images of non-osteoporotic women of the same age group. Scanned DPTs were analysed using public computer software. Mandibular atrophy was assessed by six anatomic indexes. Anatomic indexes were divided into subgroups regarding the presence of teeth. Relative bone density (RBD) was assessed using a colour histogram (CH) plugin. Nine RBD indexes were calculated as relations of CH values measured on specific sites of the mandible. RESULTS: The subtractions of average values of anatomic indexes with and without a tooth were 1.5 to 2.5 times higher in the osteoporotic group of women. Average of RBD indexes differed statistically significantly between the groups (P<0.05). Three RBD indexes differed statistically significantly between groups (P<0.05). CONCLUSIONS: Mandibular bone tissues on DPTs are statistically significantly different between osteoporotic and non-osteoporotic women. RBD of the mandible is statistically significantly lower in the osteoporotic group of women. We developed a simple method of common DPT analysis, which could represent a simple, inexpensive and readily available screening tool for osteoporosis.

Absorptiometry, Photon↗
PubMed1977

Periostitis of the mandible. A case report and review of the literature.

Periostitis of the mandible has not been previously discussed in the otolaryngologic literature and only infrequently in the dental literature. It is characterized by a hard, painless, fixed mass overlying the mandible in a child or young adult. The etiology is usually an endosteal infection in the molar region with periosteal inflammation. Reactive new bone is deposited beneath the elevated periosteum, external to the outer cortex of the jaw, and separated from it by a layer of suppurative fluid. Treatment consists of removal of involved teeth and infected bone, drainage of the fluid pocked and appropriate antibiotics. Patients are followed with repeat X-rays and erythrocyte sedimentation rates. A case is presented and the world literature is reviewed. The otolaryngologist should be aware of this entity and include it in the differential diagnosis of any fixed jaw mass to avoid mistaking it for a more malignant process with unfortunate consequences.

Adolescent↗
PubMed1988

Dynamic compression plating in treatment of the fractured, edentulous mandible.

The repair of a mandibular fracture in the edentulous patient can be a difficult surgical problem. A recent report of a large series of such cases by the University of Michigan disclosed a 20% rate of nonunion. Dynamic compression plating is particularly suited to the repair of fractures of the edentulous mandible as intermaxillary fixation is unnecessary, normal speech and diet are resumed immediately, and bone grafts can be used when necessary. This series of 36 plates used in the management of mandibular fractures in 24 edentulous patients is the largest series of its type reported thus far. No nonunion or other major complication occurred in this series. Because nonunion, delayed union, and the problems associated with intermaxillary fixation were avoided in this series, it is suggested that compression plating is a highly effective method for repair of fractured edentulous mandibles.

Adult↗
PubMed1988

Metastatic disease to the mandible.

Metastatic lesions to the mandible are rare, comprising less than 1% of all malignancies. Twenty-two cases of metastatic disease to the mandible were seen from 1938 to 1985. The records of 17 cases were available for detailed review. The age range was from 27 to 80 years with a female to male ratio of 12 to 5. A mandibular or paramandibular mass or swelling was the most common presenting sign. Three patients presented with mandibular metastasis prior to the discovery of the primary tumor. In the other 14 patients, the mandibular lesion appeared from 2 months to 20 years following discovery of the primary tumor. The mandibular lesion was the initial sign of distant metastatic disease in 11 of the 17 patients. Breast, lung, and colon cancer were the most common primary tumors. When presented with an isolated mandibular mass, a high index of suspicion is necessary to make the diagnosis of metastatic disease. Since plain x-rays may initially be normal, technetium or CT scan may be necessary to demonstrate osseous destruction. Inferior alveolar nerve anesthesia should be considered an indication of tumor until proven otherwise. Treatment is often of a palliative nature because of the presence of widespread metastatic disease; however, surgical resection may be considered in the rare patient with a well-documented, solitary mandibular metastasis.

Breast Neoplasms↗
PubMed1988

Radiotherapy of the resected mandible following stainless steel plate fixation.

