Pediatric Idiopathic Bilateral Pneumoparotid.

A 10-year-old female presented with atraumatic bilateral mandibular swelling. Through imaging and exam she was found to have bilateral pneumoparotid. This is a rare cause of facial swelling that is primarily discussed in otolaryngology literature and relatively unknown in emergency medicine. The presentation can lead to infectious and allergic workups that are unnecessary for the patient. Benign in nature, pneumoparotid is easily diagnosed if an appropriate exam and imaging are completed. Ensuring adequate follow-up and prophylactic treatment with antibiotics are vital to preventing infection.

Langerhans Cell Histiocytosis of the Mandible.

The unusual disorder known as Langerhans cell histiocytosis, which is most frequently seen in children and young adults, is caused by the clonal proliferation of Langerhans cells. Even if clinical signs and radiographic evidence of destructive bone lesions may raise suspicion of the disease, a reliable diagnosis without a thorough pathological examination is challenging. This report describes a case of eosinophilic granuloma of the mandible in a nine-year-old child with characteristic radiological, histopathological, and immunohistochemical features.

Mandibular Thickness Measurements as Predictive Tool for Specific Dental Disorders in Alpacas (Vicugna Pacos).

Background: Oral health in alpacas is often neglected until severe dental disease becomes evident under the form of a pronounced mandibular swelling with or without fistulation. Mandibular thickness measurements might serve as an easy tool to screen for early increases in thickness thereby identifying alpacas which could benefit from an oral examination. Objective: To study specific risk factors, including age, gender, level of performed measurements and dental disorders, associated with mandibular thickness in alpacas. To determine suitable cutoff values for mandibular thickness at specific locations for the development of a diagnostic test to identify animals with dental disorders. Study design: Cross-sectional study. Methods: Mandibular thickness was measured at standardized locations in 216 alpacas using a Vernier caliper. Risk factors for an increased mandibular thickness were collected through oral examination in sedated animals and by interview of the respective owner. A multivariable linear mixed model was built to identify factors associated with mandibular thickness. Cutoff values for specific dental disorders were obtained after receiver operating characteristics (ROC)-curve analysis. Results: Mandibular thickness was 0.43 ± Standard Error 0.21 mm [95% Confidence interval (CI) = 0.02-0.84 mm] higher at locations where interproximal gum recession was present (P = 0.039). Severe dental disease caused an increase in thickness of 1.90 mm (95% CI= 1.29-2.51 mm) (P < 0.001). Mandibular thickness with a cutoff of 19.4 mm showed a high accuracy for predicting severe dental disease (Se = 0.41; Sp = 0.92). Specifically, thickness at a level perpendicular to the medial canthus of the eye proved a more precise predictor for severe dental disease (AUC, 0.85; 95% CI 0.74-0.96; P < 0.001) with a lower cutoff of 18.5 mm and Sn and Sp of 0.52 and 0.82, respectively. Main limitations: No radiographic or computed tomographic studies were available to support the diagnosis of dental and/or apical disease. Conclusion: Mandibular thickness measurements in alpacas can aid early detection of animals in need of specialized dental care. Most animals with an increased mandibular thickness suffer from advanced dental disease. However, routine dental examinations remain necessary to allow the early detection of dental disorders in alpacas.

Crecimiento mandibular bilateral: un caso de querubismo / Bilateral swelling of the jaws: a case of querubism

El querubismo es una displasia ósea benigna de la infancia caracterizada por un crecimiento mandibular bilateral progresivo. Presenta herencia autosómica dominante y es más frecuente en varones. Las primeras manifestaciones aparecen en torno a los dos años de edad, con un crecimiento óseo acelerado a los 8-9 años e interrupción espontánea tras la pubertad. El diagnóstico se basa en la clínica, radiología y anatomía patológica. El tratamiento es controvertido, incluyendo tratamiento médico o quirúrgico. Presentamos el caso de un varón de nueve años que consultó por crecimiento mandibular bilateral, requiriendo finalmente extirpación quirúrgica de las lesiones (AU)

Cherubism is a benign bone dysplasia characterized by bilateral progressive enlargement of the jaws. It is an autosomal dominant disease and boys are more affected than girls. The first signs of manifestation of the disease are generally observed at about two years of age, followed by accelerated growth from 8-9 years of age and spontaneous interruption after puberty. The diagnosis is based on clinical, radiographic and histopathologic findings. Treatment is a controversial issue and therapy strategies include surgical treatment and medical treatment. We describe the case of a nine-year-old boy with bilateral swelling of the jaws who required surgical treatment. (AU)

