Ioannis Tilaveridis

Displacement of three dental implants into the maxillary sinus in two patients. Report of two cases

IntroductionReconstruction of the posterior edentulous maxilla with dental implants has become a popular practice worldwide. However, the poor bone quality and quantity in this area is sometimes related with complications. Dental implant displacement into the maxillary sinus is a rare complication.Case reportIn the present paper, we present two patients with three implants displaced into the maxillary sinus. The implants were removed soon after their displacement, using the classic intraoral approach, through the anterior wall of the maxillary sinus. The operation was performed under local anesthesia for both of the patients. The postoperative course was uneventful for both of the patients without any wound dehiscence. Recovery remained uneventful, without any signs of postoperative sinusitis.DiscussionImplant displacement into the maxillary sinus is of rare occurrence and usually related to inadequate bone quality and quantity. Dental implants into the maxillary sinus usually act as foreign bodies and should be removed, to avoid the development of sinus complications. Removal of dental implants from the maxillary sinus can be performed either with functional endoscopic sinus surgery, or with intraoral operation through the anterior maxillary wall especially in fresh cases and in the presence of oroantral communication.

Retrotuberosity versus submentosubmandibular and median submental intubation: patients with maxillofacial surgery.

OBJECTIVE In certain maxillofacial trauma cases, nasotracheal intubation is contraindicated and the standard method of orotracheal intubation interferes with maxillomandibular fixation. In such cases alternative techniques, such as submental, submentosubmandibular, and retromolar intubation have been used. STUDY DESIGN We reviewed 8 patients who underwent median submental intubation, 7 patients who underwent submentosubmandibular intubation, and 10 patients who underwent a retromolar intubation with an armored endotracheal tube secured in place with a circumdental wire. The tube was positioned in the retromolar region behind the most posterior maxillary tooth. RESULTS In the group of patients who underwent median submental intubation, 1 presented difficulty in performing a median submental intubation. No complications were recorded in the rest of the patients. CONCLUSIONS Submental and submentosubmandibular intubation are useful methods with low morbidity. However, both are invasive techniques compared with retrotuberosity intubation secured in place with a circumdental wire placed around the most posterior maxillary tooth.

Maxillary sinus osteoplasty with vascularized pedicled bone flap

OBJECTIVE This article describes the use of a vascularized pedicled bone flap, superiorly based on schneiderian membrane, for osteoplasty of maxillary sinus. STUDY DESIGN A rectangular bony window was created on the anterior maxillary wall and pedicled from its inner surface with the schneiderian membrane attached to it and left intact superiorly. After the sinus pathology was addressed, the pedicled bony window was repositioned and stabilized with sutures. This technique was performed in 9 maxillary sinuses in 9 patients. A nasoantral window was opened in all of the cases. RESULTS The follow-up ranged between 12 and 38 months. Healing in all patients was uneventful. In 1 case, a temporary hypoesthesia of the infraorbital nerve was recorded. CONCLUSIONS The procedure provides excellent visibility and access in the maxillary sinus, permitting the use of an advancement buccal pedicled flap for closure of an existing oroantral communication.

Salivary Gland Trauma: A Review of Diagnosis and Treatment

Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.

Inflammatory myofibroblastic tumour of the maxillary sinus and the oral cavity

BackgroundInflammatory myofibroblastic tumours (IMT) are benign lesions that mimic malignant neoplastic processes due to their infiltrating and destructive nature. They can be found anywhere in the body, although they are most commonly located in the lung. IMTs of the head and neck region are rare entities.Case reportWe report a case of a maxillary IMT with an enlarged intraoral component which was adequately treated with surgical excision without long-lasting additional corticosteroid treatment.DiscussionInflammatory myofibroblastic tumours can be easily misdiagnosed as malignant neoplastic processes due to their destructive nature. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures.

