1/30. ameloblastoma of the maxilla. Case report.A basal cell maxillary ameloblastoma became obvious as an asymptomatic swelling of the left buccal sulcus and alveolar process, although a large extension into the maxillary sinus up to the nasal conchae and the orbital floor had already occurred. The painless and slow growth of the lesion, the thin bone of the upper jaws, the adjacent cavities and the vital structures are the main factors for delay in recognition and thus the potentially lethal result of a maxillary ameloblastoma. A review of location, age, sex and race predilection, clinical course, radiographic appearance, histological types and treatment methods in made.- - - - - - - - - - ranking = 1keywords = alveolar, process (Clic here for more details about this article) |
2/30. So-called 'hybrid' lesion of desmoplastic and conventional ameloblastoma: report of a case and review of the literature.So-called 'hybrid' lesion of ameloblastoma, which is composed of desmoplastic ameloblastoma and conventional follicular/plexiform ameloblastoma, is an unusual variant of ameloblastoma and only eight cases of 'hybrid' lesion have been published in the English literature. To enhance knowledge of this interesting tumor, we add a case of 'hybrid' lesion that occurred in the right mandible of a 48-year-old Japanese male. Radiographic examination disclosed a honeycomb appearance at the anterior alveolar region, combined with a unicystic radiolucency in the molar region of the mandibular body. Histologically, the former showed microscopic features of desmoplastic ameloblastoma and the latter those of follicular ameloblastoma with focal granular cell transformation. The lesion was enucleated with curettage of surrounding bone and the lesional cavity was marsupialized. Although tumor tissues reappeared at 3, 5, 7 and 14 months after the surgery, the patient has remained disease free for 11 years after the last vaporization by CO2 laser of the recurred tumor. Many more cases of 'hybrid' lesion are needed to clarify the clinicopathological, histopathological and biological characteristics of this interesting variant of ameloblastoma.- - - - - - - - - - ranking = 0.99691646658189keywords = alveolar (Clic here for more details about this article) |
3/30. Ameloblastic fibroma: report of case.A 3-year-old girl had a large, painless, radiolucent lesion that involved the right side of the mandible. The lesion extended from the canine region to the condyle and coronoid process. A microscopic diagnosis of ameloblastoma was made by the hospital pathologist. Because it is unusual to find an ameloblastoma in a 3-year-old child and because the extensive surgical procedure that would be necessary to remove an ameloblastoma of this size, further consultation was required. As a result, the lesion was diagnosed as an ameloblastic fibroma and a more conservative surgical procedure was performed. Sixteen months after surgery, radiographic evidence showed complete resolution of the bony surgical defect, with no evidence of recurrence. This case once again points out the necessity for exact diagnosis of similar histologic lesions that may require a different approach in treatment.- - - - - - - - - - ranking = 0.0030835334181058keywords = process (Clic here for more details about this article) |
4/30. Epidermal nevus syndrome with development of a mandibular ameloblastoma.Epidermal nevus syndrome (ENS) is a hamartoneoplastic syndrome characterized by the association of epidermal nevi with abnormalities in other organ systems. We report a 32-year-old woman with ENS that, in addition to cutaneous manifestations, showed red plaques on the maxillary and mandibular labial alveolar mucosa and a papillomatous lesion of the midline posterior hard palate. Radiographic examination of the jaws was noncontributory. Approximately 5 years later, a follicular ameloblastoma developed in the mandible. The tumor showed duct-like cystic spaces, continuity with the overlying epithelium, and globular myxomatous areas in the connective tissue. The palatal lesion was diagnosed as papilloma, whereas the maxillary plaques showed nonspecific mucositis. The association of ameloblastoma with ENS is discussed. This is the second case of ENS associated with ameloblastoma reported in the medical literature.- - - - - - - - - - ranking = 0.99691646658189keywords = alveolar (Clic here for more details about this article) |
