Kai Forssell

Simple bone cyst: Review of the literature and analysis of 23 cases

A retrospective study of 23 simple bone cysts including analysis of clinical, radiographical, histopathological features and follow-up information was made. The age of the patients varied from 8 to 59 years (mean 21.4 years). All lesions were found in the mandible, and 2 of them were radiologically multilocular. A loose connective tissue lining was found histologically in 8 out of 17 cysts with the biopsy specimens available. At follow-up, 2 failures of the primary surgical treatment were noted. The results emphasize that a proper follow-up is required after the treatment of simple bone cyst.

Evaluating function of the inferior alveolar nerve with repeated nerve conduction tests during mandibular sagittal split osteotomy

PURPOSE This article evaluates a new intraoperative recording technique for measuring the sensory nerve conduction velocity (SNCV) of the human inferior alveolar nerve (IAN) during orthognathic surgery of the mandible to assess the effects of intraoperative strain on function of the IAN. MATERIALS AND METHODS The new test was successfully applied in 10 patients during bilateral sagittal split osteotomy of the mandible (20 IANs). The recordings were made with active wire electrodes at foramen ovale and stimulation was done at the mental foramen with two monopolar needle electrodes. The sensory nerve action potentials (SNAP) were recorded intraoperatively at three stages: 1) before the split, 2) after splitting of the mandible and possible mobilization of the IAN from the proximal bone fragment, and 3) at the end of the operation after fixation of the proximal and distal fragments with screws. RESULTS The SNCV values (mean 64.1 m/sec) were obtained in all 20 nerves at stage 1, with no significant differences between the sides in latency or amplitude of the SNAPs. The sNAPs remained stable in the IANs not exposed during the operation. In the remaining nerves, the most obvious and statistically significant changes indicating nerve injury occurred between stages and 1 and 2. Partial transsection and mobilization of the IAN were equally potent in bringing about abnormal results in objective neurophysiologic tests as well as subjective sensory disturbances. The results of the intraoperative SNCV recordings correlated well with the findings of the mental nerve blink reflex tests conducted 2 weeks after the operation, whereas comparison of the results of clinical neurosensory testing with the intraoperative events and SNCVs were more inconsistent. CONCLUSIONS Recording of the SNCV offers a useful objective tool for the examination of the IAN both intraoperatively and in clinical diagnosis.

Osteochondroma of the mandibular condyle report of a case and review of the literature

Osteochondroma (osteocartilaginous exostosis) is a rare tumour in the region of the mandibular condyle. Much confusion seems to exist in the literature in differentiating these tumours from condylar chondromas as well as from condylar hyperplasias. A case of condylar osteochondroma with a review of the literature is presented.

Non-Hodgkin's lymphomas presenting through oral symptoms

Non-Hodgkins lymphomas (NHL) presenting through oral symptoms are rare. Between 1976 and 1987, a total of 17 cases (7 male, 10 female) were diagnosed in our departments. The first symptom was an intraoral tumour mass in 9 cases, loosening of teeth in 2 cases and paraesthesia in another 2. Most tumours (13/17) were located in the lower jaw. In only 5 cases had the referring physician or dentist suspected malignancy. In 3 cases, the histological diagnosis was Burkitts lymphoma. The grade of malignancy was classified as low in 4 cases, intermediate in 3 and high in 8. None of the patients was HIV-positive. Nine patients died of their disease within 1-132 months (mean 18.3 months).

Synovial chondromatosis of the temporomandibular joint: Report of a case and review of the literature

An illustrative case of synovial chondromatosis in the temporomandibular joint (TMJ) region is presented, and 36 cases reported earlier are reviewed. The present patient, a 35-year-old woman, had been suffering from swelling and pain in the TMJ area as well as limited mandibular movements for 7 years. The condition had been treated with various conservative methods without any relief of the symptoms. Finally, radiological examination revealed calcified nodules within the joint space and a surgical exploration was performed. In all, 27 loose particles were removed from the joint in connection with the extirpation of the perforated and deformed disk. The result of surgical therapy has been favourable during the follow-up period of 18 months. Although synovial chondromatosis is rare in the TMJ, it should be kept in mind as one possible disease when treating patients suffering from symptoms similar to those of mandibular dysfunction syndrome.

A botryoid odontogenic cyst with multiple recurrences

A botryoid odontogenic cyst (BOC) which recurred 4 times over a period of 9 years is presented. Immunocytochemical comparison of cytokeratin composition of the cyst epithelium with that of the overlying oral epithelium showed distinct differences. The cyst epithelium expressed keratins typical of both simple and nonkeratinizing squamous epithelia. The keratin profile of BOC is in line with previous findings on odontogenic epithelia, thus confirming its odontogenic origin.

Oral mucosal soft tissue necrosis caused by superinfection : report of three cases

Three patients in whom flap necrosis developed after oral surgeries and antibiotic therapies were studied microbiologically by routine aerobic and anaerobic methods. In all cases the bacteria Enterobacter cloacae, Klebsiella oxytoca, Escherichia coli, and coagulase-negative penicillinase-producing staphylococci were resistant to the antibiotics used. These bacteria are frequent microorganisms of superinfection and were not found after the necrotic tissues had repaired.