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Аneurysmal bone cysts are benign osteolytic lesions with rapid growth, thin walls containing numerous blood-filled cavities. They occur mainly in the pediatric population but are rarely diagnosed in the facial skeleton. Although benign, the condition can be locally aggressive and cause significant weakening of the affected bone structure. This case report presents a 14-year-old boy with Burkitt's tumor (Non-Hodgkin's lymphoma), previously diagnosed with an aneurysmal bone cyst a year ago. He was admitted for treatment at the Clinic of Maxillo-Facial Surgery of the University Hospital "St. George" Plovdiv due to pain and swelling in the left molar area of the mandibula, dating from 2 days. A recurrence of an aneurysmal bone cyst measuring 55/25 mm, which does not require resection of the mandible, was found. After a decision for surgical removal of the formation, under general anesthesia, and preparation of a three-cornered mucoperiosteal flap, the mandibular bone, which is lysed and thinned by the formation, was trepanned. The roots of the affected teeth were resected, and the formation was extirpated. A gauze drain was placed in the formed cavity, and the wound was sutured. Drug therapy included Cefotaxime 2x1.0 - 10 days, starting 3 days before surgery, and Paracetamol 2x1 – 3 days, 2 days before and 1 day after surgery. Prophylactic examinations were scheduled on day 3, 7, 10, 15 after the operation, as well as 3, 6, and 12 months post-op, due to the recurrent nature of the formation.

Introduction. Rhinophyma is a disfiguring nasal deformity due to the proliferation of sebaceous glands and underlying connective tissue. It affects mainly men, aged between 50 and 70 years old. The disease is associated with negative stigma, low self-esteem, reduction in quality of life. The main reasons patients seek medical help are cosmetic problems and functional impairments. Surgery is indisputably the treatment of choice for rhinophyma. Cases report. We present the cases of two patients diagnosed with rhinophyma, who underwent surgical treatment in the University Hospital “St. George”, Plovdiv, Bulgaria. The subtlety and innovation of the surgery was that the hypertrophied skin of the nose was dissected in layers, the sebaceous glands that produced pus were extirpated. The normal glands sought to be preserved, to nourish the newly formed dermis postoperatively. Both patients responded well to the procedure, without postoperative complications or wound infections. Conclusions. These cases highlight the importance of an accurate treatment of rhinophyma and the post-operative period, and the need for an appropriate follow up of patients until the complete recovery of the surgical wound and the formation of new skin.

Medication-related osteonecrosis of the jaws is a commonly reported complication in patients receiving antiresorptive medications. We report a case of bone necrosis followed by comparatively fast recurrence in a patient with intravenous administration of zoledronic acid. The purpose is to focus the attention of dental practitioners on the possibility of recurrence and the importance of regular check-ups since preventive measures today are one of the most important management strategies for patients treated with zoledronate.

A case report of a patient with cancer of the lower lip is presented. The reason for the treatment is an entity in the lower lip. It has been dating for several months and has grown significantly lately. Due to the complicated, inflammatory process, he was treated in the clinic, and after the same subsidence, he was admitted for surgical treatment. Surgery performed Resectio Partialis Labii Inferioris and plastics “a modo Bernard”. The case was presented to an oncology council, establishing that the patient was being monitored and he was given recommendations for a hygienic diet. The patient was discharged with improvement.

One of the most common dental surgical procedures performed in specialized oral surgery and dental practice is extractions of mandibular third molar. In this report, we look at the case of a 55-year-old patient who is receiving hospital treatment for lower jaw pain and edema. After orthopantomography, a fracture was found in the angle of the lower jaw, accompanied by an inflammatory process. In the intraoral examination, an unhealed completely extraction wound to the left of the mandible was observed in the area of the wisdom tooth, pathological mobility and bone crepitus. Mandibular angle fracture is the most common mandibular fracture, accounting for approximately 40% of all mandibular fractures. Mandibular angle fracture is defined as a fracture line between the anterior border of the mandibular ramus and the jaw body. In the present case, the patient received an additional graphy of the facial skeleton and was treated with intermaxillary fixation with rigid fixation and restraints bilaterally in the area of the upper and lower jaws and molars.

Treatment including an orthodontic and implant prosthesis improves the occlusal connection and aesthetic appearance in the anterior region of the jaw. In this report, we describe a case of combined treatment of a patient with orthodontic abnormalities and implant therapy applied. Following the placement of braces and radiographs, the buds of the permanent upper right second premolar, lower left and right second premolars were found to be absent. Implant treatment of the upper and lower jaws was undertaken after the age of 18. Prior to the placement of the upper jaw implant and after extensive examination and discussion of OCG, sinus procedans was identified and a lateral sinus lift was required. A bone graft and a collagen membrane were used to perform the operation to raise the maxillary sinus. This case underscores the importance of a multidisciplinary approach to achieving an aesthetic result.

The negative effects of smoking and poor oral hygiene on the outcome of implant placement can be related to many factors, and their mechanism can be mediated by both local and systemic biological pathways. The effects of smoking on the survival and success of implants are more pronounced in areas of poor trabecular bone quality. In this report, we present a case of a 64-year-old patient with low oral hygiene and multiple upper jaw gangrenous roots. Relatives reported that the patient suffers from chronic alcoholism and tobacco abuse. The patient insisted on implant treatment, which he was subsequently subjected to, although he is warned about the risks. The oral cavity was rehabilitated and the existing gangrenous roots were extracted under antibiotic therapy including penicillin. In the postoperative period, extremely good wound healing of the patient was observed, with no early or late bleeding..

Introduction : Medication-related osteonecrosis of the jaw (MRONJ) is an area of uncovered bone in the maxillofacial region that does not heal within 8 weeks after identification by a healthcare provider, in a patient who is receiving or has been exposed to bisphosphonate therapy without previous radiation therapy to the craniofacial region. Case Description : The survey was conducted in 2018/2019. It was conducted at the Clinic of Maxillofacial Surgery, St. George University Hospital, Plovdiv, Bulgaria. In order to conduct the study, we obtained informed consent from the patient, who was 63 years of age. We have diagnosed medication-related osteonecrosis of the lower jaw. We performed bone resection and applied platelet-rich plasma (PRF) in order to enhance soft tissue healing. Discussion : Management of MRONJ remains a challenge and controversial topic. Multiple treatment approaches have been introduced to control MRONJ. Surgical treatment remains one of the most reliable methods but it also needs to take advantages of advanced scientific researches and technologies. One of these achievements is the use of a platelet-rich fibrin matrix (PRFM). Conclusion: In addition to the established surgical treatment options, we can add the application of platelet-rich plasma as an adjuvant treatment for MRONJ.