Influence of two different surgical techniques on the difficulty of impacted lower third molar extraction and their post-operative complications.

BACKGROUND: Post-operative complications of various degrees of severity are commonly observed in third molar impaction surgery. For this reason, a surgical procedure that decreases the trauma of bone and soft tissues should be a priority for surgeons. In the present study, we compare the efficacy and the post-operative complications of patients to whom two different surgical techniques were applied for impacted lower third molar extraction. MATERIAL AND METHODS: Patients of the first group underwent the classical bur technique, while patients of the second group underwent another technique, in which an elevator was placed on the buccal surface of the impacted molar in order to luxate the alveolar socket more easily. RESULTS: Comparing the two techniques, we observed a statistically significant decrease in the duration of the procedure and in the need for tooth sectioning when applying the second surgical technique, while the post-operative complications were similar in the two groups. We also found a statistically significant lower incidence of lingual nerve lesions and only a slightly higher frequency of sharp mandibular bone irregularities in the second group, which however was not statistically significant. CONCLUSIONS: The results of our study indicate that the surgical technique using an elevator on the buccal surface of the tooth seems to be a reliable method to extract impacted third molars safely, easily, quickly and with the minimum trauma to the surrounding tissues.

Central mucoepidermoid carcinoma of the anterior region of the mandible: report of an unusual case and review of the literature.

INTRODUCTION: Central mucoepidermoid carcinoma is a rare lesion, whose exact pathogenesis is still not fully understood. Generally, it is more frequently encountered in the mandible than in the maxilla and in the posterior than in the anterior aspect of the jaws. Cases of central mucoepidermoid carcinomas are rarely mentioned in the literature, and therefore, additional information concerning this type of lesion is needed. CASE REPORT: In the present paper, we report an extremely unusual case of a central mucoepidermoid carcinoma in the anterior region of the mandible of a 37-year-old female patient. The diagnosis and the surgical management of the tumor along with the reconstructive techniques utilized to restore the mandible and a 6-year follow-up are discussed. DISCUSSION: Central mucoepidermoid carcinoma is an unusual tumor of the jaws, especially in the anterior region. It is only locally aggressive and has most frequently a good prognosis if treated with wide surgical excision.

Metastasis of a ductal breast carcinoma to the buccal mucosa of the mandible with tooth involvement.

BACKGROUND: We present a metastatic tumour from the breast to the gingiva, with the rare finding of tooth invasion. Metastatic tumours to the oral region are uncommon. The breast is the most common primary site for metastatic tumours to the jawbones in women, with the mandible being most often affected. CASE REPORT: We report the case of a 52-year-old Caucasian woman who presented with a swelling of the buccal mucosa in the molar region of the left mandible. Biopsy revealed a metastatic lesion, with involvement of the two adjacent molars. Immunohistochemical analysis ruled out other malignancies and confirmed the diagnosis of a ductal breast carcinoma origin. DISCUSSION: Management in such cases should be in the context of the treatment of a metastatic disease that could prolong survival and improve quality of life, but is not curative. Tooth invasion has been described since 1910 for different primary malignancies with distant metastases to the oral cavity. This report seems to describe the second case in the literature of a metastatic breast carcinoma to the mandible with tooth invasion. Management in such cases should be in the context of the treatment of a metastatic disease that could prolong survival and improve quality of life, but is not curative.

Fine-needle aspiration cytology of salivary gland tumours: a 10-year retrospective analysis.

INTRODUCTION: The aim of this study was to evaluate the sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV) and negative predictive value (NPV) of fine-needle aspiration cytology (FNAC) of salivary gland tumours performed at a tertiary cancer hospital over a time period of 10 years. MATERIALS AND METHODS: A retrospective analysis was carried out between 1995 and 2004 to review the cases of patients with salivary gland tumours who had undergone pre-operative FNA and for whom definite histology was either by tru-cut biopsy or by histopathological examination of the operative specimen. RESULTS: A total of 107 cases of salivary gland tumours were treated during that period, but only 82 cases diagnosed by FNAC could be correlated with histological and clinical data and were considered for this study. The sensitivity, specificity, diagnostic accuracy, PPV and NPV were estimated considering 54 benign and 28 malignant cases. Sensitivity was 90% (28/31), specificity was 98% (54/55), diagnostic accuracy was 95.1% (82/86), PPV was 96% and NPV was 94%. DISCUSSION: This study confirms that FNA cytology is a technique that offers high sensitivity, specificity and diagnostic accuracy in salivary gland tumour diagnosis.

