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Adenoid cystic carcinoma (ACC) is a rare tumor, with a documented annual incidence ranging from 3 to 4.5 cases per million. It constitutes approximately 1% of all head and neck malignancies and around 10% of salivary gland tumors. It is imperative to adopt a multidisciplinary approach to ensure the most appropriate therapeutic outcome. Treatment strategies usually involve a multidisciplinary approach and may include surgery, radiotherapy, chemotherapy, or various combinations of these. In this context, we present a clinical case of ACC originating in the palate of a woman. Throughout this article, we will detail the diagnostic challenges and multidisciplinary treatment strategies implemented, emphasizing the importance of a comprehensive approach in cases of palatal ACC. In addition, we will discuss the rehabilitation process and the outcomes observed during the follow-up of this case., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A 47-year-old man was referred for treatment of a painful lesion of 5 months' duration located on the left side of the maxilla. A small perforation in the buccal cortex was observed during the intraoral examination. Cone beam computed tomography (CBCT) showed an extensive, well-delimited radiolucent lesion extending from the alveolar ridge to the nasal cavity. An incisional biopsy was performed, and a cystic lesion consistent with an odontogenic keratocyst (OKC) was observed microscopically. The initial treatment option was decompression to be followed by enucleation. However, 3 months after decompression of the lesion, the patient returned because there was a significant increase in the size of the perforation. A destructive lytic lesion that involved the left side of the maxilla and crossed the midline was evident in the CBCT. The examination of a second incisional biopsy specimen showed epithelial neoplasia comprising islands and projections toward the surface. There was abundant keratin deposition, resulting in the formation of pearls and plugs. A diagnosis of primary intraosseous carcinoma arising from an OKC was confirmed, and the patient underwent a maxillectomy. After 1 year of followup, there were no signs of recurrence. [ABSTRACT FROM AUTHOR]

Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group. Methods: Patients with STSGs were divided into two groups: a 'no suture' group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures. Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes). Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In India, oral squamous cell carcinoma accounts for 90%–95% of oral malignancies. The WHO classifies spindle cell carcinoma (SpCC) under malignant epithelial tumors of squamous cell carcinoma (SCC) and is a rare entity accounting for only 1% of SCCs. It is an aggressive biphasic neoplasm exhibiting high mortality rate owing to increased metastasis and recurrence which signifies the need for recognition and treatment of this perplexed tumor. We present a case of maxillary SpCC where histopathological evaluation alone was indecisive, requiring immunohistochemistry for confirmation of the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Ameloblastic carcinoma is a rare malignant lesion with characteristic histopathologic features; however, sometimes these features are vague. Tumoral cells have an appearance similar to ameloblastoma but they exhibit cytologic atypia. On radiographic view, they behave similar to typical ameloblastoma. It might present as a cystic lesion with benign clinical features or as a large ulceration, with significant bone destruction and tooth loss. The lesion is often found after an incisional biopsy unexpectedly. Because of its aggressive behavior (extension to surrounding soft tissues, extensive bone destruction, lymph node involvement and metastasis), the treatment of choice for the lesion is wide excision. Regional lymph node dissection, radiotherapy and chemotherapy have restricted value for treatment. Close periodic evaluation of the patient is obligatory. Case Presentation: We report a case of ameloblastic carcinoma of the maxilla in a 46-years-old male patient, including radiographic, clinical and pathologic features. The clinical and radiographic views mimicked ameloblastoma, while histologic sections revealed cytologic atypia associated by ameloblastic carcinoma. The patient was scheduled for preoperative radiotherapy before radical surgery. [ABSTRACT FROM AUTHOR]

Background: Cherubism is an autosomal dominant syndrome characterized by excessive bilateral maxillomandibular bony degeneration and fibrous tissue hyperplasia. Conservative management is the preferred treatment as cherubism has a self-limiting course. Functional or emotional disturbances may, however, demand surgical intervention. We report a patient who underwent surgical intervention. Method/Description: He had significant enlargement of lower cheeks and bilateral lower lid scleral show. On computed tomography of the face, the patient had significant fibrous tissue involving bilateral maxilla and mandible. The mandibular tumor was excised. Given normal inferior border, bilateral sagittal split osteotomy was performed to infracture and inset the outer cortex. During the procedure, patient required blood transfusion intraoperatively, so the maxillary portion of the procedure was delayed until 6 months later. For the maxilla, bilateral transconjunctival approach was used to resect parts of the orbital floors that were concave, resulting in 1 × 2 cm defects bilaterally which were reconstructed using resorbable plates. Then the anterior maxillary tumor was excised. Results: The patient and his parents were satisfied with his appearance after surgery. The patient was noted to have improvement in contour and decreased scleral show. He has most recently followed up 15 months after the initial surgery. There were no long-term complications. Conclusions: Severity of cherubism influences the type of surgical intervention. The present case is innovative because this is the first reported case of recontouring orbital floors with resorbable plates and infracturing of the mandible using sagittal split osteotomies for surgical treatment of cherubism. [ABSTRACT FROM AUTHOR]

