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Neurofibroma in oral mucosa: case report
Free Papers—Poster Presentations Background and Objectives: The purpose of this study is to investigate relationship between several clinical and radiographic variables and tooth sectioning during lower third molar surgery. The incidence of postoperative complications and associated factors were also examined. Methods: Data were collected retrospectively for all patients who underwent removing of lower third molar under local anaesthesia and had orthopantomography not longer than 3 months before operation in Prince of Songkla University Dental hospital between 2000 and 2007 from treatment record and film. Clinical and radiographic variables included sex, age, site, reason for attendance, operator, operation, angle, depth and ramus relationship according to Pell and Gregory classification, periodontal ligament width, second molar relationship, root width, root length and elevating line in mesioangular position. Data were analysed using descriptive, univariate and multivariate statistic. Results: 719 study samples were 67.87% female, with mean age 21.94 ± 6.5 years. Different operator, depth, ramus relationship, second molar relationship, root length and angulation affected tooth sectioning. Third molar below contact of second molar, position in mesioangular and horizontal increased risk for tooth sectioning, depth B and C decreased that risk. Complication rate is 6.01%. Increasing age, depth, and tooth sectioning were associated with an increased risk for complication. Conclusion: Tooth sectioning in surgical removal of impacted lower third molar can be evaluate by radiographic factor (angulation, second molar relationship). The tooth angulated up 30◦ has tendency toward to tooth sectioning. This tool is useful in decision making, equipment preparation and save the operation time. doi:10.1016/j.ijom.2009.03.546
P74 Dental implantation after trauma to teeth and mandibular fracture I. Khomich ∗ , A. Khomich, S. Khomich Department of Maxillofacial Surgery, Belarussian State Medical University, Minsk, Belarus
Background and Objectives: After a trauma of jaw bones, teeth and alveolar bone tissues are missing partially, or sometimes completely. In such cases it is rather difficult to restore tooth-alveolar arch and to restore optimum conditions for chewing function. Demountable artificial dentures
553
as a rule cannot be fixed in the absence of an alveolar bone and consequently designs on implants are used. Methods: In our practice we observed patients with traumatic tooth extraction and fractures of jaws after car accidents. Restoration of dental rows and chewing surfaces was divided into several stages. 1st stage: primary surgical processing of traumatic fractures and operation of osteosynthesis of a jaw, using miniplates and screws; 2nd stage: intraossal dental implantation; 3rd stage: installation of suprastructures on dental implants; and 4th stage: prosthetics on implants. Results: Full accretion of bone parts is noted after operation of osteosynthesis under emergency indications. On the bottom jaw we implanted porous cylindrical implants. Osteointegration took place in 100% of cases. Suprastructures were installed successfully where alveolar bone was missing. Then metal-ceramic fixed bridge dentures were manufactured and fixed to implants suprastructures. Also metal-ceramic artificial gum was manufactured. Conclusion: We managed to completely restore chewing function at defects of an alveolar bone after a trauma of the bottom jaw. Besides, the specified technique allows achieving good aesthetic results, to create preconditions for full medical rehabilitation of such patients.
Case Reports: First case of a NF patient with a gingival neurofibroma in the palatinal aspect of the left upper canine and premolar teeth is presented. Second case of NF patient with neurofibroma in the midline of hard palate is presented. Both of the lesions were nodular, with sessile base, non-ulcerated, painless, with normal colour and measured 1 cm in diameter. In first case bone resorption due to lesions were seen on the periapical radiographs. The lesions were totally resected without any complication. Histopathological analysis confirmed the clinical hypothesis of neurofibroma in both cases. Conclusion: The diagnosis of the neurofibroma can be difficult and can confuse easily with other oral lesions. Maxillofacial surgeons and dentists must consider that one of the clinical criteria of von Recklinghausen’s disease is neurofibroma.
doi:10.1016/j.ijom.2009.03.547
Introduction: Cemento-ossifying fibromas (COFs) form a part of a complex entity of tumours in the fibro-osseous group of lesions and are considered benign but locally aggressive tumours. This tumour generally occurs in young and middle-aged adults. The lesion is generally asymptomatic until the growth produces a noticeable swelling and mild deformity; displacement of teeth may be an early clinical feature. Case Report: A 45-year-old female presented with a large expansile, painless growth in the anterior mandible. History revealed a slow-growing mass with almost 3 years duration, progressively increasing in size without pain. Radiographic examination presented a well-defined, flecked with multiple small radiopacities between mandibular left and right premolars. Cytological biopsy was done by an intraoral vestibular approach. Needle aspiration revealed blood-tinged straw-coloured fluid that was submitted for cytological study. Cytological examination was given as a giant cell granuloma. Under general anaesthesia, the lesion was surgically removed, related teeth were extracted and curettage of the underlying bone was performed. The
P75 Neurofibroma in oral mucosa: case report O. Ozgul ∗ , Y. Kartal, D. Kocyigit, F.M. Cos¸kunses, R.S. Kisnisci, S. Karadeniz, G. Celebioglu Department of Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Besevler, Ankara, Turkey
Introduction: Neurofibroma is one of the most common tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of neurofibromatosis (NF). NF type 1 (NF1), also known as von Recklinghausen’s disease, is the most common type of NF and accounts for about 90% of all cases. It is classified as benign neural sheath neoplasms consisting of spindle cells with wavy nuclei. Gingival neurofibroma in NF is uncommon. Diagnosis is based on a series of clinical criteria and histopathological examination. Treatment of neurofibromas is surgical resection. This article describes two different patients who have swelling in their oral mucosa.
