Epidermoid Cyst of the Floor of the Mouth.

ABSTRACT: Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck region. They are usually asymptomatic over years but can be symptomatic due to secondary changes or the growing size. Clinically, the lesion presents as a slow-growing asymptomatic mass, usually located in the midline, above or below the mylohyoid muscle. Surgical excision from the floor of the mouth is indicated to relieve symptoms and prevent possible infection. This swelling on the floor of the mouth can sometimes cause serious problems with difficulty for swallowing and speaking. The purpose of this report is to present a case of sublingual epidermoid cyst of the floor of the mouth.

Uncommon benign tumour of the skin: infraorbital pilomatricoma.

Pilomatricoma is a relatively rare tumour of the skin derived from primitive basal cells of epidermis that differentiate into hair matrix cells. It comprises approximately 1% of all benign skin tumours. The most common sites for pilomatricomas are the head, neck and upper extremities. A 44-year-old woman, admitted to our department, underwent an orthopantomography examination, which revealed a well-circumscribed 1.6×1.4 mm radiopaque mass superimposed between the medial wall of the right maxillary sinus and lateral wall of the nasal cavity. Clinically, it was firm and mobile, and remained attached to the underlying skin when palpated. A cone beam CT scan was performed to ascertain its location and anatomic relations. Subsequently, it was totally excised under local anaesthesia. Histopathological evaluation of the lesion reported it to be a pilomatricoma.

Gnathic osteosarcomas, experience of four institutions from Turkey.

Osteosarcoma is the most frequent primary gnathic sarcoma. Neither the etiology nor the variables effecting the prognosis are fully known due mostly to the rarity of gnathic osteosarcomas. To date a considerable number of clinicopathologic features have been suggested in the evaluation of gnathic osteosarcomas. Still there is a need to experience on several aspects of management. The aim of this study is to report a series of 33 cases of osteosarcoma involving either mandible or maxilla. The clinical, radiological and histopathological features of our cases have usually been non-specific and the most frequent provisional diagnosis were "benign fibroosseous lesion, abnormal mass, giant cell granuloma and benign bone tumor". This non-specific presentation of osteosarcomas of the jaws is compatible with those reported previously. A combined clinical, radiological and pathological study is essential in arriving at the correct diagnosis.

Effects of systemic zoledronic Acid administration on osseointegration of hydroxyapatite-coated and resorbable blast material surface implants in rabbit models.

PURPOSE: It is unknown whether zoledronic acid (ZA) interferes with initial bone healing at implant sites. The goal of this study was to examine the effects of systemic zoledronic acid administration on osseointegration of hydroxyapatite (HA)-coated and resorbable blast material surface (RBM) implants in rabbit models. MATERIALS AND METHODS: Twenty-eight male New Zealand rabbits (aged 6 to 12 months) were used in this study. Rabbits were randomly assigned to four groups. In group A, HA-coated implants were placed in the right tibia of seven rabbits. In group B, RBM-surface implants were placed in the right tibia of seven rabbits. In group C, HA-coated implants were placed in seven rabbits with intravenous (IV) administration of ZA. Finally, in group D, RBM-surface implants were placed in seven rabbits with IV administration of ZA. For groups C and D, IV zoledronic acid (0.1 mg/kg) was performed monthly during the entire osseointegration period. All of the rabbits were sacrificed 12 weeks after the implantation, and tibial specimens were harvested. Histomorphometric bone-to-implant contact (BIC) analysis and the data were statistically analyzed. RESULTS: The highest BIC percentage was detected in group D, with a mean value of 56.73%±1.85%, as compared with 45.80%±3.77% in group C, 35.11%±0.76% in group B, and 31.14%±1.04% in group A. CONCLUSIONS: Histomorphometric analyses showed significant improvement in the osseointegration of implants in the RBM-surface ZA group compared with the HA-coated ZA group. The results of this study suggest that systemic ZA administration may improve osseointegration of titanium implants in bone.

Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey.

OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70%) males and 162 (30%) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65%) in young patients and traffic accidents (38%) in adults. The most common fracture sites were the symphysis (35%) and condyle (36%) in young patients, and the symphysis in adults (36%). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67%) and adult (39%) patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70 percent) males and 162 (30 percent) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65 percent) in young patients and traffic accidents (38 percent) in adults. The most common fracture sites were the symphysis (35 percent) and condyle (36 percent) in young patients, and the symphysis in adults (36 percent). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67 percent) and adult (39 percent) patients, and 43 percent of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Total relaxivities of material content in various cysts and ameloblastoma: implications for discriminating different fluids.

