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BACKGROUND Most common osseous destructive lesions effecting the jawbone are odontogenic cystic lesions, which are lined by epithelium, has been involved in the formation of teeth as the epithelial cell rest are present in jawbone after teeth formation. The three most common odontogenic cysts (OCs) are radicular cyst (RC), dentigerous cyst (DC) and the odontogenic keratocyst (OKC). Less common variety is the residual cyst. Odontogenic cysts are mainly developmental and inflammatory in origin. The objective of the present study was to find clinico-radiographic characteristics of odontogenic cysts in the mandible. METHODS This was a case series (descriptive) study on OCs of mandible conducted at Tripura Medical College and Dr BRAM Teaching Hospital, Hapania, Agartala, Tripura (W), India, over a period of 6 months from August 2019 to January 2020. Subjects showing clinico-radiographic features of OCs in mandible were included, subsequently confirmed by histopathological examinations. Usually orthopantomograms (OPGs) and intra oral peri apical radiograph (IOPAs) were done for radiological findings, computed tomography (CT) scan was required for examination of the size of lesion. Data were analysed using windows excel. RESULTS Diagnosis of OCs was confirmed in 20 patients, among them, males were (60 %) and female were (40 %). The age range of the patients was 17 - 65 years. Most common type of cyst diagnosed in the study was radicular cyst in 50 % cases followed by dentigerous cysts which were in 30 % cases, odontogenic keratocysts were in 15 % patients and others were 5 %. RCs were represented in higher percentage (50 %). Right side of mandible was the most effected side (60 %) than left side (40 %). Main finding of the study was, in every type of cystic lesions, males were recorded as predominant, and it occurred in early age group. CONCLUSIONS Main finding of the study was radicular cyst which was in higher percentage (50 %) and was being most common with association of carious tooth. KEYWORDS Odontogenic Cysts, Mandible, Finding

Objectives To evaluate the effects of rapid maxillary expansion (RME) and mandibular midline distraction osteogenesis (MMDO) on facial soft tissues using three-dimensional (3D) images. Materials and Methods A total of 20 patients (average age 15.86 ± 2.17 years) were treated with RME and MMDO using tooth-borne distractors. Three-dimensional photographs of each patient were taken with a stereophotogrammetry system at baseline (T0), at the end of the distraction period (T1), and at the end of the consolidation period (T2). All data were analyzed using a dependent-samples t-test at a significance level of 5%. Results Total and lower face height increased after MMDO (P < .05). Nasal and mouth width increased after RME as compared with baseline (P < .05). The labiomental angle increased at T1 and decreased at T2 (P < .05). After MMDO, the convexity angle increased while the mandibular angle decreased (P < .05). Upper and lower lip angles increased after RME (P < .05). The distance from the lower lip to the E plane increased after MMDO and decreased after RME (P < .05). Conclusions The MMDO and RME procedures provide an efficient nonextraction treatment alternative for transverse maxillomandibular deficiency. MMDO may improve the facial soft tissue profile in the transverse and vertical axis of the mandibular region.

Os traumas na região mandibular que resultem em fraturas do processo condilar da mandíbula podem levar a alterações não somente no desenvolvimento facial, como na oclusão dentária e na movimentação da articulação temporomandibular (ATM). Desse modo, o diagnóstico das fraturas e a indicação do tratamento devem ser precisos para se evitar as disfunções dessa articulação ou ainda sequelas mais graves que alterem o crescimento da face e da mandíbula ou impossibilitem a abertura satisfatória da boca, como as anquiloses temporomandibulares. Neste artigo é relatado um caso clínico de uma fratura de côndilo mandibular direito, no qual a paciente apresentava desvio em abertura bucal máxima, queixas álgicas relacionada a abertura bucal além de limitação na abertura bucal e desoclusão dentária que foi tratada cirurgicamente através da fixação da fratura. Após um ano de pós-operatório o paciente evolui com uma abertura bucal satisfatória sem desvio, sem queixas álgicas e uma oclusão estável.

