A Case of Infratemporal Fossa Abscess with Signs of Chronic Maxillary Osteomyelitis.

The infratemporal fossa is bordered superiorly by the infratemporal surface of the greater wing of the sphenoid bone and part of the temporal bone; medially by the lateral plate of the pterygoid process of the sphenoid bone; and anteriorly by the posterior surface of the maxilla. As it is completely surrounded by bone, it is frequently difficult to determine whether an abscess is present by direct visual observation or palpation alone. We report an extremely rare case of an infratemporal fossa abscess arising from chronic maxillary osteomyelitis developing after extraction of a maxillary molar. Despite drainage during initial oral anti-inflammatory treatment, pus continued to drain from the wound over a long period of time. This drainage ended when the eroded bone of the maxillary tuberosity on the affected side was curetted in a secondary procedure. The harvested bone tissue exhibited histological findings of chronic osteomyelitis. This suggests that the route of infection involved acute transformation of maxillary osteomyelitis by odontogenic infection advancing posteriorly and superiorly.

A case of mucoepidermoid carcinoma associated with maxillary cyst.

We report a case of a mucoepidermoid carcinoma associated with a maxillary cyst. The patient was an 18-year-old man presenting with the chief complaint of left buccal swelling. The left maxillary third molar was semi-impacted in the direction of the crown on the buccal side. Orthopantomography revealed a cystic radiolucency extending over a wide area, ranging from the left maxilla to the maxillary sinus and nasal cavity. Computed tomography revealed a multilocular lesion surrounded by a thin shell of bone. Biopsy findings revealed a cystic lesion, but the cause could not be identified preoperatively. The cystic lesion was resected under general anesthesia. The lesion was multilocular and surrounded by a bone shell, and had expanded into the maxillary sinus. At the same time, indurated soft tissue adhering strongly to the palatine bone on the inferior palatine side of the lesion was resected. Histopathological examination showed a cystic lesion and mucoepidermoid carcinoma. An additional resection was planned and the maxilla partially resected. Mucoepidermoid carcinomas usually occur in the parotid and minor salivary glands, but in rare cases appear in the center of a jaw bone, almost always in the mandible. In the present case, the carcinoma was associated with a cystic lesion believed to have developed from maxillary bone and involved an impacted tooth adjacent to the tumor. This suggested a central mucoepidermoid carcinoma in the maxillary cyst. Postoperatively, the missing teeth have been replaced with a denture and the course has been good, with no recurrences or metastases identified.

A case of Sotos syndrome treated with distraction osteogenesis in maxilla and mandible.

Sotos syndrome is inherited in an autosomal-dominant manner and is characterized by increased birth weight, excessive growth, advanced bone age, and distinctive facial features, including dolichocephaly, hypertelorism, and a prominent mandible. We treated a jaw deformity due to Sotos syndrome consisting of malocclusion due to a narrow maxillary dental arch and mandibular retrusion from hypoplasia of the rami. The patient was a 17-year-old man. Malocclusion due to a narrow maxillary dental arch and mandibular retrusion was diagnosed. Rapid maxillary expansion with Lines corticotomy and mandibular advancement with distraction osteogenesis were performed. The maxilla was expanded laterally a total of 3 mm and the mandible prolonged 12 mm in the posterior area of the mandibular body. Subsequently, orthodontic treatment was continued. At present, 5 years after surgery, occlusion remains good and stable.

Caveolin-1 in extracellular matrix vesicles secreted from osteoblasts.

Caveolin-1 is an essential and signature protein of caveolae, which are small invaginations of the plasma membrane enriched in cholesterol and sphingolipids. Although high levels of expression of caveolin-1 have been demonstrated in osteoblasts as well as endothelial cells, fibroblasts, and muscular cells, the role of caveolin-1 in osteoblasts has not been clarified. Here, we show that caveolin-1 is secreted from osteoblasts in the form of matrix vesicles; extracellular vesicles released from the plasma membrane of osteoblasts. In this study, caveolae and matrix vesicles were similarly enriched in cholesterol and sphingomyelin in fractions isolated from mineralizing MC3T3-E1 cells. Interestingly, in the MC3T3-E1 cells caveolin-1 was enriched in the matrix vesicle fraction as well as the caveolar membrane fraction, and the amount of caveolin-1 in the matrix vesicle fraction increased as differentiation progressed. Localization of caveolin-1 in matrix vesicles was also confirmed in murine tibia. Furthermore, overexpression of caveolin-1 enhanced matrix calcification in MC3T3-E1 cells, whereas knockdown of caveolin-1 diminished it. These results suggest that secreted caveolin-1 as a component of matrix vesicles may play an important role in osteoblast calcification.