Kurt H. Thoma

Central myxoma of the jaw

Abstract The myxoma of the jaw is seemingly a benign tumor, as evidenced by a study of eleven cases, four of which are cited in the case reports. The association of this tumor with embedded or missing teeth is striking, especially the case in which the tumor had the appearance of a dentigerous cyst. In a previous report the authors described an odontogenic fibroma which had the appearance of a dentigerous cyst. Since the myxoma, from histologic study, is derived from a degeneration of a connective tissue tumor, it is reasonable to suppose that the myxoma of the jaw is in reality an odontogenic fibroma which has undergone myxomatous degeneration.

The pathogenesis of the odontogenic tumors

Abstract The pathogenesis of the odontogenic tumors has been described. This served as a basis for the classification of these tumors as presented by Colonel Joseph Bernier, Dr. Henry M. Goldman, and me at the meeting of the American Academy of Oral Pathology in Washington, D. C., May 27, 1950.

Atrophy of the mandible

Abstract Progressive atrophy of the maxilla and mandible is not uncommon. It may affect but a section of the bone in partly edentulous patients or it may involve the entire alveolar process if all the teeth have been lost. In some cases, it extends into the bone proper. The mandible, when extensively involved, may fracture from minor trauma. Three such cases are described. An unusual case of complete resorption of the mandible with progressive resorption of the maxilla, previously reported, 7 is reviewed. The etiology of atrophy of the jaws is still obscure. Local causes, as well as systemic or constitutional factors, play a role. The treatment should first of all be directed to arrest of the process of resorption. The use of bone grafts for the prevention of fracture has been discussed. In case of spontaneous fracture also, a bone graft gives best results. In irradiated jaws excision of the section involved may be indicated, since bone grafting is not likely to be successful. Cases are included to illustrate the operative procedures.

Eosinophilic granuloma with report of one case involving first the mandible, later other bones, and being accompanied by diabetes insipidus

Abstract A case of eosinophilic granuloma which affected the mandible extensively and, later, involved other bones is presented. The disease in this patient was associated with diabetes insipidus, which was not found in cases previously reported by Farber, Mallory, Lichtenstein and Jaffe. This, therefore, links the disease still more strongly with Schuller-Christians disease.

Ankylosis of the mandibular joint

Abstract Eighteen cases of ankylosis of the temporomandibular joint have been analyzed as to cause and symptoms. The importance of early operation to prevent underdevelopment of the mandible and rampant dental caries should be stressed. Extraction of all the teeth to prevent toothaches and dental infection is not recommended, as the surgical treatment of ankylosis makes good dental care possible, and because the occlusion of the teeth plays an important role in the coordination of mandibular movement after the operation. For this reason the teeth should be preserved. Condylectomy and osteoarthrotomy are recommended rather than arthroplasty. The results of these procedures in this clinic have been very satisfactory, as they also have in the cases reported by Dingman. ∗

Olfactory neuroblastoma (esthesioneuroepithelioma) of the maxillary sinus.

Abstract 1. 1. A case of olfactory neuroblastoma (esthesioneuroepithelioma) has been presented. 2. 2. This tumor is quite rare; only twenty-seven cases have been reported in the world literature. It is usually located in the nasal fossa. 3. 3. In the case presented here the neoplasm was confined to the left antrum, which is an unusual location. 4. 4. From its radiographic appearance, it was thought to be an osteochondroma. 5. 5. Symptoms are not specific, and therefore diagnosis is difficult. Proper diagnosis can be made solely by biopsy with special and meticulous histologic techniques. 6. 6. Although these tumors are not metastatic, they are believed to be invasive in character. 7. 7. They are amenable to treatment by surgical removal or, if there are recurrences, by surgery in conjunction with follow-up x-ray therapy.

The Infected Vital Dental Pulp

CONTENTS

Stomatitis nicotina and its effect on the palate

Abstract In nicotinie stomatitis there is an early leucoplakia with round-cell infiltration of the papillary layer of the corium. The orifices of the mucous duets become occluded by desquamated keratinized epithelial cells. The papillary projections of the mucosa contain mucous cysts which are retention cysts caused by occlusion of the duet outlet. The round-cell infiltration in the corium points to an inflammatory condition and indicates the presence of a stomatitis that may be the fundamental cause of the disease. In the cases described, the etiologic factor happened to be the use of tobacco, as indicated by the habits of the patient, the deposit on the teeth, and the improvement when smoking was discontinued, as well as the fact that in one case only that part of the palate not protected by a denture was affected.

An unusual case of hereditary fibrous osteodysplasia (fragilitas ossium) with replacement of dentine by osteocementum

Abstract Unique dental pathology has been reported in a case of hereditary fibrous osteodystrophy, which was thought consistent with some stage of fragilitas ossium. Ten teeth were studied all of which showed extensive resorptive processes affecting primarily the dentine, but also involving the cementum. This resorption which in some instances removed almost the entire root of the tooth, was repaired by trabeculated osteocementum causing a complete change in the histologic appearance of the tooth. Two interesting conclusions can be drawn from the histologic study of these teeth. The first is that teeth may resorb in a similar way as bone, and therefore the fact that they are not involved in hyperparathyroidism is not because they are immune to resorption. The second conclusion concerns the genesis of osteoclasts. The fact that osteoclasts appear in dentine which contains no enclaved cells should disprove the theory that they are a conglomeration of liberated bone corpuscles.

III. Gelatin sponge in the obliteration of cavities resulting from the excision of cysts and tumors of the jaws

Abstract The use of the absorbable gelatin sponge has a definite place in the treatment of large cavities in bone left by the enucleation of cysts and tumors of the jaws. When used judiciously in selected cases, it acts as a space obliterator, and after absorption and replacement by fibrous tissue, is eventually incorporated into bone. Its application in spaces where there has been a long-standing chronic infection is not recommended, as very rapid absorption occurs, and thus no useful function is served. When used in cavities where there are unerupted or transplanted teeth, there is no interference with development or eruption, and these teeth will assume their position in the arch in a normal manner.