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Cemento-osseous dysplasia (COD) is classified, by the World Health Organization as a benign fibro-osseous lesion related to the tooth and periapical area of the jaws and is considered as a benign reactive process appearing from the apical periodontium in close relation with the apices of teeth. Usually, it is asymptomatic, discovered accidentally, and affecting particularly middle-aged African women. There are four subtypes distinguished of the lesion: periapical (PCOD), focal (FCOD), florid (FLCOD) and familial florid cemento-osseous dysplasia (FFLCOD). Pseudocysts found in the jaws go by various names, including solitary bone cyst, traumatic bone cyst, or simple bone cyst (SBC). These two pathologies have been reported separately; however, their co-occurrence remains rare and the first case of FLCOD with co-occurrence of SBC was reported by Melrose et al. in 1976 and later a few cases been reported in the literature. The aim of this report is to describe a case of a 46-year-old oriental female diagnosed with FLCOD with co-occurrence of SBC. Under local analgesia, a surgical exploration of the cyst was performed. In addition, a biopsy with a trephine was done in the region of missing right first mandibular molar. Based on the patient clinical, radiographic, and histological findings, a diagnosis of FLCOD was made in co-occurrence with a mandibular SBC. An examination of another female family member unveils a distinctive case, and the familial factor has been ruled out. No further treatment was planned and only follow-up was suggested.

Background. Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine-induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. Case Presentation. A 36-year-old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39°C fever, and chills. Standard bacteriological culture was positive for coagulase-negative staphylococci and Escherichia coli, while mycological culture was positive for Candida tropicalis. The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone’s clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro-nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow-up with a psychologist in a specialized centre. Conclusion. The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro-anastomoses are possible.

Stafne’s bone defect is a developmental anatomic bone defect in the lingual side of the mandible in the area of the mandibular angle that is filled with proliferation or translocation of adjacent structures such as salivary gland tissue. The etiology is still undefined, and two hypotheses are proposed: one is the glandular related to the submandibular or sublingual glands and the second is ischemic that affects the vascularization of the mandibular lingual. Usually, Stafne's bone defect is accidentally detected on panoramic radiographs during dental treatments as a well-limited radiolucency image with a clear peripheral regular condensation border, located below the mandibular canal. The differential diagnosis includes traumatic bone cyst, odontogenic and nonodontogenic cystic lesions, nonossifying fibroma, focal osteoporotic bone marrow defect, and other lesions. A case of Stafne’s bone defect on a 60-year-old male patient extending in the lingual posterior part of the mandibular region was presented. The panoramic radiograph revealed a well-limited radiolucency image with a clear peripheral regular condensation border, located below the mandibular canal. The lesion was discovered in a routine radiographic exam: the cone beam computed tomography gave us more details about the localization, the shape and size, and the relation with the mandibular canal, and the magnetic resonance imaging identifies the nature of the inside soft tissue. The final diagnosis was a Stafne’s bone defect resulting of a depression of the lingual cortical plate filled with expansion of the submandibular gland.

Among developmental odontogenic cysts, the dentigerous type is the second most prevailing one. It is a benign intraosseous lesion commonly affecting the mandibular region. Dentigerous cysts present a high prevalence in children as they can be caused by the eruption of permanent teeth or the infection of deciduous ones. The adopted treatment modalities include enucleation (cystectomy), marsupialization, and decompression. Decompression maintains communication between the cyst and the oral medium through a sutured fixed device, namely an acrylic stent or a pretrimmed disposable suction tube. In the mixed dentition, the extraction of the affected primary teeth and the decompression approach is recommended, especially since children and parents are more tolerant of conservative treatments. We report in this study, a case of a 9-year-old boy complaining of a painful swelling in the left mandibular region. Intraoral and radiological examination revealed an expansion of the buccal and lingual cortical plates associated with teeth #73, #74, and #75 and a well-limited, unilocular radiolucent image extending from the distal aspect of tooth #31 to the mesial aspect of tooth #36 involving the crowns of the unerupted teeth #33, #34, and #35. The preliminary diagnosis was in favor of a dentigerous cyst. The treatment was to extract the deciduous teeth and to use a sterile tube for decompression. The patient was followed up for 5 years, a complete remission of the cyst was observed and the teeth #33, #34, and #35 re-erupted normally on the mandibular arch.

