Geist Ry

Anatomic relationship of the genial tubercles to the dentition as determined by cross-sectional tomography

PURPOSE This study determined the anatomic location and the dimensions of the genial tubercles in relation to the apices of the mandibular central incisors. MATERIALS AND METHODS Linear cross-sectional tomographic images were made of 41 adult human skulls. A 2-mm-thick section was produced through each central incisor. The vertical distance between the apex of each central incisor and the level of the superior aspect of the genial tubercle was measured on the radiographs. Additional measurements were taken on the dry skulls to determine the horizontal distance between the apices of the two central incisors and the width and height of the genial tubercle. RESULTS Although 5 mm is considered a safe zone for geniotomies, 29 of the genial tubercles (35.4%) were less than 5 mm from the apices of the mandibular central incisors. The distance between the apices of these incisors ranged from 9 mm to 15 mm. CONCLUSION Osteotomy of the genial tubercles can be performed within the confines of the mandibular central incisors, but care must be taken to avoid the root apices.

Necrotizing stomatitis: report of 3 Pseudomonas aeruginosa–positive patients

Necrotizing oral lesions have been described in immunosuppressed patients, usually in association with gingival and periodontal pathoses. The etiology of these lesions has not been completely elucidated. We present 3 patients with a type of necrotizing stomatitis in which clinical patterns appear distinct from the periodontal forms of the disease. The lesions yielded bacterial cultures positive for Pseudomonas aeruginosa and reverted to no growth in 2 patients after proper antibiotic therapy. We propose that P aeruginosa may be responsible for selected necrotizing oral lesions with a clinical presentation lacking typical necrotizing periodontal disease and that this condition may represent the intraoral counterpart of ecthyma gangrenosum. In such cases, bacterial culture of the lesion becomes imperative because the disease does not respond to typical periodontal and antimicrobial therapy.

Clear cell neoplasm

We are reporting four cases of clear cell neoplasm. Local infiltration and destruction was observed in one case while in a second case, originating in the sublingual gland, metastasis to the lymph nodes occurred. The behaviour of these neoplasms has prompted the suggestion that these tumours be designated carcinomas rather that noncommittally tumours or neoplasms (Batsakis and Regezzi, 1977). The histopathological characteristics of our four cases conform to those that have been articulated and believed to be the distinctive features of these tumours (Batsakis and Regezzi, 1977). It is hoped that ours and similar reports will be helpful towards clearing the diagnostic and taxonomic confusion regarding these tumours.