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Simple bone cysts, also referred to as traumatic bone cysts, are benign connective tissueDSlined cavities occurring most commonly in young people. Most of the time, they occur as solitary radiolucencies. In the jaws, they also have been reported to occur concurrently with benign fibro-osseous lesions. The radiographic appearance of simple bone cysts could be confused with other jaw cysts and benign tumors. This case report presents a patient who had 3 separate lesions simultaneously within the mandible. The right mandibular lesion presented as a multilocular radiolucency. The 2 left mandibular lesions were periapical, with mixed radiodensities and radiographically mimicked lesions of focal or periapical cemento-osseous dysplasia. More aggressive benign lesions of the jaw were initially included in the differential diagnosis, as well. A biopsy revealed the diagnosis of simple bone cysts in all 3 locations. Minimal surgical management resulted in complete recovery of these osseous defects only to recur in 2 years on the mandibular left premolar-molar region. A new biopsy confirmed that the lesion was a recurrent simple bone cyst. Simultaneous presence of benign cemento-osseous dysplasia was also considered, as it is known to coexist with the simple bone cysts. [ABSTRACT FROM AUTHOR]

Background: Two surgical approaches usually are used in the surgical management of deep infiltrating endometriosis of the rectum: the radical approach that mainly is based on colorectal resection and the conservative or symptom-guided approach that prioritizes conservation of the rectum. There are no data available that compare long-term functional digestive outcomes of 1 approach to the other., Objective: The purpose of this study was to compare long-term digestive outcomes in women who were treated by either rectal shaving or colorectal resection for deep endometriosis infiltrating the rectum., Study Design: A retrospective comparative study was performed. All women who were treated with surgery for deep endometriosis infiltrating the rectum by either shaving or colorectal resection at the University Hospital of Rouen from January 2005 to January 2010 were enrolled. Follow-up evaluation was carried out for a minimum of 5 years. Postoperative evaluation of digestive symptoms was performed by 4 standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index, the Knowles-Eccersley-Scott-Symptom score for constipation, the Wexner score for anal continence, and the Bristol Stool Score. Symptoms that were related to endometriosis, fertility, and disease recurrence were obtained from a specific questionnaire., Results: A total of 77 women were included. Three women were lost to follow up (3.9%), and 3 were treated by disc excision (3.9%). The mean follow-up time was 80±19 months. Forty-six women underwent conservative rectal shaving, and 25 women underwent colorectal resection. Patient characteristics and the severity of the disease were comparable in both groups. Patients who were treated by rectal shaving had significantly better Gastrointestinal Quality of Life Index values, lower Knowles-Eccersley-Scott-Symptom scores for postoperative constipation, and better anal continence. No statistically significant differences were revealed for postoperative pelvic pain. Rectal recurrence occurred in 8.7% of patients who were treated by conservative surgery: 4.3% underwent secondary colorectal resection and 4.3% were treated secondarily by rectal shaving. Consequently, avoiding a recurrence for merely 1 patient would have required 11 patients to undergo colorectal resection instead of shaving., Conclusion: Our data suggest that, in patients who are treated for rectal endometriosis, colorectal resection does not improve long-term postoperative functional outcomes when compared with rectal shaving., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To report postoperative outcomes after rectal shaving for deep endometriosis infiltrating the rectum., Design: Retrospective study using data prospectively recorded in the CIRENDO database., Setting: University tertiary referral center., Patient(s): One hundred and twenty-two consecutive patients whose follow-up observation ranged from 1 to 6 years., Intervention(s): Rectal shaving performed using ultrasound scalpel or scissors and plasma energy in 68 and 54 women, respectively., Main Outcome Measure(s): Postoperative digestive function assessed using standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index (GIQLI) and the Knowles-Eccersley-Scott-Symptom Questionnaire (KESS)., Result(s): Nodules were between 1 and 3 cm, <1 cm, and >3 cm in diameter, in 73.7%, 11.5%, and 14.8% of cases, respectively. They were located on the middle (49.2%) and upper rectum (50.8%). Clavien-Dindo 3a, 3b, 4a, and 4b complications occurred in 0.8%, 5.7%, 1.6%, and 0.8% of cases, respectively. Excepting two rectal fistulas (1.6%), the majority of complications were not related to rectal shaving itself. Gastrointestinal scores revealed statistically significant improvement in digestive function and pelvic pain at 1 and 3 years after rectal shaving, but not constipation. Rectal recurrences occurred in 4% of patients, 2.4% of whom had segmental resection, 0.8% shaving, and 0.8% disc excision. Three years postoperatively, the pregnancy rate was 65.4% among patients with pregnancy intention, 59% of whom conceived spontaneously., Conclusion(s): Our data suggest that rectal shaving is a valuable treatment for deep endometriosis infiltrating the rectum, providing a low rate of postoperative complications, good improvement in digestive function, and satisfactory fertility outcomes., (Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

