Cases reported "Oral Fistula"

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1/8. Distraction osteogenesis for reconstruction after mandibular segmental resection.

    Distraction osteogenesis with the shortening and lengthening method is a well-established procedure for repairing extremities. We used this technique for reconstruction after mandibular segmental resection. A 74-year-old woman underwent distraction osteogenesis with an intraoral device, initially shortening the mandible after a 20-mm-long segmental resection, followed by lengthening at a rate of 0.8 mm per day for 21 days. Eight weeks after the distraction, the device was removed and a dental implant was placed at the site of distraction. Radiographic observation showed new bone formation, and the implant was completely osseointegrated. Although the follow-up period is relatively short, the clinical course was uneventful. Distraction osteogenesis with the shortening and lengthening method seems to be a feasible option for reconstruction after segmental resection of the mandible.
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keywords = mandible
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2/8. Clinical significance of the structural integrity of the superior aspect of the mandibular canal.

    BACKGROUND: Sparse data can be found regarding the structural integrity of the superior aspect of the mandibular canal. In many cases, the mandibular canal must be carefully evaluated prior to defining patient treatment. methods: In this case report, a 54-year-old patient presented with a periapical infection involving the mesial root of the mandibular right second molar (#31). Radiographic evaluation revealed that the periapical lesion extended from the apex of the tooth to the superior aspect of the mandibular canal. Upon surgical removal of the tooth, an apical communication between the extraction socket and mandibular nerve was located. A guided bone regeneration procedure was performed to protect the nerve from subsequent damage and to prepare the site for future implant placement. Implants were placed in the area approximately 5 months following the regenerative procedure. RESULTS: After implant placement, the patient experienced normal function and no mandibular symptomatology. Implants have been in function for the past 4 years. CONCLUSIONS: Many factors, both pathologic and developmental, can lead to a discontinuity of the superior aspect of the mandibular canal. Normally, a thin cortical plate of bone protects the nerve. When a lack of structural integrity of the canal roof is discovered, enucleation of a periapical infection or subsequent implant placement can lead to potential disruption of the nerve. Limited information is available regarding the integrity of this protective cover. This case report underscores the importance of proper clinical diagnosis before implant placement in the posterior mandible.
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keywords = mandible
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3/8. Extraoral inverted teeth eruption: a case report.

    A 14-year-old female presented with extraoral inverted eruption of left mandibular permanent molars 18 and 19 at the lower left inferior border of the mandible. Both the teeth started erupting 1 year after an extraoral surgical intervention for a discharging sinus 6 years ago. The subsequent eruption to the extraoral position of the permanent molars at the inferior border of mandible may be the result of the previous surgical procedure or pathology related to the abnormally positioned teeth. This case presents an infrequent complication affecting the adjacent permanent teeth.
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ranking = 1
keywords = mandible
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4/8. Mandibular intrabony lesion as first sign of sarcoidosis: case report.

    A 33-year-old woman with intra-bony sarcoidosis of the mandible is reported. This presentation of sarcoidosis was the first sign of the disease in this patient, and was treated surgically because of an inaccurate biopsy report. Medical therapy was instituted once the diagnosis was made, and the disease was well controlled (including the mandibular localization) at 2 years follow-up.
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ranking = 0.5
keywords = mandible
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5/8. Cutaneous facial sinus tract of denture-related aetiology? A case report.

    A case is reported of a chronic facial sinus on the mandible. It is postulated that this was due to chronic mucosal trauma associated with a poorly adapted denture in a patient rendered immunosuppressed by poorly controlled type II diabetes. Previous treatment with antibiotics alone was unsuccessful. Healing was only achieved when antibiotics were combined with removal of the denture and improved diabetic control.
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keywords = mandible
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6/8. Microvascular free tissue transfer for treatment of osteoradionecrosis of the maxilla.

    head and neck tumors often require radiotherapy as part of the treatment protocol. Although it improves the survival rate in cancer patients, it may cause osteoradionecrosis, especially in the mandible and maxilla. Twelve patients with osteoradionecrosis of the maxilla were treated with microsurgical free tissue transplantations between April of 1996 and August of 2002. There were 10 male and two female patients, with a mean age of 60.2 years. The mean radiotherapy dose was 6674 cGy. The radiation dose could not be traced in three patients because radiotherapy was performed elsewhere. Radical sequestrectomy, soft-tissue debridement, and pathologic proof of no tumor recurrence were performed before microsurgical reconstruction. Free flaps used included the following: anterolateral thigh (n = 7), radial forearm (n = 2), rectus femoris musculocutaneous (n = 2), and supracondylar chimeric (n = 1) flaps. All flaps survived completely and reconstruction succeeded. During a mean 25-month follow-up period, ectropion, plate exposure, and mild infection were encountered in three patients and treated successfully. Radical debridement and obliteration of dead space with well-vascularized tissue are essential for successful treatment of maxillary osteoradionecrosis. The anterolateral thigh flap is most versatile for almost all types of soft-tissue defect reconstruction in the head and neck region.
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ranking = 0.5
keywords = mandible
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7/8. Chronic suppurative osteomyelitis of the mandible: case report.

    BACKGROUND: osteomyelitis of the maxillofacial skeleton is rare in developed countries such as australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis (CSO) of the mandible in a 75 year old man. The precipitant factor was thought to be a retained tooth root in the (right) posterior body of the mandible. methods: Treatment included a pre-surgical course of antibiotics (clindamycin 300mg, p.o. q.i.d. for two weeks) followed by removal of the retained root, surgical debridement of the affected bone, the intra-oral draining sinus, and resection of the cutaneous sinus tract. Specimens were taken for bacterial cultures and antibiotic sensitivity testing, and the resected tissue sent for histopathological review. RESULTS: On clinical and radiographic review at three months, the patient was well, completely symptom free and the osteomyelitis had fully resolved. CONCLUSION: This case report demonstrates the typical features of CSO. The combination of antibiotic therapy and surgical debridement was effective in the treatment of chronic suppurative osteomyelitis of the mandible utilizing intravenous sedation, and so averting the need for a general anaesthetic.
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ranking = 3.5
keywords = mandible
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8/8. Orthodontic treatment in a patient with Van der Woude's syndrome.

    Van der Woude's syndrome (VDW; #OMIM 119300) is an autosomal dominant disease characterized by cleft lip and/or palate and lower lip pit (fistula). The precise skeletal characteristics are unclear, and there have been no case reports of orthodontic treatment of patients with VDW. The Japanese girl whose treatment is reported here had VDW, including bilateral cleft lip and palate and bilateral symmetric lower lip pits. Orthodontic treatment started when she was just 3 years old, with a removable maxillary expansion appliance, followed by an edgewise multibracket appliance in both arches. Retention began at 11 years of age, and a secondary bone graft was performed for the alveolar cleft. She received prosthetic treatment and achieved a desirable occlusion at 18 years of age. Early intervention helped achieve a satisfactory treatment result for our patient. In contrast, her mother also had VDW, with a severe Class III skeletal pattern, but she had not been treated orthodontically; she had an anterior and lateral crossbite even after prosthetic treatment. The pretreatment characteristics of 4 other subjects with VDW are discussed; they show wide variations in the sizes of the maxilla and the mandible, suggesting that a common skeletal pattern is not generally seen in VDW.
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keywords = mandible
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