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1.
Am J Case Rep ; 23: e936585, 2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-35972908

RESUMO

BACKGROUND Multiple myeloma is a hematological malignancy characterized by monoclonal plasma cell proliferation. Jaw lesions are found in nearly 35% of patients with symptomatic myeloma, and lesions occur in the mandible more often than in the maxilla. However, maxillary or mandibular lesions are rarely found as a primary manifestation of the disease. This report describes a case of a 65-year-old Palestinian woman with lytic lesions in the maxilla due to undiagnosed multiple myeloma identified incidentally on cone beam computed tomography (CBCT). CASE REPORT A 65-year-old Palestinian woman presented to the Oral Maxillofacial Surgery Clinic with an expansion of the maxilla which was initially thought of as an infection. CBCT imaging revealed diffuse osteolytic lesions involving multiple osseous structures. The patient was biopsied. Histopathological examination was suspicious for plasmacytic neoplasm. She was directly referred to the Hematology Department for further laboratory tests. These included complete blood count, liver function test, bone profile, protein electrophoresis, flow cytometry, and bone marrow biopsy, which were performed to confirm the diagnosis of multiple myeloma. The patient was treated with chemotherapy including zoledronic acid, dexamethasone, bortezomib, and cyclophosphamide. She went into remission for a year but unfortunately died 2 years later. CONCLUSIONS Primary myeloma of the maxilla is a rare presentation. The present report illustrates the role of CBCT imaging supported by a multidisciplinary approach to the diagnosis and management of myeloma. Consequently, it is recommended that dental practitioners be aware of radiographic features and possible oral manifestations to avoid any delay in medical intervention.


Assuntos
Mieloma Múltiplo , Idoso , Tomografia Computadorizada de Feixe Cônico , Odontólogos , Feminino , Humanos , Maxila/diagnóstico por imagem , Maxila/patologia , Mieloma Múltiplo/diagnóstico por imagem , Mieloma Múltiplo/patologia , Papel Profissional
2.
J Craniofac Surg ; 33(5): e505-e507, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36041130

RESUMO

ABSTRACT: Schwannomas are benign tumors originate from nerve sheath. In this article, the authors aimed to share our experience and review the literature on endonasal endoscopic intervention for a maxillary sinus schwannoma. A 30-year-old Caucasian female patient applying to ophthalmology clinic due to exophthalmos and proptosis in her left eye for the last 6 months. A well-defined mass was detected in left maxillary sinus that was filling and expanding the sinus. Endoscopic biopsy from the patient was reported as ancient schwannoma. The encapsulated mass was completely removed by performing a combined endoscopic medial maxillectomy and Caldwell-Luc procedure under general anesthesia. The authors have been following the patient for 2 years and there was no evidence of recurrence, however, a decrease in the volume of the maxillary sinus occurred, suggesting chronic maxillary atelectasis. In conclusion, schwannoma should be considered in the differential diagnosis of sinonasal masses.


Assuntos
Neoplasias do Seio Maxilar , Neurilemoma , Adulto , Endoscopia/métodos , Feminino , Humanos , Maxila/patologia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Seio Maxilar/cirurgia , Neoplasias do Seio Maxilar/diagnóstico por imagem , Neoplasias do Seio Maxilar/cirurgia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia
4.
J Evid Based Dent Pract ; 22(2): 101729, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35718438

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Alberto J, Mariano S, Guerrero-s Y, Pato-mourelo J. Evaluation of Quality of Life And Satisfaction in Patients with Fixed Prostheses on Zygomatic Implants Compared with the All-on-Four Concept: A Prospective Randomized Clinical Study. Int J Environ Res Public Heal. 2021; 18(3426). SOURCE OF FUNDING: The Department of Oral Surgery, University of Murcia, Murcia, Spain. TYPE OF STUDY/DESIGN: Prospective randomized clinical trial.