The present report describes 2 patients who underwent mandibular reconstruction after segmental mandibulectomy for benign pathology. The potential of an ultrasonic-aided biodegradable system for containment of a nonvascularized bone graft is discussed., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Since more than 50 million people in the United States have allergies, knowledge of the management of allergic reactions in the dental office is extremely important. Appropriate care may range from a simple referral to a primary care physician to lifesaving measures implemented during acute anaphylactic reactions. The authors present a basic review of the pathophysiology of allergic reactions and provide information detailing the diagnosis and management of allergic reactions that may be encountered in the dental office. Utilizing this information, the dental practitioner and ancillary staff will have a thorough understanding of allergic reactions and be prepared to successfully identify and treat these reactions.

Fixation of mandibular fractures using rigid hardware has gained wide acceptance over the past 3 decades. The goal of rigid internal fixation is to allow for fracture healing with limited, or no, time in maxillo-mandibular fixation. There has been significant evolution in plate and screw materials and design over the past 30 years. The term miniplate is used to describe a fracture plate with a screw diameter of 2.0 mm or less. With correct diagnosis and understanding of the forces affecting mandible fractures, miniplates can be applied transorally in various situations, allowing for less invasive treatment with open reduction of mandible fractures. This article describes the use of monocortical miniplates for the intraoral treatment of mandibular fractures.

An unusual case of a large complex odontoma with an associated impacted tooth is presented. Odontomas are hamartomatous growths of enamel, dentin, cementum and pulp tissue. Although they are usually tooth-sized or smaller, occasionally, the complex variant can exhibit considerable growth, as was seen in the case presented here. It occupied most of the maxillary sinus and displaced the floor of the orbit and the medial and posterior walls of the left maxillary sinus. Panoramic radiographs, as well as axial and coronal CT studies, showed the extent of the lesion in various dimensions. A differential diagnosis of various calcifying tumors was formulated on the basis of these findings. The lesion was surgically excised, and histologic analysis confirmed the radiographic impression. Although odontomas of this magnitude are rare, this case demonstrates the value of imaging, radiographic histopathologic diagnosis and surgical treatment planning prior to any definitive treatment.

Purpose: This study compared the effectiveness of 2 nasal hoods (Porter/Brown and Accutron) in reducing waste nitrous oxide gas during conscious sedation for routine pediatric dental treatment., Methods: Thirty children, ages 3 to 8 years (mean=5.4 +/- 1.2 years), participated in this study. Fifteen randomly selected children started with the Porter/Brown mask, which was then switched to the Accutron mask, and the other 15 children used the reverse order of masks. Four measurements of ambient nitrous oxide were recorded with a Miran 205B Portable Ambient Air Analyzer 5 minutes after each of the following: (1) administration of nitrous oxide; (2) placement of the rubber dam; (3) change of the nasal hood; and (4) reduction of the vacuum. Samples were taken 8 inches above the nose of the patient and in the room 5 feet away from the patient., Results: Nitrous oxide levels were significantly lower (P<.05) with the Porter/Brown system (31 +/- 40 ppm for the patient and 8 +/- 10 ppm for the room) compared with the Accutron system (375 +/- 94 ppm for the patient and 101 +/- 37 ppm for the room). When the suction was reduced, there was an increase in nitrous oxide levels with the Porter/Brown nasal hood (169 +/- 112 ppm for the patient and 28 +/- 18 ppm for the room), whereas the levels with the Accutron nasal hood remained high (368 +/- 107 ppm for the patient and 121 +/- 50 ppm for the room)., Conclusions: This study demonstrated that removal of waste nitrous oxide was greater with the Porter/Brown device and that recommended suction levels must be used for optimum effectiveness.

