1/1038. Assessment, documentation, and treatment of a developing facial asymmetry following early childhood injury. Prepubertal trauma is often implicated as the cause of asymmetric growth of the mandible. A series of photographs taken before and after early childhood injury to the orofacial complex illustrates the development of a three-dimensional dentofacial deformity in a patient. The diagnosis and combined surgical orthodontic treatment plan to correct the facial asymmetry and malocclusion are discussed. ( info) |
2/1038. Endoscopically assisted removal of unilateral coronoid process hyperplasia. Coronoid process hyperplasia (CPH) is an uncommon disorder characterized by an enlarged coronoid process impinging against the posterior aspect of the zygomatic arch. Young male adults are usually affected, presenting with limited mouth opening, which is typically painless and progressive in nature. The diagnosis of true CPH is established by the findings of (1) uniform coronoid enlargement on radiographic examination and (2) normal bone structure on histopathological examination (i.e., the specimen should be free of any neoplastic growth, such as the previously reported cases of coronoid osteomas, osteochondromas, or exostoses). The treatment is mainly surgical, by means of a coronoidectomy. An intraoral approach is mostly preferred for this procedure to avoid an external scar. However, to avoid the drawbacks of this approach, such as limited exposure and the risk of hematoma and subsequent fibrosis, an extraoral approach may be indicated. This report describes a case of true unilateral CPH in a 17-year-old boy who presented with progressive limited mouth opening in the absence of any pain. Computed tomography (CT) demonstrated a uniformly enlarged right coronoid process. A coronoidectomy was performed with the aid of endoscopic systems, approaching via two short incisions in the temporal scalp. Histopathological examination of the specimen demonstrated essentially a normal bony structure with no evidence of a neoplasm. The authors present the endoscopically assisted technique of coronoid process excision as an alternative method of surgical treatment of CPH and any mass of the coronoid process in general. With this method, the incision is much shorter than a conventional coronal incision and thus morbidity is diminished considerably. ( info) |
3/1038. Electromyographic activity of the jaw-closing muscles before and after unilateral coronoidectomy performed on a patient with coronoid hyperplasia: a case study. There have been few reports analyzing the activity of the jaw-closing muscles after coronoidectomy performed on a patient with coronoid hyperplasia. This paper presents a case study using electromyograms (EMGs) to evaluate the effects of unilateral coronoidectomy on the activity of masseter and temporal muscles. The patient was a 25-year-old male whose maximal range of jaw opening was 24 mm. After coronoidectomy of the left region, the range improved to 43 mm. EMGs were recorded in the center of the masseter muscles and the anterior part of the temporal muscles during gum chewing. Preoperatively, no abnormal EMG activity was observed. Eight months after surgery, increase in the ratio of the bilateral temporal muscle activity and a decrease in the ratio of the right masseter muscle activity were observed, and the proportion of activity of jaw closing muscles was out of the normal range. Eighteen months after surgery, there was slight return to the preoperative EMG activity. It was concluded that unilateral coronoidectomy could result in EMG changes of masseter and temporal muscles with a gradual return. ( info) |
4/1038. Massive osteolysis of the mandible: report of a case with multifocal bone loss. osteolysis of the jaws has been reported in association with infection, cysts, neoplasia, and metabolic, endocrine, or hematologic abnormalities. Rare cases of idiopathic osteolysis have also been recorded. We report the case of a 10-year-old girl with mandibular basal and alveolar bone resorption that has continued over a period of 9 years. The patient has subsequently developed bilateral resorption of the ascending rami and condyles. The maxilla is uninvolved. Investigations included radiology, computerized tomography, scintigraphy, hematology, serum chemistry, endocrinology, histopathology, microbiology, and immunology. Neutrophil chemotaxis, chemiluminescence, and random migration values were low but within the normal range. These findings are interpreted as indicating an unusual variant of massive osteolysis. ( info) |
5/1038. Cystic management in a 10-year old child. cysts are among the most common lesions found in the oral cavity. These may be developmental in origin or secondary to chronic infections. Untreated, cysts may expand causing local tissue destruction and deformities. Basically, two treatment methods are employed. Enucleation and/or Marsupialization. The following case involves a child treated at the College of dentistry, University of the philippines, for a large cystic lesion involving the permanent cuspid and the deciduous dentition. The lesion was accidentally discovered on a panoramic radiograph. The child underwent extraction of deciduous teeth and marsupialization, which later helped in the eruption of the malposed permanent teeth. ( info) |
6/1038. Salivary duct carcinoma in the mandible: report of a case with immunohistochemical studies. Salivary duct carcinoma is rare. We describe a 56-year-old man who developed salivary duct carcinoma in the mandible 10 years after removal of the right second and third molars. The tumour originated in the retromolar gland or the ectopic minor salivary gland in the mandible. The panoramic radiograph showed a radiolucent, poorly circumscribed area about 40 x 30 mm in size and distal to the lower right first molar. This tooth, together with all neoplastic tissue, was removed, and histopathological examination showed it to be a salivary duct carcinoma in the mandible. On immunohistochemical staining, keratin antibodies stained the ductal structure, 1A4 antibody stained myoepithelial cells, but S-100 protein and vimentin were not seen. The patient was well and with no sign with recurrence 6 years postoperatively. ( info) |
7/1038. Presentation and management of chronic osteomyelitis in an African patient with pycnodysostosis. A case is reported of pycnodysostosis (PCD) with chronic osteomyelitis in the mandible. The clinical and radiological features and the problems of management and follow-up are discussed. ( info) |
8/1038. Giant ranula causing mandibular prognathism. This is a case report of a 20-year-old man with ranula, the size of an orange, in the floor of the mouth causing mandibular prognathism with fan-shaped mandibular teeth anterior to the premolars. The tumor was extirpated. The pathogenesis, differential diagnosis and treatment of ranulas are discussed. ( info) |
9/1038. Imaging of a Stafne bone cavity: what MR adds and why a new name is needed. Stafne bone cavities are asymptomatic radiolucencies seen at the angle of the mandible. Although plain films are often sufficient for diagnosis, confirmatory imaging is needed in atypical cases. We describe the MR imaging findings of a Stafne bone cavity, describe the contents, explain why a new name is needed, and discuss the relative merits of different radiologic techniques for establishing this diagnosis. ( info) |
10/1038. Pronounced palatal and mandibular tori observed in a patient with chronic phenytoin therapy: a case report. phenytoin, an anticonvulsant drug for epileptic patients, has many adverse effects, including calvarial thickening and coarsening of the facial features. Previous studies have demonstrated that phenytoin has an anabolic action on bone cells. This report describes pronounced palatal and mandibular tori found in a 45-year-old Japanese man undergoing chronic phenytoin therapy. The tori were extremely large, lobular, and symmetrical. A palatal torus appeared along the middle of the hard palate and mandibular tori consisted of 2 pairs of nodular masses extensively filling the lingual floor of the oral cavity. Pronounced osseous outgrowth occurred for the duration of a dose-increase of phenytoin from 1985 to 1997. His parents did not have any palatal or mandibular tori. These facts suggest that these unusual tori may have been the result of chronic phenytoin therapy, rather than association with the familial background. ( info) |