Demetrius Triantafyllou

Odontogenic keratocysts: Review of the literature and report of sixteen cases

Sixteen cases of odontogenic keratocyst are reported. Two of the patients had basal cell nevus syndrome. The provisional diagnosis in most of the 16 cases was other than odontogenic keratocyst, and the presenting symptoms were usually swelling, pain, and sinus tract formation. The treatment varied from simple enucleation to marsupialization, homogenous bone grafting, and iliac bone grafting. There was a 25% recurrence rate, mostly associated with treatment by enucleation, cysts that were parakeratinized or difficulty in removing the lesion.

The superior orbital fissure syndrome

The superior orbital fissure syndrome is a very rare condition, characterized by a fixed dilated pupil, ptosis and proptosis of the eye and ophthalmoplegia. We have had the opportunity to observe a number of such cases, and now report four of them.

Ossifying fibroma of the jaws. Review of the literature and report of 16 cases

Ossifying fibroma is a fibro-osseous lesion rarely occurring in the jaws, although more often than in other bones of the skeleton. It is not clear whether it represents a distinct entity or a certain stage of the fibro-osseous condition. We are presenting our experience with 16 cases of ossifying fibroma treated with local excision or resection and bone graft. Their radiographic picture varied significantly from one case to another. One case was peripheral and one recurred.

Benign neurogenic tumors of the oral cavity

Neurogenic tumors are rare in the oral cavity, particularly so when malignant. Traumatic neuroma, although usually included with neurogenic tumors, is a reactive process rather than a true neoplasm. Neurofibroma and schwannoma derive from nerve fibers, the perineurium, the endoneurium and the neurolemmomal cells. They present histological differences. The neurofibroma may present in solitary and generalized types; the latter also known as neurofibromatosis or von Recklinghausens disease of the skin. We here report typical cases of benign neurogenic tumors of the oral cavity.

Fractures of the facial skeleton in the edentulous patient

An evaluation was made of 112 fractures that occurred in 66 edentulous patients in a 10 year period. There was an average of 1.7 fractures per person. 104 fractures occurred in the mandible and 75% of these were treated without intermaxillary fixation or were not treated at all. In 28.5% of the cases no treatment was provided other than soft or liquid diet and appropriate instructions. As a group, the condylar fractures were those that were left with no treatment to a greater extent than any other group, apart from the Le Fort type of fracture; the latter being very few in absolute numbers. The age group associated with the edentulous state quite often suffers from conditions that may prohibit aggressive treatment. These conditions may be aggravated by the accident and, by the time the patient is ready for maxillofacial surgery, one has to contemplate (and discuss with the patient) the advantages and disadvantages of a procedure. It appears that aesthetics are of minor importance (to a certain degree) for elderly patients and small deviations from the normal (both in appearance and function) are acceptable to them, considering the prospect of an operation or of the prolonged discomfort, such as that associated with intermaxillary fixation. The advisability of the latter should be assessed carefully in view of the respiratory impairment that it may cause in patients whose airway may already be compromised.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma cell myeloma of the jaws

Solitary myeloma may be the first manifestation of the disseminated form, known as multiple myeloma, and characterized by multiple skeletal lesions, general metabolic alterations, impairment of renal function and eventually death. Involvement of the jaws is not unusual, although infrequently reported. We present 2 cases, where oral involvement was the first indication of the disease.

Orbital apex syndrome

The orbital apex syndrome is a very rare complication of fractures of the facial skeleton, as well as other conditions and is characterized by blindness, fixed dilated pupils, proptosis, ptosis of the eye and ophthalmoplegia. We are reporting such a case we had the opportunity of treating.

Aneurysmal bone cyst of the jaws: Review of the literature and report of 2 cases

Strictly speaking, the aneurysmal bone cyst is not a true cyst. It is a lesion characterized by replacement of bone by fibro-osseous tissue containing blood-filled cavernous spaces. It is usually treated by surgical curettage, and access within the jaws may sometimes be difficult. We reviewed the world literature and found 63 cases of aneurysmal bone cysts involving the face, 22 reported in the maxilla, and 63 in the mandible. One was found in the zygomatic arch. Of the patients reported, 88% were younger than 30 years old; there was an equal sex distribution. Included in this report, are two cases of our own, one involving the maxilla and one the mandible.

Traumatic Le Fort III osteotomy

A case of a Le Fort III type of fracture is described which resulted after its reduction, in the correction of pre-existing Class III skeletal relationship.