The melanotic neuroectodermal tumor of infancy is a rare benign neoplasm that appears as a rapidly enlarging mass, most commonly in the anterior part of the palate. The tumor is believed to be of neurocrestal origin. The case report of a 3-month-old infant with a rapidly growing melanotic neuroectodermal tumor of infancy is presented. The tumor was surgically excised, and no evidence of recurrence has been found. [ABSTRACT FROM AUTHOR]

A case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed, and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is discussed. [ABSTRACT FROM AUTHOR]

Background and Overview. A 9-year-old girl underwent comprehensive resection and rehabilitation of a central giant cell granuloma that required phased interprofessional collaborative care to optimize treatment decisions and outcome. Case Description. The interprofessional treatment team included an oral and maxillofacial surgeon, maxillofacial prosthodontist, dentist, orthodontist, and speech-language pathologist, and treatment spanned 9 years. Treatment included surgical resection of a central giant cell granuloma and obturation with a removable interim prosthesis. After adequate growth and development, the patient then underwent a surgical free-tissue transfer reconstruction by using virtual surgical planning, followed by dental implant placement and a transitional restoration, subsequent orthodontic therapy, and eventual definitive rehabilitation with an implant-retained fixed hybrid prosthesis. Conclusions and Practical Implications. The interprofessional phased and collaborative treatment facilitated an optimal functional and esthetic process in a young patient with transitional and definitive treatments that considered long-term quality-of-life implications. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to integrate the available data published on calcifying odontogenic cyst (COC), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinomas (GCOCs) into a comprehensive analysis of their clinicoradiological features, treatment, and recurrence.Materials and Methods: An electronic search with no publication date restriction was undertaken in October 2017 in the following databases: PubMed, Medline Ovid, Web of Science, and Scopus. Eligibility criteria included publications containing enough clinical, radiological, and histopathological information to confirm a definite diagnosis of these lesions. Data were evaluated descriptively.Results: The literature review indicated a total of 234 publications reporting 367 COCs, 55 DGCTs and 44 GCOCs. These lesions have a predilection for Asian males. COCs mainly affect the mandible and patients in the second decade of life, DGCTs mostly affect the mandible and patients in the fourth decade of life, and GCOCs mostly affect the maxilla and patients in the fifth decade of life.Conclusion: Conservative surgery was the most common therapy for COCs and DGCTs, while radical surgery was most common for GCOCs. This study provides important and interesting data that could help clinicians and surgeons as well as oral and maxillofacial pathologists with the diagnosis and management of these lesions. [ABSTRACT FROM AUTHOR]

An approach for total maxillectomy with endoscopic transection of the pterygoid process via the contralateral maxillary sinus is described. In total maxillectomy, the resection of the pterygoid process of the sphenoid is a key step for successful resection. However, a conventional craniofacial approach requires extensive incision in the face, elevation of the lateral cheek flap. Even after elevation of the lateral cheek flap, visualization of this region is not good. An endoscopic approach through the contralateral maxillary sinus improved visualization of the pterygoid process, and osteotomy using a diamond-drilling bar was successfully performed. This technique has the potential to widen the indication for total maxillectomy in malignant neoplasms of the maxillary sinus. [ABSTRACT FROM AUTHOR]

Objectives: Extranodal lymphomas affecting the head and neck infrequently arise within the jaw bones. Although clinical examination and conventional radiography may initially suffice for such lesions arising within the mandible, those arising within the maxillary alveolus generally require cross-sectional imaging because of the complex anatomy of this region. This study was performed to determine the prevalence, demographic characteristics, and clinical presentations of these lesions and the imaging modalities used for their diagnosis.Study design: A systematic review (SR) on case series and another SR on case reports were performed to investigate the demographic, clinical, and radiological features of extranodal lymphomas arising within the maxillary alveolus.Results: Most case series were derived from just four nations, whereas the case reports were derived from a wider range of ethnicities. The more detailed case reports significantly reported at least one imaging modality. Most patients were aware of their lesions for nearly 2 months before presentation. The most frequent symptom was swelling. Most case reports included a provisional diagnosis, the most frequent of which was dental infection followed by squamous cell carcinoma.Discussion: Extranodal lymphomas arising within the maxillary alveolus were sufficiently frequent in four communities to be reported in two or more case series, and the occasional single case report indicated that such lesions are more widespread globally. Although the SR on case series revealed differences in the relative period prevalence and maxillary/mandibular ratio, the SR on case reports revealed details of the clinical presentation and imaging modalities used. [ABSTRACT FROM AUTHOR]

Giant Cell Granulomas (GCG) are rare tumors affecting the Head and Neck region and other sites of the body. It occurs most commonly in the mandible. The case reported here resembled a wide variety of conditions that led to a misdiagnosis bothon clinical and radiographic examination but was histopathologically diagnosed as CGCG. Wedescribe a case of central giant cell granuloma arising from the maxilla to highlight to the general dental practitioner the importance of histopathology in the diagnosis of thisenigmatic lesion. [ABSTRACT FROM AUTHOR]

