ABSTRACT
RESUMEN El ameloblastoma es un tumor odontogénico benigno, localmente agresivo y recidivante, con predilección por la región posterior de la mandíbula. Se caracteriza por su agresividad local con muy baja tendencia a metastizarse. El objetivo fue reportar el caso clínico de un paciente con ameloblastoma multiquístico derecho, tratado a través de hemimandibulectomía. Se presentó un paciente masculino, de 44 años de edad, que refirió aumento de volumen del lado derecho de la mandíbula desde hacía aproximadamente un año, acompañado también de otros síntomas, atendido en el Servicio de Cirugía Maxilofacial del Hospital Militar Principal/Instituto Superior, en Luanda, Angola. Los estudios imagenológicos incluyeron radiografía panorámica y tomografía axial computarizada. El diagnóstico clínico patológico fue de ameloblastoma multiquístico. Este tipo de tumor requiere de un adecuado diagnóstico sobre la base de la presentación clínica, localización, tamaño, edad y tipo histológico; de ahí la importancia de conocer las características clínicas e imagenológicas, pues el tratamiento conlleva gran dificultad (AU).
ABSTRACT Ameloblastoma is a benign odontogenic tumor, locally aggressive and recidivist with predilection for back of the jaw, characterized by local aggressiveness and low tendency to metastasize. The aim was reporting the clinical case of a patient with right multicystic ameloblastoma treated through hemimandibulectomy. We presented a male patient aged 44 years, who referred a volume increase of the jaw right side for around a year, accompanied also by other symptoms; he attended the Maxillofacial Surgery Service of the Main Military Hospital/High Institute of Luanda, in Angola. The image studies included panoramic radiography and computerized axial tomography the clinical pathological diagnosis was multicystic ameloblastoma. This kind of tumor requires an adequate diagnosis based on the clinical presentation, location, size, age and histological kind, therefore the importance of knowing the clinical and image characteristics, because the treatment is very difficult (AU).
Subject(s)
Humans , Male , Adult , Ameloblastoma/surgery , Mandibular Osteotomy/methods , Biopsy/methods , Ameloblastoma/complications , Ameloblastoma/diagnosis , Mandibular Diseases/diagnosis , Odontogenic Tumors/surgery , Odontogenic Tumors/diagnosis , Clinical DiagnosisABSTRACT
Metronidazole (MNZ) is prescribed for the treatment of infection caused by anaerobic bacteria and protozoa. Metronidazole-induced encephalopathy (MIE) has been known to be a side-effect, although its onset ratio is unclear. However, to the best of our knowledge, MIE associated with hyperbaric oxygen therapy (HBO) has not been previously reported. Here, we present the case of a 68-year-old man with mandibular osteomyelitis who received metronidazole for 49 days and received five times HBO therapy. He visited our hospital for evaluation and treatment of peripheral neuropathy, speech disturbance, nausea, and disturbance of gait after 47 days of initiating metronidazole treatment. Brain magnetic resonance imaging revealed hyperintense lesions in the cerebellar dentate nuclei, which was consistent with MIE. The patient's ataxic symptoms improved in 15 days after the discontinuation of MNZ. This is the first report demonstrating case of MIE could be related with HBO, as far as we had searched.
Subject(s)
Anti-Bacterial Agents/adverse effects , Cerebellar Ataxia/etiology , Hyperbaric Oxygenation/adverse effects , Mandibular Diseases/therapy , Metronidazole/adverse effects , Osteomyelitis/therapy , Staphylococcal Infections/therapy , Aged , Cerebellar Ataxia/diagnosis , Cerebellar Nuclei/diagnostic imaging , Cerebellar Nuclei/drug effects , Chemoradiotherapy/adverse effects , Chemoradiotherapy/methods , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/methods , Humans , Magnetic Resonance Imaging , Mandibular Diseases/diagnosis , Mandibular Diseases/etiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Neoadjuvant Therapy/adverse effects , Neoadjuvant Therapy/methods , Osteomyelitis/diagnosis , Osteomyelitis/etiology , Radiation Injuries/diagnosis , Radiation Injuries/etiology , Radiation Injuries/therapy , Squamous Cell Carcinoma of Head and Neck/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/etiology , Tongue Neoplasms/therapy , Treatment OutcomeABSTRACT
Necrotizing fasciitis (NF) is an infection of the soft tissues pathology with high mortality that spreads through the fascial planes and rarely seen in head and neck region. The cause of infection is often odontogenic problems. Broad-spectrum antibiotics, surgical debridement, and hyperbaric oxygen therapy (HBO) are important for the treatment of disease. We report a case of cervical NF in a 33-year-old woman who was treated with rapid surgical debridement and simultaneous HBO.
