Traumatic Neuroma of the Hard Palate Mimicking a Small Salivary Gland Tumor-A Case Report.

In the case of any pathologies arising in the hard palate, it is always important to exclude their possible odontogenic origins. Cone-beam computed tomography is mandatory. In cases where a possible non-teeth-related pathology is confirmed, each clinician should remember possible differential diagnostics. Many small salivary glands between the mucosa and bone are present in this palatal area. Both benign and malignant tumors arising from the small glands, and mucosa of the hard palate, might occur. The case presented here mimics a solid tumor because of the nodule consistency. Because of a healthy palatal mucosa without any erosions or irritations with firm attachment to the submucosal nodule, a possible malignant tumor of small salivary gland origins was suspected in this case. When the tumor diameter is small, an excisional biopsy is required to collect good and representative material for further histopathological evaluation. In most cases, bulky nodules present on the palate are hard on palpation, non-movable, and covered with healthy mucosa. Possible bone infiltrations with mucous membrane ulcerations could manifest a more expansive character of the lesion. In the presented case, an unusual occurrence of a traumatic neuroma without any past traumatic etiology of the palate was first differentiated from the occurrence of adenoid-cystic carcinoma (ACC), pleomorphic adenoma, other benign/malignant small gland tumors, or atypical, fibroma/schwannoma of the palate. This paper presents treatment options for this rare oral neural tumor occurrence in the palate and differential diagnosis between hard palate tumors in a 42-year-old male patient, furthermore highlighting the role of an excisional biopsy as a good source for a tissue sample.

Late Outcomes of Undiagnosed Unilateral Condylar Hyperplasia and Reoccurrence of Mandibular Asymmetry.

Unilateral condylar hyperplasia (UCH) is a rare cause of asymmetrical mandibular overgrowth because of the presence of an atypical growth in the affected condyle. SPECT (single-photon emission computed tomography) can easily establish the presence of an atypical, prolonged growth exceeding far beyond normal condylar growth and activity. A CT, CBCT, or LDCT (computed tomography, cone-beam computed tomography, or low-dose computed tomography) can confirm the diagnosis by evaluating the scope of bone overgrowth, mandibular basis/ramus asymmetry, tendency to condylar head enlargement, changes in bone density, and occurrence of differences in condylar head shapes, size, and bone structure. In most cases, a condylectomy is the procedure of choice in growing cases of UCH to remove the pathological condyle and reduce asymmetry levels. Sometimes, the growth is very slow and progressive over time, causing slowly growing asymmetry with similar symptoms to any other mandibular asymmetry, and this causes some troublesome procedures in UCH diagnostics, resulting in patients being underdiagnosed; it can even lead to some relapses in mandibular asymmetry and skeletal malocclusion after previously performed orthodontic and surgical treatment of such discrepancies. When the source of asymmetry is not identified in time, possible inadequate treatment protocols can be used. If any relapse of facial and mandibular asymmetry re-occur, SPECT and CT evaluation are necessary to evaluate if condylar hyperplasia is present and to establish what kind of surgical intervention should be used in each case.

Pathological Changes in Early Medieval Horses from Different Archaeological Sites in Poland.

The work is the first comprehensive analysis of equine pathological changes from the Polish territory. The research material was collected from 20 archaeological sites, mainly early medieval settlements, such as strongholds, settlements, towns and horse graves. In the material examined, 186 cases of lesions were found. Of these, 26.9% were lesions of the spine, 39.8% lesions of the limb skeleton and 31.7% lesions of the head including dental pathologies. Most of the lesions in the limbs involved their distal segments. The vast majority of pathological cases can be linked to animal use. It was found that horses in which pathological lesions were observed were used under cover. In one case, the observed cranial trauma was the cause of death associated with injury to the nasal auricles and large vessels and consequent blood loss and possible shock. It was found that, in some of the cases, the horses started to be used early which affected their organs of motion and spine.

A probable case of "lumpy jaw" in early medieval (11th - 12th c.) cattle from a stronghold in Kruszwica, Poland.