Assuntos
Implantes Dentários , Maxila , Atrofia/patologia , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Humanos , Maxila/patologia , Maxila/cirurgia , Satisfação do Paciente , Satisfação Pessoal , Estudos Prospectivos , Qualidade de Vida , Zigoma/cirurgia
5.
J Pak Med Assoc ; 72(5): 965-968, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35713066

RESUMO

Radicular cyst is the most common type of odontogenic cyst associated with the apex of non-vital teeth. The lining of the radicular cyst usually arises from the epithelial rests of Malassez. These cyst usually persists even after the elimination of microbial load from the root canals. Surgical removal is deemed necessary for the management. For larger lesions extending to the facial or palatal cortical plates, additional regenerative procedures such as bone grafting along with collagen membrane are warranted. This case report describes the surgical and prosthetic management of a giant radicular cyst that was perforating the cortical plates in the anterior maxilla.


Assuntos
Cisto Radicular , Humanos , Maxila/patologia , Maxila/cirurgia , Prostodontia , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/patologia , Cisto Radicular/cirurgia
6.
Int J Implant Dent ; 8(1): 27, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35704150

RESUMO

PURPOSE: Implant-supported prosthetic rehabilitation in the resorbed maxilla is a great challenge. The aim of this study was to determine the survival rate of conventional anterior implants placed in combination with zygomatic implants according to the Brånemark technique, and to identify risk factors for implant failure. METHODS: We collected data retrospectively from 72 consecutive patients who received treatment from 1998 to 2018 at our center, according to Brånemark's original technique. Kaplan-Meier analysis was conducted to assess survival rate, and a survival regression model was used with the patient as the random factor, applying the Weibull distribution. RESULTS: A total of 236 maxillary anterior implants were included, with a mean follow-up of 12.1 years. Kaplan-Meier analysis showed overall cumulative survival rates of 95.3% at 1 year, 94.8% at 2 years, 93.0% at 5 years, 90.5% at 10 years, 81.6% at 15 years, and 67.7% at 20 years. Survival regression showed an association between bruxism and implant failure as well as implants bearing an overdenture. Implants with length ≤ 10 mm had a significantly lower survival time. No significant association was found between the number of anterior implants and survival rate. CONCLUSIONS: We found acceptable long-term anterior conventional implant survival. Significant risk factors for failure were bruxism, overdentures, and implants shorter than 10 mm.


Assuntos
Implantes Dentários , Arcada Edêntula , Atrofia/patologia , Bruxismo/patologia , Falha de Restauração Dentária , Seguimentos , Humanos , Arcada Edêntula/patologia , Arcada Edêntula/cirurgia , Maxila/patologia , Maxila/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Zigoma/cirurgia
7.
Oral Oncol ; 130: 105876, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35550988

RESUMO

Rhabdomyosarcomas (RMS) are malignant tumors with skeletal muscle differentiation extremely rare in intraosseous sites. We reported a rare case of an aggressive intraosseous RMS found in the maxilla of a 17-year-old female patient with five months of evolution. Computed tomography revealed a large osteolytic lesion extending from tooth 21 to 27, causing buccal and lingual cortical plate perforation. Microscopically, the lesion showed a proliferation of spindle-shaped cells with elongated nuclei and eosinophilic cytoplasm, arranged in an interlaced fascicle pattern. The nuclei ranged from vesicular with distinct nucleoli to hyperchromatic. A focal component of plump to epithelioid cells with a moderate amount of eosinophilic cytoplasm was seen at the periphery of the tumor. The immunohistochemical analysis revealed positivity for desmin, MyoD1, and myogenin (scattered cells). S-100, SOX10, HMB45, ß-catenin, and CD34 were negative. Ki-67 was positive in 30% of tumor cells. Fluorescence in situ hybridization (FISH) analysis showed the presence of a FUS-TFCP2 fusion. The diagnosis was intraosseous RMS with TFCP2 fusion. Surgical excision followed by chemo- and radiotherapy was carried out; however, the patient died of disease nine months after the treatment. Because of the rarity and non-specific signs and symptoms, the clinical diagnosis of intraosseous RMS is difficult and often overlooked. Therefore, careful histopathological evaluation, supported by immunohistochemical and molecular analysis, is essential to correct diagnosis. Early surgical excision with tumor-free margins and prolonged follow-up are strongly recommended.


