Superficial Mucocele of the Ventral Tongue: Presentation of a Rare Case and Literature Review.

The superficial mucocele is a rare variant of the common mucocele and noted microscopically by subepithelial pools of mucin. To increase the understanding of oral superficial mucoceles, a database was created from the demographics of case reports and case series from a PubMed search. At least 200 patients with superficial mucoceles have been described in the English-language literature, 82 of whom had biopsy-proven lesions; additional clinical information was available for 39 of these 82 patients. Compiled data suggest superficial mucoceles offered phenotypic distinctions from the common mucocele because they were more apt to occur in middle-aged women, often on the soft palate and buccal mucosa. Affected patients frequently had multiple lesions that were smaller than 3 mm and nearly 50% of patients developed recurrence. This report also describes the first histopathologically confirmed case of a superficial mucocele arising on the ventral tongue in a 22-year-old man. It is speculated that the glossal lesion might have developed from long-term impingement from exposed metal barbs from an orthodontic splint. Persistent lesions or atypical presentations underscore the need for histopathologic examination.

Oral lipoma: report of three cases.

Oral lipomas are benign lesions that are seen infrequently in the dental practice. This article details the clinical and histopathologic findings of three cases of intraoral lipomas. All of the lesions exhibited a yellow color. Two of the tumors were located on the buccal mucosa, while the other mass arose on the mandibular buccal/labial vestibule, was considerably larger in size, produced extraoral swelling, and necessitated a preoperative MRI due to close approximation to the mental nerve. None of the patients elicited any history of attendant symptomatology. Excisional biopsies in each case revealed well-circumscribed masses surrounded by a thin fibrous capsule and composed of sheets of mature adipocytes arranged in a "chicken wire" configuration. The tumor adipocytes were similar to normal adult fat cells and contained a small, uniformly eccentric nucleus with a single, clear cytoplasmic vacuole. Surgical excision is the modality of treatment and malignant transformation or recurrence is rare.

Numb chin syndrome associated with vertical root fracture and odontogenic infection.

Numb chin syndrome (NCS) is a multifactorial neuropathic disorder associated with paresthesia to the chin, lip, and oral mucosa, particularly arising as a sequela to various dental-related procedures or infections in the mandible. Timely elucidation of the underlying etiology is of paramount importance as the presentation of NCS could serve as a harbinger of malignancy or metastatic disease. This report describes an unusual case of NCS developing synchronously with a vertical root fracture and odontogenic infection in a mandibular first molar. Clinicians should consider the inclusion of a vertical root fracture as plausible cofactor for the development of NCS.

Osteonecrosis of the jaws associated with use of risedronate: report of 2 new cases.

Use of various bisphosphonates has been associated with the development of osteonecrosis of the jaws (ONJ). At least 865 cases of ONJ attributed to these agents have been reported in the English-language literature. Approximately 96% of these published cases were seen with administration of the intravenous agents pamidronate and zoledronate, whereas only 26 cases have been associated with oral bisphosphonates, 25 of them with alendronate. Only a single case of ONJ associated with the oral bisphosphonate risedronate has been previously cited. We report 2 cases of ONJ attributed to risedronate administration. The patients developed osteonecrosis 15 and 24 months after treatment for osteopenia. A regimen of antibiotics and chlorhexidine mouthrinse resolved the osseous defect in the mandible caused by complete exfoliation of a lingual torus in 1 patient. The other patient required sequestrectomy, repeated courses of antibiotics, surgical debridement, and steroids to promote closure of an oroantral fistula and management of sinusitis after bone grafting and implant placement in the posterior maxilla. A demographic profile of reported oral bisphosphonate users affected by ONJ is also provided. With the millions of patients receiving various oral bisphosphonates for osteopenia and osteoporosis, health care practitioners should be aware of the potential for the onset of osteonecrosis and familiar with its management.