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PubMed2001

Primary intraosseous carcinoma associated with impacted third molar of the mandible: review of the literature and report of a new case.

This study investigated the clincopathologic features of primary intraosseous carcinoma (PIOC) related to the third molar of the mandible. Six cases (5 from the literature and 1 new case; mean patient age 73 years) of PIOC associated with completely impacted lower third molar were analyzed. For comparison, 8 cases of PIOC presenting after extraction of the lower third molar were also evaluated, with a significantly lower mean patient age of 56 years. Most lesions were deceptively similar to those related to the lateral type of dentigerous cyst, and half of the impacted cases revealed an asymptomatic fracture of the mandible. In all patients except for the present case, metastasis had not been recorded. Surprisingly, no patients are known to have died of PIOC. In our experience the prognosis of PIOC associated with a completely impacted third molar is much better than commonly believed, although the number of cases involved is too small to make a general conclusion. However, delay in establishing the correct diagnosis followed by extraction without awareness of the carcinoma is know to adversely affect the prognosis.

Age Factors↗
PubMed2006

Aneurysmal bone cyst of the coronoid process of the mandible.

A rare case of aneurysmal bone cyst (ABC) located in the coronoid process of the mandible in a 12-year-old girl is presented. Treatment consisted of excision of the lesion through preauricular, submandibular and intraoral approach. An access osteotomy distal to second molar region was required to gain access to medial side of the coronoid process. To our knowledge, this is the third case of an aneurysmal bone cyst of the coronoid process of mandible. While examining a patient with a large expansile intrabony jaw cavity with thin peripheral bone, which is filled with blood without presence of bruit, thrills and pulse pressure, the diagnosis of aneurysmal bone cyst should be on top of the differential diagnosis list. Seventy-four to eighty-five percent of aneurysmal bone cysts of jaws occur in 10-20 years age group. Therefore, a pediatric dentist may be the first person to see such a lesion.

Bone Cysts, Aneurysmal↗
PubMed2006

Postirradiation osteosarcoma of the mandible with heterologous differentiation.

Heterologous differentiation in osteosarcoma is rare, with only 17 cases previously described in the literature. We report a case of a mandibular osteoblastic osteosarcoma with rhabdomyosarcomatous differentiation in a 45-year-old man who had a history of Hodgkin lymphoma that was treated with chemotherapy and radiation. Radiographs showed a destructive osteoblastic tumor of the mandible that was proven by biopsy to be osteosarcoma. After the patient underwent neoadjuvant chemotherapy, the tumor was resected. It contained a high-grade osteosarcoma composed of osteoblastic and chondroblastic elements that had no definitive response to therapy. Within the center of the lesion was a discrete focus of pleomorphic cells with rhabdomyosarcomatous differentiation that was confirmed by immunohistochemical stains for desmin, myogenin, and myogenic differentiation antigen 1. The patient received additional chemotherapy and radiation therapy but developed lung, brain, and spinal metastases and died 7 months after surgery. To our knowledge, this is the first report of osteosarcoma of the mandible with heterologous differentiation.

Cell Transformation, Neoplastic↗
PubMed1990

Fractured mandible and associated oral lesions in a subsistence-harvested bowhead whale (Balaena mysticetus).

A fractured right mandible with midlength nonunion and oral lesions were noted in a subsistence-harvested female bowhead whale (Balaena mysticetus) near Wainwright, Alaska (USA). The cause of the fracture was not apparent. The fracture resulted in misalignment of the mandible. The abnormal mobility at the fracture site probably caused irregular baleen stowage within the oral cavity, leading to breakage of many baleen plates and extensive ulceration of the tongue and lips. Good body condition suggested the fracture was not debilitating.

Animals↗
PubMed1999

[Intra-oral therapy of borderline sleep-related respiratory disorders with a modified protrusion-fixation of the mandible].

BACKGROUND: Aim of this study was the investigation of the efficacy and acceptance by mechanic-prosthetic mandibular protrusion for patients with mild to moderate OSAS. METHODS AND PATIENTS: During interdisciplinary teamwork between pneumology (sleep medicine) and dentistry we studied the change in the apnoea-index (AI) of 21 unselected patients treated with a modified oral appliance according to Lyon using less protrusion of the mandible and individual occlusion of the jaws. All patients were asked to rate their complaint-score using the oral appliance. RESULTS: 21 patients--aged 55.03 +/- 9.71 years; body mass index (BMI) 28.6 +/- 2.4 kg/m2 (mean value +/- SD)--had an improvement of apnoea-index (1/h) high significant (p < 0.0005). (Al before therapy 15.25 +/- 6.6; Al with therapy 6.07 +/- 3.7). Using a validated ambulatory respiratory evaluation device we saw an improvement in the Al of 57% +/- 19% during the estimated sleeptime of 6 h 12 min +/- 30 min. After a wearing-time of about 6 months the low complaint-score of the patients verified the high acceptance and efficacy of the modified oral appliance. CONCLUSION: The modified oral appliance of Lyon can improve disease severity, life- and sleep-quality of patients with mild to moderate OSAS. Engaged teamwork of sleep medicine and dentistry is necessary to take care of a very individual and carefully fixation and occlusion of the mandible, resulting a continuing compliance and efficacy for the patients.

