Primary intraosseous carcinoma of the mandible--a case report and review of the literature.

BACKGROUND: Squamous cell carcinoma arising within bone is a rare lesion and is only seen essentially in the jaw bones. METHODS: A case of primary intraosseous carcinoma arising in the mandible is reported in a 60-year-old female patient. Twenty-eight cases of primary intraosseous carcinoma published in the literature, till date, are reviewed. RESULTS: The mean age of the patients at the time of diagnosis was 53 years and the male: female ratio was 2.2:1. The posterior mandible was the predominant site. Fourteen of 28 patients presented with routine dental disorders, while eight patients complained of swelling, four of severe pain and three had sensory disturbances. The incidence of lymphadenopathy was 10 (34.481%) out of the 29 cases reviewed here. Wide surgical excision is accepted as the treatment of choice. CONCLUSION: The most common presenting symptom of these tumours is swelling and persistent pain in the jaw. Hence, in making a diagnosis one is likely to consider benign dental conditions. The importance of considering intraosseous carcinoma as a possibility in all cases of persistent pain and swelling in the jaw is emphasized so that suitable treatment can be instituted early.

Multi-facial anomalies in mandibulofacial dysostosis. A report of three cases.

Mandibulofacial dysostosis is readily recognized on the basis of a characteristic facial appearance caused by hard and soft tissue abnormalities of the face, including malformations of the ear. Generally, the abnormality is symmetrical. The psychological and social stigma associated with severe facial deformity makes this syndrome one of the most challenging reconstructive problems presented to the craniomaxillofacial surgeon.

Effectiveness of triclosan in the management of radiation-induced oral mucositis: a randomized clinical trial.

INTRODUCTION: Oral care in cancer patients is an important aspect in the quality of life of patients undergoing cancer therapy. Mucositis, trismus, salivary gland dysfunction are the main complications of the cancer therapy, which lead to long-term complications such as radiation caries, poor oral hygiene and osteoradionecrosis. A timely oral evaluation and intervention in these patients can reduce the severity of the potential complications. Triclosan is an antibacterial agent widely used in periodontal therapy, the effectiveness of triclosan in the management of radiation induced oral mucositis is evaluated here. AIMS: 1) To determine the effectiveness of triclosan in the management of radiation-induced oral mucositis. 2) To compare the effectiveness of triclosan mouth rinse with conventional sodium bicarbonate mouth rinse. MATERIALS AND METHODS: Twenty-four patients who underwent radiation therapy for oral cancer and subsequently developed oral mucositis were included in the study. They were randomly allocated into two groups on noticing grade I mucositis (erythema). The study group was advised to use triclosan mouthwash containing triclosan 0.03% W/V and sodium bicarbonate 2 mg mouth wash for the control group. A weekly follow-up evaluation of body weight, food intake, pain and grading of mucositis were made during the radiation treatment period and post radiation treatment period. RESULTS: Both the groups were statistically identical. All the 24 patients in both the groups passed through grade 3 mucositis on the last day of radiotherapy. However, 10 patients in the control group and only one patient in the study group entered to grade 4 mucositis. A definite change was noticed in the severity of the mucositis, food intake and weight loss. The control group took more than 45 days to resolve while the study group took only less than 28 days. DISCUSSION: The results of the study were evaluated and tried to formulate a hypothesis so as to explain the less severity and early resolution of mucositis in the study group. CONCLUSION: Triclosan mouthwash was found to be effective in reducing the severity of radiation- induced oral mucositis and helped in early reversal of symptoms during post treatment period. However, further studies are necessary to confirm this observation.

Three-year follow-up of oral leukoplakia after neodymium:yttrium aluminum garnet (Nd:YAG) laser surgery.

Oral leukoplakia is a relatively common lesion with a significant proportion of cases changing into cancer. Since most leukoplakias are asymptomatic, the primary objective of treatment must aim at the prevention of such malignant transformation. The main objectives of the study are to observe (1) the efficacy, safety and acceptability of the neodymium:yttrium aluminum garnet (Nd:YAG) laser in the management of oral leukoplakia; (2) the nature of postoperative complications, if any, associated with laser ablation, and (3) the 3-year prognosis of oral leukoplakia treated with laser. Twenty-eight patients with histologically proven leukoplakia were treated with Nd:YAG laser. From this study, we observed that the patients treated with Nd:YAG laser had only mild to moderate pain, swelling and restricted mouth opening, which peaked between 72 h and 1 week. In a majority of the patients the healing was prolonged, to a maximum of 5 weeks, and there was no clinical evidence of scarring in 26 out of 28 cases. In this study we achieved a cure rate of 92.86% in a 6-month period. Further follow-up after 3 years yielded almost the same result, except that one patient was not available for follow-up. We concluded that Nd:YAG laser is an effective device in the management of oral leukoplakia, which is one of the major pre-cancerous lesions in our country.