Giant cell granuloma and neurofibroma in the mandible of a patient with neurofibromatosis type 1: a long-term follow-up case report with radiological and surgical aspects and a review of the literature.

BACKGROUND: Magnetic resonance imaging (MRI) of the brain is frequently performed on patients with neurofibromatosis type 1 (NF1), to detect and follow-up intracranial findings. In addition, NF1-related pathologies can appear in the jaws. This case study investigates if it is advantageous to assess the depicted parts of the jaws in the imaging of NF1 patients with intracranial findings, thereby detecting jaw pathologies in their initial stages. CASE PRESENTATION: We report on the 3-year management with clinical and radiological follow-ups of a central giant cell granuloma and a neurofibroma in the mandible of a patient with NF1 who underwent examinations with brain MRIs. A review of the mandible in the patient's MRIs disclosed lesions with clear differences in progression rates. CONCLUSION: NF1-related jaw pathologies may be detected in the early stages if the depicted parts of the jaws are included in the assessment of the imaging of NF1 patients with intracranial findings. This could impact the treatment of eventual pathologies before lesion progression and further damage to the vicinity.

Follow-up study of implants with turned or oxidized surfaces placed after sinus augmentation.

PURPOSE: To compare long-term survival and clinical outcomes of endosseous implants with different surface characteristics in patients with sinus elevation procedures, autologous bone grafting, and delayed implant placement. MATERIALS AND METHODS: Implant survival, peri-implant soft tissue conditions, marginal bone level, intrasinus apical bone level, and sinus health were studied in patients subjected to autologous bone graft and delayed placement of implants with turned or oxidized surfaces. After a minimum of 5 years of functional loading, all patients were clinically examined regarding gingival pocket depth (PD) and bleeding on probing (BoP). The marginal bone level (MBL) was measured in intraoral radiographs. Cone beam computed tomography was used to evaluate the apical bone level (ABL) of the implants and intrasinus conditions. RESULTS: Twenty-eight patients received sinus elevation and a total of 92 dental implants. Thirteen patients received 47 implants with a turned surface, and 15 patients received 45 implants with an oxidized surface. Mean follow-up was 10 years (range, 5 to 19 years). No significant difference was found between the two implant surfaces in terms of PD, BoP, MBL, or ABL. Four patients (14%) exhibited radiographic signs of sinus pathology, with opacification, polyp-like structures, and thickening of the sinus membrane. Radiographic signs of sinus pathology were not correlated to implant survival or to the investigated parameters. CONCLUSION: Grafting of the maxillary sinus floor with intraorally harvested bone and delayed placement of either turned or oxidized implants results in equally high long-term survival rates, stable marginal and apical bone levels, and good peri-implant soft tissue health.

An orthodontic oral appliance.

OBJECTIVE: This pilot study was performed to test the hypothesis that an orthodontic oral appliance (OA) that is designed to work against the backwardly directed forces on the upper incisors may counteract the reduction in overjet from these devices. MATERIALS AND METHODS: Thirty patients with normal bites, good oral health, and milder sleep apnea were randomized to treatment with either OAs or orthodontic OAs. Bite changes were evaluated on plaster casts and radiographs and by questionnaires after a mean of 2.4 years in 19 frequent users. RESULTS: Four of nine patients in the orthodontic OA group increased their overjet by > or =0.4 mm, while none of the 10 patients in the OA group experienced that effect. CONCLUSION: Only the orthodontic OA increases the overjet; this design may therefore be beneficial to patients at risk of negative effects on their bite during OA treatment.

Titanium screw implants in optimization of radiographic evaluation of facial growth in longitudinal animal studies.

The aim of this study was to develop a method that optimizes the reliability of longitudinal radiographic evaluation of small and fast-growing animals, such as the rabbit. Because the use of conventional cephalometric methods, including superimposition of serial radiographs, is more problematic in small animals than in humans, two titanium-alloy screws were placed 10 mm apart in the sagittal crest of the parietal bone in 10 growing New Zealand white rabbits. The anterior screw served as holder for a steel pin that, in turn, secured the fixation of the rabbit's head to a specially designed cephalostat. A lateral cephalogram of each animal was exposed on four occasions at one-month intervals. Computer-aided superimpositions were made of all four cephalograms from each animal using the screws in the calvarium as reference structures. To evaluate the method, the superimpositions were repeated after three to eight weeks, and the superimposition reproducibility was calculated. From the results, it can be concluded that the method allows congruent positioning of the animal skull relative to the film-focus assembly at repeated radiographic examinations. Furthermore, it introduces readily identified reference structures in the animal skull that can be used at high-precision superimposition of serial radiographs.