Adult↗
PubMedDate not supplied

[Pathological fracture of the mandible: a report of a clinical case treated with clodronate].

Oral squamous cell carcinoma often invades the mandible. However, the incidence of pathological fractures of the maxillofacial bones is low and their treatment is rarely satisfactory. A patient, too weak to undergo surgery, affected by squamous cell carcinoma of the mandibular region with bone involvement and pathological fracture of the mandible, underwent chemotherapy with carboplatin associated with diphosphonate.

Aged↗
PubMed1999

Florid osseous dysplasia of the mandible: report of a case.

In 1986, a 60-year-old African American woman visited the Marquette University School of Dentistry with a complaint of a vague, dull pain in her lower left quadrant. Tooth No. 19 was extracted 10 years earlier because of extensive decay, and tooth No. 18 had received root canal therapy. A panoramic radiograph revealed the presence of ill-defined, multilocular, mixed (radiopaque-radiolucent) lesions present throughout the lower jaw. She was treated with antibiotics and scheduled for follow-up visits. When the symptoms persisted, tooth No. 18 was re-treated with root canal therapy and a representative biopsy was taken from the left mandibular area. The biopsy showed the presence of chronic osteomyelitis. The patient was treated with antibiotics and was scheduled for periodic check-up visits. In February 1995, she returned with the same symptoms in the left mandible. A panoramic radiograph showed persistence of the mixed radiopaque-radiolucent lesions throughout her mandible; however, the mass on the left side was more radiopaque and had assumed a "cotton wool" appearance. Tooth No. 18 was extracted and a biopsy was taken from the area. After correlating the clinical behavior, radiographic appearance, and histopathologic features, a diagnosis of florid osseous dysplasia with osteitis was made. This case represents a classic example of the difficulty in diagnosing fibro-osseous lesions using radiographic interpretation alone and the need to correlate the clinical, radiographic, and histopathologic features to reach a diagnosis. Additionally, the present case clearly shows treatment problems of an otherwise self-limiting condition when secondary involvement with osteomyelitis is also present. A brief description of the conditions that were included in the differential diagnosis and their management is presented.

Cementoma↗
PubMed2001

Aggressive epithelial odontogenic ghost cell tumor in the mandible: CT and MR imaging findings.

We report a case of aggressive epithelial odontogenic ghost cell tumor arising from the mandible in a 32-year-old man. On CT and MR studies, the tumor was seen as a large, heterogeneous soft-tissue mass that caused marked destruction of the mandible and invaded the mouth floor and tongue base. The tumor displayed a variety of densities and signal intensities on CT and MR images, which correlated well with the degree of cellularity of epithelial islands, abundance of ghost cells and eosinophilic materials, calcification, and cystic areas on histologic sections. Owing to the unpredictable biological behavior of this type of tumor, careful, long-term follow-up is highly recommended.

Adult↗
PubMed1975

Fractures of the mandible in motor vehicle accidents.

Motor vehicle accidents are a common cause of fractures of the mandible and are the most common cause of serious and multiple fractures. The usual mechanism of injury is outlined. The common fractures that occur are through the anterior alveolar process, condylar necks, or edentulous areas of the body and symphysis. There is high incidence of other injuries associated with jaw fractures in these patients. Treatment of the mandibular fracture must wait until the patient's general condition is stabilized. Obstruction of the airway demands emergency treatment by keeping the tongue forward and repeated suction of blood and mucus from the mouth and nasopharynx. Emergency tracheostomy is rarely necessary because of mandibular fractures. The methods for immobilizing a fractured jaw are outlined. The majority of accident victims are young and therefore have teeth. When there are teeth that occlude immobilization of the mandible must include intermaxillary fixation by wiring the teeth into occlusion. Interosseus wiring is used to support unstable fragments. Intramedullary Kirschner wires are a simple and effective method for immobilizing fractures through the body and symphysis of edentulous patients.

Accidents, Traffic↗
PubMedDate not supplied

[Desmoid fibroma of the mandible in a child and one-stage reconstruction].

A 12-year-old patient case is reported, presented with a desmoid fibroma of the left pterygoid region, extended to the cortical and endosteal regions of the mandible, reconstructed immediately with a free peroneal flap, recovering with this both form and function. To date, 3 years from surgery, he has no complications. Evolution of this case and a brief review of the literature is reported. It is concluded that free peroneal graft for mandible reconstruction is safe and has excellent results, both aestethic and functional.

Child↗
PubMed2003

[Reconstruction of the mandible by an osteomuscular flap from the clavicle on the sternocleidomastoid muscle].

