Management of primary odontogenic myxoma.

BACKGROUND: This retrospective study describes our experience in the management of odontogenic myxoma. METHODS: Thirty-four patients (23 female and 11 male) with single lesions were treated. Thirty-three patients were adults (mean age 33.5 years) and one child (age 6 years). Male:female ratio was 1:2. Different surgical procedures were used to treat the tumors. 11 lesions were treated by marginal osteotomy, 12 lesions by enucleation and curettage, 11 lesions by radical treatment (segmental or block resection). The follow-up period was 5-years. RESULTS: The success rate was 73.5%. The Kaplan-Meier method was applied to examine the outcome of the treatment. Analysis showed a significant difference between 3 types of treatment (P=0.041). The median overall of complete healing was 51.34 months (95% CI: 43.12-59.55; SD 4.19). In details, the median overall of healing was 34.91 months (95% CI: 20.66-49.17; SD 7.27) in patients of group A; 56.36 months (95% CI: 42.47-68.52; SD 3.46) in patients of group B and 47.27 months (95% CI: 49.56-63.15; SD 3.46) in patients of group C. CONCLUSIONS: Our results show that enucleation and curettage offer minimal benefit, and their use must be discouraged.

Prevalence and distribution of oral mucosal non-malignant lesions in the western Sicilian population.

BACKGROUNG: The aim of the present study was to determine the prevalence of oral mucosal non-malignant lesions in the Sicilian population. In addition, we evaluated the association between each oral lesion and its risk factors. METHODS: This study analyzed a total of 2539 consecutive patients, attending the Department of Surgical, Oncological and Stomatological Disciplines of Palermo University, who were examined for the presence of various oral lesions during the period from January 2012 and February 2015. RESULTS: The sample consisted of 1330 (52%) female and 1209 (48%) male. The age ranged from 13-86 years with a mean age of 47.16 years. Among these subjects 1495 (58%), presented one or more lesions. All subjects were Caucasian. The most common lesion diagnosed was coated/hairy tongue affecting 16.7% of the subjects, followed by: lingual varices (16.3%), secondary herpes lesions (8.1%), aphthous ulcers (7.9%), fordyce granules (7.2%), frictional keratosis (5%), candidosis (4.9%), fibroepithelial hyperplasia (4.6%), squamous papilloma (3.8%), traumatic ulcers (3.7%), leukoplakia (3.2%), fissured tongue (3.2%), hemangiomas (2.7%), morsicatio buccarum (2.5%), melanin pigmentation (2.5%), lichen planus (2.5%), leukoedema (2.1%), petechiae (1.1%), geographic tongue (1%), actinic cheilitis (0.8%), and erythroplakia (0.1%). Overall, the prevalence of oral mucosal non-malignant lesions was linked to age, gender, diseases, and risk habits. CONCLUSIONS: The high prevalence necessitates adequate awareness of these lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions.

Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique.

Juvenile central ossifying fibroma of the mandible: a case report.

Central ossifying fibroma is a rare fibro-osseous neoplasm in young children. It is highly aggressive and has a strong tendency to recur. We describe an 11-year-old girl with juvenile central ossifying fibromas of the mandible that caused obstruction of tooth eruption of the lower left second premolar. Oral examination revealed the presence of the primary lower left second molar and a small bony hard swelling over the left side of the mandibular body. After a computed tomographic scan, an incisional biopsy was performed, and the lesion proved to be a juvenile ossifying fibroma. Although this tumor often recurs early, and many authors suggest radical en bloc resection, we performed a more conservative procedure to avoid damage to the mandibular nerve. There has been no evidence of recurrence 1 year later.