To present the application and the outcome of the regenerative endodontic therapy (RET) in a series of symptomatic immature mandibular molars with pulp necrosis and apical periodontitis and to review the relevant literature for the documentation of the procedure as a potential treatment option. Three young male patients were referred with pain in the left mandibular region resulting from pulp necrosis and apical periodontitis of the first permanent molar. Regenerative endodontic approach was performed for the complete resolution of the lesions and the thickening of the apical root canal walls. The databases of Medline, Pubmed and Google Scholar were also searched for articles in which a regenerative approach has been undertaken for the endodontic management of immature permanent molars with pulp necrosis and apical periodontitis. Follow-up examinations showed that the teeth remained functional without any signs or symptoms. Final radiographic examination at 12, 18 and 36 months, respectively, revealed complete resolution of the lesions and complete apical closure in the two out of three cases. The search of the literature revealed the existence of only 25 clinical articles in which necrotic immature molars were treated by the regenerative approach. The total number of the treated teeth were 46. Regenerative endodontic approach may be applied in posterior non-vital molar teeth with a possible favorable outcome. However, the literature support for the documentation of the procedure as a predictable and reproducible treatment option in posterior immature molar teeth is at present limited.

The impaction of foreign bodies in the maxillofacial region is a rare complication of dental procedures. Removal of such foreign bodies is difficult, and frequently fails because of the complex anatomical structures in this region. Navigation surgery has been introduced for the oral and maxillofacial region, but accurate registration is challenging in the mandibular region due to its mobility. The aim of this report is to describe the validity of using an all-in-one splint to facilitate easy and accurate navigation surgery of the mandible. A 55-year-old woman was referred to our hospital for the management of a suspected odontoma in the right side of the mandible. Navigation surgery was planned to remove the lesion that was suspected to be the tooth root. An all-in-one splint that a reference frame and fiducial markers were installed on was generated for the navigation surgery. Simple registration and successful removal were performed using the all-in-one splint, with high accuracy and minimal invasion. The all-in-one splint with the reference frame and fiducial markers was easier to use, and more effective than a conventional splint for navigation surgery in the mandibular region.

Objectives: The goal of the study is to evaluate the prevalence and characteristics of soft tissue calcifications (STCs) detected in the mandibular region in CBCT images. Methods: 242 (150 female, 92 male) mandibula CBCT images were evaluated in this study. Prevalence, anatomical location, pattern (bilateral or unilateral), size (mm), number (single or multiple), age (50) and gender tendency were recorded. Images were evaluated in the axial, coronal and 3D reformated images. The Chi-square test was used to test for differences of the STC groups and the percentage values. Results: 88 patients (36.4%) had at least one STC in the mandibular region. The mean age of the patients with STC was 58.3±11.06 years. No gender predilection was stated in terms of the presence of STC. STC was higher in patients over 50 years than the other age groups (p=0.00). Most of the STCs were unilateral, above 3mm in size, single and located in the lingual aspect of the mandible. Conclusion: It is of vital importance for clinicians to know characteristics of STCs and to detect STCs in early stages especially those concerning systemic conditions and to prevent life-threatening consequences.

One of the most commonly seen swiftly increasing, highly reactive proliferation of endothelial cells affecting the gingival tissue and usually happens in response to a chronic irritation is known as Pyogenic Granuloma. The current study reports a case of pyogenic granuloma located on the lingual (inner) surface of the gingiva in the left mandibular region that was managed by surgical intervention. Keywords:Pyogenic Granuloma, Pregnancy Tumor, Female Sex Hormones

Rehabilitation with dental implants is, without doubt, an ordained technique. The clinical utilization of dental implants has accelerated in recent years, and new applications continue to emerge. This retrospective study aims to report the implant dimensions commonly used for the posterior mandibular region. It was done at Saveetha Dental College and Hospitals. A total of 391 patients with 670 implant sites within the 20-80 age group who had undergone implant placement were included in the study. The case sheets of patients were obtained from patient information archives. The data on each patient were obtained and tabulated. Out of the 391 patients, 52.2% were males and 47.8%% were females; 33.3% belonged to the35 age group, 34.5% belonged to the 35-46 age group, and 32.2% belonged to the46 age group. The prevalence rate of replacement for mandibular molars was 85.2%; for mandibular premolars, 14.8%. Implant dimensions for posterior mandibles were found to differ based on gender and age group. Males had a greater mean implant width compared to females. Implant dimensions with increased height were used in premolars compared to molars. Implant dimensions with increased width were used in molars compared to premolars. In general, implant width ranged from 3.3 to 5 mm and implant height ranged from 9.5 to 13 mm in the mandibular molar region.

