• Title/Summary/Keyword: Primary Intraosseous

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Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review I: mandibular ramus and angle lesion of primary intraosseous squamous cell carcinoma

  • Lee, Won-Bum;Hwang, Dae-Seok;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.120-127
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    • 2021
  • Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.

PERIPHERAL, SOFT TISSUE ODONTOMA : CASE REPORT (Peripheral, soft tissue odontoma에 관한 증례보고)

  • Lee, Kwang-Chul;Choi, Hyung-Jun;Choi, Byung-Jae;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.157-161
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    • 1999
  • Odontomas, hamartomas of odontogenic origin, are composed of all the structures that make up teeth. The WHO distinguishes odontoma into two types. The complex odontoma is defined as "a malformation in which all the dental tissues are represented, individual tissues being mainly well-formed but occurring in a more or less disorderly pattern." The compound odontoma is defined as "a malformation in which all the dental tissues are represented in a more orderly pattern than in the complex odontoma, so that the lesion consists of many toothlike structures. Most of these structures do not resemble morphologically the teeth of normal dentition, but in each one enamel, dentine, cementum, and pulp are arranged as in the normal tooth." Almost all odontomas are located intraosseously, but they have occasionally been reported in extrabony location. Peripheral or soft tissue odontomas, those arising outside of the alveolar bone, are very rare. Peripheral or soft tissue odontoma are defined as tumors that demonstrate the histologic characteristics of their intraosseous counterparts but occur solely in the soft tissue covering the tooth-bearing portion of the mandible and maxilla. When they mature, they appear as a radiopaque mass without the peripheral halo. The final diagnosis should be confirmed by biopsy. The origin of peripheral odontoma is probably related to remnants of the dental lamina in the gingiva. The treatment of choice is complete surgical excision, similarly to intraosseous odontoma and it does not tend to recur. This report presents a case of 5-year-old boy with swelling on labial gingiva of primary central incisor. And it was diagnosed as peripheral odontoma by excisional biopsy.

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Primary xanthoma inferior to the right mandibular third molar and intraoral vertical ramus osteotomy

  • Kim, Min-Ji;Kang, Min-Jun;Kang, Sang-Hoon
    • Imaging Science in Dentistry
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    • v.52 no.2
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    • pp.231-238
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    • 2022
  • Intraosseous xanthoma of the mandible is a rare benign disorder. A 17-year-old male patient presented with a suspected abscess in the right mandibular third molar, detected on a panoramic radiograph. The patient had no history of systemic or lipid-related metabolic diseases and complained of no specific symptoms or pain. A radiographic examination revealed a heterogeneous radiolucency extending from the apical to the distal aspect of the right mandibular third molar tooth germ. The lesion measured 9 × 16 × 24 mm (antero-posterior × mediolateral × supero-inferior) and showed a relatively well-defined, multilocular, foamy appearance with hyperostotic borders spreading to the inferior alveolar nerve canal. After excisional biopsy, a diagnosis of central xanthoma was made. The lesion recurred, and intraoral vertical ramus osteotomy was done near the lesion. For the treatment of xanthoma of the mandible, extensive and delicate surgical treatment under general anesthesia should be considered.

Novel dental anesthetic and associated devices: a scoping review

  • Kyung Hyuk Min;Zac Morse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.3
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    • pp.161-171
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    • 2024
  • The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

Primary Bone Tumors in Hindfoot (후족부에 발생한 원발성 골종양)

  • Shin, Duk-Seop;Lee, Sung-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.1
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    • pp.1-8
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    • 2013
  • Purpose: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. Materials and Methods: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. Results: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. Conclusion: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.