Cases reported "Mandibular Diseases"

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1/5. Idiopathic noncondylar hemimandibular hyperplasia.

    A female patient with 'idiopathic non-condylar hemimandibular hyperplasia' was followed from the age of 7.5-11.5 years. This rare disorder was characterised by an increase in volume of the right inferior ramus and mandibular body. It also included accelerated development and eruption of the teeth on the affected side, but no indication of enlargement of the condyle or the condylar neck. To date, review of the literature revealed several cases of hemimandibular hyperplasia and unilateral condylar hyperplasia, both of which present with enlargement of the condyle. However, the patient differed significantly from any previously reported cases, since she had no enlargement of the condyle. The above mentioned patient also differed from patients with hemihypertrophy, since the teeth were accelerated in development, but not hyperplastic. In addition, from histopathologic and radiographic examinations, as well as an angiogram, benign fibro-osseous and vascular lesions of the mandible were excluded. Although this is a single case report and neither the aetiology nor the pathogenesis is yet understood, it may suggest a new disorder of the mandible. Therefore, future reporting of similar cases should be encouraged.
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2/5. Myospherulosis complicating cortical block grafting: a case report.

    BACKGROUND: Myospherulosis of the oral cavity is an inflammatory, granulomatous lesion historically associated with the use of petrolatum-based antibiotic ointment placed in third molar extraction sites to prevent postoperative infection. methods: A case of bilateral myospherulosis is presented, in which large lesions complicated the procurement of a cortical block graft used to prepare a mandibular molar edentulous space for implant placement. By obtaining the block graft from a more lateral location on the mandible, an adequate graft was procured and was successfully grafted into an atrophic edentulous ridge. RESULTS: The cortical block graft was successfully incorporated by the recipient site, which received a wide-body, threaded dental implant 6 months later. Healing was uncomplicated, and a functional implant-supported restoration was successfully achieved. CONCLUSIONS: Myospherulosis, though rare today, may present a significant obstacle to the procurement of cortical block grafts. In this case, thorough debridement of the material resulted in subsequent healing of the myospherulosis defect, but prevented procurement of the cortical graft from the planned site. The dimension and volume of the neighboring cortical bone were adequate, and the augmented edentulous space was subsequently restored with a functional endosseous implant. The success seen in these 2 sites would seem to confirm the assumption that size and location of myospherulosis defects are critical factors in obtaining a successful clinical result in implant patients.
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3/5. Mandibular ramus-related Stafne's bone cavity.

    Mandibular bone depressions located on the lingual/buccal aspect of the mandibular ramus are the rarest variants of the so-called Stafne's bone cavities, or major salivary gland-related depressions, with only 17 cases reported in the literature including both clinical cases and archaeological specimens. We report the case of a 14-year-old male patient who sought clinical assistance complaining of a hard expansion on the lower left premolar-molar region. Apart from a unilocular radiolucent lesion between the lower left second premolar and first molar, a panoramic radiograph showed another radiolucent lesion located in the right mandibular ramus, at the level of the mandibular foramen. Computed tomography (CT) revealed an expansile lesion in the left mandibular body, later diagnosed as a simple bone cyst through surgical exploration. The three-dimensional CT volume rendering reconstructed image showed that the second lesion, located on the lingual aspect of the ascending ramus, was an actual cortical bone defect, which was diagnosed as a mandibular ramus-related Stafne's bone cavity. Considering the young age of the patient, the size of the defect, the recognizedly slow development of mandibular bone defects and, above all, the location of the bone defect under discussion, we believe it to have a congenital rather than a developmental origin (i.e. it was caused by a focal failure during intramembranous ossification of the mandible). If this is the case, mandibular bone depressions should not be seen exclusively as salivary gland-related bone defects.
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4/5. Management of spontaneous osteoradionecrosis: a case report.

    Spontaneous osteoradionecrosis of the mandible is an oral complication of radiation therapy. Bone necrosis, unrelated to trauma or infection, is more common when high doses of radiation, including interstitial implants, are delivered to a large bone volume. Management provides a challenge for the dentist and patient. When conservative, non-surgical treatment is unsuccessful, surgical debridement with adjunctive hyperbaric oxygen therapy and eventual mandibular resection may result. A case of spontaneous osteoradionecrosis is described which underscores the clinical course of the disease and treatment outcomes.
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5/5. Fragile bone syndrome associated with craniognathic fibro-osseous lesions and abnormal modeling of the tubular bones: report of two cases and review of the literature.

    OBJECTIVE: To report examples of disorders characterized by bone fragility, calvarial and/or gnathic fibro-osseous lesions, and metadiaphyseal undermodeling of the tubular bones. DESIGN: The clinical, radiological, and pathological features of two patients are described and the literature reviewed. patients: The patients comprised a 10-year-old boy and a 48-year-old woman. The former exhibited multiple fractures starting in early childhood and calvarial masses which developed in late childhood; the latter showed a mandibular mass. RESULTS: Calvarial doughnut lesions, osteopenia with coarse bony trabeculae, and undermodeling of the lower limbs were radiologically demonstrated in the first patient, while multiple sclerotic foci in the maxilla and mandible, spontaneous bowing of the right femur, and minimal undermodeling of the tibiae were demonstrated in the second. Bone biopsy of the iliac crest in the first patient revealed histologically normal bony trabeculae. Bone histomorphometry suggested an increased osteoid surface. Osteoid volume was also slightly increased. The pathological findings of the mass in the jaw in the latter patient were consistent with it being a fibro-osseous lesion. The literature review revealed several patients whose features overlapped with those of our patients. CONCLUSION: These patients may represent a group of fragile bone syndromes which differ from osteogenesis imperfecta.
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