Subject(s)
Fasciitis, Necrotizing , Hyperbaric Oxygenation , Mandibular Diseases , Neck , Adult , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/pathology , Fasciitis, Necrotizing/therapy , Female , Humans , Mandibular Diseases/diagnosis , Mandibular Diseases/pathology , Mandibular Diseases/therapy , Neck/pathology , Neck/surgeryABSTRACT
A 14-year-old male with familial hypophosphatemic rickets, being treated with oral phosphate and calcitriol therapy, presented to the Division of Pediatric Dentistry, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pa. A panoramic radiograph showed multifocal, multilocular lesions in the mandible leading to surgical exploration and biopsy. Histopathological evaluation of the largest lesion showed features consistent with central giant cell granuloma. Given the patient's history, hyperparathyroidism was suspected. Laboratory data showed an elevated parathyroid hormone of 152 pg/ml (normal range equals nine to 69). This confirmed the diagnosis of multiple brown tumors in the mandible associated with secondary hyperparathyroidism, which was attributed to high-dose phosphate treatment. After endocrinology consultation, calcitriol therapy was increased. Improvement of the patient's brown tumors is expected with medical therapy. The purpose of this case report was to raise awareness among pediatric dentists about the maxillofacial ramifications of secondary hyperparathyroidism.
Subject(s)
Familial Hypophosphatemic Rickets/complications , Granuloma, Giant Cell/etiology , Hyperparathyroidism, Secondary/complications , Mandibular Diseases/etiology , Osteitis Fibrosa Cystica/etiology , Adolescent , Bone Density Conservation Agents/therapeutic use , Calcitriol/therapeutic use , Calcium Channel Agonists/therapeutic use , Ergocalciferols/therapeutic use , Familial Hypophosphatemic Rickets/drug therapy , Follow-Up Studies , Granuloma, Giant Cell/diagnosis , Humans , Male , Mandibular Diseases/diagnosis , Osteitis Fibrosa Cystica/diagnosis , Phosphates/therapeutic useABSTRACT
This case report describes the diagnosis and surgical treatment of a cyst-like periradicular lesion in an alpaca.
Subject(s)
Camelids, New World , Mandibular Diseases/veterinary , Radicular Cyst/veterinary , Animals , Male , Mandible/diagnostic imaging , Mandible/pathology , Mandibular Diseases/diagnosis , Mandibular Diseases/surgery , Radicular Cyst/diagnosis , Radicular Cyst/surgery , RadiographyABSTRACT
Central giant cell granuloma of the jaw is a benign lesion of unknown etiology that occurs with very low frequency. It mainly occurs in children and young adults and is more common in the mandible. The most common treatment is surgical removal; however, alternative therapies (intralesional injections of corticosteroids, interferon alpha, and calcitonin) have been used in order to avoid undesirable damage to the jaws and teeth. The lesion may cause root resorption, tooth germ displacement, and other dental problems, as well as malocclusion that must be treated orthodontically. The orthodontic, orthopedic, and calcitonin-based treatments of one of these cases is presented.