This retrospective study aims to evaluate the association between submandibular fossa anatomy and implant length in the posterior mandibular region. The study took place from June 1, 2019 to March 1, 2020, during which 295 implants were placed in the posterior mandibular region. Data were reviewed and analyzed from 86,000 patient records that were documented at a private institution. Statistical analysis was performed to assess the association between submandibular fossa anatomy and implant length in the posterior mandibular region. Of the 295 implants, 29.2% were placed in subjects aged 36-45 yr, and 52.9% were male. Of the total population, 52.2% had type P (parallel) submandibular fossa anatomy. The 10-mm implant was the size that was most commonly used (frequency rate, 60.3%). A prevalence of submandibular fossa according to gender showed that 53.8% of males and 50.4% of females had type P (parallel buccal and lingual) plates. A statistically significant difference was found when comparing implant length to different types of submandibular fossa by gender (p < 0.05). And, when association was compared between types of submandibular fossa and implant length, a statistically significant association was found. We conclude that high risk occurs when implants are placed in the mandibular posterior region, because many complications can arise. Proper treatment planning is necessary after complete evaluation using cone-beam computed tomography.

Three cases with severe horizontal bone deficiency on mandibular posterior region were committed by modified alveolar ridge augmentation. The therapeutic outcomes show that it is an effective methodology in cases with compromised horizontal bone.

Purpose The purpose of this study was to make a systematic review and meta-analysis of studies investigated the effects of positional factors on the bonding failure of brackets. Methods Electronic databases (PubMed, Web of science, Scopus) were searched by 3 independent researchers. Randomized studies comparing maxilla-mandibular region, anterior–posterior segments, and right-left arch were included in the meta-analysis. The odds ratio was used as the effect size. A two-tailed test was performed to compare the factors. Heterogeneity was calculated with the Cochran Q test and I2 statistics. Results Association was found between bonding failure and dental regions (OR = 1.24, 95% CI: 1.05, 1.46) (p = 0.009) and between bonding failure and anterior–posterior segments, too (OR = 1.96, 95% CI: 1.58, 2.45) (p Conclusion Clinicians should more care, especially when operating in the mandibular region and posterior segment. However, there is no difference between the left and right arch in terms of the loss of the bracket.

A randomized controlled trial was performed to evaluate and compare the changes in implant stability quotient (ISQ) of implants of the same brand, design, length, and diameter but with two different surface treatments, placed in the posterior mandible: sandblasted and acid-etched (SAE) and chemically modified SAE (hydrophilic). Twenty implants of the same design, length, and diameter (cylindrical and compressive, 3.75×11mm) but with different surface treatments (control group: 10 SAE; test group: 10 modified SAE) were randomly assigned to placement in the posterior mandibular region in 20 different patients. ISQ values were assessed in a blinded manner for six consecutive weeks. The maximum and minimum ISQ values observed during follow-up were 76.0 and 48.5, respectively, in the test group, and 76.0 and 49.0, respectively, in the control group. There was no statistically significant difference (P=0.19) in ISQ variation for the test group implants (modified SAE). Comparison between the test and control groups revealed a significant difference in the measurements: the ISQ in the test group was higher than that in the control group during the follow-up period (parametric Mann-Whitney test). This study demonstrated that implants with a modified SAE surface installed in the posterior mandible showed higher and faster ISQ stability during the healing period when compared to implants with a SAE surface.

Objective: To evaluate the frequency, pattern, and etiology of mandibular fractures at a tertiary care hospital, in Karachi Study Design: Retrospective, cross-sectional study. Setting: Abbasi Shaheed Hospital, Karachi, Pakistan Methodology: The study was initiated in Outpatient Maxillofacial Surgery Department of Abbasi Shaheed Hospital Karachi. The duration of the study was 5 years and six months. Data of mandibular trauma was evaluated. In this retrospective, cross-sectional study the patients were recruited through convenience sampling and the inclusion criteria was patients from both genders suffered from mandibular trauma of mandibular region. Patients who suffered from the trauma of face other than mandible were excluded. The sample size of the study was 464. A questionnaire was designed to enquire into the demographic details like age, sex, etiology, and site of fracture. The data was analyzed on SPSS version 17.0. Results: The majority of patients were males i.e. 384 (82.8%) while 80 (17.2%) were females. The most common type of fracture was combination fractures followed by parasymphysis i.e. 142 (30.6%) and 79 (17%) respectively. Road traffic accident was the major cause of trauma i.e. 332 (71.6%) followed by fall 96 (20.7%). Cross tabulation was done between different variables. Association of gender with etiology and type of fracture revealed non-significant p-value while the association of age with etiology revealed significant p-value. The highest number of mandibular fracture cases due to RTA were reported in the year 2019. Conclusion: It has been concluded that the frequency of mandibular trauma is quite high with male dominance. The most susceptible site of trauma is the combination and parasymphseal region and the most common etiology were road traffic accidents.

