Ines Velez

Cryopreserved amniotic membrane for modulation of periodontal soft tissue healing: a pilot study

BACKGROUND The purpose of this randomized study is to evaluate cryopreserved amniotic membrane (CAM) for helping cicatrization and wound healing after dental implant surgery. Epithelialization, pain, infection, inflammation, and scarring were studied. METHODS CAM was placed in surgical wounds related to implant surgery. The extent of healing was evaluated by a masked investigator for lesion size, epithelialization, pain, infection, inflammation, and scarring. A clinical evaluation occurred at baseline, 72 and 144 hours, 2 weeks, and 1, 1.5, and 3 months. The results were compared to conventionally managed, similar lesions that were treated the same day in the same patient allowing each patient to serve as their own control. RESULTS This prospective randomized study showed statistically significant differences between experimental and control groups regarding cicatrization, wound healing, and pain. The effects of the membrane were statistically significant during the first 3 weeks of the study, and thereafter, the effects of the membrane for the two groups were equivalent. CONCLUSIONS CAM was effective in helping cicatrization and wound healing. CAM supported the growth of the epithelium and, thus, facilitated migration and reinforced adhesion. It also decreased the pain of subjects. Regarding dental implants, the use of CAM is not cost effective. New studies evaluating other oral conditions are encouraged.

Central mucoepidermoid carcinoma with an atypical radiographic appearance.

Central mucoepidermoid carcinoma (CMC) is a rare osseous neoplasm occurring most often in the fourth to seventh decades of life. Its usual presentation is one of a locally destructive radiolucent lesion found primarily in the mandible, in the premolar region. No reported case to date has shown a mixed radiolucent-radiopaque expression of this tumor. The objective of this article is to report such a case: a CMC that presented an atypical radiographic appearance of a mixed lesion.

Conservative treatment of a pathologic fracture in a patient with Gorham-Stout disease.

Gorham-Stout disease, or massive osteolysis, is an extremely rare idiopathic condition characterized by spontaneous, localized relentless resorption of one or several contiguous bones. There is no known successful treatment. Autologous bone graft also resorbs. It is a condition with difficult diagnosis, treatment, and prognosis. We report an extreme case of massive osteolysis of the maxillofacial complex. Unique to this case is that the patient presented with a mandibular fracture, and was taking alendronate (Fosamax), one of the treatment options for patients with Gorham-Stout disease. We discuss our treatment and add to the growing list of patients who have presented with this devastating disease.

Brown Tumor as a Result of Hyperparathyroidism in an End-Stage Renal Disease Patient

A 49-year-old male with known history of end-stage renal disease (ESRD) presents with an intraoral exophytic mass of the right mandible. This lesion was given a histologic diagnosis of a Brown tumor. Purpose. To allow physicians to include this lesion in a differential diagnosis when evaluating patients with primary, secondary, or tertiary hyperparathyroidism.

The relationship between idiopathic bone cavity and orthodontic tooth movement: analysis of 44 cases

OBJECTIVES Idiopathic bone cavity (IBC), also named simple or traumatic bone cyst, is a common lesion of unknown cause. The mandible is a very common location, although it may occur in any bone of the body. The authors performed a retrospective analysis of 44 cases in order to assess the causation of this entity. METHODS Each case was analysed by two of the authors (IV and SM) for medical and dental history, history of mandibular/maxillary trauma, clinical presentation, radiographic appearance, surgical findings and histopathology. RESULTS This retrospective study suggested a possible relationship between IBCs and orthodontic treatment. This association was noted in 10/44 cases (22.73%). All of these cases were located in the mandible and were well-circumscribed radiolucencies. Evaluation of these cases disclosed that 6/44 (13.64%) demonstrated scalloping, and 3/44 (6.82%) revealed bony expansion. The age range of the patients evaluated was 9-74 years. None of these cases had a history of trauma or extractions in the area. CONCLUSIONS The findings of this retrospective study suggest an association between orthodontic treatment and the development of this IBC. This occurrence may be multifactorial; further research in the dental science is required.

S-100 Negative Granular Cell Tumor of the Oral Cavity

Classic granular cell tumor is a mesenchymal neoplasm that commonly occurs on the skin, but is not infrequently found in the oral cavity, primarily on the dorsal tongue. Diagnosis is usually straightforward with hematoxylin and eosin stained slides. Immunohistochemical studies on classic granular cell tumor shows positive immunostaining for S-100 and vimentin, while CD68 is variably positive. We report a case of otherwise unremarkable oral granular cell tumor that was immunohistochemically negative for S-100, and positive for vimentin and CD68, and discuss the differential diagnosis. The results of the immunohistochemical studies in our case are compared with those of classic S-100 positive oral granular cell tumors, as well as cutaneous and oral S-100 negative granular cell tumors. Classic S-100 positive granular cell tumors and S-100 negative granular cell tumors of the oral cavity can only be distinguished by immunohistochemical studies; however, the necessity of this distinction is unclear, as both are benign lesions in which recurrence is unlikely.

Primary Maxillofacial Large B-Cell Lymphoma in Immunocompetent Patients: Report of 5 Cases

Lymphomas of the oral cavity represent 5% of all lymphomas. They usually occur in immunocompromised patients. Lymphoma arising within a single bone, without visceral or lymph node involvement, is known as primary intraosseous lymphoma. It is a rare condition and constitutes 3.1% of malignant bone tumors and 5% of extranodal lymphomas. Primary lymphoma of the jaw is seldom seen and it is often misdiagnosed. Clinically, the manifestations are usually similar to an odontogenic tumor, cyst, or infection. Radiographically it appears as a radiolucent area that may mimic endodontic lesion, periodontal pathology, or odontogenic cyst or tumor. The initial presentation is commonly followed by multiple unnecessary extractions and/or root canal treatments. We present five cases of rare primary lymphoma of the maxillofacial complex, four of them intraosseous.

Central Mucoepidermoid Carcinoma: A Rare Entity Analysis of Five Cases

Mucoepidermoid carcinoma (MC) is one of the most common salivary gland neoplasms. When it develops inside the bone, is called Central Mucoepidermoid Carcinoma.(CMC) MC is the most common malignant salivary gland tumor in children, and the most common central salivary gland neoplasm. Misdiagnosis of CMC occurs frequently, due to the rareness of the location for a salivary gland tumor and the clinical and radiographic manifestations, which are suggestive of an odontogenic lesion. It is often treated inappropriately or late, leaving undesired sequelae. We report four cases of CMC and analyze five, with different manifestations and diagnostic problems. The dental profession should be aware of the fact that this malignant tumor may mimic benign processes.