Subject(s)
Calcitonin/therapeutic use , Granuloma, Giant Cell/therapy , Malocclusion, Angle Class I/therapy , Mandibular Diseases/therapy , Orthodontics, Corrective , Child , Combined Modality Therapy , Granuloma, Giant Cell/diagnosis , Humans , Magnetic Resonance Imaging , Male , Mandibular Diseases/diagnosis , Radiography, Panoramic , Tomography, X-Ray ComputedSubject(s)
Mandibular Diseases/diagnosis , Osteitis Deformans/diagnosis , Osteomyelitis/diagnosis , Aged , Anti-Bacterial Agents/therapeutic use , Calcitonin/therapeutic use , Chronic Disease , Combined Modality Therapy , Debridement , Female , Follow-Up Studies , Humans , Hyperbaric Oxygenation , Mandibular Diseases/therapy , Osteitis Deformans/therapy , Osteomyelitis/therapy , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Osteoradionecrosis (ORN) of the mandible is the most serious and severe side effect of combined treatment of head and neck tumors. Due to frequent failure of its conventional management, new methods are being sought and tested, including hyperbaric oxygen therapy (HBO); however, effective methods of monitoring HBO results are not yet available. The purpose of our study was to assess thermographic records of ORN patients in different stages of hyperbaric oxygen therapy. MATERIAL/METHODS: In the years 2003-2008, hyperbaric oxygen was used as an adjunct in the conventional management of 4 patients with progressive osteoradionecrosis of the mandible. The effects of the treatment were evaluated based on the clinical, radiological, and thermographic examinations. In each patient thermograms were obtained before and after HBO. RESULTS: Clinical examination showed ORN remission following 30 exposures in a hyperbaric chamber at 2.5 atmospheres for 90 minutes. Follow-up thermograms obtained after 35-60 exposures revealed a marked warming of the osteoradionecrotic area of the mandible resulting from an increase in blood supply and tissue metabolism increase. In 1 case of therapy cessation, just 5 sessions of HBO therapy was associated with a decrease in acute inflammation, as manifested by local cooling seen in a follow-up thermogram. CONCLUSIONS: Thermography is an effective method of monitoring HBO results in patients with osteoradionecrosis. However, thermograms should be interpreted in combination with the corresponding clinical picture and radiological findings.
Subject(s)
Hyperbaric Oxygenation/methods , Mandibular Diseases/diagnosis , Mandibular Diseases/therapy , Osteoradionecrosis/diagnosis , Osteoradionecrosis/therapy , Thermography/methods , Female , Humans , Male , Mandibular Diseases/complications , Mandibular Diseases/diagnostic imaging , Middle Aged , Osteoradionecrosis/complications , Osteoradionecrosis/diagnostic imaging , RadiographySubject(s)
Bone Diseases, Developmental/diagnosis , Consanguinity , Mandibular Diseases/diagnosis , Abortifacient Agents/adverse effects , Airway Obstruction/diagnosis , Airway Obstruction/etiology , Bone Diseases, Developmental/chemically induced , Bone Diseases, Developmental/complications , Bone Diseases, Developmental/congenital , Fatal Outcome , Female , Humans , Infant, Newborn , Mandibular Diseases/chemically induced , Mandibular Diseases/complications , Mandibular Diseases/congenital , Plant Extracts/adverse effects , Schisandra/adverse effects , Young Adult , Zygoma/abnormalitiesABSTRACT
Introducción: El objetivo de este trabajo es valorar las alteraciones biomecánicas que conllevan a desequilibrios musculares, causadas principalmente por hipoactividad o hiperactividad muscular y movilidad articular limitada. Material y método: Se realiza una propuesta de evaluación que involucra tres aspectos relacionados, que son: Una modificación de la pauta original hecha para pacientes con trastornos temporomandibulares, desarrollada por el Dr. Prof. Mariano Rocabado. Aspectos de la evaluación orofacial, que es un segmento perteneciente al curso básico de Evaluación y tratamiento de la hemiplejia del adulto, Bobath, y la Evaluación muscular de Daniels-Worthingham's para músculos mandibulares y cervico-torácicos. Se evaluaron 13 pacientes adultos, secuelados de Parálisis Cerebral Espástica (PCE), Accidente Cerebrovascular (ACV), Traumatismo Encefalocraneano (TEC), Esclerosis Lateral Amiotrófica (ELA) y Enfermedad de Parkinson (EP), pertenecientes a Centros de neurorehabilitación especializados (Fundación Alterego/Centro Los Coihues). Conclusiones: El grupo de pacientes con mayor compromiso neurológico (ELA, ACV hemorrágico y PCE) son los más comprometidos, en cuanto a debilidad de grupos musculares estabilizadores cervicales (principalmenete Esternocleidomasteoideo), grado funcional moderado de pterigoideos interno y externo, aumento de tono en masetero y temporal (no mensurable aún, pero inferido por la menor apertura bucal), y alteraciones posturales cervicotoracicas, de preferencia.