Assuntos
Maxila , Rabdomiossarcoma , Biomarcadores Tumorais , Proteínas de Ligação a DNA/genética , Feminino , Fusão Gênica , Humanos , Hibridização in Situ Fluorescente , Maxila/patologia , Rabdomiossarcoma/diagnóstico , Rabdomiossarcoma/patologia , Fatores de Transcrição/genética
8.
Clin Oral Investig ; 26(8): 5261-5272, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35593928

RESUMO

OBJECTIVES: The present randomized controlled clinical study aimed to investigate if, in lateral maxillary sinus augmentation, the repositioned bony wall or the application of a collagen membrane results in more preferable new hard tissue formation. MATERIALS AND METHODS: Forty patients were divided into two study groups. Both groups received a xenogeneic bone substitute material (BSM) during lateral sinus augmentation. In the bony wall group (BW), following piezosurgery, the retrieved bony wall was repositioned. In the collagen membrane group (CM), following rotary instrument preparation, collagen membrane coverage was applied. After 6 months, biopsies were taken to histologically analyze the percentage of BSM, connective tissue (CT), and newly formed bone (NFB) following both approaches. RESULTS: Forty implants were placed and 29 harvested biopsies could be evaluated. Duration of surgery, membrane perforations, and VAS were detected. Histomorphometrical analysis revealed comparable amounts of all analyzed parameters in both groups in descending order: CT (BW: 39.2 ± 9%, CM: 37,9 ± 8.5%) > BSM (BW: 32.9 ± 6.3%, CM: 31.8 ± 8.8%) > NB (BW: 27.8 ± 11.2%, CM: 30.3 ± 4.5%). CONCLUSIONS: The results of the present study show that the closure of the access window by means of the retrieved bony wall or a native collagen membrane led to comparable bone augmentation results. CLINICAL TRIAL: clinicaltrials.gov NCT04811768. CLINICAL RELEVANCE: Lateral maxillary sinus augmentation with the application of a xenogeneic BSM in combination with a native collagen membrane for bony window coverage represents a reliable method for surgical reconstruction of the posterior maxilla. Piezosurgery with bony window repositioning delivers comparable outcomes without membrane coverage.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Seios Transversos , Regeneração Óssea , Colágeno , Implantação Dentária Endóssea/métodos , Humanos , Maxila/patologia , Maxila/cirurgia , Seio Maxilar/patologia , Seio Maxilar/cirurgia , Estudos Prospectivos , Levantamento do Assoalho do Seio Maxilar/métodos , Seios Transversos/cirurgia
9.
Clin Oral Investig ; 26(9): 5893-5908, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35583662

RESUMO

OBJECTIVES: This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla. MATERIALS AND METHODS: This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years. RESULTS: The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups. CONCLUSION: Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling. CLINICAL RELEVANCE: This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling. The trial registration number is ChiCTR2100054683.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Implantação Dentária Endóssea/métodos , Humanos , Maxila/patologia , Maxila/cirurgia , Estudos Retrospectivos
10.
J Vet Dent ; 39(2): 182-193, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35360969