The fibro-osseous lesions represent a large group of disorders that have many common characteristics including clinical, radiographic and microscopic features. Although most are of unknown aetiology, some are believed to be neoplastic and others are related to metabolic imbalances. It is not unusual to see these lesions presenting with a range of radiographic appearances, causing considerable diagnostic confusion owing to their similar histology. This case report presents a histologically benign cemento-osseous lesion that is radiographically consistent with a focal cemento-osseous dysplasia, along with a concomitant simple (traumatic) bone cyst within the right mandibular alveolus, with the initial presentation as a multilocular radiolucency. Pertinent literature is reviewed.

The effectiveness of a low-dose, preoperative regimen of methylprednisolone for the reduction of postoperative facial edema after impacted third molar surgery was evaluated using the facial plethysmograph. Eleven patients were given 16 mg methylprednisolone orally the evening before surgery, combined with 20 mg methylprednisolone intravenously immediately preoperatively, in a double blind, randomized, crossover study. Facial contour was measured preoperatively, and then on days 1, 2, 3, 4, and 7 postoperatively. The low dose of methylprednisolone reduced swelling by 42% at 24 hours and 34% at 48 hours postoperatively. By the third day the difference was only 19%, suggesting the need for either a sustained release formulation or a multiday course. Trismus or the need for analgesic medication were not affected by this dose of methylprednisolone.

The oral and maxillofacial surgery patient with a sickle cell hemoglobinopathy presents a complex and challenging clinical management problem. The potential for significant morbidity and mortality among these patients is great. Thus the surgeon must adhere to sound principles of medical and surgical practice to avoid major difficulties. This article describes the complex pathophysiology, clinical course, and management principles of the oral and maxillofacial surgery patient with sickle cell disease.

Clear cell odontogenic tumors are rare. Review of the literature showed 9 cases with a prominent clear cell component. These lesions have exhibited an aggressive behavior characterized by an infiltrative local growth pattern, recurrence, or metastases. We report a case of an odontogenic tumor that exhibited a biphasic pattern and was characterized by lymph node involvement identical histologically to the primary tumor. We conclude that the presence of a clear cell component in an ameloblastomatous tumor should be viewed as a sign of de-differentiation, and that a malignancy with or without metastases should be considered and ruled out in such cases.

A critical review of methods used to evaluate postoperative facial swelling is presented. A new, noninvasive method using a feeler arm to trace and measure facial contours is described. The overall accuracy and reproducibility of this method was tested by measuring acrylic "mock swellings." The results suggest that the method was accurate to within 5% in measuring swellings of known volume. The reproducibility of replicate measures also showed a low level of error (3.3%). This device may provide a unique method for the systematic study of treatments designed to minimize postoperative facial swelling.

A variation of a previously described technique to obtain mandibular block anesthesia is presented. This technique varies from those previously described in that is uses palpable anatomic landmarks, both extra- and intraoral, to orient the placement of the needle. This technique relies on several readily observed landmarks and the integration of these landmarks. Because palpable landmarks are used, consistent results can be easily obtained even in patients who present with a wide variety of anatomical variances which otherwise make this injection technique difficult and prone to failure.

An unusual case of submandibular gland salivary flow obstruction created by an overextended denture has been described. The many potential causes of submandibular gland swelling are listed. Clinically, the opening of both Wharton's ducts appeared more anterior than usual. This anatomic fact, combined with the overextended lingual flange of the denture, combined to produce the phenomenon of bilateral submandibular gland swelling.