Nuclear magnetic resonance T(1) and T(2) relaxivities (r(1) and r(2)) exhibit efficiency of a material to alter the relaxation rates (1/T(1) and 1/T(2)), and they are being used for diagnostic purposes. The determination of total relaxivities (r(1t) and r(2t)) of cystic fluid content and ameloblastoma may therefore be useful for discriminative purposes. In order to determine what makes total relaxivities of hemorrhagic cysts, four sets of tubes containing pooled cyst were doped with increasing concentrations of iron, copper, albumin, and gamma-globulins. These sets were replaced in a phantom together with six individual cysts and one ameloblastoma. The relaxation times were measured by magnetic resonance imaging operating at 1.5 T. The relaxivities of individual ions and proteins were determined from the slope of the relation between relaxation rates and concentration, while total relaxivities were determined by using the increases in relaxation rates and material content of cystic fluid (MC). Iron, copper, albumin, and gamma-globulins were found to be the sources of r(1t) and r(2t). Each of r(1t), r(2t), r(1t)MC, r(2t)MC, and r(2t)/r(1t) are distinctive parameters for each cystic category and ameloblastoma. Except for MC, the parameters measured for ameloblastoma are significantly smaller than those of cysts. The similarity of the present results to those used in clinical applications suggests that each of r(1t), r(2t), r(1t)MC, r(2t)MC, and r(2t)/r(1t) has an ability to discriminate various fluids and masses. The present work also suggests that r(1t)MC, r(2t)MC, and r(2t)/r(1t) can be determined in vivo.

A clinical study on ankylosis of the temporomandibular joint.

INTRODUCTION: Restoration of normal function and jaw movement in patients with temporomandibular joint (TMJ) ankylosis is difficult. Various techniques have been defined for the treatment of the condition. PATIENTS: This study is based on the pre-, intra- and post-operative evaluation of 78 TMJ operations in 59 patients who were treated for TMJ ankylosis between 1985 and 2002. METHODS: The patients in this study were evaluated with regard to age, gender, aetiology of ankylosis, ankylosis type/classification, existing facial asymmetry, maximal pre- and post-operative mouth opening, the arthroplasty methods (gap and interpositional arthroplasty) including complications and recurrence of ankylosis. RESULTS: Falls represented the most widespread aetiological factor (85%), and women constituted the group with the highest incidence of ankylosis (61%). Forty cases were unilateral (68%) and 19 bilateral (32%); 82% (64 joints) were of the bony type. Gap arthroplasty was applied in 34 of the 59 cases (58%) and interpositional arthroplasty in the remaining 25 (42%). Pre- and post-operative mean mouth opening were 3.5+/-1.7 and 30.7+/-3.0mm, respectively. Re-ankylosis was noted in 5%. CONCLUSION: In addition to radical and sufficient resection of the ankylosed bone, early post-operative exercises, appropriate physiotherapy and close follow-up of the patient play an important role in the prevention of post-operative adhesions and re-ankylosis.

The contribution to success of various methods of treatment of temporomandibular joint ankylosis (a statistical study containing 24 cases).

Temporomandibular joint (TMJ) ankylosis is an important joint disorder which, in addition to emerging through trauma, can also arise as a result of local and systemic infections. TMJ ankylosis which develops in childhood in particular has its own characteristics. Despite the existence of different views on the treatment of TMJ ankylosis, various techniques have been defined, and three basic techniques are currently employed: gap arthroplasty, interpositional arthroplasty and joint reconstruction. Our study is intended as a statistical inquiry into the contribution to the operation success of the three different methods of treatment. Moreover, the effect on treatment outcome of unilateral or bilateral ankylosis is also statistically evaluated. In our study, eight cases were treated with gap arthroplasty, nine with interpositional arthroplasty and seven with joint reconstruction performed by costochondral graft. As a result of our statistical evaluation, it was determined that the effect of interpositional arthroplasty on post-operative maximal interincisal mouth opening was greater than that observed with the other methods.

Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25-year experience).

INTRODUCTION: The aim of this study was to analyse retrospectively the demographic distribution, treatment modalities, and complications of maxillofacial fractures in 2901 patients treated in this department in Southeast Anatolia between 1978 and 2002. In addition, the use of internal fixation was evaluated in an effort to determine whether there were changes in using internal fixation techniques. PATIENTS AND METHODS: Two thousand nine hundred and one cases of facial trauma were assessed according to age, sex, and aetiology, in addition to the distribution of the fractures relating to facial bones and seasons. RESULTS: It was found that facial fractures were most frequent in males (77.5%) and in the 0-10 year age group; they tended to be more frequent during summer (36.3%); and traffic accidents were the most common aetiological factor (38%). 77.9% of cases were treated with conservative methods, and 22.1% with one or more internal fixation techniques. The most favoured technique was miniplate osteosynthesis; the complication rate associated with internal fixation was 5.7%. CONCLUSION: Currently there are many techniques to be used in treating maxillofacial trauma. However, the experience of the surgical team is also an important factor in achieving satisfactory functional and aesthetic results, and in minimizing complications.

Tumors of the maxillofacial region in children: retrospective analysis and long-term follow-up outcomes of 90 patients.

The aim of this study was to carry out a retrospective analysis of maxillofacial tumors in children and to present the long-term follow-up results. Our study was performed with a retrospective analysis of 90 patients under the age of 15 years with maxillofacial tumor treated in our clinic between 1985-2002. In addition, treatment modalities and long-term follow-up results of these patients were evaluated. According to our results, it was established that maxillofacial tumors were mostly observed in the 11-15 age group (39 cases, 43.3%) and on the mandible (48 cases, 53.3%). There were 21 (23.3%) odontogenic, 63 (70%) benign nonodontogenic and 6 (6.7%) malignant non-odontogenic. Mixed tumors were the most common type of the odontogenic tumors, and mesenchymal tumors were the most common non-odontogenic tumors. Surgical excision, curettage or en bloc resection were adequate for treatment of these tumors.