The authors were grateful to CAPES, CNPq, and FAPESP for their financial support. Computed tomography (CT) and X-ray images have been extensively used as a valuable diagnostic tool in dentistry for surgical planning and treatment. Nowadays, dental cone beam CT has been extensively used in dental clinics. Therefore, it is possible to employ three-dimensional (3D) data from the CT to reconstruct a two-dimensional (2D) panoramic dental image that provides a longitudinal view of the mandibular region of the patient, avoiding an additional exposure to X-ray. In this work, we developed a new automatic method for reconstructing 2D panoramic images of the dental arch based on 3D CT images, using Bézier curves and optimization techniques. The proposed method was applied to five patients, some of them with missing teeth, and smooth panoramic images with good contrast were obtained. info:eu-repo/semantics/publishedVersion

The mandibular canal is a bony channel located within the spongiosa of the mandible. The main structure contained in the mandibular canal is the inferior alveolar nerve. The inferior alveolar nerve is a very important structure that requires due consideration during dental or surgical procedures involving the mandible. Therefore, a detailed morphological analysis of the mandibular canal should be carried out before any surgical procedure in the mandibular region in order to avoid complications and to reduce the risk of inadequate local nerve blocking. The human mandible typically has a single mandibular canal on each side; however, accessory mandibular canals have been described previously in the literature. The most common variant of the mandibular canal is the bifid mandibular canal, which has a prevalence ranging from 10% to 66% on cone-beam computed tomography (CBCT) examinations. A rare variant of bifid mandibular canal is the trifid canal, accounting for less than 6% of all bifid canals. In some cases, the bifid and trifid mandibular canals are associated with a double mandibular foramen, which is a rare anatomical variant with a reported incidence of 1.35% on CBCT images. Herein, we present the interesting CBCT images of an unexpected anatomical variant characterised by unilateral triple mandibular canal with double mandibular foramen in a young Caucasian woman.

Peripheral ameloblastoma, also called as extraosseous ameloblastoma is a rare variant of ameloblastoma. It comprises of 2-10% of all ameloblastomas. This lesion can be mistaken for any other peripheral lesion both clinically and radiographically. Hence a correlation between the clinical, radiographical and histopathological findings is inevitable. Herewith we present a case of peripheral ameloblastoma in a 47-year-old male patient affecting the lingual alveolar mucosa of the mandibular region with complete clinical, radiological and histopathological details. Keywords: Gingiva, Ameloblastoma, Odontogenic Tumors.

Glandular odontogenic cyst (GOC) is a developmental odontogenic cyst of jaw bones, described in 1987 by Gardner et al. The cyst is rare in occurrence, especially in Indians, unpredictable in nature, potentially aggressive in its behavior and has a very high recurrence rate. Clinically, the age, gender, and site of occurrence of GOC as per the literature are 5th- 6th decade of life, slight male predilection and mandibular anterior region. This article presents a case of GOC in a 28-year-old female patient in the posterior mandibular region which is a rare combination of age, gender and site of occurrence for GOC.

A Follicular or Dentigerous cysts are the second most common type of odontogenic cysts. They are formed over the unerupted or partially erupted tooth like fluid filled sac and can further lead to infections if left untreated. Follicular cysts are benign and are most common in the age group of 20 30years. Smaller follicular cysts do not show any symptoms but as it grows larger than 2cm, patient starts experiencing tooth pain, sensitivity, swelling or displacement of teeth occasionally. Generally the treatment of choice is enucleation or marsupialization along with infected tooth removal, but the treatment options may vary depending on size and location of the cystic lesion. Dr. Harish Kumar. A | Dr. Ruchika Raj | Dr. Simran Kaur | Dr. Sachin Sunda "A Case of Follicular Cyst in Lower Right Mandibular Region - A Case Report" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-1 , December 2018, URL: https://www.ijtsrd.com/papers/ijtsrd18958.pdf

The object of our study was to contribute to anatomical knowledge of this region with data on the prevalence, number and location of lingual foramina (LF) in dentate and edentate macerated mandibles from Brazilian individuals, differen-tiating them by sex and race. In this way we hope to help dental surgeons with their planning prior to implant placement in the anterior mandibular region. 103 macerated mandibles were analysed. The prevalence, number and location of LF were analysed in the median (MLF) and lateral (LLF) regions and the median (AMLF) and lateral (ALLF) alveolar process regions. Measurements for their location were taken with a digital calliper. 99% of the mandibles presented at least 1 MLF, 82.5% at least 1 LLF, and the frequency of ALLF was 67%. In dentate mandibles, MLF were located in the region superior to the genial spine, and in edentate mandibles in the regions superior and inferior to the genial spine. LLF were located in the middle region in both dentate and edentate mandibles. The height of the symphysis was significantly greater in dentate than in edentate cases. The distance from the alveolar crest (AC) to the MLF was significantly greater in dentate than in edentate mandibles. LF are constant structures, with MLF found more frequently than LLF. Mandibles which present a smaller measured distance from the base of mandible to AC present MFL and LLF closer to AC, implying a greater risk of complication during implant placement. (Folia Morphol 2018; 77, 2: 310-322).