Recurrent glabellar mucous cyst: a rare postrhinoplasty complication.

INTRODUCTION: The appearance of postrhinoplasty mucous cysts is a very rare complication, affecting mostly the nasal dorsum, along with the lines of a nasal osteotomy. There have been also descriptions of other rare locations like the nasal tip, the medial canthus, and the paranasal area. CASE: We present for the first time the appearance of a recurrent mucous cyst in the glabellar area, away from any intervention field during a rhinoplasty. Ectopic free mucosal graft implantation during surgical treatment, herniation of mucosa through intranasal incisions, or improper clearing of mucous epithelial remnants and bony or cartilage parts during the operation are the most accepted theories for the formation of mucous cysts after rhinoplasty. Until now, there have been published 19 cases of postrhinoplasty mucous cysts, with the nasal dorsum being the most affected side. The glabella, as a site away from any line of osteotomy in an usually performed rhinoplasty, has never been before reported as a region of mucous cyst formation. CONCLUSION: The patient is still under periodical control, and 68 months postoperatively, there is no evidence of a recurrence.

Influence of two different surgical techniques on the difficulty of impacted lower third molar extraction and their post-operative complications

BACKGROUND: Post-operative complications of various degrees of severity are commonly observed in third molar impaction surgery. For this reason, a surgical procedure that decreases the trauma of bone and soft tissues should be a priority for surgeons. In the present study, we compare the efficacy and the post-operative complications of patients to whom two different surgical techniques were applied for impacted lower third molar extraction. MATERIAL AND METHODS: Patients of the first group underwent the classical bur technique, while patients of the second group underwent another technique, in which an elevator was placed on the buccal surface of the impacted molar in order to luxate the alveolar socket more easily. RESULTS: Comparing the two techniques, we observed a statistically significant decrease in the duration of the procedure and in the need for tooth sectioning when applying the second surgical technique, while the post-operative complications were similar in the two groups. We also found a statistically significant lower incidence of lingual nerve lesions and only a slightly higher frequency of sharp mandibular bone irregularities in the second group, which however was not statistically significant. CONCLUSIONS: The results of our study indicate that the surgical technique using an elevator on the buccal surface of the tooth seems to be a reliable method to extract impacted third molars safely, easily, quickly and with the minimum trauma to the surrounding tissues

Benign lip lesions. A 10-year retrospective study.

OBJECTIVES: This paper aims to present a retrospective analysis of a cohort of patients with benign lip lesions managed over the last decade at the Department of Maxillofacial Surgical Oncology of Theagenio Cancer Hospital of Thessaloniki. It aims to highlight the substantial clinical and histological diversity of the lesions, as well as to present an epidemiological analysis for the specific cohort/population. STUDY DESIGN: During the period 1995-2004 a total of 420 patients were managed for lip lesions. Of these, 280 were malignant and 116 benign. A total of 24 cases of actinic keratosis were added in the latter group. RESULTS: Of the benign lesions, the commonest were haemangiomas (19.28%), actinic keratosis (17.14%), intradermal naevus (14.28%), fibroma (9.28%), papilloma (7.85%), mild and moderate dysplasia (7.85%) and mucocele (7.14%). The group included 17 different histological types of benign lesions. The most frequent site of presentation was the lower lip (56.42%). Post-operative follow-up ranged from 6 months to 2 years (average 15.5 months). There was a single case of recurrence during follow-up. CONCLUSIONS: Benign lip lesions do not usually pose a problem for the clinician and their surgical management is straightforward. Accurate auditing and detailed statistical analysis aid in disease prevention and help avoid errors in diagnosis and management.