RESUMO

This retrospective case series presents a unique group of odontogenic cysts that are lined by heavily keratinized epithelium and contain laminated keratin. Keratinized odontogenic cyst (KOC) is proposed as appropriate terminology for the described lesions. The series evaluates cysts from 29 dogs, including clinical presentation, diagnostic imaging, and histopathology. All 29 lesions occurred in tooth bearing regions of the jaws; 21 were maxillary and 8 were mandibular. These keratinized odontogenic cysts were unilocular or multilocular, and some demonstrated considerable expansion resulting in bone destruction. In 13 of 29 cases, there was evidence of tooth displacement associated with the expansion of the KOC. The KOCs did not have a distinctive radiographic appearance. 48% of the cysts had a soft tissue defect through which the keratin contents could be visualized. Cyst contents ranged from hard mineralized keratin to fluid consistency with soft flecks of keratin. The pathoetiology of KOCs is unknown; however, the biological behavior is benign and thought to be slowly progressive despite potential for locally destructive growth. Recurrence is uncommon when cyst enucleation and debridement are aggressive or when solid cysts are excised en bloc.


Assuntos
Doenças do Cão , Cistos Odontogênicos , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Queratinas , Mandíbula/patologia , Maxila/patologia , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/veterinária , Estudos Retrospectivos
11.
J Oral Pathol Med ; 51(4): 342-349, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35122318

RESUMO

BACKGROUND: A glandular odontogenic cyst (GOC) has an intriguing, aggressive behaviour whose mechanisms have not yet been clarified. OBJECTIVE: To conduct a collaborative cross-sectional study on the clinical, demographic, microscopic and immunohistochemical characteristics of GOCs, emphasizing the histopathological characteristics and expression of proteins related to invasiveness. METHODS: Twenty-two cases of GOC from three oral and maxillofacial pathology services in Brazil were selected from 1988 to 2018. Clinical and demographic data were collected. Histopathological features were evaluated in detail. Sixteen cases of GOC were also submitted to immunohistochemistry to detect MT1-MMP, TKS4, TKS5 and cortactin, the key regulators of invadopodia formation. RESULTS: Glandular odontogenic cysts were primarily seen in men over 40 years of age, in the posterior mandible and the anterior maxilla as a unilocular, radiolucent lesion. All cases presented hobnail cells, clear cells and variable thickness of the lining epithelium, 3 of the 10 key histopathological parameters to be evaluated in GOCs. Immunohistochemistry revealed a greater expression of the studied proteins in the GOCs than in the controls (p < 0.0001). CONCLUSION: Overexpression of proteins that regulate cell invasiveness was identified, and the present study's findings suggest that invadopodia activity is a possible mechanism used by GOCs to promote local invasion, which could partly explain its intriguing biological behaviour.


Assuntos
Cistos Odontogênicos , Adulto , Estudos Transversais , Humanos , Imuno-Histoquímica , Masculino , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Cistos Odontogênicos/patologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-35165055

RESUMO

OBJECTIVE: Oral squamous cell carcinoma involving the maxilla (MSCC) is a rare malignancy. The aim was to perform a systematic review and meta-analysis of available literature on local recurrence (LR), overall survival (OS), and associated risk factors of MSCC. STUDY DESIGN: The Cochrane, PubMed, and EMBASE databases were searched with related keywords and synonyms. The pooled proportions of both LR and OS were subsequently calculated with 95% confidence intervals. RESULTS: In total, 2638 articles were screened on title and abstract, 131 articles were screened on full text, and 20 were included. The pooled 5-year LR rate was 19.3%, and the 5-year OS rate was 53.7%. The subgroup analysis between surgery only and surgery with (neo)adjuvant treatment resulted in an odds ratio (OR) of .76 (95% confidence interval [CI]; .41-1.40). CONCLUSIONS: Postoperative (chemo)radiotherapy or preoperative intra-arterial chemoradiotherapy improves survival when adverse tumor characteristics are present. Posterior tumor extension into the soft palate, pterygoid muscle, pterygoid process, and infratemporal fossa was significantly associated with decreased OS in multiple studies. More research into the risk-reduction of local recurrence is warranted.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Maxila/patologia , Neoplasias Bucais/cirurgia , Recidiva Local de Neoplasia , Carcinoma de Células Escamosas de Cabeça e Pescoço
13.
Artigo em Inglês | MEDLINE | ID: mdl-35153188