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands and is seen most commonly in the parotid gland. Intraosseous MECs can be rarely seen and is mostly detected in the posterior part of the mandible. This condition can be acknowledged as an entity different from salivary gland MECs. In this case series, we delineated three patients of intraosseous MEC, two mandible tumors and one maxillary tumor and discussed the diagnostic characteristics and treatment methods of this rare entity. [ABSTRACT FROM AUTHOR]

Objective: Demonstrate the use of wide-field optical fluorescence as an adjunctive examination in a clinical routine to oral diagnosis. Background data: Use of wide-field optical fluorescence in the oral cavity has been restricted to topics related to the detection and diagnosis of oral cancer. Materials and methods: In a regular medical appointment, a 58-year-old female patient, without any complaint or oral symptom, underwent the complementary examination by wide-field optical fluorescence. A device with high-power light-emitting diode emitting light centered at a wavelength of (400 ± 10) nm and maximum irradiance of (0.040 ± 0.008) W/cm2 was used for fluorescence visualization. Results: We report the location of a firearm projectile, intraosseous, in the maxillary tuberosity using wide-field optical fluorescence. Conclusions: It is evidenced that wide-field optical fluorescence, within a clinical routine, can provide relevant images and data, with an immediate result, without the use of ionizing radiation, enabling an efficient oral diagnosis. [ABSTRACT FROM AUTHOR]

Tissue engineering combining cross-linked serum scaffolds with bone-derived mesenchymal stem cells has displayed excellent results for repair of maxillofacial bone defects in animal models, but it had not been tested in humans yet. We present here a pilot clinical trial using autologous bone-derived mesenchymal stem cells (H-MSV) grown in a serum cross-linked scaffold ( BioMax ) for treatment of maxillary cysts in 9 patients. Cells obtained from alveolar bone were seeded in the BioMax scaffold prepared from autologous serum, expanded under GMP conditions, and subjected to osteogenic differentiation for 3–4 weeks before application. Evolution of the cystic cavity was followed by computerized tomography (CT) for 7 months. There was no inflammation or other adverse effects, and the CT density of the cyst interior increased significantly after the treatment. The ratio of the CT values after/before treatment was (mean ± SE) 2.52 ± 0.45; in contrast, the density of the contralateral control area of spongy alveolar bone without treatment did not change (ratio after/before, 0.99 ± 0.14). In conclusion, cell therapy with BioMax could be considered as an alternative therapy for maxillary bone defects and other losses of bone substance. Further research with allogeneic cells would be useful for reducing costs and improving logistics. Clinical trial registration numbers EudraCT 2010-024246-30 and NCT01389661 . [ABSTRACT FROM AUTHOR]

Leiomyosarcomas (LMSs) are relatively uncommon mesenchymal neoplasms of smooth muscle differentiation. Only 1% of the lesions occur in the head and neck region. Surgical excision with radiotherapy and chemotherapy is the most commonly executed procedure for recurrent and metastatic tumors. We report a rare LMS case of the maxilla, defined in a 19-year-old male patient. Following the diagnosis of a malignant neoplasm on frozen section, wide resection, with a 1 cm clear margin, was performed. The lesion was then sent for histopathological examination. Spindle cell malignancy was found in histopathological sections of the lesion, histologically consistent with LMS. A radiographical evaluation, magnetic resonance imaging, computerized tomography, and positron emission tomography were performed to detect metastasis. Signs of local recurrence or distant metastasis were not noted at the 12-month follow-up following the definitive surgical procedure. [ABSTRACT FROM AUTHOR]

Background: Odontogenic myxoma (OM) is an uncommon neoplasm of the jaws. Considering the importance of defining the relative incidence and demographic profile of these lesions in South America, the aim of this study was to analyze the clinical and imagiological features of OM from three South American oral pathology services and to discuss these findings in light of the literature.Methods: Data regarding age, gender, anatomic site, and imagiological features from 85 cases of OM were collected. Additionally, we did a review of OM studies published in three electronic databases.Results: Among 63 450 oral biopsies, 1178 (1.85%) were odontogenic tumors (World Health Organization - 2017), of which 85 (7.21%) met the criteria of OM. The mean age was 30.7 years (range: 10-61 years; SD: 12.22). Forty-five (52.9%) cases occurred in females and 40 (47.1%) in males (ratio: 1:1.12). Maxilla was affected in 44 cases (53%) and mandible in 39 (47%). Of the 41 informed cases (48.2%), all of them were radiolucent lesions. The literature review indicated a majority of mean ages in third decade and a predilection for females, mandible, and multilocular radiolucent lesions.Conclusions: The features of OM samples have strong similarity to that reported in studies from other continents. It is possible to infer that geographic variation does not help to explain some differences observed in the clinical features of OM. [ABSTRACT FROM AUTHOR]

