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An unusual case of overgrowth of the alveolar processes of the maxilla and mandible of a 20-month-old child has been presented. Photographs and roentgenograms and the microscopic report on the tissue taken from one of the processes at the postmortem examination are submitted.
The purpose of the present investigation was to evaluate the biocompatibility of vitreous carbon, pyrolytic carbon, and pyrolytic graphite/silicon-carbide with rabbit mandibular tissues. Titanium was employed as the control material. Twelve New Zealand albino rabbits were implanted with each of the four materials described. Groups of four animals each were killed at 14 days, 45 days, and 90 days. Block sections containing the implants were then removed from the rabbit mandibles, and representative sections were evaluated histologically. All of the implants elicited similar reactions, including fibrous connective tissue capsule formation, multinucleated phagocytic cells, a mild inflammatory infiltrate, and reactive bone. On the basis of these findings, it appears that further detailed investigations are necessary to elucidate the biologic ramifications of the implantation of carbons in mammalian tissues.
Salivary gland tissue inclusions in the posterior part of the mandible are not rare. Inclusions in the anterior portion, however, are very unusual, and the case presented here brings the number of reported cases up to a total of seven. The aberrant gland appeared on a panoramic radiograph as a radiolucency judged to be a periapical lesion on the right mandibular second premolar.
This study tested a hypothesis that some radiopacities on radiographic surveys, specifically in the alveolar bone of the mandible from first molar to first molar, not related to the teeth by position or by pathosis, were related to the taking of oral contraceptives. The random sample included 218 adults entering consecutively for full-mouth radiographic surveys at the Radiology Department. All female patients were asked pertinent questions regarding their use of oral contraceptives. Those not responding (fourteen) were not included in the final tabulations. Radiographs were viewed without regard to sex by two persons at the same time, and an interpretation was made concerning the presence (positive) or absence (negative) of the radiopacities in question. Results were based on 204 patients (112 women and 92 men). Positive radiographic findings were significantly more frequent in women (45/112 versus 14/92; chi-square = 14.12; df = 1; p less than 0.001). Positive radiographs were significantly more likely in women using oral contraceptives (28/45 versus 5/67; chi-square = 36.25; df = 1; p less than 0.001).
Forty-three dried South African Bantu mandibles were examined visually and radiographically for the frequencies of occurrence of apical defects, bifurcation involvements, dehiscences, and fenestrations. Statistical evaluation of the data revealed no significant discrepancy between the visual and radiographic findings.
A case of myxoma of the mandible is described. The tumor was examined by both light and electron microscopy. Histochemistry showed an abundant acid mucopolysaccharide stroma, embedded in which were stellate cells with branching processes. Ultrastructurally, these cells were seen to be fibroblasts. Occasional myofibroblasts were seen in the tumor. No odontogenic epithelium was identified, and this component was not thought to be important in the histogenesis of the tumor.
A pilot study was conducted to investigate the osteogenic potential of autogenous cancellous marrow grafts placed in irradiated tissue. Five dogs and three monkeys received either 4,100 or 6,520 rads of cobalt-60 irradiation during a 5- or 8-week period. Postirradiation discontinuity mandibular defects were created surgically and restored with autogenous cancellous bone marrow grafts held in position by a titanium mesh basket. Bony union occurred in all the mandibles. Intraoral ulceration was common in the dogs, and extraoral wound dehiscence was found in the monkeys. Hematopoietic marrow was present in the graft sites of both species 6 months to 1 year after surgery.
The mandible of a prehistoric male Indian, 35 to 40 years old at death, displays a probable bilateral submandibular gland defect. This defect is described, its incidence in prehistoric and modern populations is reviewed, and a possible genetic etiology is proposed.
An arteriovenous aneurysm of the mandible in a 10-year-old boy presented as a pulsating epulis associated with slight intraoral bleeding. A few hours after the child was admitted to the hospital, there was a massive spontaneous hemorrhage which was successfully arrested by ligation of the external carotid artery. Rapid regression and recalcification of the lesion have followed this preliminary procedure which, unexpectedly, has proved in this case to be the best form of definitive treatment. A review of the literature concerning the treatment of this rare lesion is given.