5/30. Peripheral ameloblastoma with potentially malignant features: report of a case with special regard to its keratin profile.A peripheral ameloblastoma with atypical features occurring on the left maxillary alveolar ridge of 40-year-old man is described, along with an immunohistochemical profile of its cytokeratin (CK). The lesion apparently originated from the surface gingival epithelium. The tumor nests or strands were highly cellular with a variable degree of squamous differentiation and microcyst formation. Occasional mitotic figures and dystrophic calcification, both of which are not seen in conventional ameloblastomas, were also observed. The tumor infiltrated deep into the alveolar mucosa, including the periodontal ligament, and showed histological and topographical evidence of atypism, resulting in resorption of the underlying alveolar bone. On the CK immunohistochemistry, CK19 was demonstrated in all the types of neoplastic epithelia, including microcyst-forming cells, densely packed round or spindle cells within the tumor nests, cells with squamous metaplasia, and peripheral tall columnar cells. The CK immunohistochemical findings suggest the lesion's cell of odontogenic origin; they may reflect an immature phenotypic expression of cell differentiation in the odontogenic epithelia during the tumor growth in the gingival mucosa.- - - - - - - - - - ranking = 3.2828598989815keywords = alveolar, ridge (Clic here for more details about this article) |
6/30. Prosthodontic treatment for patients with large mandibular defects; porous hydroxyapatite grafts.It is difficult for both prosthodontists and their patients with large marginal defects to achieve a satisfactory prosthodontic result, because retention, support, and stability of the prosthesis are limited and recovery of esthetics is unsatisfactory owing to large mandibular defects. alveolar ridge augmentation therapy is performed to compensate for such problems. We have experienced a good prognosis of prosthodontic treatment for over 10 years in two patients with large marginal defects of the partially edentulous mandible, who had undergone grafting of porous hydroxyapatite blocks to their bone defects. It has been reported that porous hydroxyapatite blocks are unsuitable for edentulous patients, because the mucosa covering the hydroxyapatite block is too thin and delicate to support dentures. We, therefore, designed the denture to prevent concentration of occlusal stress on the mucosa. In both of these two cases, we achieved recovery of occlusal function and esthetics by affixing denture to the large marginally resected defect augmented with a graft of porous hydroxyapatite block.- - - - - - - - - - ranking = 0.29211049923577keywords = ridge (Clic here for more details about this article) |
7/30. Case challenge. Chronic maxillary inflammation.A 30-year old male was referred by a dental practitioner to the Department of Oral radiology at the University of Lund, sweden, for a radiological evaluation of chronic symptoms of inflammation on the right side of the maxilla. According to the patient, at age 12 he had surgery to remove a non-erupted maxillary right second premolar. Postoperatively, a draining sinus tract appeared on the buccal aspect of the alveolar process. Thirteen years later, at age 25, surgery was again performed and the sinus tract reappeared. Intermittent discharge of exudate from the sinus tract occurred since the second surgery. Clinical and radiological examinations were conducted prior to a third surgery. The clinical examination revealed pus draining from the tract located on the buccal aspect of the alveolar process between the right maxillary first molar and first premolar. The radiological examination included periapical radiographs of the right maxillary first premolar and canine, a panoramic radiograph, and frontal tomograms of the maxillary right premolar area.- - - - - - - - - - ranking = 2keywords = alveolar, process (Clic here for more details about this article) |
8/30. Pericoronal radiolucencies and the significance of early detection.Pericoronal radiolucencies are common radiographic findings encountered in general dental practice. They usually represent a normal or enlarged dental follicle that requires no intervention; alternatively they may represent a pathological entity that requires appropriate management and histopathological interpretation. A pericoronal space of greater than 2.5mm on an intraoral radiograph and greater than 3mm on a rotational panoramic radiograph should be regarded as suspicious. Although many pathological processes may present radiographically as pericoronal radiolucencies associated with unerupted teeth, the most common is the dentigerous cyst. These lesions may enlarge considerably if allowed to develop unchecked, and have the potential for pathological transformation. In this report we present four cases of large pericoronal radiolucencies associated with unerupted teeth, and highlight the importance of early detection and management of such lesions.- - - - - - - - - - ranking = 0.0030835334181058keywords = process (Clic here for more details about this article) |