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Carcinoma cuniculatum (CC) is an extremely rare neoplasm of the oral cavity. It is essentially a well-differentiated variety of squamous cell carcinoma and shows lower metastasis risk. The histological features of CC can mimic that of papillary squamous cell carcinoma or verrucous carcinoma. CC commonly affects the plantar region of the foot, and very few cases have been described in the oral cavity. The classical histological characteristics noted are infiltration of underlying connective tissue by squamous epithelium with keratin cores and keratin-filled crypts. Herewith, we present a case of CC of the right maxilla in a young Dravidian male patient who works in a battery factory. The case presented a diagnostic challenge both clinically and histopathologically before it was completely resected using a total maxillectomy technique. The case delineates the diagnostic challenge and management of the disease. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the frequency of malignant oral and maxillofacial lesions among children and adolescents from representative geographic regions of Brazil.Materials and Methods: A retrospective study was conducted on biopsies obtained from 1990 to 2016 at six Brazilian oral and maxillofacial pathology referral centers. A total of 85,105 biopsy specimens from children and adolescents were analyzed. Gender, age, anatomical location, symptomatology and histopathological diagnosis were evaluated. Data were analyzed using descriptive statistical methods.Results: Fifty-eight (0.06%) malignant oral and maxillofacial lesions were diagnosed in children (19%) and adolescents (81%). The lesions were more frequent among females (60.3%) and adolescents. The most prevalent lesions were mucoepidermoid carcinomas (22.4%), osteosarcomas (13.8%), squamous cell carcinomas (12.1%), and Burkitt's lymphomas (12.1%). The most commonly affected sites were the palate (19%), mandible (13.8%), and maxilla (13.8%). Almost half the patients were asymptomatic.Conclusion: Pediatric oral and maxillofacial malignant lesions were infrequent and showed wide diversity, with a prevalence of mucoepidermoid carcinomas. Analysis of malignant lesions in children and adolescents helps pediatric dentists and oncologists to obtain a better understanding of such lesions and to reduce the time for diagnosis, with a consequent improvement of prognosis. [ABSTRACT FROM AUTHOR]

Osteomas are benign, slow-growing tumors that most frequently occur in the craniomaxillofacial region. These tumors are mostly asymptomatic and are generally found incidentally. A giant osteoma is generally considered to be greater than 30 mm in diameter or 110 g in weight. A 35-year-old female presented to us with complaints of a firm mass that showed continuous growth on the forehead following trauma. A hairline incision was made to expose the osteoma. Biopsy of the tumor confirmed a osteoma. There were no complications after surgery. Postoperative computed tomography revealed that the tumor was completely removed. Because a peripheral giant osteoma of the frontal bone with a history of trauma is a rare finding, thorough history-taking, physical examination, and preoperative imaging tests are needed for patients with a history of trauma to rule out a giant osteoma. [ABSTRACT FROM AUTHOR]

Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned. First the intracranial tumor mass was removed using bifrontal trepanation. A duraplasty was sewn in to cover the brain. In the second procedure, a combined bifrontal and midfacial approach was used by craniofacial plastic surgeons and neurosurgeons. A perisinusoidal tumor mass and retropharyngeal tumor mass was removed up to the skull base. The left orbit was completely exenterated, and a fibular bone-muscle graft was used for palatal, orbital, and facial reconstruction. The facial vein and artery were carefully prepared to feed the bone-muscle graft by end-to-end anastomoses. Conclusion Ameloblastomas are very rare slow-growing tumors that show a tendency to recur. They are responsible for only 1% of all oral tumors. Their growth can be enormous, and they can extend into sinusoidal cavities, the orbit, and the brain. Complex and extensive palliative surgery can ease the concerns of these patients and prolong their survival. [ABSTRACT FROM AUTHOR]

Introduction: Ameloblastoma is a relatively rare benign tumor. This is a true neoplasm of the enamel organ. This tumor is characterized by its remarkable latency and also its aggressiveness and high recurrence rate. Materials and methods: This is a retrospective study over 11 years (2002-2012) on 22 patients. The data were processed and analyzed by the Excel 2007 software. Results: This tumor affects young adults with male predominance. 95% of patients presented most frequently with a single (90%) and posterior (76.2%) mandibular swelling. The standard radiological exam (panoramic radiography) showed a multilocular radiolucency in 67% of cases. The treatment was surgery for all patients with or without immediate repair. Conclusion: Although the management of the majority of ameloblastic tumors is the privilege of the maxillofacial surgeon in Tunisia, the role of the dentist is paramount: an early diagnosis taking into account the several dental signs and also a prosthetic rehabilitation. [ABSTRACT FROM AUTHOR]

Dental and immunological features of the influence of various prosthetic structures of orthopedic prostheses on tissues and organs of the maxillofacial region were evaluated by the parameters of expression of oral fluid biomarkers. Healthy people without tumor and somatic diseases and patients with neoplasms of maxillofacial area in need of dental rehabilitation were examined before and in 2 weeks and 3 months after treatment. Certain regularities in the reaction of biomarkers to orthopedic prostheses were observed: a decrease in activity of MMP-2 and MMP-8 and their inhibitors or an increase in MMP-9; an increase in activity of biomarkers at early terms and a decrease in delayed terms after prosthetics. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article was to introduce a modified temporalis muscle flap (TMF) which was used to reconstruct palate and temporal deformity. Patient and methods: This was a retrospective review of the use of the modified TMF in reconstruction of palate and temporal deformity. We evaluated the result which included operative time, bleeding, necrosis, infection, facial nerve deficit, and cosmetic deformity. Results: All the 16 patients accepted the modified TMF surgery successfully. There were no complications. All of them were satisfied with the postoperative appearance. Conclusions: The modified TMF was a reliable and safe flap that can be used to reconstruct the surgical defect of plate and fill the temporal fossa. [ABSTRACT FROM AUTHOR]