doi:10.1016/j.ijom.2009.03.548
P76 Cemento-ossifying fibroma mimicking giant cell granuloma Y. Kartal, D. Kocyigit, O. Ozgul ∗ , F.M. Cos¸kunses, R.S. Kisnisci, S. Dadakoglu Department of Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Besevler, Ankara, Turkey
P74 Dental implantation after trauma to teeth and mandibular fracture I. Khomich ∗ , A. Khomich, S. Khomich Department of Maxillofacial Surgery, Belarussian State Medical University, Minsk, Belarus
Background and Objectives: After a trauma of jaw bones, teeth and alveolar bone tissues are missing partially, or sometimes completely. In such cases it is rather difficult to restore tooth-alveolar arch and to restore optimum conditions for chewing function. Demountable artificial dentures
553
as a rule cannot be fixed in the absence of an alveolar bone and consequently designs on implants are used. Methods: In our practice we observed patients with traumatic tooth extraction and fractures of jaws after car accidents. Restoration of dental rows and chewing surfaces was divided into several stages. 1st stage: primary surgical processing of traumatic fractures and operation of osteosynthesis of a jaw, using miniplates and screws; 2nd stage: intraossal dental implantation; 3rd stage: installation of suprastructures on dental implants; and 4th stage: prosthetics on implants. Results: Full accretion of bone parts is noted after operation of osteosynthesis under emergency indications. On the bottom jaw we implanted porous cylindrical implants. Osteointegration took place in 100% of cases. Suprastructures were installed successfully where alveolar bone was missing. Then metal-ceramic fixed bridge dentures were manufactured and fixed to implants suprastructures. Also metal-ceramic artificial gum was manufactured. Conclusion: We managed to completely restore chewing function at defects of an alveolar bone after a trauma of the bottom jaw. Besides, the specified technique allows achieving good aesthetic results, to create preconditions for full medical rehabilitation of such patients.
Case Reports: First case of a NF patient with a gingival neurofibroma in the palatinal aspect of the left upper canine and premolar teeth is presented. Second case of NF patient with neurofibroma in the midline of hard palate is presented. Both of the lesions were nodular, with sessile base, non-ulcerated, painless, with normal colour and measured 1 cm in diameter. In first case bone resorption due to lesions were seen on the periapical radiographs. The lesions were totally resected without any complication. Histopathological analysis confirmed the clinical hypothesis of neurofibroma in both cases. Conclusion: The diagnosis of the neurofibroma can be difficult and can confuse easily with other oral lesions. Maxillofacial surgeons and dentists must consider that one of the clinical criteria of von Recklinghausen’s disease is neurofibroma.
doi:10.1016/j.ijom.2009.03.547
Introduction: Cemento-ossifying fibromas (COFs) form a part of a complex entity of tumours in the fibro-osseous group of lesions and are considered benign but locally aggressive tumours. This tumour generally occurs in young and middle-aged adults. The lesion is generally asymptomatic until the growth produces a noticeable swelling and mild deformity; displacement of teeth may be an early clinical feature. Case Report: A 45-year-old female presented with a large expansile, painless growth in the anterior mandible. History revealed a slow-growing mass with almost 3 years duration, progressively increasing in size without pain. Radiographic examination presented a well-defined, flecked with multiple small radiopacities between mandibular left and right premolars. Cytological biopsy was done by an intraoral vestibular approach. Needle aspiration revealed blood-tinged straw-coloured fluid that was submitted for cytological study. Cytological examination was given as a giant cell granuloma. Under general anaesthesia, the lesion was surgically removed, related teeth were extracted and curettage of the underlying bone was performed. The
P75 Neurofibroma in oral mucosa: case report O. Ozgul ∗ , Y. Kartal, D. Kocyigit, F.M. Cos¸kunses, R.S. Kisnisci, S. Karadeniz, G. Celebioglu Department of Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Besevler, Ankara, Turkey
Introduction: Neurofibroma is one of the most common tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of neurofibromatosis (NF). NF type 1 (NF1), also known as von Recklinghausen’s disease, is the most common type of NF and accounts for about 90% of all cases. It is classified as benign neural sheath neoplasms consisting of spindle cells with wavy nuclei. Gingival neurofibroma in NF is uncommon. Diagnosis is based on a series of clinical criteria and histopathological examination. Treatment of neurofibromas is surgical resection. This article describes two different patients who have swelling in their oral mucosa.
doi:10.1016/j.ijom.2009.03.548
P76 Cemento-ossifying fibroma mimicking giant cell granuloma Y. Kartal, D. Kocyigit, O. Ozgul ∗ , F.M. Cos¸kunses, R.S. Kisnisci, S. Dadakoglu Department of Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Besevler, Ankara, Turkey