Search

Peripheral ameloblastoma (PA) is an uncommon variant of ameloblastoma that occurs in extraosseous soft tissue. Our patient, a 10-year-old girl, was hospitalized with a mass in the anterior plate gingiva. The elastic hard mass was approximately 7 mm in length, the surface mucosa was normal, and no spontaneous or oppressive pain was present. Computed tomographic and panoramic X-ray examination revealed no infiltration into the anterior plate. First, we performed biopsy of the mass; pathologic study revealed that the tumor was a PA. The prognosis of patients with PA is generally good, but recurrence has been reported. In surgery, we resected the tumor with 5-mm margins, which included the periosteum. After surgery, no recurrence was observed, and the wound healed well. No evidence of recurrence was found at follow-up observation, but we plan to continue monitoring the patient carefully.

It is known that congenitally missing teeth can often cause differences in craniofacial morphology; however, there are few reported cases of orthognathic surgical treatment for these patients. Herein, the authors report a rare case of maxillary hypoplasia with congenital oligodontia treated by maxillary distraction osteogenesis with internal device. A 17-year-old male presenting with multiple tooth agenesis and maxillary recession was referred to our hospital for orthognathic surgical treatment. Preoperative simulation surgery was performed using Full-Color 3-dimensional salt model. After surgery, improvement in maxillary recession and occlusal stability was observed. This report demonstrates the advantages of the method used herein, which includes reduction in operating time with increase in the safety of the procedure.

OBJECTIVES The aim of this study was to examine the relationship between morphologic factors of mandibular protrusion patients and clinical indices of obstructive sleep apnea (OSA). METHODS Fifty-two Japanese patients divided into 2 groups: 1 jaw surgery group (30 patients) and 2 jaw surgery group (22 patients). Morphologic changes were studied using cephalograms taken before surgery and 1 year after surgery. Functional changes studied using impulse oscillometry and pulse oximetry during sleep, both of which are clinically useful measures in assessing OSA, taken before surgery and 1 year after surgery. RESULT Lower face cage area significantly decreased in 1 jaw group than in 2 jaw group patients. Positive significant correlation was found between changes in 3% oxygen desaturation index (ODI) and changes of tongue area and vertical position of the hyoid bone in 1 jaw surgery group. Multiple regression analysis indicates that tongue area and airway area were independently significant predictors of 3% ODI in 1 jaw group patients. CONCLUSION In 2 jaw surgery, maxillary surgery compensated for the effect of mandibular setback surgery. Mandibular setback surgery to mandibular protrusion patients was performed within the range of adequate movement distance, but precautions for risk of postoperative obstructive sleep apnea syndrome should be considered.

Robinow syndrome is very rare and is characterized by congenital anomalies of the head and neck. Symptoms occurring in the head and neck region include osteosclerosis of the skull, midface hypoplasia, cleft palate, and impacted teeth. There is no case report describing oral maxillofacial surgery in Robinow syndrome. We report the case of a 19-year-old female in whom a panoramic radiograph revealed a radiopaque lesion in the right maxillary molar region along with multiple impacted teeth, hypodontia, and retained deciduous teeth in her jaws. Impacted tooth was also present in the radiopaque lesion on the right maxilla. Computed tomography revealed a high-density area on the right maxilla, representing a lesion containing an impacted tooth. The general findings and the presence of impacted teeth indicated symptomatic disease, and biopsy examination confirmed an osteoma. After additional examinations, Robinow syndrome was diagnosed. Tooth extraction was performed under general anesthesia. About 8 months after operation, the wound showed epithelialization and osteoma-like tissue formation was confirmed in the extraction socket. We considered repeated observations to be necessary in this case because of the possibility of recurrence. It is necessary to be aware of the possible diagnosis of Robinow syndrome on the basis of intraoral symptoms after school age.

Bernard–Soulier syndrome is characterized by thrombocytopenia, giant platelets, and severe bleeding; although bleeding varies widely, it is usually evident from childhood and requires particular attention during surgeries. We extracted a fractured tooth and performed hemostasis management in a male patient with a Bernard–Soulier syndrome-related severe bleeding tendency after intracerebral hemorrhage. The preoperative platelet count was abnormally low (7 × 10 9 /L). Normal coagulability was observed. After intravenous hydrocortisone administration, he received 10 human leukocyte antigen-matched platelet units. The extraction sites were packed with gelatine sponges and a splint was used for hemostasis. Excellent hemostasis was achieved with minimal human leukocyte antigen-matched platelets.

Congenital thrombocytopenia is a rare, intractable hereditary disease characterized by thrombocytopenia and abnormalities of platelet function. In contrast, idiopathic thrombocytopenic purpura (ITP) is a more frequent thrombocytopenic disease. Furthermore, it is possible that chronic and refractory ITP include congenital thrombocytopenia. We describe a case in which we extracted a tooth and performed hemostasis in an 87-year-old man with a suspected congenital X-linked thrombocytopenia (XLT)-related severe bleeding tendency. XLT is very rare in congenital thrombocytopenia. The patient had a platelet count of 2.0 × 104/μL and received 20 units of platelet concentrate before and after the extraction in liaison with our hematology and oncology department. We have previously reported a model on hemostasis management and extraction of Bernard–Soulier Syndrome (BSS) patients with congenital thrombocytopenia. The extraction sites were packed with gelatin sponges, and sutured, then a splint was used for hemostasis. Excellent hemostasis was achieved with minimal required platelet infusion.