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Aim: We evaluated the safety and efficacy using a mini-retromandibular transparotid approach to reduce and rigidly fix displaced mandibular condylar neck fractures., Material of Study: Retrospective evaluation of patients who underwent surgical reduction of condylar fracture from January 2012 to December 2014 at the Department of Cranio Maxillo-Facial Surgery of the University Hospital of Catanzaro, Italy. All the patients were clinically assessed for signs/symptoms of infection, signs of Frey's syndrome or salivary fistula, facial nerve palsy ,postoperative scar, TMJ function, and occlusion with range of mouth opening and deviation., Results: The sample was composed of 15 patients. Good results were achieved in all patients and with an average follow- up of 20 months. No major intraoperative or postoperative complication remained at 6 months of postoperative follow- up., Discussion: Management of condylar fractures is still one of the most controversial topics in maxillofacial surgery. Regarding our experience with the mini-retromandibular approach, we evaluate the advantages in comparison with other extra-oral approaches. Advantages include the shorter working distance from the skin incision to the condyle with direct alignment of the fractured segments, less conspicuous facial surgical scarring with good cosmetic result, short operation time, with a low risk of postoperative complications and possible injuries of the facial nerve., Conclusions: According to our results, we believe that the mini-retro-mandibular approach is a viable and safe approach for the surgical treatment of condylar fractures, with a relatively low risk of postoperative complications., Key Words: Condylar fracture, Extraoral approach, Mini-retromandibular access.

Purpose: Mesenchymal stem cells (MSC), which are multipotent stromal cells, are considered to be a promising resource in tissue engineering and tissue regeneration. MSCs have been used to generate new maxillary bone with clinically successful results. The aim of this study was to determine the role of MSC in bone regeneration procedures in patients with benign maxillary lesions., Methods: A study was conducted on five patients treated for maxillary bone defects resulting from biopsy of benign lesions at the University Hospital of Magna Græcia, Catanzaro, Italy from January 2015 to October 2016. MSC from autologous bone marrow were used for bone regeneration. The bone mineral density was compared, using the Hounsfield scale, before and after treatment. Follow-up was monthly for six months, and the patients underwent a computed tomography scan of the maxilla at 6 months., Results: Five patients, who underwent biopsy of osteolytic odontogenic benign tumors, were included in the study. There were no intraoperative or postoperative complications. The mean volume of the newly formed bone was 2.44cm3 (range 2,0-3,1) and the mean bone density was 1137 Hounsfield Units (range 898-1355)., Conclusions: Bone regeneration with MSC from autologous bone marrow appears to be a valid treatment option for maxillary bone defects., Key Words: Bone regeneration, Mesenchymal stem cells, BM-MSC, Upper jaw, Mandible.

Unlabelled: Lipomas are the most common benign soft tissue mesenchymal tumours composed of mature adipose tissue. They are uncommon in the oral and maxillofacial regions, with 15-20 % of cases involving the head and neck region and less than 5% of all benign oral lesions. Multiple symmetric lipomatosis is rare and characterized by diffuse growth and nonencapsulated lipomas. It is usually found in the posterior neck and upper trunk and they are relatively infrequent on the oral and maxillofacial regions like Madelung disease. In the report, we describe a rare case of symmetrical lipomatosis of tongue with OSAS and Dysartria. This lesions were resected under general anesthesia. Intraoperative findings revealed only adipose tissues with replacement of lingual muscles and no capsulation. The lesion was finally diagnosed as symmetric lipomatosis of the tongue based on clinical radiological and histologic examination. SLT (Symmetrical lipomatosis of the tongue) is an extremely rare case that appears like a macroglossia. Partial glossectomy is the treatment of choice because of the improvement of symptoms and the low rate of recurrence., Key Words: Macroglossia, Oral lipoma, Tongue lipomatosis.

