Oral and Maxillofacial Considerations in Gardner's Syndrome: A Case Report

ORAL AND MAXILLOFACIAL PATHOLOGY e116 Abstracts Brown deposits in stromal/tumour cells demonstrated positive reaction. Mean a-sma intensity score (Ma-smaIS) and mean asma quantity scores (Ma-smaQS) for each CHTA were determined (using Lewis et al, 2004 format). Multiple regression was the statistical analysis. Statistical package was SPSS 17. Results: Ma-smaIS 2.00
0.970 (AC) was higher than 1.78
0.808 for SMA [p<0.001]. UA (Ma-smaIS 1.5
0.924) had positive correlation (0.853) with AC, but negative multiple regression weight -0.086 (p¼0.008). Ma-smaQS were: 2.39
1.14 (AC), 1.94
0.94 (SMA), 1.83
0.71(DA) and 1.61
0.92(UA). Difference in Ma-smaQS (AC vs. UA) was significant (p¼0.008). AC expressed MD in tumour and stromal cells. Conclusions: MD expression and CHTA are correlated. Expression is strongest for AC and weakest for UA. Keywords: Ameloblastoma, Stroma, Myofibroblasts, Density

SAPHO SYNDROME INVOLVING THE MANDIBLE: CASE REPORT Çigdem Sarikir, Ilkay Peker, Gazi University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara, Turkey Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disorder of unknown etiology. This report presents a case of SAPHO syndrome. A 20-year-old female attended to our clinic complaint of recurrent pain and swelling of the right mandible. Medical history revealed that the patient was implemented acne therapy. Dental history showed that mandibular third molars were extracted. In extraoral examination, asymmetry of the face was observed and intraoral examination was unremarkable. A diffuse appositional bony growth surrounding the corpus of the right mandible was observed in cone beam computerized tomography. The patient diagnosed as SAPHO syndrome. Medical treatment including roxithromycin and non-steroidal anti-inflammatory drug (NSAID) was administered. Additionally, the patient underwent 40 cycles of hyperbaric oxygen therapy. The enlargement of the right mandible significantly decreased. There is no generally accepted treatment strategy for SAPHO syndrome. Conservative treatment with antibiotics, NSAIDs and hyperbaric oxygen therapy are recommended. Keywords: Sapho syndrome, Chronic osteomyelitis, Medical treatment

ORAL AND MAXILLOFACIAL CONSIDERATIONS IN GARDNER’S SYNDROME: A CASE REPORT Çi gdem Sarikir, Zühre Zafersoy Akarslan, Ilkay Peker, Gazi University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara, Turkey Gardner’s syndrome is an autosomal dominant disease and is a subtype of familial adenomatous polyposis. Multiple osteomas, intestinal polyps, multiple dens bone islands and surface tumors of soft and hard tissues are the manifestations seen in the disease. In this case report a 24 year old male patient with Gardner’s Syndrome, and familial Gardner’s Syndrome history, presenting clinical and radiographic manifestations of the syndrome including persistent primary molar teeth, multiple dense bone islands and multiple impacted teeth both the maxilla and mandible and multiple osteomas in the frontal and ethmoid sinuses is reported. Keywords: Familial intestinal polyposis, gardner’s syndrome, impacted teeth, osteoma, dense bone islands

OOOO March 2015 IS ODONTOAMELOBLASTOMA A REAL ENTITY? A LITERATURE ANALYIS Ömer Günhan1, Ömür Dereci2, 1 Gülhane Military Medical Academy, Department of Pathology, Ankara, Turkey; 2Eskis¸ehir Osmangazi University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Eskis¸ehir, Turkey Objective: Odontoameloblastoma is an extremely rare odontogenic tumor which is composed of both epithelial and mesenchymal components. Although odontoameloblastoma is considered to be a separate entity by WHO, some authors question its authenticity. In this study, some examples from our cases were presented and several recent well-established case reports of odontoameloblastoma in English medical literature were analysed in order to understand the true nature of the lesion. Study Design: The data of our own instituonal cases and 9 well-established English-written case reports of odontoameloblastoma were analysed. Figurative data of the studies were extracted and re-evaluated in accordance with WHO classification definition of odontoameloblastoma. Results: All reported cases in selected studies and our institutional cases were re-diagnosed as in 4 different entities; early stage odontoma, adenomatoid odontogenic tumor, dentinogenic ghost cell tumor and ameloblastic fibro-odontoma. Conclusions: According to our analysis of our own and reported cases, odontoameloblastoma should not be considered as a separate entity. Keywords: odontoameloblastoma, ameloblastoma, ameloblastic fibro-odontoma, adenomatoid odontogenic tumor, dentinogenic ghost cell tumor, early stage odontoma

JUVENILE CHRONIC MANDIBULAR OSTEOMYELITIS: HISTOLOGICAL AND IMMUNOHISTOCHEMICAL FINDINGS FROM AN ENIGMATIC INFLAMMATORY CONDITION Brendan Conn1, Victor Lopes2, 1Department of Histopathology, Royal Infirmary of Edinburgh, Edinburgh, Scotland; 2Department of Oral and Maxillofacial Suregery, Edinburgh Dental Institute, Edinburgh, Scotland Juvenile chronic mandibular osteomyelitis (JCMO) is a paediatric inflammatory condition of unknown aetiology. Patients present with pain, soft tissue swelling and unilateral mandibular enlargement without an identifiable inflammatory trigger. Existing case series lack detailed description of microscopic features. Method: Sections from 5 patients aged 5-14 with JCMO symptoms were reviewed. Immunohistochemistry for inflammatory cell and stromal markers were performed in all cases. Results: Zones of active and quiescent disease activity were apparent. Some biopsies featured areas of both. Presumed active areas showed fibroblastic stroma, frequent neutrophils, osteoclastic resorption and deposition of woven bone around an inflammatory nidus. T cells and histocytes outnumbered B cells and plasma cells. Presumed quiescent zones featured maturing bone and a scant infiltrate predominantly of histiocytes. Lymphocytes and plasma cells were of insignificant number. Conclusions: Histological observation of zones of variable disease activity may explain the unpredictable progressive nature of this interesting, somewhat enigmatic disease process. Keywords: Juvenile, Mandible, Osteomyelitis, Histology, Immunohistochemistry