A method for mandible repair with a osteomusculocutaneous flap on the sternocleidomastoid muscle has been developed. This treatment was used in 25 patients. The flap healed in 23 (92%) patients. For plastic repair of the mandible defect with the opposite clavicle, the muscular pedicle was elongated by cutting muscle from the mastoid process. Special attention should be paid to fixation of the cutaneous part of the compound flap so that to prevent its tension and torsion of its pedicle. The presence of cervical metastases and previous radical radiotherapy are contraindications precluding the use of such a flap.

Adult↗
PubMed2003

Malignant haemangio endothelioma (angiosarcoma) concomitant presentation in the mandible and occiput--a case report.

A case of angiosarcoma presenting simultaneously in the mandible and occiput is presented. The mandibular swelling was preceded by toothache for which the patient had tooth extraction, after which the rate of growth increased tremendously. It was not possible to determine without doubt which lesion presented first. The need to evaluate and investigate all cases of jaw swelling that require tooth extraction is emphasised. Angiosarcoma being a haemorrhagic lesion could be complicated life threatening haemorrhage, if a tooth related to it is extracted, as was experienced on incisional biopsy of this lesion. The procedure was accompanied by torrential bleeding which was only controlled after external carotid artery ligation. This, to our knowledge, is the first reported case of angiosarcoma occurring simultaneously in the mandible and occipital bones.

Adult↗
PubMed2003

[Primary non-Hodgkin lymphoma of the mandible: apropos of three cases].

BACKGROUND: Primary non-Hodgkin lymphoma is rarely located in bony tissue, observed in only 5% of primary bone tumors and 4-6% of extranodal non-Hodgkin lymphomas. The mandibular localization is exceptional (0.6%). Clinical and histological features may be misleading, raising the risk of late diagnosis. Chemotherapy and radiotherapy are required. CASE REPORTS: We report three cases of primary non-Hodgkin lymphoma of the mandible diagnosed between 1993 and 2000. All patients were males, aged 9, 37, and 45 years. Mean delay to diagnosis was 8 months. The inaugural complaint was a painful mass of the mandible in all patients. The histomorphology study and immunohistochemistry established the diagnosis. Two patients had diffuse large B cell non-Hodgkin lymphoma, the third anaplastic non-Hodgkin lymphoma. All patients were staged IE and given chemotherapy, associated with radiotherapy in one case. All patients achieved complete remission and continued to be in good health during follow-up lasting from 1 to 9 years.

Adult↗
PubMed2003

Cystosarcoma phyllodes metastatic to the mandible: report of a rare case and literature review.

Cystosarcoma phyllodes is a rare breast tumor with variable malignant potential. Metastasis has been reported in a small percentage of cases. We describe the case of a 52-year-old woman who developed a large facial tumor 1 year after she had undergone a mastectomy for a rapidly enlarging breast neoplasm. The facial lesion was found to be a malignant cystosarcoma phyllodes metastatic to the mandible, and the patient died shortly after diagnosis. To our knowledge, this patient represents only the third reported case of a phyllodes tumor metastatic to the mandible.

Breast Neoplasms↗
PubMed2003

Uncommon peripheral osteoma of the mandible: report of two cases.

The osteoma is a benign osteogenic neoplasm of bone. Peripheral osteoma of the mandible is uncommon. It is often asymptomatic and usually discovered when a patient complains of esthetic problems and presents for treatment. Peripheral osteomas have a characteristic clinical and radiographic appearance, but their pathogenesis is obscure. Described here are two patients with peripheral osteoma of the mandible, which might occur as a result of a combination of trauma and muscle traction.

Adult↗
PubMedDate not supplied

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

Ewing's sarcoma, a malignant tumor, rarely occurs in children younger than 5 years of age. Although it may appear in any bone, it is more common in the axial skeleton, rarely involving the jaws (1 to 2% incidence, mostly in the mandible). The most common symptoms are pain and swelling in the affected area. History of trauma often is reported. The case of a 4-year, 10-month-old Caucasian male with a rapidly expanding mass on the right side of his face following an injury to his mandible is reported.

Age Factors↗
PubMed1992

[Digital image processing of radiography of 32 cases with mandible sarcomas].

The radiographys of 32 cases with mandible sarcoma were analysed with digital image processing. The processed image of fibrosarcoma showed many scattered fine grains after the X-ray film were edge detected. In the same processing, the image of chondrosarcoma showed many little rings or arc structures. For osteosarcoma, the processed image showed very irregular veins. These digital processing pictures can help us to differentiate mandible sarcomas.

Chondrosarcoma↗
PubMed2003

Clinics in diagnostic imaging (85). Mandible osteoradionecrosis complicated by infection.

Mandibular osteoradionecrosis is a rare but well-known complication that may be seen in patients with head and neck tumours following radiation therapy. A 42-year-old man presented with painful soft tissue swelling and a discharging sinus over the right mandible. Radiographs showed osteolytic destruction. Computed tomography confirmed bony destruction and fragmentation, as well as signs of soft tissue infection. The diagnosis of mandible osteoradionecrosis complicated by infection was confirmed by biopsy and surgically. The clinical and imaging features of osteoradionecrosis are highlighted.

Adult↗