There is general concern among otolaryngologists that irradiation of a stainless steel prosthesis used in mandibular reconstruction may cause irradiation overdosage to adjacent tissues. A tissue-equivalent plastic/steel model, simulating the characteristics of a stainless steel, reconstructed mandible, was irradiated and measurements were made with a parallel plate ionization chamber. The results of our measurements show that irradiation of an implanted steel plate results in an overdosage (120%) "in front" and an underdosage (80%) "behind" the steel plate. The regions of overdosage and underdosage are 2 to 3 mm thick. The overall dose modification is greatly reduced when two opposing fields are used. We conclude that irradiation of a stainless steel, reconstructed mandible with a 6-mV photon beam through opposing fields does not significantly alter the amount of radiation delivered to surrounding tissues.

Bone Plates↗
PubMed1984

Garre's osteomyelitis of the mandible resolved by endodontic treatment.

A case of Garre's osteomyelitis of the mandible is presented. The occlusal radiographs are good examples of the redundant cortical layering of the bone (onion skinning) that is classically found with this phenomenon. The cause of this case was a necrotic pulp in a carious molar with a periapical radiolucent area. We believe this is the first reported case in which an odontogenic source of infection (carious tooth) was treated not by extraction but by endodontic therapy. During the year after the root canal filling, the periapical radiolucent area filled in with new bone and the bony expansion of the mandible was completely resolved.

Child↗
PubMed1988

Chondrosarcoma of the mandible and falx cerebri in a Chinese hamster (Cricetulus griceus): report of a case.

A Chinese hamster (male, 1-month-old) was found to have a large nodular mass at the left mandible. The tumor appeared to replace the entire left mandible, extending from the third molar to the incisor. The tumor mass occupied most of the oral cavity to compress the tongue ventrally. Histologically, the neoplasm was composed of islands of chondrocytes with bizarre and enlarged nuclei which were surrounded by poorly differentiated mesenchymal cells. The tumor involved the falx cerebri to compress the frontal crest of the cerebrum. On the basis of histological features, this tumor was diagnosed as chondrosarcoma.

Animals↗
PubMed2002

Reconstruction of the severely resorbed atrophic edentulous ridge of the maxilla and mandible for implant rehabilitation: report of a case.

We describe a case with a severely resorbed atrophic edentulous ridge in both the maxilla and mandible. The maxilla was reconstructed using a sinus-lifting procedure and onlay bone graft. The mandible was reconstructed by anterior osteotomy with an interpositional sandwich iliac bone graft at the symphysis area, subperiosteally with iliac bone chips mixed with hydroxylapatite bilaterally at the posterior atrophic ridge, and vestibuloplasty with a split thickness skin graft (STSG). After full-mouth implant rehabilitation, a 5-year follow-up of this case shows a satisfactory result.

Aged↗
PubMed2000

Ameloblastic fibroma in the midline of mandible: a case report.

The ameloblastic fibroma (AF) is a rare benign mixed odontogenic tumor. It is composed of both epithelial and mesenchymal elements, but lacks of any calcified dental structures. Most of these tumors occur in the mandible and appears preferentially in the posterior portion of the dental arch with molar area predominates over premolar area. It is important to differentiate the lesion from ameloblastoma, since unlike the latter, it does not exhibit a locally invasive growth pattern. It is a well-circumscribed lesion and does not require the radical excision that may be necessary to effect cure with ameloblastoma. The present case report describes a 15-year-old patient with an ameloblastic fibroma in the symphysis of the mandible, a rare reported site. In the beginning of the article an extensive review of the previously published literature on ameloblastic fibroma has been made. In the later part, the diagnosis, differential diagnosis, histology and therapeutic procedures and postoperative follow up of the present case have been described.

Adolescent↗
PubMed1993

Periodontal infection leading to periostitis ossificans ("Garrè's osteomyelitis") of the mandible. Report of a case.

