1/24. eosinophilic granuloma as a form of inflammatory reaction. A case report.eosinophilic granuloma consists of the proliferation and/or accumulation of langerhans cells in the bones, generally of the cranium and face, as a uni- or multifocal cystic lesion. It is considered to be a localized chronic form of Langerhans cell disease. The most frequent oral location is the posterior part of the mandible, where the bone lesion often gives rise to lesions of the overlying soft tissues. We report a case showing bilateral involvement of the upper jaw and unilateral involvement of the mandible. The eosinophilic granulomas arose in association with odontogenic periapical infectious processes, suggesting that this disorder may be a form of inflammatory response.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/24. Midfacial osteomyelitis in a chronic cocaine abuser: a case report.We describe the case of a 56-year-old man who was admitted for treatment of a progressive destruction of his hard palate, septum, nasal cartilage, and soft palate that had been caused by chronic cocaine inhalation. biopsy of the bony septum revealed acute osteomyelitis and an extensive overgrowth of bacteria and actinomyces-like organisms. There was no evidence of granuloma or neoplasm. The patient received intravenous ampicillin/sulbactam for 6 weeks, followed by lifetime oral amoxicillin. When there was no further evidence that destruction was progressing, the patient underwent nasal reconstruction with a cranial bone graft. The surgery was completed with no complications. To our knowledge, this is the first reported case of midfacial osteomyelitis associated with chronic cocaine abuse. The severity of this patient's complications, coupled with the success of his reconstructive surgery, makes this case particularly interesting. We believe that it is important for physicians to understand that septal perforation in a cocaine abuser should not be underestimated because it could result in a secondary bone infection. Nasoseptal destruction secondary to intranasal cocaine abuse is a result of cocaine's vasoconstrictive properties, and a decrease in the oxygen tension of intranasal tissue can facilitate the growth of anaerobic pathogens.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/24. Central giant cell granuloma of the palate; unusual localisation in a five year old child.The central giant cell granuloma of the maxillo-mandibular region is a relatively uncommon lesion (3.5%-0.1%). Essentially, it occurs in the second decade of life and it is mainly located in the mandibular region. The female/male ratio is 3:1. The authors present an unusual localisation of central giant cell granuloma in a five year old child's maxillary bone. After a surgical curettage of the lesion, an eighteen months follow-up examination did not show any recurrence.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/24. Maintaining and attenuating periodontal tissues for aesthetic implant placement.Alveolar ridge resorption and soft tissue recession after tooth extraction inevitably disrupted the harmonious pre-existing periodontal complex, compromising clinicians' ability to recreate successful aesthetic restorations. Although numerous surgical procedures had been advocated for the augmentation of both the alveolar ridge and its soft tissue to ideal contours, questions remain regarding viability and predictability of these procedures. This is especially critical in the maxillary anterior region, where a the condition of the soft tissue complex and its relationship to the implant restoration and its adjacent dentition often determines the implant's success. The described technique of retaining the root remnant and inducing the proliferation of the surrounding tissue in conjunction with immediate implant placement results in the preservation of existing soft and hard tissue, thus minimizing the necessity of grafting procedures and facilitating primary flap closure during implant placement.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
5/24. Odontogenic cyst with verrucous proliferation.An unusual case of an odontogenic cyst with verrucous proliferation is described in a 13-year-old girl. This histologically distinctive odontogenic cyst variant does not appear to have been reported previously. The cyst was characterised by a series of verrucous projections in the lumen with hypergranulosis and cells resembling koilocytes, raising the possibility of a viral aetiology. However, no evidence of human papillomavirus (HPV) was found using immunohistochemistry and polymerase chain reaction (PCR) amplification.- - - - - - - - - - ranking = 5keywords = life (Clic here for more details about this article) |
6/24. Severe fusobacteria infections (lemierre syndrome) in two boys.Abscess formation is a rare cause of febrile illness in childhood but always has to be considered in such clinical presentations. Belonging to the resident flora of the oropharyngeal region, fusobacteria are known to cause local infections; from here they may extend to other sites via the bloodstream or are aspirated into the lung (Lemierre disease). We report on two boys with Lemierre disease due to infection by fusobacteria in monoculture causing two different clinical phenotypes. Case 1 presented with a large subphrenic abscess and pneumonic infiltration of the right middle lobe. Primary focus of infection was periodontal disease. Case 2 presented with a life-threatening septicaemia due to a retropharyngeal abscess and perforated otitis media followed by osteomyelitis of the atlas and thrombosis of the left sigmoid sinus and internal jugular vein. CONCLUSION: fusobacteria should be considered in any abscess formation in children. A thorough examination of the oropharyngeal region as a possible site of primary manifestation is mandatory.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
