Treatment For The Large Aggressive Benign Lesions Of The Jaws.

OBJECTIVES: Our aim was to evaluate the clinical outcome of the conservative management of the significantly large benign aggressive lesions of the jaws. SUBJECTS AND METHODS: Twenty-two patients were reviewed regarding the demographic, radiographic, and operative findings. Patients were treated by decompression followed by curettage or only with curettage. RESULTS: No bone grafts were used. Mean follow-up time was 56.2 months. The mandible was more affected than the maxilla. Two of the ameloblastoma, two of the keratocystic odontogenic tumours, and one odontogenic myxoma were recurred. CONCLUSIONS: Despite the low number of the patients, it is concluded that the conservative management is predictable for the management of the benign aggressive lesions in order to reduce morbidity instead of directly performing radical surgery. The life during follow-up is mandatory in the situation of performing conservative surgery for the management of large aggressive lesions with high recurrence rate.

Genotoxicity of fixation devices analyzed by the frequencies of sister chromatid exchange.

BACKGROUND: Metal alloys utilized in the management of jaw fractures may exert genotoxic effects. Our purpose was to compare the genotoxicity of intermaxillary fixation devices containing nickel and chromium to that of titanium miniplates utilized in treatment of jaw fractures through the analysis of sister chromatid exchange. METHODS: In this prospective study, in a total of 28 non-smoker patients (10 females, 18 males; mean age 33.43±10.76; range 15 to 60 years) with jaw fractures, 14 were treated with intermaxillary fixation by administration of nickel-chromium wire and arch bar and 14 with titanium miniplates to investigate the genotoxicity of different metal alloys. The outcome variable was the frequency of sister chromatide exchange in peripheral lymphoctyes, determined through the analysis of venous blood samples obtained preoperatively and 4 to 6 weeks postoperatively. RESULTS: The frequency of the average sister chromatid exchange was found to be significantly higher in patients treated with the nickel-chromium intermaxillary fixation devices than those treated by titanium miniplates (1.29±0.29 vs. 0.46±0.39, p<0.001). CONCLUSION: Although titanium miniplate osteosynthesis is an invasive technique in comparison with the nickel-chromium-containing intermaxillary fixation devices, titanium seems to exert less genotoxic effect than the nickel-chromium alloy. However, this finding should be supported in clinical studies with a larger sampling size.

Three-dimensional cone-beam computed tomography for diagnosis of keratocystic odontogenic tumours; evaluation of four cases.

The keratocystic odontogenic tumour (KCOT), formerly known as the odontogenic keratocyst (OKC) is a benign intraosseous lesion that derives from remnants of the dental lamina. Due to its characteristics, clinical and histopathological features and various treatment approaches, this pathology is different comparing with other odontogenic cysts. Radiographically the KCOT appears as well-defined unilocular or multilocular radiolucency with thin radiopaque borders. In most cases, conventional radiographic imaging, such as panoramic views and intraoral periapical films, are adequate to determine the location and estimate the size of an KCOT. However, the clinical use for cone-beam computed tomography (CBCT) in oral and maxillofacial surgery increases and provides additional information about the contents and borders of the large lesions. In the present cases, the diagnostic performances of CBCT versus panoramic radiograph for four KCOTs were evaluated. It was concluded that appearance of lesions in the maxillofacial region could be better documented in the correct dimensions by CBCT versus panoramic radiograph.

Pathological changes and immunoexpression of p63 gene in dental follicles of asymptomatic impacted lower third molars: an immunohistochemical study.

OBJECTIVE: The aim of this study was to examine the pathologic changes and immunoexpressivity of p63 gene in dental follicles (DFs) of asymptomatic partially and completely impacted lower third molars. STUDY DESIGN: Clinical and radiologic examinations included 50 DFs with no signs of abnormal radiolucency (follicular space <2.5 mm), taken from 50 patients. RESULTS: Histopathologic examinations of the specimens revealed 47 normal dental follicular tissues, 1 ameloblastoma, and 2 dentigerous cysts. p63 Immunoexpressivity was stronger in the DFs of the group with completely impacted teeth (64%),than it was in the case of DFs of the group with partially impacted teeth (40%). CONCLUSIONS: Stronger p63 gene immunoexpression in the group with completely impacted teeth might be a consequence of bigger number of stem cells than it is in the case of the group with partially impacted teeth. This study also supports prophylactic removal of impacted teeth because of the development of pathologies associated with them.

Orbital pain and headache secondary to overfilling of a root canal.

A 35-yr-old woman was referred to the Istanbul University, Faculty of Dentistry, Oral Surgery Department with complaints of orbital pain and headache. Panoramic radiographs showed overfilling of a maxillary premolar, which caused a perforation in the maxillary sinus floor. The etiology, clinical manifestations, and treatment of this complication are discussed with emphasis on early surgical intervention to decrease the risk of a superimposed aspergillosis infection.