Swelling of the submandibular region is a pathological condition that is frequently encountered in clinical practice. However, the fact that it can result from "sublingual gland herniation," in which the sublingual gland protrudes from a fissure of the mylohyoid muscle into the submandibular space, is not well known. Here, we report our experience with a case in which swelling of the submandibular region was caused by sublingual gland herniation. The patient visited our hospital with a chief complaint of swelling of the mandibular region. Detailed examination (including ultrasonography, computed tomography (CT), and functional magnetic resonance imaging (MRI) with Valsalva maneuver) confirmed the presence of a fissure in the mylohyoid muscle and protrusion of the sublingual gland into the submandibular space. As a result of no findings indicating inflammation or lymph node swelling including a malignant disease, a follow-up observation was performed. These findings suggested that it was necessary to consider the sublingual gland herniation in a case of submandibular swelling and that echographic and/or MRI examinations combined with the Valsalva maneuever were useful to distinguish.

Lipoma is the most common benign mesenchymal soft tissue neoplasm in adults. It is rarely seen in the oral cavity and comprises 1–4% of all benign oral lesions. There are different types of lipomatous tumors that contain other predominant mesenchymal elements such as cartilaginous/osseous tissues. Osteolipoma is a rare histopathologic variant of lipoma accounting for less than 1% of all lipomatous cases. Eight cases of this type of lipoma were reported in the mandibular buccal vestibule. The present study aims to report a rare condition: a patient with osteolipoma situated in the mandibular region. In addition, a literature review is presented.

The inferior alveolar nerve block is the most common method of local anesthesia for intraoral surgery at the posterior mandibular region. However, unexpected complications may occur when administering the local anesthesia. One of these uncommon complications is the fracture of the needle. If the injection needle is broken during the surgery, it should be removed immediately. However, this is one of the most difficult procedures. In this report, we present two cases of needle fracture during the procedure, and its successful removal under general/local anesthesia administration.

Background. The present study was conducted to investigate the marginal bone loss around two different types of implant‒abutment junctions, called platform-switched (Implantium system) and non-platform switched (XiVE system) after two years of loading. Methods. Sixty-four implants in 49 patients were included in the study. The implants were placed in the posterior mandibular region according to the relevant protocols. The extent of bone loss around the implants was measured and compared after 24 months, using digital parallel periapical radiographs. Results. The means ± SE of bone loss values in the platform-switched and non-platform-switched groups were 0.47 ± 0.048 mm and 1.87 ± 0.124 mm, respectively. The difference between the two groups was statistically significant (P < 0.0001). Conclusion . The platform-switching technique seems to reduce the periimplant crestal bone resorption, which supports the long-term predictability of implant therapy.

Ameloblastoma is an epithelial odontogenic tumor that primarily affects the posterior mandible in patients from 20 to 60 years of age. It usually presents as a well-defined, unilocular to multilocular radiolucency with associated expansion of the jaws. Ameloblastoma arising from the anterior mandibular region is rare. We report 2 cases of ameloblastoma affecting the anterior mandible. The first case is a 59-year-old male patient with a swelling of 1 year duration, and the second is from a 74-year-old female with a painless swelling and tooth mobility lasting 2 years. Panoramic radiography showed in both cases a well-defined multilocular radiolucency with thin corticated borders. Microscopic analysis of both cases revealed islands of odontogenic epithelium with central stellate reticulum-like areas and peripheral ameloblastic areas, arranged in a follicular pattern. The treatment was surgical resection, and no evidence of recurrences was observed.