Subject(s)
Adult , Humans , Mandibular Diseases/diagnosis , Central Nervous System Diseases/complications , Masticatory Muscles/physiopathology , Brain Stem/physiopathology , Severity of Illness IndexABSTRACT
Diffuse sclerosing osteomyelitis (DSO) is an interesting and debilitating entity with a disputed, unknown or unproven etiology. This case report illustrates the complexity of managing these cases, which are refractory to multiple therapeutic modalities.
Subject(s)
Mandibular Diseases/diagnosis , Osteomyelitis/diagnosis , Adult , Biopsy , Follow-Up Studies , Humans , Hyperbaric Oxygenation , Male , Mandibular Diseases/surgery , Osteomyelitis/surgery , Osteosclerosis/diagnosis , Osteosclerosis/surgery , Tomography, X-Ray ComputedABSTRACT
Se presenta el caso de paciente de sexo femenino con una calcificación sintomática del Ligamento Estilohioideo, patología diagnosticada bajo el nombre de Síndorme de Eagle. Los síntomas asociados se pueden confundir con una Patología Disfuncional Temporomandibular por lo cual el diagnóstico específico determinado por un detallado examen clínico y un importante análisis de los exámenes imagenológicos permitirán diferenciar patologías que su manejo clínico y terapias son particulares en cada caso
Subject(s)
Humans , Female , Middle Aged , Facial Pain/etiology , Hyoid Bone/physiopathology , Ossification, Heterotopic/diagnosis , Clinical Diagnosis , Mandibular Diseases/diagnosis , Temporomandibular Joint Dysfunction Syndrome/diagnosis , Temporal BoneABSTRACT
Primary hyperparathyroidism is due to benign or malignant neoplasia of one or more parathyroid glands, causing a wide spread osteoclastic resorption of bone with fibrous tissue replacement. A case of primary hyperparathyroidism involving mandible of a 16 year old Saudi female is being reported. The patient was terated by surgical intervention. This case supports the opinion that negative laboratory tests viz., calcium and phosphorus levels do not exclude the existence of hyperparathyroidism (normocalcaemic type).
Subject(s)
Hyperparathyroidism/complications , Mandibular Diseases/etiology , Adenoma/complications , Adenoma/diagnosis , Adenoma/surgery , Adolescent , Calcium/blood , Facial Asymmetry/etiology , Female , Humans , Hyperparathyroidism/blood , Hyperparathyroidism/diagnosis , Mandibular Diseases/diagnosis , Mandibular Diseases/surgery , Parathyroid Neoplasms/complications , Parathyroid Neoplasms/diagnosis , Parathyroid Neoplasms/surgery , Phosphorus/bloodABSTRACT
Diffuse sclerosing osteomyelitis (DSO) is a well-known chronic osseous disease. However, the diagnosis can be difficult as it has been observed for a case which is presented with more than 10 years survey. The clinical, radiographic, scintigraphic, histologic and bacteriologic aspects are discussed. The treatment can be made by various medical or surgical methods. None of these is completely efficient, even if good results could be observed in some cases. The prognosis seem to be at least uncertain. The real etiology is probably infection, but has never been proved.