Inflamación mandibular en el tapir centroamericano (Tapirus bairdii) / Mandibular inflammation in Central American Tapirs (Tapirus bairdii)

Resumen El tapir de Baird o centroamericano (Tapirus bairdii), también conocido como danta, habita en bosques tropicales, bosques montañosos bajos, bosques caducifolios, praderas inundadas y humedales. La anatomía interna del tapir es análoga al caballo doméstico, al igual que su fórmula dental. Los molares carecen de cemento y tienen coronas pequeñas o bajas, por lo que son totalmente lofodontes. La inflamación mandibular en los tapires es muy común en las colecciones cautivas y su etiología y prevalencia han sido objeto de discusión, pero no se han definido. Este trabajo sugiere al cambio de dentición y la retención de la corona "tapas" como una posible etiología de inflamación mandibular, basado en su contraparte: el caballo, que fisiológicamente sobrelleva el siguiente proceso: a medida que los dientes permanentes se desarrollan por debajo de los dientes primarios, se desarrolla un proceso fisiológico de reabsorción y desplazamiento de vértices dentales, lo que acelera la erupción del diente caducifolio. La presión continua hace que las raíces sean reabsorbidas, y el poco suministro de sangre lleva a que los tejidos blandos sufran necrosis y, por ende, que la "tapa" se afloje. Tanto la gingivitis como la enfermedad periodontal pueden resultar de los restos radiculares de las raíces fracturadas que permanecen en el espacio subgingival después de eliminada "la tapa", aunado a la contaminación con los alimentos y bacterias.

Abstract Baird's tapir (Tapirus bairdii), also known as danta, inhabits tropical forests, lower mountain forests, deciduous forests, flooded meadows and wetlands. The internal anatomy of the tapir is analogous to the domestic horse, as is its dental formula. Molars lack cement and have small or low crowns, being fully lofodonts. Mandibular inflammation in tapirs is very common in captive collections and their etiology and prevalence have been discussed, but have not been defined. This work suggests changing teething and retaining the crown "caps" as a possible etiology of jaw inflammation based on its counterpart the horse, which physiologically copes with the following process: as permanent teeth develop below the primary teeth, a physiological process of resorption and vertex displacement develops, accelerating the eruption of the deciduous tooth. Continuous pressure causes the roots to be reabsorbed, and low blood supply leads to necrosis in the soft tissues and thus loosening the "cap". Both gingivitis and periodontal disease can result from splinters of broken roots that remain in subgingival space after "the cap" is removed, and this coupled with contamination with food and bacteria.

Mandibular swelling as the initial presentation for renal cell carcinoma: A case report.

INTRODUCTION: Renal cell carcinoma (RCC) is the most common malignant tumour of the kidney. It usually presents in an occult manner, rarely with the classical triad of haematuria, abdominal mass and abdominal pain. Up to a third of patients have metastasis on presentation and only a few case reports have involved the mandible. PRESENTATION OF CASE: We present the case of a renal cell carcinoma that presented, in a 56-year-old lady, with mandibular swelling as its main clinical manifestation. This patient presented with a 3-month history of right sided facial swelling, associated with pain and intermittent paraesthesia to the right side of the tongue and lower lip. Imaging of the mandible revealed a lesion that had caused complete destruction of the right condyle, coronoid and ramus. Ultrasound guided biopsy revealed the nature of the mass to be metastatic renal cell carcinoma. Subsequent computed tomography (CT) imaging of the abdomen and pelvis confirmed the presence of a tumour in the right kidney. Due to the advanced nature of the disease, radical treatment was not suitable, and the patient passed away 11 months after diagnosis with palliative care. DISCUSSION AND CONCLUSION: Whilst mandibular swelling is usually benign, it should be kept in mind that orofacial symptoms can be the initial presentation of systemic disease. Persistent swellings with infection ruled out, or those causing cranial nerve palsy, should be investigated further.

Diagnosis and Treatment of an Odontogenic Epithelial Tumor in a Dog With Features of Squamous Odontogenic Tumor.