OBJECTIVE: The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered. MATERIALS: The skeletal material included a caudal fragment of a cattle mandible. The specimen, exhibiting chronic disease was separated from approximately 10,000 early medieval cattle remains discovered during excavations of the former Kruszwica stronghold. METHODS: The bone was underwent macroscopic, radiological and histopathological examination. RESULTS: Location, macroscopic, microscopic and X-ray images of the lesions within the examined mandible indicate it could have been caused by the actinomycosis. CONCLUSIONS: In the face of infection, no effective therapies were undertaken in the Middle Ages. SIGNIFICANCE: Descriptions of lumpy jaw in the paleopathological literature are rare. This disease, due to its background and course, eliminated animals from breeding for centuries until the era of antibiotics. The case described in our paper is in an advanced stage, but its adult age suggests that efforts were possibly made to keep the cow alive as long as possible, indicating the significant economic importance of the animal. LIMITATIONS: This analysis is limited by the absence of other anatomical elements of the affected animal, which impacts the interpretation of the palaeopathological bone. SUGGESTIONS FOR FURTHER RESEARCH: It is recommended that similar studies are conducted on better preserved and more numerous cattle assemblages.

Anatomical and Surgical Implications of the Usage of Bichat Fat Pad in Oroantral Communication, Maxillary, Palatal, and Related Surgeries-Narrative Review.

The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.

The CBCT Retrospective Study on Underwood Septa and Their Related Factors in Maxillary Sinuses-A Proposal of Classification.

Introduction. The presence of bone septum in the maxillary sinus is one of the most common anatomical findings. So-called Underwood septa (US) are an atypical bone formation in the maxillary sinuses. Mostly they are quite easily found in CBCT studies and have major importance in sinus lift procedures in dental surgery. Furthermore, the shape, location, and size of the bony septa are important in each maxillary sinus surgery. Material and methods. A retrospective study of 120CBCT scans from the authors' own database was conducted. Results. Approximately 37.5% of each CBCT was associated with the occurrence of US, while just 25% had a full septum, and a total of only 14 patients had a half septa. More females have US, while healthy pneumatized maxillary sinus is most commonly found (82.22%). There is no correlation between the occurrence of silent sinus syndrome (p = 0.174), mucosal thickening (p = 0.325), or retention cyst formation (p = 0.272). Most sinuses are without any opacification in CBCT evaluation (91.11%), while other syndromes are not statistically relevant. Conclusions. It seems that the occurrence of Underwood septa is not statistically related to any clinical, radiological, or pathological condition within the sinus (p > 0.05). Furthermore, a more full or partial appearance of US was found in female patients.

The Temporary Mental Nerve Paresthesia as an Outcome of Dentigerous Cyst Removal during Preparation for Dental Implant Placement: A Case Report.

The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1-2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.

Battle wound as a probable cause of the death of an early medieval horse in Ostrów Lednicki, Poland.

OBJECTIVE: In this paper we interpret a pathology observed in an early medieval horse skull discovered near the abutment of the eastern Gniezno bridge in Ostrów Lednicki in Poland. We consider the possible cause of the observed damage in the context of the armed invasion of the Czech prince Brzetyslaw and a battle of Ostrów Lednicki. MATERIALS: A skull of a 10-year-old male horse dated to the 11th century. METHODS: The skull was examined macroscopically and through computed tomography. Metric analysis was performed using digital callipers and the shoulder height was calculated. RESULTS: A penetrating lesion through the left frontal and nasal bones was observed. The floor and roof of the left conchofrontal sinus were destroyed along with the dorsal ethmoturbinates of the ethmoid labyrinth. CONCLUSIONS: The observed damage was most likely a result of trauma, which caused a fatal haemorrhage rather than sudden death. Considering the historical context and the area where the skull was discovered, it could be a battle wound. SIGNIFICANCE: This case is a rare example of an unhealed peri-mortem lesion in an animal skeleton that can be associated with an immediate cause of death. LIMITATIONS: The lack of a complete skeleton does not allow a complete analysis of horse's condition and circumstances associated with its death. SUGGESTIONS FOR FURTHER RESEARCH: Identification of the tool or weapon that was used to deliver the blow.

Horses in the Early Medieval (10th-13th c.) Religious Rituals of Slavs in Polish Areas-An Archaeozoological, Archaeological and Historical Overview.