RESUMO

Adenoid ameloblastoma with dentinoid is an uncommon benign odontogenic neoplasm, and its unicystic variant seems to be even rarer. A 34-year-old man was referred for evaluation of an asymptomatic swelling in the posterior maxilla. Intraoral examination showed an expansive lesion, soft to palpation, covered by a normal color mucosa. Cone beam computed tomography revealed a well-defined unilocular hypodense tumor involving the left maxillary sinus. Histopathological examination of the surgically excised specimen showed a cystic tumor lined by an ameloblastic-like epithelium containing columnar basal cells with hyperchromatic and polarized nuclei. In some areas of the capsule, the tumor showed mural infiltration by sheets of cells containing central whirling structures. Dentinoid material was also observed in association with ameloblastic-like cells. The tumor was BRAF and KRAS wild-type. Collectively, these findings were consistent with the diagnosis of a unicystic variant of adenoid ameloblastoma with dentinoid.


Assuntos
Tonsila Faríngea , Ameloblastoma , Tumores Odontogênicos , Tonsila Faríngea/patologia , Adulto , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/genética , Ameloblastoma/cirurgia , Epitélio/patologia , Humanos , Masculino , Maxila/patologia
14.
Acta Odontol Scand ; 80(5): 363-373, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35044889

RESUMO

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.


Assuntos
Implantes Dentários , Arcada Edêntula , Atrofia/patologia , Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Arcada Edêntula/patologia , Arcada Edêntula/reabilitação , Arcada Edêntula/cirurgia , Maxila/patologia , Maxila/cirurgia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Resultado do Tratamento , Zigoma/cirurgia
15.
Artigo em Inglês | MEDLINE | ID: mdl-35065903

RESUMO

OBJECTIVE: The purpose of this multicenter retrospective study was to report the clinical and radiologic features of 92 glandular odontogenic cysts (GOCs) diagnosed over a 20-year period. STUDY DESIGN: Histologically confirmed cases of GOC were retrospectively reviewed from 4 oral pathology laboratories in South Africa and Brazil to categorize the clinical and radiologic spectrum of GOCs. RESULTS: The mean age of patients was 46 years (range 17-87) with a male-to-female ratio of 1.2:1. GOCs had a mandibular predilection (68%), with 42% of all cases located anteriorly. Additionally, 42% of cases crossed the midline. Radiologically, most lesions were unilocular (53%) and uniformly radiolucent (97%), with well-demarcated borders (93%). Cortical expansion (62%), loss of cortical integrity (71%), and maxillary sinus (67%) and nasal cavity encroachment (72%) were common findings. Significant differences in lesions between the 2 countries were discovered in sex predilection, clinical signs and symptoms, and lesion locations within the mandible and maxilla. CONCLUSION: GOCs present with a wide spectrum of clinical and radiologic features, ranging from cysts with typical GOC-like presentations to more aggressive lesions. The need for advanced imaging in the surgical planning of GOCs exhibiting radiologic signs of aggression is justified based on the high recurrence rate.


Assuntos
Doenças Mandibulares , Cistos Odontogênicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Mandíbula/patologia , Doenças Mandibulares/patologia , Maxila/patologia , Pessoa de Meia-Idade , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/patologia , Estudos Retrospectivos , Adulto Jovem
16.
Angle Orthod ; 92(2): 161-172, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34986216