Infiltrating Angiolipoma of a the Oral Cavity: Report of a Case and Literature Review

enign lipomatous tumors are classified into 5 groups: ) lipoma; 2) variants of lipoma; 3) heterotopic lipoas, hamartomatous lesions; 4) infiltrating or difuse neoplastic or non-neoplastic proliferations of ature fat; and 5) hibernoma. Angiolipoma is a ariant of lipoma and is distinguished in the noninltrating and infiltrating type. Infiltrating angiolioma most often occurs in the trunk and extremiies and is rare in the head and neck region. Some uthors believe that infiltrating angiolipoma ould represent diffuse angiomatosis associated ith fat, rather than a neoplasm. Review of the iterature revealed only 8 cases of infiltrating angio-

Basal cell carcinoma arising in association with a maxillary keratocyst in a patient with Gorlin–Goltz syndrome. Report of a case

IntroductionGorlin–Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder which is characterized by the presence of multiple basal cell carcinomas, maxillary keratocysts, and musculoskeletal anomalies.Case reportWe present a case of a patient suffering from Gorlin–Goltz syndrome who developed an intraosseous basal cell carcinoma associated with a recurrent maxillary keratocyst. To our knowledge, this is the first case of malignant transformation of a keratocyst into a basal cell carcinoma described in the literature.ConclusionThis case highlights the importance of careful histologic examination of keratocysts excised in patients suffering from Gorlin–Goltz syndrome.

The Use of Magnification and Microsurgical Instruments for the Excision of Lower Lip Mucoceles

n t p b T g a f Mucoceles are benign cystic lesions that contain mucus and most frequently appear in the oral cavity, paranasal sinuses, gallbladder, and appendix. They ave a characteristic clinical appearance with wellircumscribed, transparent, bluish-colored swelling of he lip with soft and fluctuant sensation to palpaion. Mucoceles are the second most frequent benign soft-tissue lesion of the oral cavity, with an incidence rate at 2.5 in 1,000 persons, following irritative fibromas. Mucoceles affect the minor salivary gland—which predominantly secretes saliva mucus in nature—and, less frequently, the major salivary glands. They are considered to be traumatic or obstructive in their origin, with the lip being the most frequently affected site. According to their etiopathogenesis, most mucoceles of the lower lip are of the extravasation type, which accounts for over 80% of all mucoceles, and are more common in younger patients. Mucoceles are usually asymptomatic. However, in some cases they may cause some difficulty in speech, swallowing, or chewing. Sometimes, these lesions re ruptured after biting or spontaneously releasing heir viscous mucoid fluid. However, the secretions accumulate again, and the lesions recur. Repeated injuries could lead to fibrosis making the rupture more difficult. Surgical removal is usually performed to treat mucoceles, because these lesions rarely resolve on their

Pulmonary Metastasis in a 65-Year-Old Man With Mandibular Ameloblastoma: A Case Report and Review of the Literature

t s i o 8 d t t s m Ameloblastoma is the second most common odontogenic neoplasm after odontoma, accounting for 1% of all jaw tumors. Although the 1992 World Health rganization classification characterizes ameloblasoma as a benign but locally invasive epithelial odonogenic neoplasm, its aggressive biologic behavior vokes wide differences of opinion among investigaors concerning its position in the neoplastic specrum. This has led some investigators to refer to meloblastoma as a low-grade malignant tumor beause it is prone to recur, capable of aggressive local nvasion, and capable of metastasizing to distant ites. Ameloblastoma occurs in all areas of the jaws, but 80% of cases arise in the mandible. Despite being locally aggressive, metastases are not generally expected because they are extremely rare. Nevertheless, regional and distant metastases have been reported in the literature and are well documented. Metastatic meloblastoma is known as malignant ameloblasoma. Malignant ameloblastoma is described in the orld Health Organization classification as a neolasm in which the features of ameloblastoma exist in

Lipoma of Parotid Gland: Report of Two Cases

IntroductionLipoma is a benign mesenchymal tumor originating from adipose tissue cells. In the head and neck, this tumor is not common. The occurrence of lipomas in the parotid gland is extremely rare, ranging between 0.6 and 4%.Case ReportsIn this article, we present two clinical cases of lipomas of the superficial lobe of the parotid gland.DiscussionClinical diagnosis of parotid gland lipomas is difficult, while usually, they are asymptomatic and presented as a painless swelling of the parotid gland. Tomographic imaging modalities are very accurate in preoperative diagnosis in contrast to FNA or FNAB which is not helpful in the case of lipoma. This pathological entity should be considered in the differential diagnosis of parotid gland’s mass lesions. The usual indication for surgical intervention is cosmetic appearance. Meticulous surgical excision should be performed to avoid disturbing adverse events.