Background: Maxillofacial tumours in children and adolescents have been documented worldwide; however, few studies were reported from Africa, especially sub-Saharan Africa. In Nigeria, most of the studies emanated from the Southwest region.Aim: To present an audit of clinicopathologic features and treatment of orofacial tumours in children and adolescents in Sokoto, Northwest Nigeria.Patients and Methods: Clinicopathologic records of the Departments of Dental and Maxillofacial Surgery, Paediatrics and Histopathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were reviewed for all the oral and maxillofacial tumours managed in children <19 years from January 2011 to December 2015.Results: Two hundred and twenty-two tumours were noted in all age groups during the study duration and 75 (33.8%) of these occurred in children and adolescents. A total of 45 (60%) males and thirty (40%) females constitute the patient population with a male to female ratio of 1.5:1. There are 32 (42.7%) benign tumours and 43 (57.3%) malignant tumours. Burkitt's lymphoma was the most common malignant tumour in 24 cases (55.8%), whereas pleomorphic adenoma was the most common benign soft tissue tumour in 4 cases (30.8%) and fibro-osseous lesions were the most common benign jaw tumours in 10 cases (52.6%). Chemotherapy alone was the treatment modality in 24 cases of malignant tumour whereas 13 cases had combination chemotherapy and irradiation.Conclusions: Our findings established that oral and maxillofacial tumours in children and adolescents are quite common in Sokoto, Northwest region of Nigeria, particularly the malignant types. There is a need for improved universal healthcare insurance for all citizens to adequately manage these children effectively. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among older adults (≥60 years) from representative regions in Brazil. Design Retrospective descriptive cross-sectional study. Setting Biopsy records were obtained from the archives of four Brazilian referral centers of oral diagnosis between 2000 and 2016. Participants A total of 45,506 biopsy records of all patients were analyzed, of these 7,259 persons aged 60 and older were selected. Measurements Data such as gender, age, race, anatomical location, and histopathological diagnosis were collected and categorized. Pearson's chi-square test ( P < .005) was used to evaluate differences in the frequency of the several groups of oral lesions. Results Oral and maxillofacial lesions were diagnosed in 7,259 older people, including 59.4% women ( P < .001) and 61.3% white patients ( P = .07). The most commonly affected sites were the cheek mucosa (20.3%) and mandible (8.9%) ( P < .001). Reactive and inflammatory lesions were the most common lesions, followed by neoplasms. Oral squamous cell carcinoma was the most prevalent neoplasm (83.4%) ( P < .001). Conclusion Knowledge of oral diseases obtained from biopsy records provides more accurate data about the diagnosis and oral health of elderly patients. These indicators thus support the development of specific health policies for the prevention and treatment of oral and maxillofacial lesions that affect this population. [ABSTRACT FROM AUTHOR]

Calcifying epithelial odontogenic tumor (CEOT) is a rare, benign, odontogenic tumor arising from the odontogenic epithelium and accounts for approximately 1% of all odontogenic tumors. Clear cell variant of CEOT is a distinct entity and has more aggressive biological behavior and higher chances of recurrence. Here, we present a unique case of clear cell variant of CEOT involving the left side of the maxillary alveolus in a 73-year-old female patient with thorough clinical, radiological, and histological details. [ABSTRACT FROM AUTHOR]

Surgical management of malignant tumors disfigures and demoralizes individuals. Management of such patients requires concern humane approach, meticulous planning and judicious management of a case. It is the responsibility of a dentist to restore the lost function, speech and esthetics. This clinical case report signifies the role of the dentist starting from diagnosis, presurgical phase, surgical phase and postsurgical phase of a patient diagnosed with squamous cell carcinoma of the right maxilla. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Maxillary ameloblastomas are rare and associated with an aggressive course because of the anatomic composition of the maxilla and adjacent structures. The risk factors associated with recurrence were analyzed in this retrospective study. Methods Cases of maxillary ameloblastoma reported in a tertiary hospital from 2005 to 2015 were analyzed to identify clinicopathological and radiological factors associated with recurrence using univariate and multivariate Cox regression analyses. Results A total of 890 patients with ameloblastomas were treated in this study, of whom only 51 (5.7%) had maxillary ameloblastomas. The median follow-up period was 56 ± 28.65 months. Of the maxillary ameloblastomas, 29 (56.8%) were primary and 22 (43.1%) were recurrent. Soft tissue or maxillary sinus invasion and primary or recurrent tumor status were risk factors significantly associated with recurrence in the univariate analyses ( p = .006 vs p = .025, respectively), whereas the association between recurrence and surgical methods was borderline significant ( p = .08). The multivariate Cox regression analysis showed that soft tissue or maxillary sinus involvement was significantly associated with recurrence ( p = .023). Conclusion Recurrent tumors and tumors with soft tissue or maxillary sinus involvement were risk factors for recurrence among patients with maxillary ameloblastoma. © 2017 Wiley Periodicals, Inc. Head Neck 39: 996-1000, 2017 [ABSTRACT FROM AUTHOR]