RESUMO

OBJECTIVES: To examine the stability of combined surgical and orthodontic bite correction with emphasis on open-bite closure. All study patients were treated with strict and consistent orthodontic and surgical protocols. MATERIALS AND METHODS: Study inclusion required all patients to have anterior open bites, maxillary accentuated curve of Spee, 36-month minimum follow-up, and no temporomandibular joint pathology. Thirty patients met the inclusion/exclusion criteria. Importantly, segmental upper arch orthodontic preparation (performed by EG) was used. Surgery consisted of a multisegment Le Fort I (MSLFI) combined with a bilateral sagittal osteotomies (BSSO). Surgery was performed (by ADA and LT) at the Department of Dentistry and Maxillofacial Surgery of the University of Verona, Italy. RESULTS: The long-term open bite and overjet relapse were not statistically significant. The mean transverse relapse of the upper and lower molars was statistically significant. Of great importance, the upper and lower arch widths narrowed together, maintaining intercuspation of the posterior dentition which prevented anterior open bites from developing. CONCLUSIONS: This study revealed stability of three-dimensional occlusal correction including anterior open bite. Stable open bite closure was achieved by using rigid protocols for orthodontic preparation, surgical techniques, surgical follow-up, and orthodontic finishing.


Assuntos
Mordida Aberta , Dente , Cefalometria , Humanos , Maxila/patologia , Mordida Aberta/patologia , Mordida Aberta/cirurgia , Osteotomia de Le Fort
17.
BMC Oral Health ; 22(1): 20, 2022 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-35081952

RESUMO

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphatic tumor; however, extranodal DLBCLs that exhibit initial symptoms in the maxilla and mandible are rare. Moreover, DLBCL is clinically classified as a moderate to highly malignant lymphatic tumor that can progress rapidly; therefore, early diagnosis is crucial. However, diagnosis is difficult as the disease causes a diverse range of clinical symptoms with no characteristic imaging findings. We conducted a clinical investigation to clarify the clinical characteristics of DLBCL that exhibits initial manifestation in the maxilla and mandible. METHODS: Of the 2748 patients with malignant tumors of the oral and maxillofacial region examined at our hospital during a period of 11 years between January 2006 and December 2016, 27 primary cases diagnosed with DLBCL based on the chief complaint of symptoms in the gingiva and bone of the maxilla and mandible were enrolled in this study. Evaluations were based on sex, age, whether treatment was provided by a previous physician, symptoms, duration of disease until treatment was sought, clinical diagnosis, laboratory findings, and imaging results. RESULTS: There were 15 cases that involved the maxilla and 12 that involved the mandible. The median duration of disease until treatment was sought was 60 d (3-450 d). All cases exhibited a tumor or a mass, and hypoesthesia of the chin was confirmed in eight cases wherein the mandible was involved. The clinical stages were stage I in eight cases, stage II in ten cases, and stage IV in nine cases. Serum lactate dehydrogenase (LDH) levels were elevated in 13 of 22 patients. The overall survival rate was 63%. CONCLUSIONS: Symptoms associated with nontender swelling and numbness of the lip or chin in the absence of other findings such as dental infections should raise suspicions about DLBCL. Patients should be provided appropriate imaging and accurate biopsy assessments to improve prognosis.


Assuntos
Linfoma Difuso de Grandes Células B , Maxila , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Mandíbula/patologia , Maxila/patologia , Prognóstico , Estudos Retrospectivos
18.
Oral Oncol ; 124: 105467, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34315641

RESUMO

Chondromyxoid fibroma (CMF) is a benign chondroid/myxoid matrix-producing tumor that often develops in the long bones of young adults. CMF is rarely reported in the craniofacial skeleton, with most cases presenting with bone erosion or destruction, which may lead to a misdiagnosis. To date, approximately 129 cases of CMF in the craniofacial region have been reported, with only three cases in patients aged less than 1 year. Of these 129 cases, only 34 affected the jaws. A 1-year-old boy presented with a mass in the left anterior maxilla, extending and compressing the ipsilateral nasal cavity. After surgical excision of the lesion, microscopy revealed spindle-to-stellate tumor cells surrounded by a predominant myxoid stroma containing focal slit-like vascular channels and hemorrhagic areas. Immunohistochemistry showed positivity for vimentin, CD10, and α-SMA (focal). The Ki-67 labeling index was 6%. CFM should be included in the differential diagnosis when assessing maxillary tumors in pediatric patients.