Knowledge about horses from early medieval (10th-13th c.) Poland has been largely based on historical and archaeological data. Archaeozoological information has only been used to a limited extent. Therefore, this article aims to present the current state of knowledge on this subject, drawing on archaeozoological data from studies of horse bones. Apart from confirming earlier reflections regarding the sacred significance of the horse, additional information was obtained about specific individuals who were the subject of magical treatments. It turned out that sites with horse skeletons and skulls are few compared to the familiar presence of horse remains among kitchen waste. This contrasts with the neighbouring regions, where horses were buried more frequently among the Germans, Scandinavians and Prussians. Some new data have been obtained thanks to taphonomic analyses, which demonstrated that horse skulls of apotropaic status were not only exposed to public viewing but were also deposited under stronghold ramparts. Horses suffering from infectious diseases could also be buried under such ramparts. Considerations in the article lead to conclusions that horses were used in religious rituals as sacrificial animals, apotropaic deposits, as fortune-telling animals and cosmological figures.

Methods of Definitive Correction of Mandibular Deformity in Hemimandibular Hyperplasia Based on Radiological, Anatomical, and Topographical Measurements-Proposition of Author's Own Protocol.

In order to fully evaluate and establish the degree of bone overgrowth, various radiological studies are essential in the careful planning of the amount of surgical excision. In the presented paper, the authors use self-designed anatomo-topographical reference points for planning the surgeries. Routine panoramic radiographs and low-dose computed tomography based on anatomical landmarks help in measuring the proportions of mandibular bone overgrowth with the following preoperative anatomical landmarks: (Go-Go), (Go(Right)-Gn), (Go(Left)-Gn), and (Me−Gn). Measurements taken at selected points and landmarks (gonion-gnathion/gnathion-menton) are easy to conduct. In the authors' proposal, the main key factor is total chin correction, which is necessary in cases of severe overgrowth; when F0 > C and Go-Gn>, there is >7 mm of vertical bone overgrowth, and the mandibular canal is positioned <5 mm from the inferior mandibular border­MIB. Larger overgrowths (>7 mm) have a greater outcome on the final symmetry than smaller overgrowths. As no guidelines are known, the authors present their own proposal.

A Model for Dental Age Verification Using Ultrastructural Imaging for Modern and Fossil Representatives of the Rhinocerotidae Family.

The analyses were performed on a right third premolar (P3) of a white rhinoceros female (Ceratotherium simum, Burchell 1817). The specimen was born in captivity at London Zoo (Zoological Society of London), then in the 1970s transferred to Kiev Zoo (Peremohy Avenue), Ukraine, and was kept there until it died at a documented chronological age of 48 years. The female died because of its age, which indicates it was kept in good conditions adequate to the requirements of this species. Photographs and micrographs with radiological documentation were taken on the said tooth. Its structural characteristics were determined, and on the occlusal surface areas and points of anatomical constitution of its crown were identified. The tooth was also histologically evaluated via sections taken horizontally in a mesial-distal plane through the crown, horizontally in a mesial-distal plane through the coronal portion of the root, and longitudinally in a lingual-buccal plane through the crown and the root. Preparations with ground sections were made and observed in white, polarized, and reflected light. In the subsequent stage X-ray and SEM imaging has also been used, for analysis of the distribution of annual growth layers of mineralized dental tissues of cement and dentine, counted from the root canal center to the buccal surface. An attempt was also made to confirm the annual season in which the animal died, based on cement growth lines. It was observed that the growth lines were visible in all the analyzed sections, in dentine and cement. In the cement, the lines were relatively few and did not represent the attested age of the animal. The analysis of the coloration of the cement lines indicated that the animal was regularly fed a diet that was not seasonally differentiated. From the X-ray examination comes a conclusion that the animal did not suffer from periodontal diseases. Visible growth lines were observed on the dentine. On the horizontal section through the crown growth lines in the dentine were few and unclear. On the longitudinal section, both on the caudal and rostral roots, these lines were clearly visible and much more numerous than expected considering the known age of the animal, as more than 50 were counted. On horizontal sections through the upper part of both roots, distinct growth lines were observed in the dentine, and their number-48 for both roots-corresponded precisely to the age of the animal. The results of our study indicate that this method has significant potential for application to verify the age at death for modern and fossil representatives of rhinoceros.

Vertebral disease in excavated canine in Lower Silesia, Poland.

A mostly complete canine skeleton was excavated during rescue archaeological explorations in Domaslaw (Lower Silesia, Poland). The archaeozoological analysis revealed loss of several left maxillary incisors. Discospondylitis was observed in two adjacent lumbar vertebrae. Potential causes of the vertebral pathology are discussed. The cause of death is unknown, but sepsis should be considered. No other pathological changes or evidence of human manipulation to the skeleton were identified.