Cases reported "Mandibular Diseases"

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1/95. 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.
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2/95. Type 1 gaucher disease presenting with extensive mandibular lytic lesions: identification and expression of a novel acid beta-glucosidase mutation.

    The finding of extensive lytic lesions in the mandible of a 19-year-old Ashkenazi Jewish woman led to the diagnosis of Type 1 gaucher disease. She had extensive skeletal involvement, marked hepatosplenomegaly, and deficient acid beta-glucosidase activity. mutation analysis identified heteroallelism for acid beta-glucosidase mutations N370S and P401L, the latter being a novel missense mutation in exon 9. Expression of the P401L allele resulted in an enzyme with a reduced catalytic activity (specific activity based on cross-reacting immunological material approximately 0.21), which was similar to that of the mild N370S mutant enzyme. The expression studies predicted a mild phenotype for the proposita's N370S/P401L genotype which was inconsistent with her severe diffuse skeletal disease and organ involvement. Since lytic mandibular lesions may be complicated by osteomyelitis, pathologic fracture, and tooth loss, regular dental assessments in Type 1 Gaucher patients should be performed.
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3/95. Spontaneous uprighting of permanent tooth germs after elimination of local eruption obstacles.

    Four clinical cases are presented to demonstrate the self-correcting potential of aberrant tooth germs after the elimination of eruption obstacles (in 2 cases cysts, in 2 other cases severely infraoccluded primary teeth). In the case of the submerging deciduous teeth, the tilted adjacent teeth were orthodontically uprighted after the surgical procedure. Possible causative mechanisms are discussed.
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4/95. Treatment of central giant cell granuloma of the jaw with calcitonin.

    Giant cell granuloma of the jaw is a benign lesion that may cause local destruction of bone and displacement of teeth. The common therapy is curettage or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. An alternative treatment has recently been introduced, in which patients receive a daily dose of calcitonin. Four patients who have been treated with calcitonin in various concentrations for at least 1 year are reported. In all patients, complete remission of the giant cell granuloma was observed, without signs of recurrence. The working mechanism of calcitonin is discussed, as are length of treatment and optimal dose.
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5/95. Florid osseous dysplasia of the mandible: report of a case.

    In 1986, a 60-year-old African American woman visited the Marquette University School of dentistry with a complaint of a vague, dull pain in her lower left quadrant. Tooth No. 19 was extracted 10 years earlier because of extensive decay, and tooth No. 18 had received root canal therapy. A panoramic radiograph revealed the presence of ill-defined, multilocular, mixed (radiopaque-radiolucent) lesions present throughout the lower jaw. She was treated with antibiotics and scheduled for follow-up visits. When the symptoms persisted, tooth No. 18 was re-treated with root canal therapy and a representative biopsy was taken from the left mandibular area. The biopsy showed the presence of chronic osteomyelitis. The patient was treated with antibiotics and was scheduled for periodic check-up visits. In February 1995, she returned with the same symptoms in the left mandible. A panoramic radiograph showed persistence of the mixed radiopaque-radiolucent lesions throughout her mandible; however, the mass on the left side was more radiopaque and had assumed a "cotton wool" appearance. Tooth No. 18 was extracted and a biopsy was taken from the area. After correlating the clinical behavior, radiographic appearance, and histopathologic features, a diagnosis of florid osseous dysplasia with osteitis was made. This case represents a classic example of the difficulty in diagnosing fibro-osseous lesions using radiographic interpretation alone and the need to correlate the clinical, radiographic, and histopathologic features to reach a diagnosis. Additionally, the present case clearly shows treatment problems of an otherwise self-limiting condition when secondary involvement with osteomyelitis is also present. A brief description of the conditions that were included in the differential diagnosis and their management is presented.
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6/95. Case report of regional alveolar bone actinomycosis: a juvenile periodontitis-like lesion.

    BACKGROUND: Cervicofacial actinomycosis infection most often involves the mandibular bone and rarely the alveolar crest. methods: We describe a 14-year-old patient who had actinomycosis involving the alveolar bone at the left lower dental quadrant region. Resembling juvenile periodontitis, it was difficult to diagnose properly and resulted in devastating dental and periodontal consequences: loss of one tooth with most of its adjacent regional alveolar bone, severely compromising the support of two other teeth. RESULTS: With the diagnosis came successful treatment, including surgical removal of the soft and hard tissues with concomitant prolonged penicillin administration. CONCLUSIONS: We feel that this case should raise the interest and concern of both the periodontist and the general practitioner so that early diagnosis can be obtained, significantly improving the clinical outcome.
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7/95. The use of gutta-percha point to locate the origin of facial sinus.

    infection from the wisdom teeth usually causes severe swelling at the region of the angle and body of the mandible. Occasionally, it tracts outward to form a cervicofacial sinus. This paper demonstrates the use of gutta-percha point to locate the origin of a cervicofacial sinus due to an asymptomatic impacted wisdom tooth. The advantage of using gutta-percha point is discussed.
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8/95. Odontogenic carcinoma occurring in a dentigerous cyst: case report and clinical management.

    This case report describes an unusual odontogenic carcinoma, which was detected during routine periodontal examination. The lesion occurred in a dentigerous cyst associated with an impacted third molar in an otherwise asymptomatic 66-year-old male patient. The impacted tooth and lesion were excised based on evidence of radiographic change and clinical findings. An unusual histopathologic presentation is reported. The treatment provided for this tumor and the management of impacted teeth is reviewed.
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9/95. Longitudinal in vivo observations on odontogenic keratocyst over a period of 4 years.

    A case is presented of simultaneous adjacent odontogenic keratocyst and dentigerous cyst occurring in the same quadrant. Their in vivo behaviour, influence and effect on each other, surrounding tissues and on tooth development over a period of 4 years are described. This unique case may further advance the understanding of the behaviour of the odontogenic keratocyst in vivo.
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10/95. Garre's osteomyelitis of an unusual origin in a 8-year-old child. A case report.

    Garre's osteomyelitis is a type of chronic osteomyelitis that primarily affects children and adolescents. Although the disease is well described in the dental literature and is usually associated with an odontogenic infection resulting from caries, a number of other causative factors have been occasionally reported, such as a dental extraction or a mild periodontitis. There have also been cases of unknown aetiology. This paper describes a case of Garre's osteomyelitis in an 8-year-old child, in whom the condition arose following a local periodontal infection in an ectopically erupting first permanent molar that was in infraocclusion. The lesion remained unresolved for a period of over 6 months as a result of misdiagnosis, following a number of unsuccessful treatment attempts. Identification of the true cause and treatment through periodontal surgery resulted in lesion resolution and resolved the diagnostic problem. dentists should be aware that the periodontium may be a potential source of infection for Garre's osteomyelitis in children, particularly in the presence of ectopically erupting posterior teeth. In such cases, periodontal treatment should be sufficient to treat the disease and extraction of the tooth involved may not be necessary.
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