Objective. To determine the morphological features in the anterior mandibular region, the presence of lingual foramen and canal dimensions in Saudi subjects that would interfere with standard implant placement. Methods. CBCT scans of patients seeking implant treatment were examined. Based on the dentition status, patients were categorized into edentulous (group I) and dentulous (group I). On the panoramic view, the distance between the two mental foramina was divided into vertical segments of 10 mm width. In each segment, vertical bone height and buccolingual thickness at three levels (alveolar crest, 5 mm, and 10 mm apical to the crest) were assessed. The lingual foramen prevalence and canal features were assessed as well. Comparisons between the two groups regarding the assessed parameters were performed using the t-test. The percentage of edentulous mandibles with thickness P < 0.0001 ). The lingual foramen was detected in 90% of patients. In both groups, males had significantly greater mandibular height than females ( P = 0.02 and 0.005). At the crestal level, the thickness was

A full-term male newborn presents with a large hemifacial swelling extending from the frontal region to the mandibular region, encroaching on the orbit and displacing the pinna. (Figs 1 and 2) Figure 1. Large hemifacial swelling on the right side of the face displacing the pinna. Figure 2. Swelling encroaching on the orbit. ### Prenatal and Birth Histories ### Presentation At birth, the infant was noted to have a hemifacial swelling over the right temporal area. Investigations showed persistent thrombocytopenia, and the lowest platelet count was 51 × 103/μL (51 × 109/L). No platelet transfusion was required before transfer. The infant was referred 9 days after birth to our institution for further management. ### Vital Signs (Day 9) ### Physical Examination (Day 9)

Introduction: The pleomorphic adenoma is a benign tumor of the salivary glands. Its extra parotid locations are rare. The aim of this study is to describe the particular management of the pleomorphic adenoma in its unusual location. Observation: This patient was a 35 - year - old patient referred from Zinder Hospital for the management of tumefaction in the mandibular region that had been undergoing surgery for 10 years. The clinical and paraclinical examinations led to the conclusion of a pleomorphic adenoma of the submandibular gland, by imaging and confirmed by the anatomo-pathological examination of the surgical specimen, which measured 15x12x8cm following submandibulectomy with complete tumor resection. The follow-up was simple and no recurrence or malignant transformation was reported after a mean follow-up of one year. Conclusion: The extra-parotid localization of the pleomorphic adenoma is dominated by the submandibular gland. This localization stands out in its clinical and therapeutic peculiarities. Introduction: L’adenome pleomorphe est une tumeur benigne des glandes salivaires. Ses localisations extra parotidiennes sont rares. L’objectif de ce travail est de decrire la prise en charge particuliere de l’adenome pleomorphe dans sa localisation inhabituelle. Observation: Ils’agissait d’un patient de 35 ans, refere de l’Hopital National de Zinder pour la prise en charge d’une tumeur de la region mandibulaire evoluant depuis 10 ans. Les examens cliniques et paracliniques avaient permis de conclure a un adenome pleomorphe de la glande submandibulaire, par l’imagerie et confirme par l’examen anatomo-pathologique de la piece operatoire qui mesurait 15x12x 8cm suite a la submandibulectomie avec resection tumorale complete. Les suites operatoires etaient simples et aucune recidive ni transformation maligne n’a ete rapportee apres un recul d’un an. Conclusion: La localisation extra-parotidienne de l’adenome pleomorphe est dominee par la glande submandibulaire. Cette localisation se distingue dans ses particularites cliniques et therapeutiques.

We present a 45-year-old black woman diagnosed with a florid cemento-osseous dysplasia (FCOD) affecting the right lower quadrant and the anterior mandibular region. The patient requested dental implants to rehabilitate the edentulous central lower incisors area (teeth # 31 and # 41) corresponding to a periapical cemento-osseous dysplasia (PCOD). Successful osseointegration of the two implants was obtained using a two-step procedure in order to limit the risk of complications associated with implant placement. Follow-up at one year showed no recurrence and good implant stability. Due to the abnormal quality of the bone in cemento-osseous dysplasia (COD), implant placement is generally avoided, and no other case reports have been reported in the literature in patients affected by PCOD. The present case suggests that in an appropriate clinical setting, implant placement may be a successful procedure.

O aumento dos índices de violência interpessoal tem gerado um grande impacto na sociedade mundial, principalmente pelo número de vítimas acometidas por ferimentos causados por projéteis de arma de fogo (PAF). Levando-se em consideração a gravidade desse tipo de lesão, a necessidade de intervenção cirúrgica e o aumento significativo de mulheres vitimizadas, destaca-se a importância do conhecimento, por parte do cirurgião bucomaxilofacial, do procedimento técnico cirúrgico e do acolhimento da vítima. Este trabalho tem como objetivo destacar a problemática social envolvendo o feminicídio e relatar de maneira descritiva um caso, no qual a paciente foi vítima de uma tentativa de homicídio, necessitando, dessa forma, de intervenção cirúrgica para redução e fixação de uma fratura cominutiva em região mandibular. A paciente encontra-se com 8 anos de pós-operatório, apresentando estabilidade da osteossínte e da oclusão, realizando normalmente todas as funções do sistema estomatognático. Mostrando assim sucesso da abordagem cirúrgica escolhida.