Periostitis ossifications ("Garrè's osteomyelitis") of the mandible is a rather rare pathology that occurs as a hard swelling at the mandibular angle, persists for a long period, and is mostly painful on palpation. Clinical signs of infection are rarely noted. The etiological factor is generally a carious first permanent molar with a periapical infection or a fracture of the jaw. In this case, a 10 year-old girl showed a fixed painful swelling of the right mandibular angle. This revealed to be periostitis ossificans, although none of the classical causes were present. The symptoms were evoked by a periodontal infection: there was an osseous crater and a probing pocket depth of more than 10 mm disto-lingually of the first right permanent molar of the mandible. This was likely the etiological factor. Extraction of the first and second permanent right molar, curettage of the corresponding alveoli, and antibiotic treatment resulted in complete healing, clinically and radiologically, after 9 months.

Child↗
PubMed1995

Eosinophilic granuloma of the mandible involving the periodontal tissues. A case report.

This case reports on a 14-year-old boy with multiple radiolucent lesions widely distributed in the mandible, particularly in the right side (body-angle-ascending ramus). The lesion was first diagnosed as early-onset periodontitis and treated accordingly. It continued to grow very quickly, however, over a 6-month period, resulting in involvement of the entire mandible, with complete destruction of the lingual cortical bone, erosion of the external cortex with expansion in the neighboring soft tissues, and with a periosteal reaction in some areas. This case may serve to illustrate the rapid progress of eosinophilic granuloma, the importance and the difficulties of an early diagnosis, and the consequences of late diagnosis and treatment.

Adolescent↗
PubMed1982

Vitamin D resistant hypophosphatemic osteomalacia associated with osteosarcoma of the mandible: report of a case.

A case of vitamin D resistant hypophosphatemic osteomalacia associated with osteosarcoma of the mandible is presented. The patient complained of lumbar, knee and foot pain and muscle weakness of two years' duration. Serum phosphorous was 1.0-1.6 mg/dl, tubular reabsorption of phosphorus was 47 to 58%, TmPO4/GFR was o.7-1.2 mg/dl. Aminoaciduria was noted. Bone biopsy confirmed the diagnosis of osteomalacia. He partially responded to the treatment with 1 alpha()H) D3 and sodium phosphate. After removal of sarcoma of the mandible, symptoms remitted and pertinent laboratory data became normal except serum alkaline phosphatase for more than one year without treatment. It is suggested that an impaired response of the tubule and bone to active vitamin D3, caused in some way by the osteosarcoma might be one of the causes of osteomalacia in this case.

Adult↗
PubMed2004

Osteogenic sarcoma of the mandible and maxilla: a Canadian review (1980-2000).

OBJECTIVE: To determine factors that influence survival in patients with osteogenic sarcoma of the jaws. STUDY DESIGN: Multicentre retrospective clinical pathologic study of 35 patients with osteogenic sarcoma of the jaws by the Canadian Society of Otolaryngology-Head and Neck Surgery Oncology Study Group. METHODS: Clinical charts and pathology results were reviewed on 35 patients treated between 1980 and 2000 for osteogenic sarcoma of the maxilla or mandible. Records were acquired from several major Canadian cancer registries. The following variables were examined for the effect on survival: age, gender, tumour site, grade and subtype, margins, and method of treatment. RESULTS: The average age of patients was 40 years (range 14-76 years). The sex distribution was similar, with 18 males and 17 females. The primary site was the mandible in 20 patients and the maxilla in 15 patients. The overall survival was 79 +/- 7% at 2 years and 57 +/- 9% at 5 years. Local recurrence (41%) was more common than distant metastases (17%). Positive margins were the factor most strongly associated with poor prognosis on multivariate analysis (hazard ratio = 3.5, p < .04). Disease-free survival dropped to zero by 3 years for those with positive margins (n = 7). For those who were resected with clear margins (n = 25), 5-year disease-free survival remained greater than 50% and the overall survival rate was almost 80%. Tumour site, grade, and subtype did not correlate with prognosis. There was a trend toward better prognosis in those who received chemotherapy in addition to surgery. CONCLUSION: Osteogenic sarcoma of the jaws is an aggressive disease with a high mortality rate despite a relatively low risk of distant metastases. Negative margins are paramount for optimizing survival rate. Chemotherapy, although contentious, should be considered given the data from long bone studies and the trend toward better survival in several studies, including ours.

Adolescent↗