Assuntos
Fibroma , Neoplasias Maxilares , Criança , Diagnóstico Diferencial , Fibroma/diagnóstico , Fibroma/patologia , Fibroma/cirurgia , Humanos , Imuno-Histoquímica , Lactente , Masculino , Maxila/patologia , Maxila/cirurgia , Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/cirurgia , Adulto Jovem
19.
J Formos Med Assoc ; 121(4): 787-795, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34531103

RESUMO

BACKGROUND/PURPOSE: Due to the rarity and diversity of primary intraosseous malignancies in jawbones, we aimed to evaluate the clinicopathological features and discuss the findings of our collected cases with the literatures. METHODS: Twenty-nine patients (2000-2020) diagnosed with primary central malignancies of jawbones were selected from the database of Oral Pathology Department in our institution. Clinical features, radiographic appearance, and histopathological diagnosis of the 29 cases were analyzed. RESULTS: Twenty-nine patients aged between 19 and 84 years (average, 57.4 years) with a male to female ratio of 1.2:1 were included. The most frequent site was the mandibular body and ramus, followed by the posterior maxilla and mandibular symphysis. The most common diagnosis was osteogenic sarcoma (n = 13), followed by odontogenic carcinoma (n = 7), hematologic malignancies (n = 5), salivary gland malignancies (n = 2), and neurogenic sarcomas (n = 2). The most frequent symptoms were swelling, pain, paresthesia of lower lip, and mobile tooth. Radiographically, they usually presented as ill-defined osteolytic to osteoblastic lesions depending on the amount of ossification. Wide excision comprising partial maxillectomy and segmental mandibulectomy were the most common therapeutic methods. CONCLUSION: Despite the rarity of primary central malignancies in jawbones, the clinical features may mimic infectious process or benign lesions. Detailed history-taking, clinical and imaging examination and awareness of the patient's signs and symptoms combining with the histopathological inspection are important for early diagnosis and improved prognosis. The current data contributes a useful basis for clinical investigation regarding intraosseous malignancies occurring in the jawbones.


Assuntos
Neoplasias Bucais , Tumores Odontogênicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Maxila/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Tumores Odontogênicos/patologia , Estudos Retrospectivos , Adulto Jovem
20.
Oral Oncol ; 124: 105524, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34531146

RESUMO

Dentinogenic ghost cell tumor (DGCT) represents a rare benign odontogenic neoplasm that can appear in a central or peripheral form and may rarely undergo malignant transformation to ghost cell odontogenic carcinoma (GCOC). We aim to report a case of a central DGCT with focal cytological malignant aspects. A 24-year-old woman exhibited a painful enlargement and dental mobility in the left posterior maxilla for about one year, which appeared as an expansive well-defined hypodense maxillary image with hyperdense foci invading ipsilateral maxillary sinus. Incisional biopsy showed a predominantly solid hyperchromatic basaloid epithelium presenting cellular pleomorphism and mitotic activity, admixed with abundant ghost cell aggregates and dentinoid material. The lesion was immunopositive for p53 and had 21% of Ki-67 proliferation index (PI). These microscopic features suggested initially a GCOC diagnosis. Partial left maxillectomy was performed without complications. The surgical specimen presented an exuberant variation of the epithelial parenchyma, including ameloblastomatous, fusiform, and cribriform areas, with numerous ghost cells and dentinoid material, lacking any signs of malignancy. The final diagnosis was DGCT. The patient is in a strict regular follow-up for over two years, and there are no signs of recurrence.


Assuntos
Ameloblastoma , Carcinoma , Neoplasias Maxilomandibulares , Tumores Odontogênicos , Adulto , Feminino , Humanos , Neoplasias Maxilomandibulares/patologia , Maxila/patologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Tumores Odontogênicos/cirurgia , Adulto Jovem
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