9/30. Early functional loading in the fully edentulous mandible after mandibular resection and reconstruction due to an ameloblastoma: case report.BACKGROUND: Immediate or early functional loading of implants in fully edentulous mandibles can enhance patient comfort and the ability to masticate within a few days after implant placement. Recently there has been evidence that this method of restoring edentulous mandibles is predictable. PURPOSE: The goal of this case report is to present the treatment of a patient diagnosed with a large ameloblastoma in the mandible. After removal of the tumor and mandibular reconstruction, the patient had complete anesthesia in the right mandible, with an alveolar ridge deformity. methods: Two years after removal of an ameloblastoma in the right mandibluar sextant, five implants were installed between the mental foramina. One implant was installed for safety reasons in the event one of the others was lost. This implant remains buried. A denture was used as a drilling guide. Abutments were attached to the implants, and impression copings were fixed to the abutments. The denture was used for the "pickup" impression. Flaps were sutured, maintaining exposure of the abutments. In the laboratory, gold cylinders were heat cured to the tissue side of the denture. The cylinders were attached to the cast with laboratory screws. The gold cylinders were heat cured to the intaglio side of the denture. Five days after implant placement, the nonmetal reinforced acrylic denture was fixed to the implants with laboratory screws. The bridge is removed annually, and the implants are examined for mobility and periapical radiographs are taken. RESULTS: The patient has worn the prosthesis for 2.5 years without loss of implants and without breakage of the nonmetal reinforced denture. At 2.5 years the implants are stable, implant sites demonstrate stable crestal bone, and the patient is eating comfortably and without limitations. CONCLUSION: Early functional loading of implants in the edentulous mandible may offer patients the option of wearing implant-supported prosthesis immediately or shortly after implant insertion.- - - - - - - - - - ranking = 1.5811374650534keywords = alveolar, ridge (Clic here for more details about this article) |
10/30. Segmental mandibulectomy and immediate free fibula osteoseptocutaneous flap reconstruction with endosteal implants: an ideal treatment method for mandibular ameloblastoma.Thirteen patients with large ameloblastomas of the mandible underwent segmental mandibulectomy and immediate reconstruction, with simultaneous placement of osseointegrated implants. All patients received palatal mucosal grafts around the dental implants 6 to 10 months after surgical treatment and received implant-supported prostheses another 1 to 2 months later. There were five female and eight male patients, with a mean age of 32 years (range, 17 to 50 years). The mean length of the mandibular defect was 8.8 cm (range, 5 to 13 cm). All free fibula flap procedures were successful, with no reexplorations or partial flap losses. There was no clinical or radiographic evidence of failure during the osseointegration process for any implant. With functional occlusal loading, the marginal bone loss around the implants was less than 1.5 mm in a mean follow-up period of 40 months (range, 18 to 70 months). There were no recurrences during that time. The technique described allows improved access to the bone at the time of reconstruction, immediate assessment of alveolar ridge relationships, and accurate fixation of the implant-fibula construct. The advantages of this procedure include a reduced risk of recurrence with segmental resection, reliable mandibular reconstruction, and reduction of the number of surgical procedures, allowing full oral rehabilitation in a shorter time. It is concluded that segmental mandibulectomy and immediate vascularized fibula osteoseptocutaneous flap reconstruction, with simultaneous placement of osseointegrated implants, represent an ideal treatment method for large ameloblastomas of the mandible.- - - - - - - - - - ranking = 1.2921104992358keywords = alveolar, ridge, process (Clic here for more details about this article) |
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