Background: Central giant cell lesion is a non-neoplastic proliferation, usually asymptomatic, of unknown etiology. The purpose of this case report is to report the diagnosis and the treatment of a recurrent central giant cell lesion in the maxilla.Case Presentation: A 31-year-old Brazilian woman presented to our Surgery Service for evaluation of a cystic lesion in her teeth 13 and 15, although she had previously received endodontic treatment for her teeth 13 and 15 without regression of the lesion. On clinical examination, an increase and painless swelling was observed in her right jaw. An excisional biopsy of the lesion was performed under general anesthesia; the material was sent for pathological examination and a diagnosis compatible with central giant cell lesion was made. She presented again, 10 months after the removal of the lesion, with a recurrent lesion that surrounded her incisors, canine, and right premolar. We suggested that she underwent treatment with intralesional corticosteroids injection. The lesion was significantly reduced and the remainder of the lesion was enucleated. She is monitored at 3-month intervals; at 6 months postoperatively there has been no recurrence.Conclusions: Central giant cell lesion can have a high degree of invasiveness, which increases the importance of early diagnosis. Combination therapies can provide a favorable prognosis. Periodic monitoring is recommended, thus avoiding the chance of a relapse. [ABSTRACT FROM AUTHOR]

Objective: The management of the clinically node negative (N0) neck in patients with squamous cell carcinoma of the maxilla (MSCC) is a matter of debate. In this retrospective cohort study the incidence of occult metastases is determined in clinically N0 MSCCs, as well as histopathological factors associated with occult metastases.Patients and Methods: 95 patients with clinically N0 MSCCs had maxillectomy. 18 patients with elective treatment of the neck were excluded. The remaining 77 patients followed a 'watch and wait' strategy for the neck and were included in this study. The incidence of occult metastases was calculated and Cox regression analysis was used to assess the predictive and prognostic value of clinical and histopathological parameters.Results: Occult metastases occurred in 14.3% (11/77) in the whole cohort and in 19.0% (11/58) in T2-T4 clinically N0 MSCC. Patients with T4 clinically N0 MSCC, showed the highest rate of occult metastases (24.1%). 45.5% of the occult metastases developed in the contralateral neck. The hazard ratio to develop occult metastasis was 5.39 (p=0.017) for perineural growth and 11.12 (p=0.003) for perivascular invasion. Salvage for cervical recurrence was poor at 40%.Conclusion: We recommend elective treatment of the neck or improved diagnostics to detect occult metastases in T2-T4 clinically N0 MSCC or when the biopsy specimen shows perineural growth or perivascular invasion. Since the contralateral neck was involved in 45.5% of the regional recurrences, we emphasize the importance of bilateral neck management. Improved diagnostics, like sentinel node biopsy, could possibly further reduce occult metastatic disease. [ABSTRACT FROM AUTHOR]

Joseph Gensoul was a pioneer of ENT surgery. In 1827, he performed the first total maxillectomy on 17-year-old boy. His work inspired many surgeons, who were previously unwilling to remove maxillary tumours. A paleopathological study performed in the Dupuytren museum allowed us to identify a skull from the early 19th century, with a large maxillar tumour. There were indications that this skull was operated according to Gensoul's technique. The aim of this study is to confirm that this patient had, in fact, received this surgical treatment. This is a historical and descriptive paleopathological study of a skull of the early 19th century of Dupuytren Museum in Paris. The historical research was conducted in collaboration with the French Academy of Medicine and the Museum of Medicine History (Paris). Bones mark cut studies allowed us to confirm that the patient was operated according to the method described by Gensoul in his 'Surgical letter' in 1833. Our historical research has allowed us to understand the perspectives of surgeons in the 19th century and the intellectual processes that led to this discovery. At a time when the robotization and industrialization dominate our art, it is interesting to look to our past, our origins, and our history. The study of ancient humans remains and allows us to understand the origin of our specialty and pay tribute to these pioneering surgeons. Their intellectual approach and boldness should be acknowledged and applauded, especially as it is also the key to our success. [ABSTRACT FROM AUTHOR]

Many clinical studies and literature reviews have suggested that bar and ball attachments in maxillary and mandibular implant-supported overdentures (ISOs) should be indicated only when there is sufficient interocclusal space (IOS; minimum = 30 mm). The aim of this clinical report was to present the prosthetic rehabilitation of a patient with adenoid cystic carcinoma associated with microstomia due to radiotherapy (IOS = 23 mm). ISOs offer superior retention and greater stability than conventional obturators, so that base extensions were kept to the minimum. Placing the balls parallel to the prosthesis path of insertion is much easier with this treatment modality. [ABSTRACT FROM AUTHOR]

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla. Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term follow-up is recommended.