Aim: To evaluate the effectiveness of Hilotherm, a recently introduced cooling system, in controlling postoperative edema and pain and to compare the results with those obtained with conventional cryotherapy., Material of Study: The investigators selected 40 patients with unilateral angle fracture of the jaw and divided them into two groups, cryotherapy with ice bag (A group), and Hilotherapy system (B Group); both groups with the same drug treatment. Facial swelling was preoperatively quantified measuring skin segments (called α, β, γ and δ), pain and patient satisfaction were measured for each with questionnaires., Results: Data analysis showed better decrease of soft tissue edema and better pain control with Hilotherapy system in post-surgical treatment., Discussion: The cooling procedures described are ice packs, gel packs or cold compresses. An alternative to conventional cooling methods is Hilotherapy (HilothermGmbH, Ludwigsburg, Germany) a water-circulating cooling device that permits continuous cooling through a face polyurethane preshaped mask., Conclusions: The results of this study suggest that Hilotherm is the better method for patient's postoperative edema and pain management when compared to conventional cooling probably due to possibility of mean temperature control and to greater patient's compliance., Key Words: Cold therapy, Cooling methods, Mandibular fractures.

Necrotizing fasciitis is an uncommon soft tissue infection, usually caused by toxin-producing virulent bacteria especially in mediastinum. It is characterized by widespread fascial necrosis primarily caused by Streptococcus hemolyticus characterized by necrosis of skin, subcutaneous tissues, fasciae, and muscles. It usually occurs in adults and is most often localized to the abdominal wall, the extremities, the perineum, the pelvis, and the thoracic region. Localization to the head and neck area is rarely encountered. Descending necrotising mediastinitis is a form of mediastinitis caused by odontogenic infection or deep cervical infections, which spreads to the mediastinum from the cervical fascial planes. Early diagnosis, prompt surgical drainage, monitoring of disease process, appropriate medical management in an intensive care unit and a multi-disciplinary approach can significantly reduces the mortality in this otherwise fatal condition.

Aim: The aim of our study is to describe the rare location of metastasis cancers (kidney and prostate) in the jaw bones (maxillary branch and the condyle); this is the first and the only sign of disease., Material of Study: Two patients referred to us for a swelling in his left preauricolar region with a moderate pain. They underwent a radiologic and bioptic examinations that showed a metastasis which could arise from a primary prostatic and renal adenocarcinoma. The patients underwent surgical treatment (Subtotal-emimandibulectomy and reconstruction with metallic endoprosthesis)., Results: The final follow up for the first patient was acceptable and without any motor or sensory deficit. The patient also underwent chemotherapy for his primary tumour and radiotherapy of his mandibular condyle metastasis during the preoperative stage. The final follow-up of the second patient was performer two years after the surgery and it did not show any recurrence and after about 18 months from surgery has performed dentistry rehabilitation. The patient had a chemotherapy treatment with the administration of bisphosphonates for the presence of skeletal metastases., Discussion and Conclusion: Just 1% of carcinomas metastasizes in jaw bones. The low rate is linked to the low active bone marrow content in jaw bones of adult patients. For the prostatic and breast adenocarcinomas the neoplastic embolis reaches the skeleton directly, passing through the vertebral venous system (Batson's hypothesis). Early diagnosis made the treatment both of the primary tumour and of its recurrence (single metastasis) more effective.

Aim: The aim of the study is to give an explanation on the Intra-osseous Schwanoma etio-pathogenesis, based on the isto-pathological findings presented by the Authors., Material of Study: In a 40 years old patient with pain on the territory innervated by the third right trigeminal branch, OPT showed a like ground-glass area that involved the mandible with the mandibular canal disappearance and dental roots resorption. They removed the lesion with preservation of the vascular-neural beam on which the lesion were extremely attached; the histological examination confirmed the diagnosis of intra-osseous Schwannoma. Immunohistochemically the Schwannoma labelled with antibodies to S-100, Vimentin, Osteopontin and Osteonectin. RESULST: The clinical and radiological follow-up after one year since the surgery, using OPT showed an improvement of bone formation and the disappearance of the pain., Discussion: Schwannoma rarely presents as an intraosseous mass, comprising less than 1% of all bone tumors with a strong predilection for the mandible. Data like the expression of osteopontin are believed to be distinctive feature of other schwannian cell tumors such as the granular cell tumor. Such data might explain the prevalence of mandibular location among the rare intraosseous schwannomas and might point out that the calcified shwannoma of the skull is similar to an hamartomatous lesion.