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Calcified structures in anterior maxillary cysts
LETTERS TO THE EDITOR J Oral
Maxillofac
43.000-000.
Surg
1985
taking coumadin and lanoxin. A tentative diagnosis of nasopalatine ductal cyst containing a calculus was made. Following a complete medical workup, the patient’s coumadin was stopped three days preoperatively, and the patient was heparinized. The heparin was stopped six hours prior to surgery, and the patient received prophylactic antibiotics as recommended by the American Heart Association schedule II. The patient was taken to the operating room, and an incision was made along the crest of the alveolar ridge. A mucoperiosteal flap was developed revealing a cystic cavity in the nasopalatine canal area. The cystic lining was curetted along with the central calcified mass. Gelfoam@ was placed in the bony defect, and closure was accomplished with 3-O chromic sutures. The nonrestorable teeth were extracted in a routine fashion, and the tissues were closed with 3-O chromic sutures. Heparin therapy was started six hours postoperatively, and the postoperative course was uneventful. The pathology report was consistent with a nasopalatine ductal cyst that contained a calcified amorphous mass.
CALCIFIED STRUCTURES IN ANTERIOR MAXILLARY CYSTS To the Editor:-This letter is to report a case very similar to one published in the January 1985 issue of the Journal of Oral and Maxillofacial Surgery by Ezedin M. Sadeghi and David M. Angel1 entitled “Sialolith in a Median Anterior Maxillary Cyst. Report of a Case A 46-year-old hispanic women was referred to the Oral and Maxillofacial Surgery Department at Temple University Dental School for extraction of her remaining teeth and evaluation of a radiopaque, radiolucent lesion of the anterior maxillary ridge. Clinical examination revealed nine mandibular nonrestorable teeth with advanced periodontitis. A bony defect was palpable in the nasopalatine area, and an old fistula was associated with the area. Radiographic examination revealed a round, l-cm radiolucent lesion with a central area of radiopacity (Fig. 1). The past medical history was significant for rheumatic fever and a mitral valve prosthesis. The patient was
ANDREA HABER-COHEN MICHAEL P ECKHART Philadelphia, Pennsylvania
MODIFIED TECHNIQUE FOR EXTERNAL FIXATION FOLLOWING MANDIBULAR
RESECTION
To the Editor:-In an article published in the March 1984 issue of the Journal of Oral and Maxillofacial Surgery entitled “A Modified External Pin Appliance for Resections that Include the Mandibular Condyle,” I discussed a technique of external skeletal fixation that included placing screws within the body and arch of the zygoma. In that article, I recommended the use of 2” ramus screws for this purpose. Since that time, I have found several patients in whom the screws have become loose due to the long lever arm produced by this type of screw. This problem can be corrected by the use of short body screws with a length of 1%“. This reduces the lever arm and, therefore, forces placed on such screws in the zygoma and has allowed this appliance to remain stable for up to one year or more.
FIGURE 1. Presurgical radiograph of radiolucent lesion.
ROBERT E. MARX Miami, Florida
563
Maxillofac
43.000-000.
Surg
1985
taking coumadin and lanoxin. A tentative diagnosis of nasopalatine ductal cyst containing a calculus was made. Following a complete medical workup, the patient’s coumadin was stopped three days preoperatively, and the patient was heparinized. The heparin was stopped six hours prior to surgery, and the patient received prophylactic antibiotics as recommended by the American Heart Association schedule II. The patient was taken to the operating room, and an incision was made along the crest of the alveolar ridge. A mucoperiosteal flap was developed revealing a cystic cavity in the nasopalatine canal area. The cystic lining was curetted along with the central calcified mass. Gelfoam@ was placed in the bony defect, and closure was accomplished with 3-O chromic sutures. The nonrestorable teeth were extracted in a routine fashion, and the tissues were closed with 3-O chromic sutures. Heparin therapy was started six hours postoperatively, and the postoperative course was uneventful. The pathology report was consistent with a nasopalatine ductal cyst that contained a calcified amorphous mass.
CALCIFIED STRUCTURES IN ANTERIOR MAXILLARY CYSTS To the Editor:-This letter is to report a case very similar to one published in the January 1985 issue of the Journal of Oral and Maxillofacial Surgery by Ezedin M. Sadeghi and David M. Angel1 entitled “Sialolith in a Median Anterior Maxillary Cyst. Report of a Case A 46-year-old hispanic women was referred to the Oral and Maxillofacial Surgery Department at Temple University Dental School for extraction of her remaining teeth and evaluation of a radiopaque, radiolucent lesion of the anterior maxillary ridge. Clinical examination revealed nine mandibular nonrestorable teeth with advanced periodontitis. A bony defect was palpable in the nasopalatine area, and an old fistula was associated with the area. Radiographic examination revealed a round, l-cm radiolucent lesion with a central area of radiopacity (Fig. 1). The past medical history was significant for rheumatic fever and a mitral valve prosthesis. The patient was
ANDREA HABER-COHEN MICHAEL P ECKHART Philadelphia, Pennsylvania
MODIFIED TECHNIQUE FOR EXTERNAL FIXATION FOLLOWING MANDIBULAR
RESECTION
To the Editor:-In an article published in the March 1984 issue of the Journal of Oral and Maxillofacial Surgery entitled “A Modified External Pin Appliance for Resections that Include the Mandibular Condyle,” I discussed a technique of external skeletal fixation that included placing screws within the body and arch of the zygoma. In that article, I recommended the use of 2” ramus screws for this purpose. Since that time, I have found several patients in whom the screws have become loose due to the long lever arm produced by this type of screw. This problem can be corrected by the use of short body screws with a length of 1%“. This reduces the lever arm and, therefore, forces placed on such screws in the zygoma and has allowed this appliance to remain stable for up to one year or more.
FIGURE 1. Presurgical radiograph of radiolucent lesion.
ROBERT E. MARX Miami, Florida
563