We present a 10-year old boy with recurrent swelling of the right mandibular region. Based on the diagnosis of chronic recurrent parotitis, he received only supportive treatment. Because of frequent relapses, the diagnosis was reconsidered. Magnetic resonance imaging, scintigraphy and biopsy were compatible with chronic osteomyelitis. This lead to a diagnosis of mandibular primary chronic osteomyelitis, an uncommon non-suppurative inflammatory disease of unknown origin. After decortication of the mandible, the patient recovered well. Because there were no further complaints, the follow-up was ended 18 months after the operation.

Correction of severe vertical bone deficiency in the posterior region of mandibular alveolar ridge requires surgical management if implants are scheduled and cannot have primary stability. The aim of the present study is to report two cases; one treated with alveolar osteogenesis distraction and the other with segmental osteotomy with autologous graft interposition, by describing the surgical steps as well as show the results and experiences acquired with these techniques. We opted for these methods to reconstruct the posterior mandibular region after remarkable vertical bone loss based mainly by the height and thickness of the remaining bone. Alveolar osteogenic distraction is highly advisable when vertical deficiency is severe, and if these cases are treated with the segmental osteotomy and autologous graft interposition, complications as graft failure, necrosis and resorption are more prone to occur due to insufficient vascularization. After bone maturation and bone neoformation secondary to alveolar osteogenic osteogenic distraction and segmental osteotomy with autologous graft interposition, respectively, the two presented case reports were able to securely receive dental implants. In cases of vertical bone loss of the posterior mandibular region, both surgeries currently represent the best choice for bone gain prior dental implants placement for oral rehabilitation, without technical challenges, although biological evidence to assure the superiority of one technique over the other must be further investigated. RESUMO A correção de deficiência óssea severa em altura na região posterior do rebordo alveolar da mandíbula requer tratamento cirúrgico caso a inserção de implantes dentários seja necessária e não se pode ter uma estabilidade primária. O objetivo do presente estudo é relatar dois casos; um tratado com distração osteogênica alveolar e o outro com osteotomia segmentar associada à interposição de um enxerto autógeno, descrevendo a sequência cirúrgica, bem como mostrar os resultados e as experiências adquiridas com essas técnicas. Optamos por esses métodos para reconstruir a região mandibular posterior baseados principalmente na altura e espessura óssea remanescentes. A distração osteogênica alveolar é altamente recomendável quando essa deficiência é avançada e, se esses casos são tratados com a osteotomia segmentar e interposição de enxerto autógeno, complicações como falha do enxerto, necrose e reabsorção são mais prováveis de ocorrer devido à vascularização sua insuficiente. Após os períodos de reparação e neoformação óssea secundária à distração osteogênica alveolar e à osteotomia segmentar com interposição de enxerto autógeno, respectivamente, os dois casos relatados estavam aptos a receberem seguramente os implantes dentários. Nos casos de perda óssea em altura na região mandibular posterior, ambas as cirurgias representam, atualmente, a melhor escolha para o ganho de estrutura óssea antes da colocação dos implantes dentários e reabilitação oral, sem muita complexidade quanto à técnica cirúrgica, embora ainda sejam necessário estudos posteriores para assegurar a superioridade de uma técnica em relação a outra.

Langerhans cell histiocytosis (LCH) is a rare reactive and proliferative disease of histiocytes. The disease occurs predominantly in children and rarely in adults. This disease of unknown etiology exhibits extreme clinical heterogeneity. Even though LCH manifests initially in the oral cavity in most of the cases, owing to the relative rarity of the condition, it remains a disease in which the diagnosis is often delayed, missed or misdiagnosed. This is a case of LCH in a child which presented with swelling in the mandibular region.

The adult gingival cyst is an uncommon lesion, considered a representative of the soft tissue counterpart of the lateral periodontal cyst, being derived from the dental blade. The cyst has a striking predilection for the canine region and lower premolars. The aim of this study is to report a case of adult gingival cyst in a 74-year-old patient. A cystic lesion in the mandibular region, in gingival, between 32 and 33, about 1.0 cm was observed. An excisional biopsy was performed. Microscopic findings confirmed the diagnosis of adult gingival cyst. About 1 year later there is no sign of recidivation. This study was important for documenting an unusual lesion in the population.

