Central giant cell granuloma in the posterior region of mandible mimicking a fibro-osseous lesion and hemangioma: a case report.

BACKGROUND: A central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion occurring primarily in children and young adults. On the histological level, it is characterized by numerous multinucleated giant cells scattered randomly throughout a sea of spindle-shaped mesenchymal stromal cells which are dispersed throughout the fibrovascular connective tissue stroma containing areas of haemorrhage. When it comes to radiographic features, CGCG can have an array of variations, ranging from well-defined expansile lesions to ill-defined and destructive lesions, with or without expansion. CASE PRESENTATION: This case report reviews an 11-year-old Caucasian patient with a chief complaint of slow-growing swelling involving the right posterior mandibular region. The cone beam computed tomography (CBCT) revealed an ill-defined mixed lesion mimicking both fibro-osseous lesion and hemangioma. However, microscopic examination revealed multinucleated giant cells in a fibrous stroma suggestive of central giant cell granuloma. CONCLUSION: Our intent in reporting this case is to highlight the importance of thorough clinical, radiographical and histopathological examination for accurate diagnosis and therapeutic interventions as well as to emphasize the importance of taking different possibilities into consideration when examining bony swellings in the head and neck region.

The effect of tooth loss on the temporomandibular joint space: A CBCT study.

OBJECTIVE: The tooth loss has a significant impact on the positioning of the condyle in the glenoid fossa and joint spaces of the temporomandibular joint (TMJ). The aim of this study was to assess the association between tooth loss and TMJ spaces using cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: This retrospective investigation involved the evaluation of CBCT images of the bilateral TMJs in a cohort of 111 individuals, comprising 68 males and 43 women. The dentition of the patients was categorized into three categories, including A (65.4%), B (19.1%), and C (16.4%), based on the Eichner index. Anterior, superior, and posterior joint spaces were then measured in sagittal views. The Kruskal-Wallis test and Mann-Whitney test were employed to identify significant differences among the three Eichner groups. RESULTS: The findings of the present study suggested that there was no statistically significant variation in the anterior joint space among different Eichner groups within the general population (p = .781). Nevertheless, the superior and posterior joint spaces exhibited statistically significant alterations, as indicated by p-values of .039 and .010, respectively. It was detected that condyles were positioned inferiorly and posteriorly in group C when compared to groups A and B. CONCLUSION: The present study indicated that greater loss of tooth-supporting zones is associated with posterior and inferior displacement of condyles. Understanding these relationships helps emphasize how crucial it is to replace missing teeth to enhance occlusion support and, in turn, stop the progression and further deterioration of temporomandibular disorders.

Association between Condylar Bone Changes and Eichner Index in Patients with Temporomandibular Dysfunction: A Cone Beam Computed Tomography Study.

Statement of the Problem: Eichner index is a dental index, which is based on the occlusal contacts between naturally existing teeth in premolar and molar regions. One controversial topic is the association between occlusal status and temporomandibular joint dysfunction (TMD) and its associated degenerative bony changes. Purpose: Through the use of cone-beam computer tomography (CBCT), the current study sought to ascertain the relationship between the Eichner index and condylar bone alterations in TMD patients. Materials and Method: In this retrospective study, the CBCT images of bilateral temporomandibular joints (TMJs) of 107 patients with TMD were evaluated. The patients' dentition was classified into three groups of A (71%), B (18.7%), and C (10.3%), according to the Eichner index. Radiographic indicators of condylar bone alterations, including as flattening, erosion, osteophytes, marginal sclerosis, subchondral sclerosis, and joint mice, were either present or absent and registered as 1 or 0, respectively. Chi-square test was used to evaluate the link between the condylar bony changes and the Eichner groups. Results: According to the Eichner index, the most prevalent group was group "A". The most prevalent radiographic finding was "flattening of the condyles" (58%). Condylar bony changes were found to be statistically related to age (p= 0.00). However, no significant relationship was found between sex and condylar bony changes (p= 0.80). There was a significant relationship between the Eichner index and condylar bony changes (p= 0.05). Conclusion: Patients with greater loss of tooth supporting zones have more condylar bony changes.