Osteoid osteoma (OO) is a benign osteogenic lesion that is extremely rare in jaws. It is characterized by proliferation of either cancellous or compact bone and can be central, peripheral or extraskeletal. Pain is a distinctive feature of this lesion accompanied by vasomotor disturbances, which occur long before radiographic and histopathology findings manifest. Here, we present a rare case report of OO of maxilla in a 40-yr-old male patient with noteworthy clinical, radiological and histological presentation. The diagnosis of OO is usually obtained by radiographs confirmed by histopathological analysis. Thus, the oral physician should have keen observation and appropriate knowledge concerning the same to avoid confusion with similar bony lesions. [ABSTRACT FROM AUTHOR]

Odontogenic fibroma (OF) is considered an unusual, benign mesenchymal neoplasm and one of the most little-understood lesions amongst all odontogenic neoplasms. The incidence rate of the tumor is from 0% to 5.5%. WHO classified them into intraosseous or central and extraosseous or peripheral variants. It chiefly consists of fibroblastic tissue with an inconsistent amount of inactive appearing odontogenic epithelium. The lesion has a slow growth along with cortical expansion with equal predilection in the anterior maxilla and posterior mandible. Radiologically, multilocular radiolucency is the most frequent finding with few cases being associated with root resorption or displacement. Microscopically, mature collagen fibers and numerous fibroblasts along with odontogenic epithelial islands are characteristically found. Central Odontogenic Fibroma responds well to surgical enucleation with no tendency for malignancy or recurrence. Here we report a rare case report of an 18 yr old male patient with Odontogenic fibroma of the posterior maxilla. [ABSTRACT FROM AUTHOR]

Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients’ return to their prior living situation, occupational and family lives. [ABSTRACT FROM AUTHOR]

Background: Odontogenic myxoma is a benign, locally aggressive neoplasm of the jaws. Prevalence rates range between 0.5% and 17.7% of odontogenic tumours. There are few reports in the literature on this lesion in African populations, and therefore, this study aimed to report on odontogenic myxoma in a South African population over a 40-year period.Methods: The clinical records and orthopantomograms of 29 histopathologically diagnosed odontogenic myxoma were retrospectively analysed. Details of age, gender, ethnic origin and clinical, histological as well as radiological features were recorded.Results: The ages of patients ranged from 7 to 44 years with a mean of 21.3 years. The male-to-female ratio was 1:2.6 with the majority of patients being of mixed race and Africans. Clinically, 31% complained of pain while 58.6% had a history of swelling. The majority of odongenic myxomas (62.1%) were located in the mandible with the posterior region being most commonly affected. Multilocular lesions (69.2%) were more common and were significantly larger than unilocular lesions (P < 0.05). The outline of these tumours was mostly well-defined (84.6%) with different degrees of cortication. Only one tumour caused tooth resorption, while 20 cases (76.9%) caused tooth displacement. Six tumours expanded into the maxillary sinus, and 14 tumours caused expansion of the mandible.Conclusions: Odontogenic myxomas have variable clinical, radiological and histological features. Most of these features in this population were similar to other populations. It is mandatory to use conventional radiographs along with histopathological examination to aid in arriving at an accurate diagnosis. [ABSTRACT FROM AUTHOR]

The calcifying epithelial odontogenic tumor (CEOT), also known as the Pindborg tumor, is a benign locally invasive neoplasm. Common variants of CEOT include noncalcifying, Langerhans cell, bone and cementum forming and clear cell, which have a prognostic significance. Pigmented variants are known to occur in other odontogenic tumors. However, a definitive pigmented variant of CEOT has not been reported in literature so far. Here, we report the first case of pigmented Pindborg tumor arising from the maxilla in a young female. The pigment was demonstrated as melanin by staining and confirmed by immunohistochemistry. The pigmented variant of CEOT did not recur within 18 months postsurgery. Our report indicates that it is essential to recognize the pigmented variant. We discuss the common variants of CEOT and potential histogenesis of the pigmented variant. Further studies are required to reveal the histogenesis of melanocytes and their pathological significance in the odontogenic tumors. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumor (SFT) is a ubiquitous rare mesenchymal neoplasm. Pleura is the favored site of origin and is rare in the oral cavity. SFT occurs across a wide histopathologic spectrum. Fibrous form characterized by hyalinized, thick-walled vessels with opened lumina and strong CD34 reactivity constitute one end and on the other end, a cellular form representing the conventional hemangiopericytoma, with branched, thin-walled vessels and focal or negative CD34 reactivity characterize the spectrum. A case of oral SFT in a 30-year-old female patient with its clinical, histopathological and immunohistochemical features is being presented here. [ABSTRACT FROM AUTHOR]