Fractures of an atrophic edentulous mandible may present a serious problem in oral surgical treatment. A case is described in which a traumatic mandibular fracture, initially treated by means of a Gunning type of splint, and a subsequent spontaneous fracture on the opposite side were treated without mechanical fixation.
A longitudinal study of bone changes in the mandible was conducted. Duplicate radiographs were taken at 3-month intervals with the use of a positioning instrument, which included an aluminum calibrating wedge. The in-duplicate values obtained over the investigation period made it possible to assess the precision of the method and to analyze effects that take place with time. Significant bone changes were observed in seven volunteers between various observation periods at intervals of 6 and 9 months.
Little is known concerning the adaptation of the tongue and hyoid bone after surgical mandibular advancement. This study was undertaken to evaluate the relationship between tongue and hyoid bone posture and their adaptation following mandibular advancement in fourteen adults. The data indicate that (1) there is no statistically significant correlation between changes in the posture of the tongue and hyoid bone; (2) the hyoid bone returns toward its presurgical posture; and (3) the tongue assumes a new position relative to both the cranial base and the mandible. The changes in tongue position occurred immediately after surgery and persisted 2 years postoperatively.
Two cases of fibrous defect (nonossifying fibroma) of the mandible are presented. Each case occurred in the mandibular ramus of an 11-year-old girl. The usual fibrous defect of bone is an intraosseous fibrous, nonneoplastic, reactive lesion which appears as a well-delineated defect in the metaphysis of long bones. This report reviews the literature, histopathology, and classification of the fibrous defect of bone.
A case of osteogenic sarcoma of the mandible is presented. The most striking radiologic finding in this case was irregular widening of the mandibular canal, with areas of narrowing and loss of fine parallel cortical margins of the walls of the canal. These changes were accompanied by widening of the periodontal membrane of the adjoining teeth, an early sign of osteogenic sarcoma described by Garrington and colleagues, and loss of lamina dura of the same teeth and one additional adjacent tooth.
Modifications of the sagittal split osteotomy of the mandible have essentially reduced the major drawbacks of the procedure, such as condyle displacement, short-term skeletal relapse, and protracted maxillomandibular fixation and mental nerve dysesthesia. These techniques have proved effective over a period of 4 years in fifty-seven patients treated.
Large arteriovenous malformations of the jaws are relatively rare, potentially life-threatening lesions. When the lesion is not suspected, extraction of teeth can be fatal. The occurrence and treatment of arteriovenous vascular communications in the head and neck region have traditionally presented most perplexing problems. Traditional treatment has usually involved the obtaining of proximal and distal vascular control and surgical removal of the lesions, when feasible. This article presents a case that is of particular interest because it illustrates the successful use of cyanoacrylate as the only treatment for a large arteriovenous malformation of the left side of the mandible. A 4-year follow-up shows no evidence of the lesion and demonstrates complete regeneration of bone in the same area.
The combination of a relatively new alveolar ridge augmentation material composed of purified fibrillar bovine collagen (PFC) and particulate hydroxylapatite (HA) (Alveoform Biograft Collagen Corp., Palo Alto, Calif.), along with endosseous root form dental implants, was simultaneously placed by a combined flap and tunneling technique to reconstruct and augment endentulous and atrophic mandibles. Prosthodontic and patient surveys reported great satisfaction with overdenture stability, retention, comfort, esthetics, speech, and function. Six reported cases showed that clinically significant alveolar ridge augmentation and form were achieved and maintained with the added prosthetic support and improved stability and retention produced by the combination of procedures. Histologic study of core specimens obtained through the ridge augmentation graft material provided evidence of supracortical bone ingrowth into the graft matrix.
Arteriovenous malformations (AVMs) can be life-threatening lesions and must be considered in the differential diagnosis of most radiolucent lesions of the jaws. The clinical and radiographic presentation of an AVM of the mandible and its treatment is reported. Diagnosis of the lesion was confirmed by arteriography, and the lesion was treated surgically by enbloc resection. The bony defect was successfully grafted with a porous hydroxyapatite block.