7/24. tuberous sclerosis: presentation of a clinical case with oral manifestations.tuberous sclerosis (TS) is a genetic disorder affecting multiple body systems, and resulting from alterations in cell differentiation and proliferation. The disease is characterized by the development of benign hamartomatous tumors: neurofibromas and angiofibromas, located in the skin, central nervous system, mucosas and other organs. Abnormal neural cell migration plays an important role in the neurological dysfunctions found in TS, the predominant features being mental retardation, seizures and behavioral disorders. The condition is produced by mutations in genes TSC1 of chromosome 9q34 and TSC2 of chromosome 16p13.3, and exhibits a dominant autosomal hereditary trait--though 60-70% of cases are sporadic and represent new mutations. The phenotype is highly variable. The prevalence of TS varies between 1/6000 and 1/10,000 live births. The present study reports the case of a 21-year-old male with TS and oral manifestations of the disease. The clinical characteristics are described, along with the diagnostic criteria and the management strategies, with a review of the literature on the disease.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
8/24. Solid variant of odontogenic keratocyst.A case of an unusual lesion from the maxilla is presented. Macroscopically, the lesion was solid and histologically consisted of 'multiple separate keratocysts' of varying size that infiltrated into the surrounding bone and soft tissues. Panoramic image and CT scans showed a multilocular honeycomb ill-defined radiolucency with infiltration into the maxillary sinus and floor of orbit. This lesion should be differentiated from similar odontogenic lesions, such as keratoameloblastoma and papilliferous keratoameloblastoma. As there was no evidence of follicles, islands of ameloblastoma, or papilliferous structures in the entire specimen, the lesion could not be diagnosed as either a keratoameloblastoma or a papilliferous keratoameloblastoma. The invasive and destructive growth behavior, the histopathological features, and the histochemical pattern of the collagen stroma imply that this solid lesion is a neoplasia. It is suggested that the proper term for this lesion is solid variant of odontogenic keratocyst.- - - - - - - - - - ranking = 3keywords = life (Clic here for more details about this article) |
9/24. diagnosis and surgical management of nasopalatine duct cysts.OBJECTIVES/HYPOTHESIS: Nasopalatine duct cysts are the most common cystic lesion of nonodontogenic origin of the maxilla. The purposes of the study were to review the epidemiology and clinical presentation, to describe the radiographic and pathological findings, and to discuss surgical management of this entity. STUDY DESIGN: Case presentations of two patients with nasopalatine duct cysts at a tertiary care institution with a review of the English medical literature from January 1960 to the present. methods: A 69-year-old man presented with an asymptomatic swelling of the premaxilla, and a 17-year-old woman presented with a painful swelling of the hard palate. A computed tomography scan, fine-needle aspiration, and preoperative workup were obtained in both cases. literature was reviewed with respect to epidemiology, etiology, presentation, diagnostic studies, operative management, and recurrence rates. RESULTS: Computed tomography scan demonstrated midline ovoid cystic lesions in both cases. Fine-needle aspiration of both lesions revealed no evidence of malignancy. Surgical treatment consisted of enucleation in the first case and marsupialization in the second case. Both patients did well with no evidence of recurrence. Nasopalatine duct cyst presents in the fourth to sixth decades of life with a male predilection. recurrence rates range from 0% to 11%. CONCLUSION: Nasopalatine duct cyst occurs in approximately 1% of the population. Presentation may be asymptomatic or include swelling, pain, and drainage from the hard palate. A well-circumscribed, round, ovoid, or heart-shaped radiolucency is seen on computed tomography. Pathological findings reveal squamous or respiratory cell types, or a combination of these, infiltrated by inflammatory cells. Enucleation is the preferred treatment with low recurrence rates.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
10/24. Imaging modality correlations of an odontogenic keratocyst in the nevoid basal cell carcinoma syndrome: a family case report.Multiple maxillary and mandibular cysts are principle features of nevoid basal cell carcinoma syndrome (NBCCS; Gorlin-Goltz syndrome). We present a family case report of NBCCS with odontogenic keratocyst where the findings on plain films, CT, clinical, and histopathologic examinations are compared and analyzed. The systemic manifestations included frontal bossing, odontogenic keratocyst, ectopic calcification in 1 patient, and bifid rib in 1 patient. CT examination displayed aspects of bone morphology not visible on the plain films. Odontogenic keratocyst diagnosis was confirmed by histopathological examination. The features identified by these combined clinical, imaging, and histologic findings are helpful in identifying an NBCCS patient, distinguishing keratocyst from others cysts or neoplasic lesions, and can therefore influence surgical management. NBCCS is a rare autosomal dominant cancer predisposition syndrome, which is important to recognize when a patient has multiple odontogenic keratocysts, because lifelong monitoring is essential for patient management.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
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