A 9-year-old standard poodle presented for a comprehensive oral health assessment and treatment, at which time a left rostral mandibular swelling was recognized. The mass was biopsied and eventually excised by a left rostral mandibulectomy en bloc resection. Histopathology supported the diagnosis of a benign, intraosseous, epithelial tumor that was otherwise unclassified. The clinical, radiological, and histological features of this case are similar to those reported for squamous odontogenic tumor (SOT) in humans. This case study relays the diagnosis, treatment, and follow-up of the first SOT-like tumor in a dog.

Non-Hodgkin's Lymphoma of the mandible in HIV patient - A Rare Case Report.

Non-Hodgkin's lymphoma (NHL) is a lymphatic system tumor originating from either B or T lymphocytes and shows a high malignant potential. In HIV-seropositive patients, NHL of head and neck is mainly found in Waldeyer's ring, oral mucosa, salivary glands, paranasal sinuses, and laryngeal tissue. Primary NHL rarely affects the bone. When the lesion affects the bones of the jaws, it is rare in the mandible when compared to the maxilla. In the reported cases, only 0.6% are found in the mandible. NHL of the mandible can be difficult to diagnose, and so the prime aim of the present case report is to establish appropriate diagnosis of one of such kinds. Clinically, they may imitate a dental infection with symptoms of pain and discomfort. A delay in diagnosis may lead to a poor prognosis. Herewith, we present a case of NHL on the lower-right mandible in a 40-year-old male. A correlation of clinical findings, radiological examination, and histopathological examination enabled us in early diagnosis and differentiating it from other similar conditions, thus aiding in initiation of prompt treatment.

Anaplastic myeloma presenting as mandibular swelling: Diagnosis by cytology.

Multiple myeloma is a disease resulting from clonal proliferation of plasma cells. A disease of the elderly, jaw lesions are seen in 14% of patients affected with myeloma. Rarely the oral and maxillofacial lesions can be the first manifestation of the disease. We report the case of a 75-year-old man who presented with mandibular swelling. Fine-needle aspiration cytology was done from the swelling and smears were suggestive of anaplastic myeloma, which is a rare and aggressive variant of myeloma. The diagnosis of a plasmacytoma was confirmed by biopsy. Further workup of the patient revealed osteolytic lesions in skull, M band in electrophoresis and evidence of renal failure. Peripheral smear and bone marrow findings were also consistent with myeloma.

Swellings of the angle of the mandible in 32 horses (1997-2011).

Disorders of the horizontal ramus (body) of the equine mandible are well reported, but there is minimal documentation of disorders of the angle of mandible. A retrospective examination of the records of Edinburgh University Equine Hospital (1997-2011) showed that 32 horses were referred due to swellings of the angle of the mandible. The aetiology of these swellings was identified in just 13/32 cases (41%) including fractures (n=2), traumatic, localised periosteal/cortical lesions (n=4), traumatic soft tissue lesions (n=2), neoplasia (n=3), and inflammation of the adjacent salivary gland (n=1) and masseter muscle (n=1). The remaining 19 (59%) cases without a definitive diagnosis showed two patterns of lesions. Twelve cases had localised periosteal/cortical lesions of the ventral aspect of the angle of mandible that were most likely traumatic in origin. The remaining seven undiagnosed cases without mandibular bony changes all had sinus tracts/chronic soft tissue infections on the medial aspect of the angle of the mandible which were believed to be caused by a draining retro-pharyngeal lesion in five cases. Surgical excision of abnormal soft tissues (if present) and bone curettage was the most successful treatment. It was concluded that the aetiology of swellings of the angle of the equine mandible are often obscure; most appear to be traumatic in origin, yet horses seldom develop gross fractures at this site due to the support of the dense surrounding musculo-tendinous structures. A smaller proportion are caused by draining retropharyngeal lesions that respond poorly to medical therapy, but respond well to surgical treatment.

Primary extra-nodal non-Hodgkin's lymphoma of gingiva: A diagnostic dilemma.

Primary non-Hodgkin's lymphoma (NHL) is a rare entity. When it does occur, mandibular NHL typically manifests similar to an odontogenic pathology. This results in delayed diagnosis and treatment. We present a 50-year-old female who was erroneously treated for a pyogenic granuloma several months before the correct diagnosis of extranodal primary NHL of the oral cavity was made. Fortunately, the solitary bony lymphoma had not disseminated and management by chemo-radiation allowed for disease eradication and new post-treatment bone formation. The purpose of this report is to describe a rare case of primary NHL of the mandible, explore the diagnosis and work-up and discuss treatment strategies. This case illustrates the need for co-operative diagnostic referrals between physicians and dentists.