Ameloblastic fibroma (AF) is an uncommon benign odontogenic tumor in which both the epithelial and ectomesenchymal components are neoplastic. We report a case of a 6-year-old male patient presenting a painless swelling in the left posterior mandibular region with 1-month evolution. Computed tomography scans showed a large osteolytic lesion (6.0 × 4.5 cm). An incisional biopsy was performed, and the histopathologic analysis revealed cords and islands of proliferating odontogenic epithelium laid in a loose cell-rich connective tissue. The diagnosis was AF. A surgical conservative excision followed by curettage was performed, but the lesion recurred after 6 years, which was histologically confirmed. A new surgical excision and curettage was performed, including the removal of the tooth involved. The patient is under follow-up for 3 months with no recurrence sign. Despite the benign nature, a judicious pathologic analysis in cases of recurrent tumors is essential to rule out any malignant changes.

Solid ameloblastoma is an odontogenic epithelial benign neoplasia, but it is aggressive and affects mainly young adults between their third and seventh decade of life, with no predilection for sex. It is clinically characterized as a slow-growing tumor, asymptomatic and with a high recurrence rate. Radiographically, it may present as unilocular or multilocular radiolucent lesions, usually with well-defined borders similar to "soap bubbles" or "honeycombs." This study aims to report a case of solid ameloblastoma that occurred in a 29-year-old patient, submitted to treatment of segmental mandibular resection, presenting a satisfactory result. It is fundamental to know the characteristics of the lesion and to request complementary examinations for a correct diagnosis of this pathology.

WOS:000460868900001 PubMed ID: 30937195 Orocutaneous fistulas in the maxillofacial region may be due to tumor resection, osteoradionecrosis, or trauma, and these defects limit the function of the patients and effect aesthetic and also psychological condition. Articulation and nutrition are also affected by these fistulas. Local flaps can be used for the reconstruction of small- and medium-sized defects with ease. Submandibular gland with its rich blood supply from the facial artery is a practical and useful choice for the reconstruction of mandibular region defects.

Background High-intensity focused ultrasound (HIFU) has recently been introduced in the treatment of facial wrinkles and laxity. Objective The purpose of the study was to evaluate efficacy and safety of HIFU in facial and neck rejuvenation. Methods High-intensity focused ultrasound treatment was performed on face and neck by using two different probes with focal depth of 3 mm and 4.5 mm. Two independent, blinded clinicians evaluated the clinical improvement at 3 months after treatment. The patients also scored their satisfaction with the treatment. Adverse effects were assessed up to 3 months post-treatment. Results Seventy-five patients (73 female, 2 male) with Fitzpatrick skin phototypes 2-4 were enrolled in the study. After treatment, improvement in nasolabial, jawline, submental, and neck areas was separately evaluated. The rate of improvement in each area was more than 80% according to the physicians' assessment, while patients' satisfaction degree in each area was over 78%. Most common adverse effect was pain, reported in 25.3% of the patients during the procedure while transient erythema was reported in 6.7%. Both resolved spontaneously after the procedure. Only one patient complained development of numbness on right mandibular region which resolved spontaneously within 10 days. Conclusion High-intensity focused ultrasound can be an effective noninvasive treatment modality in facial and neck rejuvenation with an acceptable safety profile.

Introduction : Ultrasound guided neuro-anaesthesia is a developing field of interest to clinicians from various disciplines. The objective of this proof of concept study was to explore the ability, ease and rapidity of ultrasonography in locating the mental foramen. Methods : A convenience sample of 100 patients aged 18 years or older, with no known pathology to the mandibular region, that presented to a single urban ED were enrolled. All patients underwent an ultrasound examination on both sides of the face to locate the mental foramina. Results : A total of 100 patients' mental foramina were studied. Mean age was 35.7 years (SD 9.1 years), 50% were black and 25% each were asian and white. The mental foramina were ultrasonographically identified in all (100%) of the subjects in the study group. Although requiring a larger quantity of ultrasound gel, the mental foramina were also visualized in all twelve subjects with facial hair. Three out of the 100 subjects were noted to have accessory mental foramina. The overall mean time taken to locate the first mental foramen in each patient was 16.1 seconds (SD 12.9 seconds). For the first 25 subjects studied, the mean time taken was 34.7 seconds (SD 13.4 seconds), whereas for the next 75 subjects studied, the mean time taken was 9.9 seconds (SD 3.0 seconds). Conclusion : Bedside ultrasound imaging is a potentially reliable method to identify and locate the mental foramen. With practice and experience, the mental foramen can be more easily identified.