Sinus lift augmentation techniques, lateral or crestal approaches, have been well documented, with bone substitute graft, or without bone material, with immediate or delayed implant placement as a treatment option for the atrophic maxilla in the posterior area. However, the sinus lift procedures performed in the presence of cysts, mucoceles, mucous retention cysts (MRCs), and antral pseudo-cysts could mainly decrease the sinus cavity volume and could increase the possibility of ostium obstruction and might lead to infection followed by failure of the grafting procedure. A radiological assessment should be made with computerized tomography (CT) or cone-beam CT to evaluate the remaining bone volume and to detect any pathology in the sinus. Different techniques were described in the literature for sinus lifting and bone grafting in patients with cysts. For some authors, cysts should be treated before sinus grafting and six months later, the procedure could be performed. For others, sinus lifting can be performed without lesion removal. At this time, controversy exists regarding the decision on whether lesions must be removed/aspirated or not before sinus grafting. In this study, we report a case where an MRC was aspirated and instantaneously, the sinus membrane was lifted and grafted, and implants were installed with 1-year follow-up after loading. Identifying lesions in the maxillary sinus is essential before planning any type of sinus augmentation and implant placement.

Vascular malformations of the maxillofacial region are unusual, and they occur more rarely in bone than in soft tissue. Mandibular intraosseous vascular lesions represent 0.5-1.0% of all bone tumors, and they are classified as venous malformation, lymphatic malformation, arterial malformation, arteriovenous malformations, and arteriovenous fistulae. Venous malformation is the most common vascular malformation, accounting for 44-64% of all vascular malformations, and is considered a low-flow malformation. Endovascular therapy as selective angiographic embolization is considered as the first-choice treatment associated or not with emboli injections with a success rate of 70%, and this evades mutilating surgery and related sequelae. We report a case of mandibular venous malformation on a 45-year-old female complaining of unilateral swelling of the left body of the mandible with facial deformation. The computed tomography scan images and the T1-weighted MR images showed a lesion that expresses an expansible lesion in the spongy bone of the left of the mandible with a buccal cortical rupture. Signal voids were not identified, suggesting a low-flow vascular lesion. The T2-weighted images exposed hypersignals; accordingly, a vascular lesion was suspected. The treatment was done under locoregional analgesia; after selective angiography, direct histoacryl injection was completed, followed by bone cement injection. The patient was followed yearly since1998. Radiological images of 10-year follow-up MRI showed a stabilization of the lesion without any new extensions. The panoramic radiograph after 22 years showed a bone formation inside the body of the mandible. The long follow-up period and the absence of any complications are favorable for the adopted treatment plan.

The extraction of retained and completely impacted third molars is one of the most common surgical procedures performed by dental practitioner’s with low rates of complications. The accidental displacement during the surgeries of the maxillary one into adjacent anatomical spaces is one of the most critical problems that can arise. The most common sites of migration during surgical interventions is the infratemporal fossa, the pterygomandibular space, the maxillary sinus, the buccal space, or the lateral pharyngeal space. In this paper, two cases of a maxillary third molar accidentally displaced into the buccal space are presented, and the retrieval of the tooth via intra-oral approach is explained and discusses the anatomical spaces implications. [ABSTRACT FROM AUTHOR]

The extraction of retained and completely impacted third molars is one of the most common surgical procedures performed by dental practitioners with low rates of complications. The accidental displacement during the surgeries of the maxillary third molar into adjacent anatomical spaces is one of the most critical problems that can arise. The most common sites of migration during surgical interventions are the infratemporal fossa, the pterygomandibular space, the maxillary sinus, the buccal space, and the lateral pharyngeal space. In this paper, two cases in which a maxillary third molar accidentally was displaced into the buccal space are presented, the retrieval of the tooth via intra-oral approach is explained, and the anatomical spaces implications are discussed.