Diagnostic and surgical aspects of central hemangioma of mandible: a surgical approach for the reconstruction of mandible.

Intraosseous vascular lesions are rare lesions, accounting for 0.5-1% of all intraosseous tumors. They were found to be affecting the second decade of life, more frequent in women. The frequency found affecting the vertebral column and skull; the mandible is a quite rare location. At present, according to the World Health Organization, these lesions are now considered as benign vasoformative neoplasms of endothelial origin. However, the origin of the central hemangioma is debatable. Some authors state it as a true neoplasm, few state it is a hamartoma. On examination, the patient may or may not show any symptoms, some present discomfort, blood discharge, bluish discoloration, mobility of the teeth. The radiographic finding is a multilocular radiolucenies with classic honeycombs or soap bubble appearance. Differential diagnosis includes odontogenic lesions like ameloblastoma, cystic lesions such as residual cyst, central giant cell tumor, fibrous dysplasia. The wide surgical excision along with the reconstruction is choice of treatment of hemangioma. We present a case report of a 24-year-old female diagnosed with intraosseous mandibular hemangioma and surgical reconstruction of mandible with rib graft.

Cytokeratin 14 and cytokeratin 18 expressions in reduced enamel epithelium and dentigerous cyst: Possible role in oncofetal transformation and histogenesis- of follicular type of adenomatoid odontogenic tumor.

INTRODUCTION: Odontogenic cysts and tumors arise from the structures and remnants associated with tooth development. Cysts and tumors derived from the odontogenic tissues constitute an unusually diverse group of lesions. This diversity reflects the complex development of the dental structures, since all these lesions originate through some alteration from the normal pattern of odontogenesis. Cytokeratin (CK) 14 is the typical intermediary filament of odontogenic epithelium, CK 18 is the major components of the intermediate filaments of simple or single layered epithelial tissue; it is not expressed in stratified squamous epithelium. The present study was undertaken to understand the expression pattern of these cytokeratins in dentigerous cyst, dental follicular tissue, adenomatoid odontogenic tumor (AOT) and unicystic ameloblastoma. MATERIALS AND METHODS: The present study consists of 60 specimens consisting of 20 samples of Dentigerous cyst, 20 samples of Reduced enamel epithelium/dental follicles, 10 samples of Follicular type of AOT, 10 samples of unicystic ameloblastoma. The sections of these specimens were stained for CK 14 and CK 18. The number of cells positive for CK 14 and CK 18 was counted per 100 cells. The cells were counted in four randomly selected high-power fields and the mean was calculated. Scoring of cytokeratin 14 expressions was done using Remmele score. RESULTS: The highest expression of cytokeratin 14 was noted in AOT, least was seen in dental follicle/Reduced enamel epithelium (REE). CK18 was negative in all the cases included in the present study. CONCLUSION: In the present study, the expression of CK14 was noted in AOT, Dentigerous cyst (DC), Unicystic Ameloblastoma (UCA) and Dental follicle/REE. The expressions between these lesions were compared. These expression pattern may provide an insight to the histogenesis of AOT.