Inflammatory pseudotumour (IP), also known as inflammatory myofibroblastic tumour (IMT), is a rare lesion of the maxillofacial skeleton and a diagnosis by exclusion. We describe three cases which affected the maxilla, two women and one man of ages 67, 56 and 70 years at presentation. All showed the typical, rather non-specific histopathological features. IgG4-positive plasma cells varied greatly in prominence, and none of the three lesions expressed ALK-1. Both women responded to steroids and radiotherapy, though one also required azathioprine. Despite maxillectomy, radiotherapy, steroids and cyclophosphamide, the man suffered intracranial spread and succumbed to persistent disease. The cases described here demonstrate the clinicopathological difficulties presented by this entity and its aggressive, unpredictable behaviour. [ABSTRACT FROM AUTHOR]

Ewing sarcoma (ES) of the jaw bones comprises a small fraction of ES at all sites. Due to their rarity, a specific policy for local treatment is lacking. The aim of this study was to evaluate the local therapy for ES and recommend measures to individualize treatment options. Patients with primary non-metastatic ES of the jaw bones treated between August 2005 and February 2015 were analyzed. All patients received primary induction chemotherapy, following which lesions amenable to resection based on specific radiological criteria were resected; those with unresectable lesions were offered definitive radiotherapy. The maxilla was the primary site in 13 patients and the mandible in eight. The median age of patients was 11.6 years (range 5–17 years). Overall, surgery was performed in 17 patients and definitive radiotherapy was used in four patients. Postoperative radiotherapy was administered to 12 patients and was avoided in five patients with 100% tumour necrosis. The 3-year overall survival, event-free survival, and local control were 68.1%, 63.6%, and 80.2%, respectively. Mandible primary and a histological response to chemotherapy were significant prognostic factors. The stratification of patients based on radiological criteria aids in selecting local therapy. In eligible patients, surgery with contemporary reconstruction results in optimal oncological and functional outcomes. Surgery also has the added advantage of identifying patients who may not need radiotherapy. [ABSTRACT FROM AUTHOR]

Ameloblastomas are slow growing, locally invasive, benign odontogenic tumors of an epithelial origin, accounting for approximately 1% of all oral tumors. A 40-year-old man presented with a chief complaint of a swelling over the left side of his face of 4 years' duration. On examination, gross facial asymmetry was detected, and a well-defined swelling was noted intraorally involving the left maxilla medially from the mid palatal raphe and obliterating the buccal vestibule laterally. The swelling was non-tender and exhibited dual consistencies: firm in the palate and cystic in the vestibular region. Computed tomography revealed a multilocular radiolucency, which involved the left maxilla, encroached into the left maxillary sinus and the nasal complex, and caused bony erosion. Early diagnosis and treatment are the key tools in managing ameloblastomas, failure of which may lead to a significant deterioration of the prognosis and an increased recurrence rate. Uncommon variants of ameloblastomas have been gaining interest recently. To date, 25 cases of hybrid ameloblastomas have been documented in the scientific literature. We present an extremely rare hybrid type of the ameloblastoma with combined follicular, cystic, acanthomatous, and desmoplastic variants, which render it the first of its kind to have ever been reported. [ABSTRACT FROM AUTHOR]

Ameloblastoma is a rare odontogenic neoplasm of the mandible and maxilla, with multiple histologic variants, and high recurrence rates if improperly treated. The current mainstay of treatment is wide local excision with appropriate margins and immediate reconstruction. Here we review the ameloblastoma literature, using the available evidence to highlight the change in management over the past several decades. In addition, we explore the recent molecular characterization of these tumors which may point towards new potential avenues of personalized treatment. [ABSTRACT FROM AUTHOR]

Odontogenic myxomas are a rare benign odontogenic mesenchymal tumor found exclusively in the tooth-bearing area of the jaw and are usually located centrally in the mandible. Soft tissue localization is rarely seen and is classified as peripheral odontogenic myxoma (POM). POM is slow growing and less aggressive as compared to central myxoma. It has a low recurrence rate, comprises 3-6% of all odontogenic tumors. Only a few cases of POM on maxillary gingiva are reported in the literature. Here, we present an unusual case of primary POM occurring in the gingiva of anterior maxilla in a 14-year-old female patient. [ABSTRACT FROM AUTHOR]

Summary A 7-year-old, male cocker spaniel was presented with a gingival proliferative lesion in the rostral maxilla and enlargement of the regional lymph node. Morphological and immunohistochemical analysis revealed a collision tumour composed of two malignant populations, epithelial and melanocytic, with metastasis of the neoplastic melanocytes to the regional lymph node. The epithelial component consisted of trabeculae and islands of well-differentiated squamous epithelium immunoreactive to cytokeratins. The melanocytic component had a varying degree of pigmentation of polygonal and spindle-shaped cells, growing in nests or densely packed aggregates and immunolabelled with S100, melanoma-associated antigen (melan A), neuron-specific enolase and vimentin antibodies. Protein markers involved in tumorigenesis or cell proliferation (i.e. COX-2, p53, c-kit and Ki67), were overexpressed by the neoplastic cells. To the authors' knowledge, this is the first description of an oral collision tumour involving malignant melanoma and squamous cell carcinoma in the dog. [ABSTRACT FROM AUTHOR]