Myxoma of the upper lip: a case report and brief review of the literature.

Myxomas are rare neoplasms of mesenchymal origin, which consist of many undifferentiated stellate and spindle-shaped cells in abundant loose myxoid stroma with collagen fibers. A 74-year-old patient presented in our oral and maxillofacial department with a slow growing mass within the upper lip. The mass was surgically excised in the toto, followed by a histological and immunohistochemical examination. The findings revealed that it was a myxoma. These tumors are very rare and should be included in the differential diagnosis of damage of the upper lip. As long as the myxoma is properly removed, there is no risk of recurrence.

Remodelling of the superficial vascular network of skin flaps in rats, following a vasodilatory cream application, before elevation.

Flap necrosis on random pattern skin flaps continues to be a challenge. In this study, we evaluated whether topical application of a vasodilator substance (the prostaglandin PGI2 analogue, Iloprost®, in cream form) as pre-treatment, would increase blood flow and improve flap viability. Wistar rats randomly allocated into four groups with 7 rats per group and two flaps 4cm × 2cm in the same rat i.e. 56 flaps were developed. Flaps on the wright side received pre-treatment with Cream in different drug concentrations, 2.5µgr/gr, 5 µgr/gr, and 10µgr/gr and 20 µgr/gr containing the active factor Iloprost®® ZK 36,374(M. W 360.5) prepared with white petrolatum as a base. Flaps on the left side received placebo cream (white petrolatum). After 10 days of flap pre-treatment, evaluation of blood flow by laser Doppler flowmetry (LDF) were recorded, then flap elevation and re suturing back were performed. After 7 days we estimated flap viability on digital imaging and the percentages of flap survival estimated. Means and standard deviations were used to describe blood flow measurements and survival percentages. The significance was set at 0.05 in all cases and the analysis were carried out with the use of the SPSS v23.0. Furthermore, we performed dynamic analyses of circulation using the radioisotope 99mTc which confirmed hyperaemia of the treated areas relative to that observed in control areas. These findings demonstrated that pretreatment of skin flaps with Iloprost® cream for 10 days prior to elevation increased blood flow in the flap and improved their overall survival rate.

Foreign Bodies of Dental Iatrogenic Origin Displaced in the Maxillary Sinus - A Safety and Efficacy Analysis of a Retrospective Study.

Introduction: Foreign bodies (FB) of the paranasal sinuses are an uncommon clinical entities with the maxillary sinuses being those most frequently affected. According to the literature, 60% of paranasal sinus FB are of iatrogenic origin, while 25% are of traumatic origin. This article aims to present an iatrogenic origin series of cases of FB displaced or projecting into the maxillary sinus. Materials and Methods: In this retrospective study, the presence of the foreign body was revealed with radiologic methods and confirmed during the operation with macroscopic or later with histopathologic examination. All cases were treated with osteoplasty with vascularised pedicled bone flap or through minimally invasive intraoral procedure. Results: A total of 27 patients were included in our study, 14 men and 13 women. The age range was 18-65 years with mean age of 46.14 (standard deviation = 10.35) years. Foreign body was displaced fragments of teeth in 11 patients (40.27%), complete teeth in four patients (14.81%), dental implants in five patients (18.51%), dental impression material in 2 cases (7,40%), gutta percha cone in two patients (7.40%), endodontic sealer associated with aspergillosis in two patients (7.40%), and dental burr in one patient (3.7%). The time between dental foreign body displacement and the surgical intervention for its removal was critical for the occurrence of sinusitis. All operated patients remained asymptomatic during a follow-up of at least 1 year. Discussion: Prompt intervention for removal of FB eliminates the risk for chronic inflammation of the affected maxillary sinus and reduces the odds for sequelae.

Peripheral Osteoma of the Mandibular Condyle-Case Series.

The purpose of this article is to present four new cases of peripheral osteoma of the mandibular condyle and the literature review. A retrospective study of files from our Department of Oral and Maxillofacial Surgery over the last 6 years revealed four cases of peripheral osteomas located in the area of the mandibular condyle. Diagnostic procedure included clinical, radiographic, and histologic criteria. Gardner's syndrome was excluded from patient history and clinical evaluation. One patient had only an aesthetic disturbance, with facial swelling, and the other three patients presented disturbances of the mandibular function, including deviation during mouth opening along with malocclusion. Three of the patients were male and one was female; all were of middle age (45-65 years old). The proposed surgical treatment was accepted by half of the patients, while the remaining half declined the operation after a confirmation of the diagnosis. Peripheral osteomas of the maxillofacial region are uncommon, and some cases with multiple osteomas are related to Gardner's syndrome. An osteoma of the mandibular condyle is very rare and surgical treatment is challenging for the surgeon with regards to the approach selection and the related complications. In the two cases that accepted the proposed surgical treatment, no recurrence and no complication was observed.

The use of mineralized bone allograft as a single grafting material in maxillary sinus lifting with severely atrophied alveolar ridge (1-3 mm) and immediately inserted dental implants. A 3- up to 8-year retrospective study.

OBJECTIVE: The primary aim of our study was to evaluate the efficacy of mineralized bone allograft alone in sinus floor augmentation with simultaneous implant placement in cases with severe atrophy of the residual maxillary bone (bone height < 4 mm). METHODS: Thirty-five dental implants were placed in 29 patients who underwent sinus augmentation via traditional lateral window technique from 2008 to 2013. Patients with residual alveolar height between 1 and 3 mm at the site of implantation were included in the study. The height of residual bone was initially estimated by plain panoramic X-ray and reevaluated intraoperatively by precise micrometric measurement at the site of implantation. Implants of 13 mm height and 3.5 or 4.3 mm in diameter were inserted simultaneously. Mineralized bone allograft was used alone to augment the sinus floor. RESULTS: No wound dehiscence was recorded. In one case there was a postoperative site infection which subsided with antibiotics without implant failure. One implant migrated during the postoperative period to the maxillary sinus and was removed. One implant failed. The remaining 33 implants were successfully loaded. Follow-up ranged from 3 to 8 years. CONCLUSIONS: Maxillary sinus lift in severely absorbed alveolar ridges with simultaneous implant placement could be safely performed using mineralized allograft alone, rendering the procedure less invasive and less time-consuming.